It is often said that in the addict brain there are between three and five people or forces. There is one with the will kidnapped that only seeks the welfare that generates his addiction. Another, anticipates what that will generate in the short and long term: anxiety, depression, withdrawal syndrome ... Their other "selves" have the silhouette of their loneliness, the weight of conscience, the shape of the family and the burden of fear.
The presence of all those voices does not respond at all to the classic profile of someone with a multiple personality. Because if there is something that should be known about addictions is that they completely fragment their own identity, thought and will. Addiction is like a thief waiting patiently in a corner to invade one's property and disrupt every apex and fragment of our brain, mind and dignity.
"I was convinced that for some mysterious reason I was invulnerable and would not get hooked. But the addiction does not negotiate and little by little it spread within me like fog. "
Eric Clapton
Sometimes even the finest techniques of cognitive-behavioral therapy do not make that thief turn around and give up. Hence, one more strategy to redirect an addict brain is also the medical and pharmacological approach.
However, we should not be wrong. The medications relieve the withdrawal syndrome and many associated side effects, but those neural pathways that generate addiction, as well as certain habits of thought and behavior do not always respond to the first such treatments. It is a long and expensive process that requires a multidimensional approach.
This means that many people with a chemical or behavioral addiction find themselves in authentic blind alleys. In those revolving doors where they leave and re-enter until they give, effectively, with that strategy, focus or assistance that each person works on based on their characteristics and needs.
The addict brain: the compulsion of the emotional vacuum
When we talk about addiction, it is common to immediately see someone using opiates, hallucinogens or designer substances, such as amphetamines. We forget, perhaps, that addiction has many faces, many forms and behaviors. There are the shopaholics, those who can not separate from their mobile phone. We have addicts to sex, sports, games, certain foods ...
An addict is not just an alcoholic or someone who uses hard drugs or certain drugs. It is, in essence, unadjusted behaviors where a person generates a physical and psychological dependence on a substance or a certain behavior. From here, a wide range of possibilities opens up, where the result is always the same: inability to function normally in your life, loss of health and suffering.
What do all addiction processes have in common?
If we ask now if there is any common element in all addictions, it can be said that it seems that it is. At the fourth International Conference on Behavioral Addictions held in Budapest last year and promoted by the medical journal Journal of Behavioral Addictions, it was concluded that the common denominator in all cases is compulsion.
Naomi Fineberg, a psychiatrist and neuropharmacology specialist at the NHS Foundation Trust (HPFT) in Hertfordshire, England, explained that people with an addiction have an obsessive-compulsive disorder, as well as low cognitive flexibility and limited or non-existent personal goals.
The addict brain always shows certain alterations in the ventral regions of the prefrontal cortex, an area related to the emotional meaning and our control capacity.
Thus, something that many neurologists and specialists in addiction conclude is the following: people with a dependence on a substance or behavior replace their addictions with an emotional need. However, in their quest to satisfy this gap, they derive in compulsive behaviors, in behaviors that the brain is unable to control and that also provide feedback over and over again.
The neurological mechanism of addiction
The addict brain works differently. Its only objective, its most priority need is to find that well-being that it obtains with the use of that substance or with the activity of said behavior, the same that generates a momentary and limited pleasure. Little by little that external "stimulant" replaces the natural rewards of the organism itself, and the brain needs more.
- The work of dopamine in any addiction process is key. The reason? It is she who generates the desire and desire, she who "turns on" the rest of brain regions to be directed towards that same cause and need. The corpus striatum, for example, is the first to start and the one that "recruits" structures such as the mesencephalon and the orbitofrontal cortex. The whole brain understands that this substance, that behavior is a priority and focuses on that single objective.
- In general, all drugs of abuse generate serious alterations in the activity of the mesocorticolimbic dopaminergic system. In this way, if the consumption becomes chronic, neuroadaptative and neuroplastic changes will appear to the point of completely altering the structure of this system.
- The prefrontal cortex is one of the most affected. In him also drastic changes take place like effect of the addictions. Our emotions and their regulation are altered, as well as our cognitive processes. It is hard to focus attention, reason clearly, control one's behavior and make decisions.
On the other hand, there is an aspect that we can not neglect. When we talk about alcohol and drug consumption, the changes that are generated in the brain are immense, sometimes devastating. The alterations generated in the prefrontal cortex, the amygdala and the striate are immense and in many cases irreversible.
Is addiction a chronic disease?
As we have pointed out, the addicted brain can sometimes show chronic alterations. Poisoning by certain substances impairs short-term memory and the ability to record new information. Likewise, alcohol for example has a serious impact on the cerebellum, which can interfere in aspects such as motor coordination.
- Thus, experts from the National Institute on Drug Abuse often make it clear that addiction is basically a recurrent and chronic brain disease. However, there are already many neurologists who question this claim.
- The key to such an assertion is in a concept that we all know and have heard on more than one occasion: cerebral neuroplasticity.
- The brain is not like the heart, the stomach or the pancreas. The brain has an exceptional virtue: it is designed to change, to produce new neuronal connections, to learn, to train to create new tissues and nerve cells. Thus, if our brain had not changed throughout our lives we would be in a coma. We evolve, change, generate new capabilities ...
What does this mean and what does it have to do with the addict brain? Basically there is hope. Just as many patients with brain damage are able to improve certain aspects to have a better quality of life, the same can happen in people with an addiction.
It would be, in essence, to generate new synaptic patterns based on new behaviors and thoughts. A door to change that is already developing in many clinics and rehabilitation centers with good success rates. Science and knowledge about the human brain is constantly evolving, something that will make it easier to give better answers to all kinds of needs.