Contract for Injury?

In the past few years, there has been controversy surrounding concussions in the National Football League (NFL). It all began to snowball in 2002, where Dr. Bennet Omalu identified chronic traumatic encephalopathy (CTE) in the brain of Mike Webster, 50, a former Pittsburg Steeler whom committed suicide. Webster being the first case of CTE found in American football players.

Image result for cte nfl

CTE is a very scary degenerative brain disease most prevalent in athletes, military veterans, and others with a history of repeated brain trauma. CTE is characterized by Tau protein aggregating and killing brain cells; the same protein plays a role in Alzheimer’s disease. Symptoms of CTE include memory loss, confusion, decreased cognitive functioning, behavioral changes, impaired judgement, and eventually progressive dementia. As with any degenerative diseases, symptoms worsen over time.

CTE is caused by many repeated blows to the head, which have been nearly unavoidable in football. These hits, combined with the magnitude of force behind them are a significant cause of concern for the immediate and future safety of the players. However, it was not until March 2016 where the NFL openly admitted to a connection between football and CTE. This statement was only after copious amounts of irrefutable research and film was presented to the NFL.

Later in 2016, the NFL and NFL Player’s Association implemented a new policy to enforce a concussion protocol, and a similar concern was echoed by Commissioner Goodell to increase the safety of the game specifically by attempting to reduce the number of head injuries sustained as well as offer better protocols for those who have suffered an injury.

Such actions involved having a neurologist on the field to determine if a player has suffered a concussion after a significant blow to the head. Other actions include making certain blocks and hits involving specific head to head contact illegal. Particular care was placed on plays during kickoffs, which have proven to be the most dangerous plays, which makes sense because you have 300 lb men sprinting as fast as they can 70 yards and hitting others as hard as possible making a very dangerous situation for both the receiving and the kicking team.

Image result for nfl concussion

In the 2016-17 season, the impact of these new restrictions was lackluster, there were very few penalties called by the referees. Therefore, when there was a call made correctly as implicated by the new rules, many players, coaches, and fans alike would become very frustrated. This inconsistency of calling opened the NFL up to criticism by many.

Moreover, a study published in July 2017 identified CTE in 99% of deceased NFL players’ brains. The players donated their brains for the study, so the study is not 100% reflective of the NFL as a whole, but the sheer magnitude of 99% (110/111 players) should be met with a striking concern.

Moving forward in the 17-18 and 18-19 season, referees have become much more consistent and aware to which plays are illegal and deserve to be penalized. Many fans are still upset about the rules and a common sentiment being, “it changes the integrity of the game.” This is inherently true, but as the players adjust to the tighter hitting restrictions, there will be fewer interruptions due to appropriately called penalties, and the game will continue on.

Image result for nfl concussion tent

Yes, the game will never be the same. But, do we really want a game where the players are receiving head injury after head injury causing them to have severe neurological issues? The safety and well-being of the players should reign over the “big hit” mentality. There will undoubtedly still be big hits, just not hits by a head or to a head.

 

https://www.cnn.com/2013/08/30/us/nfl-concussions-fast-facts/index.html

http://www.espn.com/nfl/story/_/id/24743994/really-changed-nfl-call-action-concussions

http://www.espn.com/nfl/story/_/id/22603654/nfl-doctor-says-rising-concussion-numbers-sparks-call-action

https://concussionfoundation.org/CTE-resources/what-is-CTE

Its Never “Just a Concussion”

Not a simple brain bruise

Concussions are serious brain injuries resulting from an impact to the head. This “sloshing” of the brain induces a change in neurochemistry beginning with a change in ion flux between different neurons. Abnormal brain cell activity activates an immune response in the brain and inflammation occurs. Oxidative stress from inflammation causes toxic proteins in cells to build up and promote cell death. Clearly, this series of events is nothing to take lightly. There is much more going on the in the brain than a simple bruise and many different pathways interact in the brain’s frantic rush to recover.

³

Unfortunately, the tests we have today mostly rely on subjective information from the patient. This leads to a variety of problems with proper diagnosis and severity of the injury. Athletes with concussions often say anything that will help them get back on the field, and often lie about their condition. Today, there are a few objective tests that can be used to determine the severity of concussion.

Concussion assessments

Many high schools and colleges around the U.S. require students to take a baseline test for concussions. These tests ask questions relating to the student’s ability to spatially rotate objects, memorize words, and reaction time. Once the student has a baseline score, it can then be used to compare with the score the student gets after he or she takes the test again after a concussion. If there is a significant drop in performance, it is understood that the student has a concussion. Although these tests do provide some information about the severity of concussions, there are some flaws. For one, some people may perform poorly on the baseline test either because they are simply bad at taking tests or because they want to set the bar low on purpose. This would provide insignificant results if the student were to take the test again after a concussion. Also, staring at a screen for a 30 minute test is the last thing you should do after experiencing a concussion. A more definitive objective test is necessary.

Biomarkers for concussions

Recent research of biomarkers has revealed promising information on developing a blood test for concussions. It was found that the S100-beta protein spikes in concentration shortly after a concussion and can be used as a marker for concussive symptoms.² This protein is a product of glial cells after attending to mild traumatic brain injuries. Shortly after injury, microglia and astrocytes work tirelessly to attempt to heal the brain by releasing all sorts of proteins that prevent cell death. One of these proteins, s100-beta, is able to pass through the blood brain barrier and enter the peripheral blood stream.

4.

Measuring this proteins is easy, accurate, cost effective, and mildly invasive. Being able to see what is going on in the brain without actually invading brain tissue would be huge for the field of concussion research. This way, we could test to see if people are telling the truth about their concussive symptoms through a simple blood test.

 

Main takeaway

Concussions are severely dangerous injuries that are often overlooked by society. Many think that they can just tough out the symptoms of concussions and return back to normal in a couple days. Recent research has suggested otherwise. Permanent damage of cognition can result from concussions if treated improperly so it is crucial to follow all instructions by your doctor before returning to normal life.

 

Sources:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520152/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003664/
  3. https://www.uclahealth.org/brainsport/sports-concussions
  4. https://www.europeanpharmaceuticalreview.com/news/78008/blood-test-heart-attack/

Just Try it Once, Some Choices in Life are Less Forgiving Than Others

Addictive practices arise from similar chemical pathways in our brain. The development of these pathways is through exposure to substances or other uncontrollable compulsive behavior. These pathways result in the euphoric feelings from the release of dopamine from the reward. This can result in an addiction, where your brain develops a sensitization to the substance or activity that triggers the reward pathway. This develops and rewires portions of your brain to crave the substance or activity. Following this, the addiction requires more substance to deliver a similar rewarding response, thus the user develops a tolerance, potentially leading to the user having an overdose of the substance.

Over the past 30 years increasing number of individuals are becoming addicted to opioids. This has resulted in a major number of deaths, and millions of individuals that attempt to self medicate with other street drugs.

Opiod crisis facts

So what are potential solutions?

Mitigating the usage of opioids, and utilization of alternative painkillers. There should be more regulation and documentation of prescribed opioids, like antibiotics, abuse of something good can result in severe problems.

In the US  Drug related deaths result in more deaths(64,000) annually than automotive accidents(40,000), and firearm related deaths(39,000). Approximately two-thirds of those deaths are related to the abuse of synthetic opioids. So besides the constraints placed on the healthcare system to minimize opioid prescription, what other factors could be utilized to address this? Gateway drugs still remain widespread, and are sought by many for recreational use. These may not result in being potentially fatal, however the normalization of these in society, and the push for legalization further contributes to this problem. The justification to smoke recreational drugs is somehow normalized, when there is a major push to eliminate the usage of cigarettes because of their harmful effects. Yes legalization allows for more fiscal gain and control of the substances by the government, though this still will take a major toll on the healthcare of our country in a few decades due to the side effects of substance abuse. Where there will be some gain from taxes, the implications of substance abuse will result in costing the system more over the course of time, as this will increase the number of individuals experimenting with opioids, further increasing the opioid crisis in the US.

Sources:

https://www.hhs.gov/opioids/about-the-epidemic/index.html

https://www.centeronaddiction.org/the-buzz-blog/we-asked-you-answered-did-guns-car-crashes-or-drug-overdoses-kill-more-people-2017

Dopamine’s Story

As humans, we are driven to do what makes us feel good and those feelings are produced by chemical signals in our brain. We are trained to repeat experiences that produce reward but this pathway is susceptible to takeover by drugs that produce large euphoric feelings. With this chemical groundwork, drug addiction can permanently override the reward signaling in our brains, causing everyday activities that would make us feel good to pale in comparison to the unnatural high.

The Reward Pathway

The human brain is capable of many complex memories and emotions all driven by chemical interactions and signaling in distinct brain regions. In response to experiences like eating food, sleeping, or having sex a portion of the brain called the reward pathway is activated. This pathway creates lasting memories connecting certain activities with the feeling of reward and encouraging repetition of the behaviors. Activation of this pathway takes place in the ventral tegmental area (VTA) which projects to the nucleus accumbens (NAc), with signals propagated by the release of the neurotransmitter dopamine. Dopamine creates the feelings of euphoria and energy and function to remind our brains to do things that help us survive.

Overthrown Reward Pathway: Drugs

However, when addictive drugs are involved in this brain circuitry and dopamine levels are unnaturally raised the reward pathway is overthrown. A large euphoric high along with the connection of drug using behaviors with the reward leads to what we know as addiction and drug seeking behaviors. Addictive drugs act in different ways in the brain, but all function to make more dopamine available to activate the neurons in the NAc and signaling to the frontal cortex.

Addiction and Stress

The stress pathway can add to the dopamine levels in the reward pathway and compound drug-seeking behaviors in addiction. The release of dopamine driven by glucocorticoid hormones functions to increase the euphoric sense and desire to return to the behavior triggering the reaction. In an experiment done on rats addicted to cocaine, after being given a small amount of cocaine as a trigger, rats with excess stress hormones or an external stressor showed more signs of relapse than those that did not have increased stress levels.

For further research

Images

  • http://evolver.fm/2013/04/12/theres-a-part-of-the-brain-for-buying-music-heres-how-it-works/
  • https://www.rehabcenter.net/how-drug-addiction-affects-serotonin-and-dopamine/
  • http://mcgovern.mit.edu/news/news/new-sensors-track-dopamine-in-the-brain-for-more-than-year/

Stress and Addiction – Enhancing Each Other

What is Addiction?

Addiction is a condition that is caused by an individual using a substance or behavior for the rewarding effects that compel them to continuously repeat the activity despite it being harmful to them. Common substances that induce addictive effects include opioids, cocaine, nicotine, and alcohol, and behaviors such as gambling and video games can be addictive. These substances and behaviors have been scientifically proven to activate pathways in the brain related to reward and reinforcement, and most of them involve the neurotransmitter dopamine. Addiction also affects the brain’s executive functions, so some people who suffer from the disorder may not realize that they are harming themselves or others around them.

The cause of addiction stems from the first initial use of the substance or behavior, but there are many other factors that contribute to the continual use and eventual addiction. Genetic and biological factors contribute to the susceptibility of individuals to the condition, but social, psychological, and environmental factors have been shown to be the most powerful contributors. As many doctors like to say, with any disease, genetics loads the gun, but environment and behaviors pull the trigger.

A Link Between Stress and Addiction

There is an interesting link between stress and addiction. Stress is a known risk factor of addiction along with risk of relapse. The correlation has been assumed for decades, and has recently been proven scientifically through sophisticated human brain imaging and cross examination with other laboratory methods. These studies have shown a correlation between stress and craving and their link to the brain regions responsible for reward and addiction risk.

Stress – The Good and the Bad

Stress is a very broad term that needs some defining before we dive deeper into the link between it and addiction. Stress is defined as a process involving perception and response to a harmful or challenging event or stimulus. Stress responses are meant to be an adaptive response to regain homeostasis. Examples of stressors include loss of relationship, death of a family member, food deprivation, insomnia, and binge use of psychoactive drugs.

Stress is mostly associated with bad and harmful situations, there is also “good stress.” Good stress refers to stimuli that are moderately difficult to deal with, and if the individual handles the situation well, they generate a feeling of mastery, and are usually perceived as pleasurable. However, as intensity of the stimuli increases and is prolonged, the less control an individual has on the situation, and usually the sense of accomplishment and mastery decreases. This can increase the stress response, which as we will see, increases the susceptibility for addiction or relapse.

Three Groups at Risk

The most widely accepted and common association between stress and addiction is that drugs are used as a coping strategy to deal with stress or to self-medicate. There is sufficient evidence to this theory, and it can be categorized into three types. The first type involves adolescents experiencing negative life events such as loss of a parent, parental divorce, or a single parent family. The second type involves trauma and maltreatment, such as childhood sexual and physical abuse. The third type includes lifetime exposure to stressors and the impact is has cumulatively. These stressors are mostly unpredictable events, such as victims of gun violence, loss of parent, or natural disaster. Unsurprisingly, it has been found that the more of these uncontrollable events an individual experiences in their life, the more likely they are to become addicted to a substance or relapse, despite factors such as race, gender, or family history of drug abuse.

Brain Pathway Disfunction

Scientists have also studied neurobiological mechanisms explaining the effect stress has on addiction. Drugs of abuse such as alcohol, nicotine, and opioids all activate dopamine pathways, which is associated with higher craving. Additionally, stress exposure increases dopamine release. Because both stress and drug abuse both activate similar brain pathways, they both result in changes to neuronal synapses, enhancing the effect of each.

A Vicious Cycle

The link between stress and addiction creates a vicious cycle because they both feed into each other. The more stressed someone is, the more likely they are to abuse drugs, and drug abuse itself creates a very stressful environment for the body. They best way to avoid addiction is simply to never try drugs in the first place, but that can be easier said than done with social pressures and acceptance of drug use in pop culture. In our increasingly fast paced world, stress is tough to avoid, so staying stress and addiction free really comes down to making healthy decisions in all aspects of life.

Images:

https://www.google.com/search?safe=off&biw=1082&bih=565&tbm=isch&sa=1&ei=WXrrW-uCJY6ksAXRxqmYAw&q=stress+and+addiction&oq=stress+and+addiction&gs_l=img.3..0j0i24l4.236183.238454..238624…0.0..1.163.1953.14j6……1….1..gws-wiz-img…….0i67j0i8i30.W3_prnFKycU#imgrc=LojOaK9Nh8DJbM:

https://www.google.com/search?q=dopamine+and+addiction&safe=off&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiz7e7a3dLeAhVxmK0KHY4WC-cQ_AUIFCgC&biw=1082&bih=614#imgrc=eo551pZVRyzTIM:

Addiction – Its Not Just Once

At the end of class the other day a friend was telling me about her time working in an ER in which she helped many overdose patients. Almost all of them would say something along the lines of “it wasn’t supposed to do this.. It normally doesn’t do this..” After many days receiving these answers she finally asked one of the patients, “so if it wasn’t supposed to do this, what is it supposed to do?” “Help me forget.”

Humans turn to vices daily, using them to help mitigate our lives. These can be healthy or harmful depending on the vice and reasoning behind it. Addiction can stem from any activity that generates a pleasure response in your brain. This is called the reward pathway. It involves the release and transmission of dopamine from the ventral tegmental area (VTA) to the limbic system and frontal cortex where it binds to its receptors. Once bound to the receptor this reward takes place teaching us the actions and situations surrounding the stimulus. Naturally, this pathway enhances certain behaviors necessary for survival such as eating, drinking, sex and social interaction.

Drugs however don’t play by the rules. They take over the system, not only increasing the levels of dopamine but physically changing the brain. Depending on the drug, different areas are affected in different ways primarily by changing the density of receptors (decreasing D2 receptors), blocking re-uptake of dopamine, or triggering the release of excess dopamine. They all work in the same way, increase the dopamine present to therefore prolong the euphoria. This has now changed the behaviors from survival to drugs. Every need is now encompassed by and inferior to the need for drugs.

There is a great lack of self control in drug addiction. Even when the drug is no longer pleasurable and enjoyable the abusers must continue. This lack of self control stems from the reduced concentration of D2 receptors in the brain which regulate the frontal areas responsible for self control. It becomes compulsive and impulsive. This is not the same as an addiction to your phone where you still truly have control over the actions. They truly have lost all control, yet as a society we act as though they are still fully functioning and can stop at the drop of a hat. We have unrealistic expectations for those suffering from abuse. As a society we must change the narrative surrounding this, likely needing to categorize addiction as a mental illness rather than just a personal problem. It not only destroys them but those around them as they slowly lose the one they love to drugs.

Addiction and Reward System: A Vicious Cycle

Figure: Addiction causes you to become dependent on an activity or substance and you can abandon all other parts of your life that are important to you. Eventually you start to fade away as a functional member of society.

Since the beginning of our school lives we have heard about addicts. The thing that came to my head every time I heard this was “Why would anyone even do drugs?”. After growing older I could see how some people could get pressured into drugs, but then I would think “Why would people keep doing drugs even if they know that they can kill them?”. Drugs keep people from experiencing healthy family lives, keep some from working, and experiencing a normal life in general. This addiction can be attributed to a broken reward system in the brain and the cycle of addiction that keeps bringing people back to the drugs.

Cycle of Addiction

Drug abuse and addiction is a vicious cycle that feeds into itself. It starts with usage of the drug. Then as you use more and more you start to build up a tolerance to the drug, which takes more of it to give you the same effects. This means that the brain has adapted to the drug and “put up defenses”. At the same time, it takes less of the drug to make the pathway go through into your brain. This is sensitization. It means that there is a change in the pathway of the brain to make this effect easier to acquire. It is now dependent on the drug. Eventually you stop taking the drug and there are feelings of withdrawal which are the brain trying to adapt back to the way it was before this stimulus entered it and made changes. Sometimes the brain can become clean and is no longer dependent upon the drug. However, there are still cravings and environmental factors that cause individuals to acquire the drug and get a relapse, starting the cycle over again. Since that pathway has already been made into a priority in the brain it is really easy to go back into the cycle of abuse.

http://ccbhc.org/drug-abuseisstill-a-growing-problem/

Reward System

The reward system in a normal, healthy brain gives doses of pleasurable dopamine as a reward for certain activities. This dopamine binds to receptors and once the activity is over the dopamine is taken away, or goes through reuptake. Many drugs block this process of reuptake and the dopamine remains bound to receptors for a longer time. The drugs may also cause a release of dopamine without an activity taking place. The dopamine receptors get used to having this much dopamine and do not associate it with activities that would normally bring it this dopamine since it is getting supplied by the drug. Along with that the receptors are building up a tolerance to the dopamine resulting in the need for more drugs to duplicate the same sensation when originally taking the drugs. More drugs are then needed to cause the same feeling.

https://www.care2.com/greenliving/3-prescription-drugs-that-do-more-harm-than-good.html

How can we stay away from drugs? This seems like a pretty easy question to answer: Just don’t do drugs. This is getting harder and harder as prescription drugs are so commonly used in our world today. They are very addictive as well and there is no discrimination for who can become addicted. If you are ever prescribed drugs, use them as directed and if you no longer need them, stop using them. You can do this by bringing them to a local DEA, National Drug Prescription Take-Back events, or DEA registered collectors, which are generally pharmacies or drug stores.

Anyone can be an Addict: Understanding the Science behind Addiction

Addiction, a topic that is not always heavily discussed, yet more likely than not most people reading this know someone who deals with addiction. Many people believe that addiction is a choice, and not a disease, but what if I told you that addiction changes the wiring in the brain. That’s right, when you use a drug it changes neuroplasticity, and that change leads to the user craving the drug more. While this sounds scary, which it is, it is important to learn the science behind the epidemic plaguing society, so we can help those who are struggling.

From a young age we are taught, DON’T DO DRUGS. From our teachers, to our parents, and even commercials on T.V. the world told us that if we tried drugs it would RUIN our lives. These constant reminders, and scare tactics lead to the stereotypical image we hold of a drug addict.

Most people, think a drug addict is…

  • A criminal
  • A liar
  • A low life

And, that drug addicts look…

  • Dirty
  • Have yellow or missing teeth
  • Have scabbed or scarred skin

You look at yourself in the mirror, and think well I don’t fit those characteristics. I will NEVER become addicted. I’M NOT THAT TYPE OF PERSON. I hate to break it to you, but ANYONE can become addicted to drugs.

What do drugs do to your brain?

Today, many people see addiction as a choice, and not a disease. The scary true is that when you try an addictive drug your brain begins to RE-WIRE itself. Also, most people don’t realize that a person’s genetics makes up 50% of their risk of becoming an addict, and the other 50% is made up of environmental factors. While many people believe addiction won’t happen to them, the truth is you don’t know how drugs will affect you until you try, and for many this simple one time trial leads to addiction.

Why is it so hard to quit?.

Besides rewiring the brain, drugs act on the mesolimbic pathway which is involved with the feelings associated with the reward given off by the neurotransmitter, dopamine. When an individual experiences a reward the concentration of dopamine in the frontal cortex, the nucleus accumbens, and ventral tegmental area increase, and give the person a sense of euphoria. Drugs of abuse have a way of making this euphoria or “high” last for a prolonged time. Cocaine, for example, blocks dopamine re-uptake thus causing the reward to stay in a person’s system for longer. When a drug of abuse is taken for a long time the amount of dopamine decreases, and the “high” decreases. The individual will begin to crave their drug of choice, and if they are unable to gain access to that drug they will begin to experience withdrawal. To satisfy their cravings, due to the rewiring in the brain, a person will take more of their drug of abuse in order to experience a high, and without even noticing the person has become ADDICTED.

What can you do?

If you are an addict…

  • Seek treatment. Please know that people do truly care for you, and want to see you succeed.
  • Don’t be afraid to ask for help.

If a loved one is addict….

  • Be there for that person
  • Be supportive
  • Provide a safe space, and a listening ear
  • Do not judge that person. Remember addiction is a DISEASE not a choice.

 

Image 1: https://www.therecoveryvillage.com/family-friend-portal/how-to-understand-a-drug-addict-signs-symptoms-and-behaviors/#gref

Image 2: https://slideplayer.com/slide/4334071/

Image 3: https://alteristic.org/hope-new-year/

More Addiction, Less Treatment: Why?

Stigma and addiction. These two words go hand in hand. Many will try to deny that claim and pry those hands apart. I would argue that that is impossible. Addiction, especially to hard drugs and alcohol but also to foods and nicotine, are so often blown off by our society for many reasons. Perhaps people think that those struggling with addiction are ‘junkies’, shameful, or lesser than others. However, these stigmas perpetuate the problem. An article on drugabuse.com put it perfectly:

“We live in a society where millions of Americans are dependent on drugs or alcohol and only a small percentage receive treatment at a facility.”

Why is this? What is going wrong? Or a more purposeful question, what are we doin wrong? Why do those struggling with addiction not seek out treatment? There are many, many questions that need answers surrounding the topic of addiction. Ironically, addiction is one the few mental diseases that is actually able to be broken down into simpler terms and understood by practically anyone. It is much more difficult to do that with disorders such as Schizophrenia, Bipolar, or Multiple Personality Disorder. So, if what addiction does to your brain and behavior can be described in terms that are easily understood, why do very few people know about it?

The answer can be found in a few areas. First, society in general needs to know what happens to your brain when you experiment with drugs of abuse. These drugs have the potential to do the following: 

  • They can block or activate needed neurotransmitters in your brain that work to send the correct signals through and to stop the unwanted ones
  • The more a drug is used, the more it will change the normal pathways in your brain. This can lead to altered behavior and personality due to now different wirings in your brain
  • They can also create dependency issues of tolerance, sensitization to the drug, as well as detrimental withdrawal symptoms. These can lead to lifestyle changes that are catered to attaining more and more of that drug

There are plenty of articles, TedTalks and more on how addiction simply works in the brain. But, no one is talking about it. Perhaps getting this information into health classes and school assemblies at the late middle school/early high school age would be beneficial. Health and Wellness teachers are already discussing topics such as sex education, drugs, and alcohol – they should be warning the students of what happens to the brain, addictive tendencies, signs of addiction, and environmental factors.

Another reason that people are not well-informed may be because of the stigma surrounding addiction, as mentioned above. Even friends and family members of those struggling with addiction may not want them to go to treatment centers because they think everything will change. However, that often needs to happen in order to have a holistic recovery for the one struggling. Treatment centers are meant to take the patient out of their daily routines and away from harmful environmental factors such as family members that supply a drug, unhealthy living situations, and more. From the outside, treatment centers may look intimidating or even harmful, but that is perpetuating the stigma of addiction as well. 

If we want to change the stigmas surrounding addiction, we need to start with education. Educating students and teenagers of the dangers of addictive substances and environmental factors as well as educating adults and family members of those struggling with addiction. Taking small steps towards these goals can eventually lead to larger changes with addiction altogether.

https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898681/

 

 

Rewards Gone Rogue: Drugs and your Brain

Image result for drug addictionAddiction occurs when a person is physically and mentally dependent on a specific substance. Most the time, the substance is a drug. Drug addiction has always been depicted as a choice. From the outside, it has always seemed that getting rid of an addiction should be as easy as stopping the intake of the drug. However, research into drug addiction has shown that it is actually a disease of the brain. Drugs alter a very important pathway in the brain called the reward pathway by blocking the reuptake of signaling molecules, thus increasing reward signaling. Altering this pathway creates long lasting changes in the addict’s brain, which makes it very difficult for addict’s to stop their drug intake.

Reward Pathway

The reward system is a pathway in your brain that enhances behaviors by producing pleasure and rewarding effects following a specific behavior. After a desirable behavior, an action potential occurs in your brain, transmitting dopamine from the ventral tegmental area of the midbrain to the limbic system and frontal cortex.Image result for reward pathway and addictionDopamine binds to dopamine receptors in the synaptic space, which stimulates the neuron, creating the pleasurable sensation. Once the action potential that releases the dopamine is over, dopamine is removed from the synaptic space back into the transmitting neuron via a dopamine transporter. This ensures that the reward is cognitively linked to the stimulus.

Drugs can affect the reward pathway in many ways. They can increase the level of dopamine released by increasing the amount of action potentials, block the reuptake of dopamine after the action potential, or release dopamine without an action potential. These situations cause increased and prolonged stimulation of the dopamine receptors, creating a prolonged and more intense euphoria. This overstimulation desensitizes the reward system because it isn’t able to reset before the next stimulation occurs. Your reward system will no longer be stimulated by everyday stimuli, creating a world where only drugs are rewarding. You will also begin to need higher dosages of drugs to create the same rewarding experience, as a tolerance to dopamine levels will begin to build.Image result for dopamine and addiction

Remaking the Reward Pathway

It is disheartening to understand how drugs alter the brain, but that doesn’t mean there is no way to recover from a drug addiction. There is a behavioral treatment that simulates a reward pathway to help addicts feel pleasure without the use of drugs. This treatment is called the Contingency Management program and it offers voucher based reinforcement as treatment. Whenever the addict provides a drug-free urine sample, they are rewarded with a voucher that can be used for food, movie tickets, or anything else that helps the addict live a drug-fee lifestyle. They can then associate a life without drugs with positive and rewarding effects so they no longer feel the need to take drugs to feel pleasure.

While there is more to drug addiction than the reward pathway, it is a key player in the addiction process. Understanding how this pathway in the brain is affected by drugs leads to a greater understanding of what happens when someone is suffering from addiction. This knowledge leads to the development of treatments that will accurately target the person’s needs and hopefully let them live the life they desire.

 

 

 

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