By Luke Gilleran, LADC, NCC, CCDP Why do some people find themselves psychologically chained to a drug for a lifetime? Experts have learned the answer to this question. Through imaging and other technologies, researchers have been able to “see” the psychological addictive mechanism in the brain, and have identified differences in the structure and operation of some people’s brains that predispose them and keep them locked into addiction. Knowing how the addictive mechanism works, some researchers go so far as to say it is virtually impossible for one to avoid addiction if one has this predisposition and is exposed to alcohol or drugs at some point in life. It has been widely accepted that addiction can be inherited. In the 1980s researchers discovered the majority of alcoholics have a smaller than usual P3 brainwave. The P3 brainwave promotes a sense of well-being, implying that a diminished P3 means a reduced sense of well-being. By testing the young children of alcoholics, and finding most also had a diminished P3, researchers concluded the difference existed prior to the use of alcohol and was inherited. In the 1990’s researchers used brain scanning technology to determine that a disproportionate number of alcoholics and drug addicts have fewer Dopamine receptors. Known as the “pleasure chemical” Dopamine enters the brain’s pleasure center through these receptors creating a pleasurable feeling. Fewer dopamine receptors mean less pleasure because less of the chemical reaches the pleasure center. The combined results of the diminished P3 and fewer Dopamine receptors results in a free-floating “angst” or psychic pain in these individuals, for which the brain desperately seeks a solution. Complicating matters is another difference in the form of the brain’s response to the ingestion of drugs and alcohol. Normally when one takes a drink, for example, the brain responds with a slight increase in certain “feel-good” brain chemicals, such as Dopamine and Serotonin, creating a relaxed state with slightly lowered inhibitions and increased pleasure. Images of the brains of addicts reveal a flood of chemicals, especially Dopamine, which results in a euphoric response that far more than compensates for the psychic pain, such that the brain “hardwires” the experience in its circuitry so that repeating the experience is the highest of priorities. The brain begins to see repeating the experience as a matter of survival which over time makes it more important than food, family, job, etc., and the person is psychologically addicted. The compulsion to repeat the experience is known as a “craving.” Nora Valkow, head of the National Institutes on Drug Abuse, and preeminent brain imaging researcher, has used PET Scans, a form of brain imaging, to see cravings in the brain. A rapid change of color in the image indicates a person is “triggered” and craving drugs or alcohol. The most important finding is that cravings occur in the identical spot in the brain as the survival instinct – one of the strongest instincts humans experience. The survival instinct subsumes all reason as millions of years of evolution are geared toward self preservation. Indications are the brain prioritizes the desire to use drugs similarly, creating a compulsion to use drugs as strong as the compulsion to flee a burning building, for example. It is no wonder the drug craving overwhelms all reason to the contrary, and the person uses. What does this all mean for the addict? It changes little actually. Addiction, while proven to be a powerful psychological mechanism, often innocently inherited, remains a behavioral issue because without the behavior of ingesting drugs or alcohol, there is no active addiction. Despite predisposition, disease concept, and the overwhelming nature of drug craving, the person him or herself can (and must) place the disease in complete remission by eliminating one specific behavior. The good news is that through a “rewiring” of the brain’s circuitry via modified thought processes, education, a redefining of drug use as destructive as opposed to a tool of survival, and spiritual growth, all of which come from recovery efforts, the brain can be taught to quiet cravings while bolstering reason in sufficient quantity to overpower the instinct to use, thereby avoiding relapse. Millions of recovering alcoholics and drug addicts are testament to successful, long-term abstinence. Moreover, because the addictive mechanism is now completely known, experiments have begun on animals that have successfully “short-circuited” the addictive mechanism, eliminating any desire to use drugs. It is only a matter of time that effective psychopharmacological treatments may cure addiction once and for all. With over 20 years of experience in addiction therapy, Mr. Gilleran has overseen programs ranging from psychiatric hospitals to inpatient and outpatient chemical dependency treatment programs for both adults and adolescents. He is a Licensed Alcohol and Drug Counselor (LADC), a National Certified Counselor (NCC) and was one of first therapists in Connecticut to earn the states Co–Occurring Disorder Professional (COD) certification, which is granted to therapists uniquely qualified to treat clients with co-occurring disorders. Luke can be reached at 203.520.3465 or email him at lukegilleran@yahoo.com