Sunday, July 1, 2018

Addiction damages the Brain

Addiction damages the Brain
Dr. Dwijesh Kumar Panda

Addiction hijacks the brain’s neural pathways. It is a moral failing of desire, unrestrained eating and withdrawal that traps tens of millions of people in the world. Addiction denote dependence of a substance with increasing tolerance. If it is used more and more nasty withdrawal effects occur when use stops. These are alcohol, nicotine and heroin. Nicotine is a water soluble poisonous alkaloid found in tobacco leaves which is smoked and chewed. Heroin is a white crystalline powder derivative of morphine having euphoric effect. Marijuana and cocaine don’t cause shakes, nausea and vomiting like withdrawal. Addiction is a disease, not a moral failing. It is characterized by compulsive repetition of an activity despite life damaging consequences. Anything that induces euphoria (feeling of vigor, well-being) or is calming, can be addictive. Addiction depends person’s vulnerability, which is affected by genetics, trauma, and depression. Many people have persistent desire to eat certain foods. Pizza- typically made with white-flour crust and topped with sugar-laden tomato sauce is the most addictive food, with chips and chocolate. That is a major reason why people struggle with obesity.
More than two lac people worldwide die every year from drug overdoses according to the United Nations office on drugs and crime. Much more than this die from smoking and drinking. A billion people smoke tobacco. It is the top five causes of death: heart disease, stroke, respiratory infections, chronic obstructive pulmonary disease and lung cancer. Nearly one of every 20 adults worldwide is addicted to alcohol. Gambling and compulsive activities are also recognized as addictions. In the United States 33,091 cases of opioids overdose deaths happened in 2015. The U.S. surgeon general’s report on addiction concluded that 21 million have a drug or alcohol addiction. 3.3 million worldwide die each year from alcohol. This disorder is more common than cancer. 1.1 billion people in the world smoke tobacco. Behavioral addictions are strong desires for gambling and other attractions of modern life- junk food, shopping, smartphones. These are potentially addictive because of their powerful effects on the brain’s reward system. Gambling and Internet gaming resemble drug addiction.
M.R.I. (Magnetic Resonance Imaging) can unravel the mysteries of addiction. The brain scans are coverted to images that pin point the circuits. The brain images visualize the brain state. There is a spike in the neurotransmitter dopamine. It is a chemical messenger that carries signals across the synapses. Dopamine plays wide-ranging roles in the brain. In addition, the flow of dopamine heightens. Each drug that’s abused affects brain chemistry. They all send dopamine level soaring far beyond the natural range. The brain’s executive control centre is the prefrontal cortex and other cortical regions. Changes in this part of the brain affect judgement, self-control and cognitive (memory) functions. People with addiction often in using drugs to relieve the misery they feel when they stop.

Normal Neuronal Activity
Cocaine addicts have reduced gray matter volume in the prefrontal cortex. The deficiency of the volume results in poor executive function, memory, attention, decision- making. They generally perform worse. Cocaine is a white powder obtained from dried coca leaves which is an American shrub. This drug that is abused affects brain chemistry. They increase dopamine levels far beyond the natural range. The cells that make dopamine are the little devils in our brain. They powerfully enhance the chemical drive desire. Several studies don’t answer the chicken-and-egg question. Does addiction cause these impairments, or do brain vulnerabilities due to genetics, trauma, stress or other factors increase the risk of becoming addicted? Goldstein, director of NIDA discovered disappointing evidence that frontal brain regions begin to heal when people stop using drugs.
Cocaine interfering with dopamine transport
Our brain evolved a dopamine –based reward system to encourage behaviors that help us survive. They are eating, procreating, and interacting socially. Different drugs interact with the reward system in unique ways to keep the synapses artificially flooded with dopamine. That dopamine rush can rewire our brain to want more drugs, leading to addiction. Brain’s reward system controls craving and pleasure. Craving is driven by neurotransmitter dopamine. Pleasure is stimulated by other neurotransmitters in “hidden hot spots.” When the craving circuits overwhelms the pleasure hot spots, addiction occurs. People use more drugs despite the consequences.

Heroin flood the synapses with dopamine
The application of electromagnetic pulses to the prefrontal cortex or transcranial magnetic stimulation is a hope of success. This technique is now being tested around the world. Medications that can prevent the activation and keep people from falling prey to unseen triggers are in the pipe line of modern research.
In the world of addiction, the best hope for treatment lies in melting modern science and depend on ancient meditating practice. Use of meditation and other techniques to bring awareness to habits that drive self –defeating behavior. In Buddhist philosophy, craving (strong desire) is viewed as the root of all suffering. Mindfulness can counter the dopamine flood of contemporary life. It is more effective in preventing drug-addiction. It can ride out the wave of intense desire.  Mindfulness trains people to pay attention to cravings without reacting to them. It breaks the habit of ice cream and chocolate. Yoga, counselling, amino acid supplements, and dieting changes can be more effective in preventing drug addiction. Meditation quiets the Posterior Cingulate Cortex and the neural space that don’t lead to obsession (evil spirit ruling a person). Our brains evolved a dopamine based reward system to encourage behaviors that help us survive, such as eating, procreating and interacting socially. The brain can rebuild itself. That’s the most amazing thing.
1.     Journal of European Neuropsychopharmacology, January 2016.
2.     Diagnostic and statistical Manual of Mental Disorders, 2016.