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Biological and Neurological Causes of Addiction

Tracie Timme

 

Addiction – Biological and Neurological Causes

An academic paper by

Tracie L. Timme – Online Counselor and Therapist

This paper is about the biological and neurological causes of addiction, how it affects many people, and systems of the body that are affected.

The category that addiction best falls into is a behavioral syndrome, noted for compulsive drug use with relapse into more drug use.  Addiction can happen without being physically dependent, and physical dependency can happen without being addicted (Spanagel & Heilig, 2005).  For the past 20 years scientists have looked at positive drug reinforcement as what lies beneath addictions.  According to Spanagel & Heilig (2005), other neuronal systems must aid in addictive behavior, all systems work together.  This means that one system affects the other.  One of these systems, which detect influencing environmental stimuli, is the mesolimbic dopamine system, which affects the core brain reinforcement system.  The hypothesis for the neurobiology of addiction is that there are changes on the molecular and structural levels that are irreversible, caused by the dopaminergic reinforcement system having synaptic plasticity, due to constant drug use. (Spanagel & Heilig, 2005).  Scientists seem to think that there is some kind of modular switch that explains the irreversible transition from controlled drug use to compulsive drug use.  These scientists say “It has been claimed that transcription factors such as “AFosB” may constitute such a molecular switch” (Spanagel & Heilig, 2005, p. 2).  This transition factor builds up in the mesolimbic dopamine system with continuous drug use.  However a modulator of transcription factors is Per2 and that does remain in the brain for quite a few weeks after drug treatment.  Some change in the mesolimbic dopamine system that is irreversible that has been seen is the micro structural alterations on the dendrites of medium spiny neurons, which are the essential cell population inside the mesolimbic dopamine system.  However, that change is not seen past 3 months after drug treatment ends.  That contradicts the irreversible switch theory of moving from controlled drug use to compulsive drug use (Spanagel & Heilig, 2005).

Schepis, Adinoff, & Rao, state that adolescents are more persistently and acutely affected by addiction than are adults.  These differences possibly have to do with neuroplastic changes that aid entrenchment and accelerated use, which leads to more neurobiological liability and SUD (substance use disorder) being great factors as the outcome (Schepis et al., 2008).  This study also shows that adolescents with a family history of substance use are more likely to have neurobiological and neurobehavioral dysfunctions (Schepis et al., 2008).  Adolescence is the period when most neurons grow.  Neurocognitive functions such as decisions, monitoring oneself, controlling impulses, and gratification delay, are relative to the PFC (prefrontal cortex) and the anterior cingulate activity; these things seem to be affected by changes in pretty much all of the neurotransmitter systems.  The most important factors in becoming a SUD are alterations in the dopamine related systems.  Dopamine is a key factor in the mesolimbic neural pathways (Schepis et al., 2008).  According to Schepis et al., “This circuit originates in the ventral tegmental area (VTA) and projects to the nucleus accumbens (NAc) and various limbic structures” (p. 8).  A variety of environmental reinforcers trigger the mesostriatal to release dopamine (DA).  In order to assign value to these reinforcing stimuli, there needs to be an increase in striatal concentrations of DA (Schepis et al., 2008).

Big scary spiderIn an article about SUD by Taylor, he explains Gray’s behavioral inhibition system (BIS) and the behavioral activation system (BAS), which, may be seen in the physiological reactions and shown in the psychopathology.  Gray also says that the neural structure of the BIS incorporates information to the prefrontal cortex (PFC), and the neural structure of the BAS could be related to the dopaminergic reward circuit (Taylor, 2005).

Love passion, what some people consider an addiction, has neurobiological links with addiction.  In love passion, neurochemicals that play a part in wanting that feeling all the time are dopamine, ocytocin, and vasopressin.  Dopamine plays a major role in addictions.  Other neurotransmitter systems that are common between addiction and love passion are GABA and glutamate, noradrenaline and serotonin, opioid, and cannabinnoid.  These are implicated in the addiction process, as is the corticotrophin system that regulates the oxytocinergic and dopaminergic systems (Reynaud, Karila, Blecha, & Benyamina, 2010).  Even though love passion is not considered to have a recognized definition or diagnosis criteria, it is very similar to addiction.

Alcohol affects GABAA  receptors and a subtype of glutamate receptors called N-methyl-D-aspartate (NMDA).  These neurotransmitters control the excitatory tone and activity of the brain.  GABA is the inhibitory neurotransmitter and glutamate is the excitatory neurotransmitter (Devaud, Risinger, & Selvage, 2006).  Incoordination, reduced nervousness, anticonvulsant, and relaxation, the symptoms of intoxication, are partly controlled by coming across these neurotransmitter systems.  These actions show how the central nervous system (CNS) reacts to more GABAergic activity and less glutmatergic activity (Devaud, et al., 2006).  GABAA  and  NMDA receptors are part of a larger receptor family and each has their own protein make-up.  The different neurological responses are due to the combination of the different receptors.  Men and women have a different chemical make-up as far as systems go.  The difference between men and women when they drink is in the brain- and endocrine-mediated stress reactions.  Men take the flight or fight response, whereas women tend to try to nurture the other and avoid aggressiveness (Devaud et al., 2006).

Another test shows that substance use and most psychiatric disorders are common and complex and have multiple genes that play into the phenotype, which show no pattern of Mendelian transmissions.  There are two parallel mechanisms that influence this genetic complexity.  One is the explanation of polygenicity, which means many genes come together at the same time to ensure vulnerability.  In SUD, the genes that might be involved are genes related to drug-specific metabolism, neurobiological processes regulators similar to all abused drugs, and some that comorbidity-related that change environmental vulnerability.  The second parallel mechanism that influences genetic complexity is heterogeneity, which shows that it is only one genetic variation that could make up a single specific phenotype that could be needed for the initiation and possibly the upkeep of addictions (Schumann, 2007).

Different people have different chemical make-ups, so everyone, more than likely, will have different effects from addictions.  The many different receptors bind with different chemicals; if there is some disruption of that binding, many different affects could happen.  Some people simply do not to become addicted to things, where others become addicted very easily.  It is all in how chemicals bind together with the receptors, and apparently in the genetics.

Alcoholism is a terrible addiction that has been shown to be passed down from generation to generation.  People who have a history of alcohol abuse in their family, have a greater chance of using themselves.  According to previous studies Hanson, Medina, Nagel, Spadoni, Gorlick, and Tapert, (2010) hypothesis says that there is a difference in the size of the hippocampus of adolescents with a family history alcohol use problems and those adolescents who do not have a history of alcohol use issues.  When the hippocampi of non-drinking youth with a family history of alcohol use was compared with youth who did not have a history of alcohol use in the family, those who had the history had smaller hippocampi or asymmetry that was abnormal (Hanson et al., 2010).  The hippocampus is involved in making new memories.  There is ongoing myelination in teen years, so if there is a problem with family history of alcohol use, then there will no doubt be a neurodevelopmental lag that hinders the proper growth of the left and right hemispheres of the hippocampus (Hanson et al., 2010).  From their own preliminary findings, their hypothesis found not to be correct.  Hanson et al. (2010) found that the hippocampal asymmetry was the same for youth with and without a family history of alcohol use.

Slutske et al. (2002) looked at four different studies on alcohol expectancies.  Out of those four, three of them were done on twins.  All of the participants of these studies were experienced drinkers (Slutske et al., 2002).  What people expect of alcohol starts when they are young.  Children see adults drink all the time, whether it is on the television, the radio, in a restaurant, or, sadly enough, in their own homes.  From these experiences we can see how others are affected by alcohol.  They look like they are having a lot of fun. Whether they are laid back and relaxed, laughing hysterically, or not afraid of anything, almost superhero type, so we expect what we see to happen to us.  With that in mind we start to drink.  Those who have a family history may start sooner than others, because they were exposed to it much younger and on a regular basis.  In a recent study Slutske et al. (2002), examined how genetics, parents’ thoughts, and the same peer groups, affected thoughts of alcohol use, compared to thoughts of alcohol use with factors that are unrelated, peer groups that are not the same.  What they came up with from this study, was that genetics alone did not make a significant difference, but when added to the family environment, together they made a huge difference on how people thought of alcohol and its use (Slutske et al., 2002).  The thought here is that the social learning theory has more to do with alcohol use and dependence than does only genetics.

The ethanol in alcohol effects the predisposition of abuse and dependence.  The way neural pathways are activated or deactivated by alcohol.  With this in mind, research has turned to pharmacology, where medications affect cellular and physiological levels in the brain (Ray et al., 2010).  These endophenotypes affect the subjective responses of alcohol, therefore may work to help treat alcoholism.  The medication that is approved by the FDA has shown to lessen the good feelings of the alcohol, bring out more of the fatigue, stress, and confusion felt by alcohol use, therefore lowering the enjoyment (Ray et al., 2010).

Carlson (2010) explains that there are variations of genes that do play a big role in becoming addicted to substances.  Environment also has a lot to do with whether you become dependent or not.  He also goes on to explain that being prone to becoming an addict could be how your body metabolizes substances or by how the structures and biochemistries in your brain differ (Carlson, 2010).

A cause for alcoholism could be that the person is predisposed to the genetics of an alcoholic.  However, just because you may be predisposed to alcoholism does not mean you will automatically become an alcoholic yourself.  It may take outside factors to play a role in becoming an alcoholic.  Coming from a line of alcoholics and seeing it every day, may have great impact on how you see the disease.  Having friends that you spend most of your time with, could also have a great impact on whether or not you drink.  A trusted friend, colleague, boss, or family member may offer you a drink to calm down, and it works, you like it, therefore you use it to chase away the blues or your bad day.  You repeat these feelings of being alright enough that you now need it to get through your day.  You become addicted.

References

Carlson, N. R. (2010). Physiology of behavior (10th ed.). Boston, MA: Pearson Education.

Devaud, L. L., Risinger, F. O., & Selvage, D. (2006). Impact of the hormonal milieu on the neurobiology of alcohol dependence and withdrawal. Journal of General Psychology, 133(4), 337-356. doi:10.3200/GENP.133.4.337-356

Hanson, K. L., Medina, K., Nagel, B. J., Spadoni, A. D., Gorlick, A., & Tapert, S. F. (2010). Hippocampal volumes in adolescents with and without a family history of alcoholism. American Journal of Drug & Alcohol Abuse, 36(3), 161-167. Retrieved from EBSCOhost.

Ray, L. A., Mackillop, J., & Monti, P. M. (2010). Subjective responses to alcohol consumption as endophenotypes: Advancing behavioral genetics in etiological and treatment models of alcoholism. Substance Use & Misuse, 45(11), 1742-1765. Retrieved from EBSCOhost.

Reynaud, M., Karila, L., Blecha, L., & Benyamina, A. (2010). Is love passion an addictive disorder? The American Journal of Drug and Alcohol Abuse, 36(5), 261-267. doi:10.3109/00952990.2010.495183

Schepis, T. S., Adinoff, B., & Rao, U. (2008). Neurobiological processes in adolescent addictive disorders. The American Journal on Addictions, 17(1), 6-23. doi:10.1080/10550490701756146

Schumann, G. (2007). Okey lecture 2006: Identifying the neurobiological mechanisms of addictive behaviour. Addiction, 102(11), 1689-1695. doi:10.1111/j.1360-0443.2007.01942.x

Slutske, W. S., Cronk, N. J., Sher, K. J., Madden, P. F., Bucholz, K. K., & Heath, A. C. (2002). Genes, environment and individual differences in alcohol expectancies among female adolescents and young adults. Psychology of Addictive Behaviors, 16(4), 308-317. doi:10.1037/0893-164X.16.4.308

Spanagel, R., & Heilig, M. (2005). Addiction and its brain science. Addiction, 100(12), 1813-1822. doi:10.1111/j.1360-0443.2005.01260.x

Taylor, J. (2005). Substance use disorders and cluster B personality disorders: Physiological, cognitive, and environmental correlates in a college sample. American Journal of Drug & Alcohol Abuse, 31(3), 515-535.

Click here to contact Tracie Timme for your counseling needs.

Women and addiction

Tracie Timme

 

Women and addiction

An academic paper by

Tracie L. Timme – Online Counselor and Therapist

 

This paper will look at women and addiction.  Women have differences in treatment from men, so this paper will examine the differences between the etiology of addiction in men and women.  Because men and women differ on many things, we will also look at the specific needs of women in treatment.  This paper will discuss both the good and bad aspects of using single and co-ed gender groups in treatment.  In addition, this paper will also see the co-occurring issues women face when they are in treatment.

Men and women differ in their makeup.  When men and women drink the same amount of alcohol, even when the body weight is calculated for, women have a higher blood alcohol level (Frances, Miller, & Mack, 2005).  Men have more body water and less body fat than do women.  Men also have more alcohol dehydrogenase (ADH), which is an enzyme in the gastric mucosa.  This enzyme increases the metabolism of alcohol in the stomach, therefore allowing less to pass into the bloodstream (Frances et al., 2005).  Women have a faster metabolism when it comes to alcohol, less of a tolerance for it, and their blood alcohol concentrations have great variability.  These factors lead to more unpredictable reactions to alcohol that are more intense.  A lot of the differences come from the differences in our blood.  Women have menstrual cycles; therefore the plasma levels vary depending on the time of the month.  When it comes down to the environment vs. genetics thoughts, it appears that women are more susceptible to environmental factors and men are more likely to have genetic factors influencing them (Frances et al., 2005).

addictionThere are few same-gender programs, but the few that there are have programs to meet the specific needs that women have, such as those that have dependent children.  There is also a growing concern for older women who have not had addiction problems in the past; those who have lost many people they love, have declining health, and have access to prescription drugs, may fall into addiction.  Women who are retiring may be lost and confused now that they do not feel they have meaning in their life (Matheson, 2008).

One concern that has been reported by women when in a treatment program that is co-ed is that they are afraid of being a target and being harassed sexually by the male staff members and the males in the group; this is a concern because there is still such a bad stigma attached to females with addictive disorders and who are in treatment (Matheson, 2008).

Women face many problems other than their addiction when they seek treatment.  In the past, when women had a problem with addiction, their families tried to keep them secluded and out of the treatment setting.  Many families figured that in isolation, the woman’s problem would just go away (Wechsberg, Luseno, and Ellerson, 2008).  Very often when a woman did finally get to attend a treatment program, she already had poor mental and physical health.  Not to mention the fact that the women had to still care for their families and could not leave home.  Many have issues with transportation and child care.  According to Najavits, Rosier, Nolan, and Freeman, 2007, women have more health problems related to substance use disorders (SUD), they are, higher rates of death, co-occurring mental health disorders, more stigma and social isolation, and get addicted quicker.  Depression often occurs with substance use and women, clinicians need to determine with is the primary problem, and which the secondary is.  The question to be answered is whether depression lead to abuse or abuse lead to depression.  Often if the abuse lead to the depression, depressive symptoms diminish when substance use decreases (Frances et al., 2005).  Women more often seek medical help for things such as anxiety, depression, infertility, sleeplessness, peptic ulcers, and hypertension.  When a woman complains of these things, the clinician should delve deeper into whether or not the woman has an alcohol or drug problem (Frances et al., 2005).

It seems women benefit more from a same-gender treatment center setting.  Women can feel safer and receive care that is specifically tailored to meet their needs.  They can be with others who understand exactly what they are going through.  Same sex clinicians would also benefit women with addiction problems, they can feel more comfortable talking with another women, this way they do not fear the judgment and thoughts of a man who they may feel sees them as promiscuous, asking for it, a slut, or a monster (Wechsberg et al., 2008).

There seems to be a great need for more funding and services for just women with addictions.  They have many more needs as do their male counter parts.  For the most part men with addictions do not need to seek care for children to attend a treatment program.  Since males are generally the bread winners, they often have benefits to help them cover cost for treatments.  Less fortunate women most often do not get the medical help they need because they do not have access to it.  We, for the best interest of this world, need to recognize the need for treatment programs that specialize in the problems that women face when they have an addiction and need treatment.

References

Frances, R. J., Miller, S. I., & Mack, A. H. (Eds). (2005). Clinical textbook of addictive disorders (3rd ed.). New York: Guilford.

Matheson, J. L. (2008). Women’s Issues With Substance Use, Misuse, and Addictions: One Perspective. Substance Use & Misuse, 43(8/9), 1274-1276.

Najavits, L. M., Rosier, M., Nolan, A., & Freeman, M. C. (2007). A New Gender-Based Model for Women’s Recovery From Substance Abuse: Results of a Pilot Outcome Study. American Journal Of Drug & Alcohol Abuse, 33(1), 5-11.

Wechsberg, W. M., Luseno, W., & Ellerson, R. (2008). Reaching Women Substance Abusers in Diverse Settings: Stigma and Access to Treatment 30 Years Later. Substance Use & Misuse, 43(8/9), 1277-1279.

Click here to contact Tracie Timme for your counseling needs.