Neurobiological Research: Understanding Loss of Control and Continued Use

neurobiology research also investigates the loss of control.

defined as continued drug use despite significant adverse consequences.
2 frontal areas of the brain are key components of the inhibitory pathway of the brain

the pathway that allows us to control our impulses. Neuroimaging studies suggest that compulsive behavior requires dysfunction within the ACC - Anterior cingulate cortex and OFC - Orbitofrontal cortex.
neuroimaging studies suggest that compulsive behavior as seen in both intractable addiction and OCD requires dysfunction within the two highly interconnected cortical systems ACC and OFC
results from neuroimaging studies examining the effects of mindfulness practices on the brain have suggested future directions for addiction treatment and brain healing.
Corticocobasal ganglia network

Dorsal striatum

plays a role in executive functioning and decision making
experiences increased dopaminergic signaling in the presence of drug abuse

the brain pathway that begins from the VTA to the dorsal striatum is referred to as the habit circuit

because of its role in conditioned learning

Anterior cingulate cortex
orbitofrontal cortex

Mindfulness-based relapse prevention

targets a reduction of cravings and relapse
shows promise as an effective modality to be used in conjunction with other types of addictions treatment

As compulsive using and drinking continue the brain sustains physical damage and becomes less capable of unlearning

continued emphasis on brain circuitry alteration can assist counselors in improving their understanding and empathy when the addict can not " just learn to stop"

Neuroimaging has revealed a number of additional findings related to the effects of drug and alcohol use on the brain

cue reactivity

the array of psychological, physiological, and behavioral effects elicited by drug-related stimuli.

Imaging studies have identified the visual cortex as an important part of drug cue reactivity and demonstrated with remarkable consistency that substance-dependent individuals have significantly higher activity in the primary and secondary visual cortices when exposed to drug versus nondrug cue

this finding is supportive of the hypothesis that attentional bias to drug cues may be a biomarker for addiction and has implications for the ability to predict relapse.

Other neuroimaging studies have supported the relationship between drug cue reactivity and length and intensity of drug use, addiction severity, relapse risk, use-associated problems, and treatment outcomes and highlighted the role that individual factors play in neural reactivity to drug cues.
Neuroimaging studies have demonstrated the effect of drugs on the brain's functioning long after substances have been eliminate from the body

about 20 million people with alcoholism in the USA have some degree of brain damage
highlighted imaging studies that determined relapsers showed increased atrophy in the bilateral orbitofrontal cortex and in the right medial prefrontal cortex and ACC

Brain areas associated with error monitoring
researchers have determined that some alcoholics seem to exhibit more damage to the right hemisphere of the brain than the left hemisphere and significant brain volume shrinkage.
cocaine dependence appears to result in a marked reduction of gray matter in the prefrontal cortex, especially the orbitofrontal cortex
research also suggests that depending on age the brain of the detoxified alcoholic appears as ravaged as that of a patient with Alzheimer's disease
substantial changes have been noted in the hippocampus of youth who engage in binge drinking.
the brain's ability to form new cells is disrupted by addiction

new brain cells are created from the division of neural stem cells

a process called neurogenesis

alcohol can significantly disrupt neurogenesis

Promising new approaches in the treatment of cocaine addiction may involve neurosurgical procedures such as deep brain stimulation.

currently used with certain patients with Parkinson's disease
the effect of deep brain stimulation in the subthalamic nucleus of rats has found evidence of a decrease in motivation for further cocaine
extensive research with PET scans and other neuroimaging technology will add to the knowledge of the cause's effects and treatment of addiction
these imaging tools are adding to the addiction specialist's treatment toolbox and may make it possible to develop biomarkers to predict disease trajectories and therapeutic outcomes that are necessary for individualized medicine and optimal patient care.

Resources

Capuzzi, D., & Stauffer, M. D. (2019). Foundations of Addictions Counseling (4th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135169858