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 

Neurotransmitters and Addiction

 

Neurotransmitters

Neurobiological Components of Addiction: Understanding the Reward Pathway

 Neurobiological Components of

Addiction: Understanding the Reward

Pathway

Reward pathway

The basic concept in the neurobiology of addiction is the reward pathway which comprises the areas of the brain most involved in addiction. 

The limbic system

Home of the areas of the brain thought to make up the reward pathway. When stimuli activate particular areas of the brain then pleasurable sensations are produced. Neurotransmitters play critical roles in transmitting information between neurons through synapses. A synapse measures twenty to fifty nanometers.

Dopamine

Dopamine is an important neurotransmitter involved in reward and euphoria experiences. Dopamine is made by very few brain cells and acts mainly within a subset of brain regions. Dopamine seems to have a disproportionately large impact on brain function.

Cocaine

Cocaine interferes with the normal action of dopamine by blocking the removal or reuptake of dopamine which results in an increase of dopamine in the neurons, resulting in overstimulation of receiving neurons called neuroreceptors. This is experienced by the user as a pleasurable euphoria. An addict seeks to continue experiencing this sensation which results from an abundance of powerful neurotransmitters including dopamine. In the brain, this dopaminergic transmission and reward pathway is a primary feature of addiction.

The areas of the brain involved in the reward pathway

VTA

The VTA has emerged as a new research interest in understanding how addiction and drugs affect the brain. The stress of VTA may be a potential factor in relapse. Advanced research will unlock more keys to understanding the VTA and GABA's role in inhibiting or slowing the dopaminergic surge.

References 

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

 Neurobiology and the Physiology of

Addiction

                                    References

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

 Combating Negative Self-Talk

Negative self-talk is the inner voice that criticizes, doubts or belittles yourself. It can affect your mood, confidence, and performance at work. Negative self-talk can also lead to stress, anxiety, depression, and burnout. But how can you combat negative self-talk and replace it with positive affirmations? Here are some tips to help you:

• 
  Identify the triggers. What situations or events make you feel insecure, frustrated, or inadequate? Is it a difficult project, a demanding client, a challenging colleague, or a personal issue? Try to notice when and why you start to talk negatively to yourself. 
•  Challenge the thoughts. Don't accept your negative thoughts as facts. Ask yourself if they are realistic, helpful, or fair. For example, if you think "I'm not good enough for this job", ask yourself "What evidence do I have for this? How would I respond if a friend said this to me? What can I do to improve my skills or confidence?"
  
• Replace the thoughts. Once you have challenged your negative thoughts, replace them with positive ones. Use affirmations that are specific, realistic, and empowering. For example, instead of saying "I can't do this", say "I can do this if I work hard and ask for help when I need it".
• Practice gratitude. One way to combat negative self-talk is to focus on the positive aspects of your life and work. Make a habit of writing down or saying out loud three things you are grateful for every day. This can help you appreciate what you have and what you have achieved. 
•  Seek support. You don't have to deal with negative self-talk alone. Talk to someone you trust, such as a friend, family member, mentor, or therapist. They can help you gain perspective, offer encouragement, and provide feedback. You can also join a support group or online community where you can share your experiences and learn from others

 The Top Seven Self-Defeating Behaviors

Some habits and patterns can prevent us from achieving our goals and happiness. Here are the top seven self-defeating behaviors and how to overcome them.

1.  Procrastination: Putting off important tasks until the last minute or avoiding them. Solution: Break down the task into smaller steps, set realistic deadlines, and reward yourself for each step.
2. Perfectionism: Setting unrealistically ambitious standards for yourself and others and being overly critical. Solution: Recognize that perfection is impossible and unnecessary and that mistakes are part of learning. Focus on your strengths and achievements and appreciate the effort and progress of yourself and others.
3.  Negative self-talk: Talking to yourself in a harsh, pessimistic, or self-defeating way. Solution: Become aware of your thoughts and challenge them with more positive and realistic ones. Practice gratitude, affirmations, and self-compassion, and surround yourself with supportive and encouraging people.
4. Comparison: Measuring your own worth and success by comparing yourself to others. Solution: Realize that everyone has their own strengths and weaknesses, goals, and challenges, and that you are not in competition with anyone but yourself. Celebrate your own uniqueness and achievements and appreciate the diversity and value of others.
5. 
   Fear of failure: Fearing not meeting your own or others' expectations or facing negative consequences or judgments. Solution: Redefine failure as an opportunity to learn and grow, rather than a sign of weakness or incompetence. Embrace uncertainty and change as inevitable parts of life, and view challenges as chances to test your abilities and expand your horizons.
6. Fear of success: Fearing achieving your goals, reaching your potential, or facing the increased responsibility or scrutiny that may come with it. Solution: Acknowledge your own worthiness and capability and believe that you deserve happiness and fulfillment. Prepare yourself for the possible changes and challenges that may accompany your success and seek support from others who can help you cope with them.
7. Lack of assertiveness: Not expressing your own needs, opinions, or feelings in an honest, respectful, and confident way. Solution: Recognize your own rights and responsibilities as an equal person in any relationship or situation and communicate them clearly and calmly. Listen actively and empathetically to others, and respect their rights and responsibilities as well.

Social Anxiety Disorder