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| soberskater |
The science of addiction... Long post!by Elaine GottleibThe United States is a nation of addicts. According to a 2001 survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), there are 16 million drug users, 13 million heavy drinkers, and 66 million smokers in the United States. That doesn't include the overeaters, gamblers, compulsive exercisers, and the sex obsessed. Yet most people are able to eat, drink, and exercise without becoming addicted to those activities. Why? Defining Addiction Neuroscientists define addiction in medical terms as "a brain disease….a chronic, relapsing disease." Addiction is considered a brain disease because it alters the brain in fundamental, long-lasting ways. That's not surprising when you consider that the brain changes constantly in response to our everyday experiences. For instance, when a student learns that the Pilgrims landed in 1620, the brain is affected by just that simple piece of information. Imagine the more dramatic changes produced by powerful substances like alcohol and heroin! Neuro-imaging techniques like PET scans and MRIs have documented actual changes in the size and shape of nerve cells in the brains of addicts. Networks of nerve cells determine our feelings and behavior. Drugs influence behavior by transforming the way these networks function, according to Dr. Stephen Hyman, former director of the National Institute of Mental Health. The Dopamine Connection The biological link among all addictions is dopamine. This brain chemical is released during pleasurable activities ranging from sex and eating to more detrimental behaviors such as drinking and drug taking. "If a drug or an activity produces a sharp spike in dopamine, the odds are phenomenal that people will like it, they'll experience it as pleasurable, and it will be addictive," says Alan Leshner, PhD, of the National Institute on Drug Abuse. A powerful drug like crack cocaine elevates dopamine levels much faster than normal pleasurable activities. It creates the classic drug-induced feelings of exhilaration and power. In a landmark 1950s experiment, scientists stimulated rodent brains and found that the animals kept returning to the place where they received the stimulation. Getting—and Staying—Hooked Coming down from a drug high is caused by a decrease in dopamine levels. If you force brain cells to produce excessive dopamine on a regular basis, they become stressed and produce less dopamine. Over time, addicts become depressed and need drugs just to stimulate dopamine to normal levels. They become trapped in a cycle of cravings and addiction to avoid withdrawal symptoms and depression. Leshner believes that once a person crosses the line from user to addict, the brain is so changed that he can no longer control his behavior. "... the truth is, addiction is not a voluntary behavior. It's actually a different state," he explains. "It's hard for people to understand that, but if you take drugs to the point of addiction, functionally you move into a different state. A state of compulsive, uncontrollable drug use." This transformation helps explain why it's so difficult to break an addiction. "There is no motivator more powerful than the drug craving and the need for them," says Leshner. Cravings are more significant than physical withdrawal in keeping an addict hooked. Drugs like cocaine and methamphetamine, unlike heroin and alcohol, don't produce intense physical withdrawal symptoms, but they do produce overpowering cravings. These cravings can be aroused by external or internal stimuli that are as innocuous as walking by a pub or feeling sad, according to Patricia Owen, PhD, director of Research and Development at the Hazelden Foundation in Minnesota. An Addictive Personality? Although researchers have tried to determine the type of person who becomes an addict, they have failed to identify an "addictive personality," according to Owen. It is only after people become addicts that certain common personality traits emerge, like "difficulty delaying gratification, self-centeredness, lack of concentration and impatience," says Owen. Sol, a former alcoholic and drug addict turned addiction counselor and administrator at a major treatment facility, feels that using a term like addictive personality "paints a hopeless picture. Some people are very compulsive but they can change," he says. Indeed, according to Owen, 60% of addicts use both alcohol and drugs and 80% of alcoholics also smoke. Many addiction professionals believe addiction stems from a combination of biological, psychological, and environmental factors. "The Alcoholics Anonymous 'Big Book' describes alcoholism as a physical, emotional and spiritual disease. They were aware of the physiological affects before we were able to do PET scans to actually see the changes," says Owen. The progression to addiction can develop this way: Sue may have a genetic or biological predisposition to an addiction. If she grows up in a family and environment without addiction or stress, she may never begin even casual use. However, if Sue grows up in a stressful family or an environment where substance abuse is common and encounters more stresses as an adult and over time, she may move from casual to regular use to full-blown addiction. We know that children of alcoholics have a four times higher risk of becoming alcoholics themselves than the offspring of non-alcoholics. Scientists are also studying whether addicts are born with inadequate endorphins, the brain chemicals that regulate stress. Quitting To be an addict means that addiction has overwhelmed your entire existence. "When you speak to drug addicts about their experiences, they'll tell you that there is nothing in their life but drugs," says Leshner. So breaking an addiction often involves major lifestyle changes. For Sol, it meant losing most of his friends who were also addicts. He also had to cope with feelings that he had suppressed for years with drugs. "Using drugs prevents you from learning to handle emotions. You don't go through the maturation process," he explains. Willpower is not a factor in quitting since addiction also impairs that faculty. That is why Leshner calls it a "relapsing disease." Most addicts who seek treatment relapse several times before they kick the habit. New Treatments For years, heroin and narcotics addictions have been treated successfully with methadone, which eases withdrawal and blocks the effect of drugs. Naltrexone is another drug commonly used for alcohol and narcotics addiction. A new experimental drug, buprenorphine, has shown promising results in tests on narcotics addicts. Scientists are also working on a cocaine "vaccine," which could be used to inoculate addicts who relapse. It is unlikely, however, that a magic pill will ever be found that "cures" addiction. "No matter what you do with medication, I believe that you will always need psychological treatment to provide support and manage behavior," says Jan Kaufman, Director of Substance Abuse Treatment at the North Charles Foundation in Cambridge, Massachusetts. On the other hand, aerobic exercise offers a simple and natural way to help combat addiction. During aerobic exercise dopamine levels are increased in the areas of the brain involved with addiction, and feelings of depression and anxiety are decreased. Diagnosing Addiction Drug and alcohol problems can affect every one of us regardless of age, sex, race, marital status, place of residence, income level, or lifestyle. You may have a problem with drugs or alcohol, if: You can't predict whether or not you will use drugs or get drunk. You believe that you need to drink and/or use drugs in order to have fun. You turn to alcohol and/or drugs after a confrontation or argument, or to relieve uncomfortable feelings. You need to drink more or use more drugs to get the same effect as previously. You drink and/or use drugs by yourself. You have periods of memory loss. You have trouble at work, in school, or in your personal relationships because of drinking or using drugs. You make promises to yourself or others that you'll stop getting drunk or using drugs but are unable to keep them. You feel alone, scared, miserable, and depressed. Adapted from "Just the Facts" published by the U.S. Substance Abuse and Mental Health Services Administration. RESOURCES: Drug Abuse: How to Break the Habit American Academy of Family Physicians http://familydoctor.org/ National Institute on Drug Abuse http://www.nida.nih.gov/ The National Clearinghouse for Alcohol and Drug Information www.health.org References: Substance Abuse and Mental Health Services Administration. Available at: http://www.samhsa.gov/. Accessed on June 20, 2003. Roger "Doc". 
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| noonecantellimadog |
Doc...
Great post, thank you. There is only one thing that I want to weigh in on here very heavily: "On the other hand, aerobic exercise offers a simple and natural way to help combat addiction. During aerobic exercise dopamine levels are increased in the areas of the brain involved with addiction, and feelings of depression and anxiety are decreased." I can attest to this in both my sobriety AND smoking cessation. Here's the thing, and I urge you all to look into it... when you are feeling depressed, one of the FIRST things a good psych professional SHOULD prescribe is exercise. The reason is that exercise has a way of promoting healthy seratonin production and uptake. This, in turn, has been linked to decreased depression. There are other benefits I will discuss later. I guess dopamine gets into the picture as well. Good deal. When you go off whatever substance you are hooked on, there will probably be something of a mild depression associated with that. "The loss of a friend" is what many smokers refer to, and I recall this clearly when I went off the booze. Exercise helps this a great deal. Additionally, I would say that depression is probably also a huge component in our addictions. Look, I am not going to blame any one thing in my life for my addiction(s). I am going to take responsibility for myself, my actions, and my addictions. I am the author of my own experience. On the other hand, sh*t happens. My mother killed herself when I was 12. Let's just say that that experience probably did not HELP me in any significant way, and it took years and years and years to even acknowledge it and its effect on me. Hell, I'm STILL dealing with it. Thing is, I was a bit depressed by the time I reached the age of 18, and I am certain this depression, and a sense of meaninglessness, and hoplessness, abandonment, etc., grew to a point where I'd just go drown it. Quite simply, exercise helps depression. I know. I may be quit of booze for 20 years, but I am still recovering, and I am a work in progress. Somehow recently quitting smoking brought out a lot of issue relative to my mom and all that. I suppose I was masking it and perhaps I just was finally ready to deal with it. Becoming a dad might have had something to do with it too. All I know is that I NEED to get this sh*t OUT. So I stopped "stuffing it," pushing it down. I became mindful of it, and would see it and "catch" it as it came up. I have started to deal with it. And with all that came some depression. I think that might be natural and expected. I think it has always been there and I am just becoming mindful of it now. It has a very familiar ring... a hum, like background noise that I recognize has been there a long, long time. I needed to deal with THAT too. You know how you get to a point and it all seems to be too much. That happened to me relatively recently. Kind of a "I can't hide from myself." Finally e I found some articles on exercise => seratonin => decreased depression. It took some work-up, but eventually Idecided to try it. Damn if it did not work. In high school I was a swimmer. Captain of my swim team. I know, gaaaaaaaaay...  But it is what I know, so I started again. I started by trying to swim 1/2 mile (1000 yards, 40 lengths). It took me 50 minutes, and I was nearly dead. Just about a year later, I kill a mile (2000 yards, 80 lengths) in 32 minutes on a good day.
But here are the REAL kickers. I am not depressed. I continue to deal with my issues, and this gives me strength. There's more. I have lost 45 pounds in the year I have been swimming. THAT is a huge accomplishment. I cannot avoid the boost in self-esteem THAT has given me. Now let's face this right here and now... a component of addiction is self-esteem. The LACK of self-esteem. If we held ourselves in higher regard, perhaps we might not have fallen quite so far. The science of addiction is one thing, but I will contend that self-esteem issues are very tightly integrated with the entire complex. So we start to see kind of a feedback loop here. We lack self-esteem, and we do things that probably further compromise that. We may be depressed as a result of whatever took our self-esteem, and we may be depressed as a result of both our addiction and later when we try to beat it. It is a constant background noise and the self-esteem/depression issues are always there. EXERCISE HELPS BOTH IMMEASURABLY. It can be one of the cornerstones of your recovery. Seriously. It builds self-esteem which to me is one of the other cornerstones, and promotes a healthy mind-set, ie: cuts depression. That is the other cornerstone in my mind... positive mental attitude. All the cornerstones become related and they begin to work in harmony and that is a HUGE thing. You know, if you are not convinced yet, let me tell you that another benefit is that I am a much better skater now, and much less prone to injury. Bottom line: I will live longer and therefore skate longer. Seriously guys, I believe in anything that works in terms of recovery. Anything. Support groups are great. Work the steps. Whatever. But I also believe strongly that we are all the responsible parties and in the end we MUST heal ourselves. Exercise is perhaps the number one best thing you can do for yourself. It's hard to get started, but guys it will pay you back 1000 per cent in your efforts. I promise. Please let me know your thoughts. Sorry so long. woof. |
| soberskater |
 Woof, great reply! I agree with what you said about exercise. I also have to admit, I don't do enough... Especially here in the cold gloomy Utah winters. This is an area I need to improve in my life. I know all about depression, have struggled in that deep dark chasm since I was a teenager... My Mom was killed in a drunk driving accident when I was 13, and things went down hill from there. I self-medicated a lot, to cover the pain and issues that were eating me alive. I never was suicidal, but there were a lot of times I wished I could die... My self-medicating almost literally killed me on more than one occasion. Today, being clean and sober again, I am thankful to be alive! Using the techniques and tools of REBT has really changed my perspective on life and it's issues. I'm glad you added this info here, you brought to the surface something that was there but dormant in my mind, something that I have been neglecting and ignoring. I have an awesome gym at work, weight & cardio room. pool, steam sauna etc. that I can use for free! I just need to get off my ass and do it! Hey, now there's a catchy phrase, I like that one better than Nike's... My new motivational phrase, "Just get off your ass and so it!" Thanks for your post, I think it's time to do a CBA (Cost/Benefit annalysis) on the subject of exercise, and it's time to see if my ABC's are in order... (ABC's=SMART and REBT technique) Thanks for bringing this up! 
Roger "Doc". |
| noonecantellimadog |
>> My Mom was killed in a drunk driving accident when I was 13, and
>> things went down hill from there. I self-medicated a lot, to cover the >> pain and issues that were eating me alive. I never was suicidal, but >> there were a lot of times I wished I could die... My self-medicating >> almost literally killed me on more than one occasion. Doc... you and I are very much alike I think. Change a couple of words in at the beginning concerning the circumstances of Mom's death and you are talking about me. I self-medicated to the point that I was in TWO car accidents that resulted in the car being totaled, and I am not at all sure that there was not an unconscious desire to off myself. Even that didn't stop me. Dude... I pay $50.00 a month for my membership. I'd be ALL over free access. You are indeed lucky... make use of it. I personally think you have yourself pretty well squared away, and I have a lot of respect for you for that. But just wait and see how much better and squared away you feel in every way just from a little cardio. Lift weights and do strength training by all means ... I lift weights too... but my experience is that it is the cardio that results in really feeling good. Try to work up to a minimum of 40 minutes at a time if you can. The first 20 min. is anaerobic, and places your body in the "zone" where cardio will really be of benefit. Half of my weight loss came at a time when I was only doing about 40-50 minutes per week in a single sitting! Anyway... the impact on my daily outlook has been ... profound. That's the thing that I see as being the miracle here. Best wishes Doc. Keep up the great work. Props man... woof gettin' off my ass and doin' it! |
| UncleMike |
Exercise also oxygenates the cerebral cortex the thinking part of the brain allowing us to use cognitive or rational thinking to win over the Limbic or animal brain where the addiction reflexes are.
This way we can act on rational thoughts rather than react to emotions. |
| noonecantellimadog |
>> This way we can act on rational thoughts rather than react to
>> emotions. Amen to THAT Brother! Woof |
| soberskater |
More info from SAMHSA...Media Contact: SAMHSA PressTelephone: 240-276-2130 SAMHSA Issues Consensus Statement on Mental Health Recovery The Substance Abuse and Mental Health Services Administration today unveiled a consensus statement outlining principles necessary to achieve mental health recovery. The consensus statement was developed through deliberations by over 110 expert panelists representing mental health consumers, families, providers, advocates, researchers, managed care organizations, state and local public officials and others. “Recovery must be the common, recognized outcome of the services we support,” SAMHSA Administrator Charles Curie said. “This consensus statement on mental health recovery provides essential guidance that helps us move towards operationalizing recovery from a public policy and public financing standpoint. Individuals, families, communities, providers, organizations, and systems can use these principles to build resilience and facilitate recovery.” The 10 Fundamental Components of Recovery include: • Self-Direction: Consumers lead, control, exercise choice over, and determine their own path of recovery by optimizing autonomy, independence, and control of resources to achieve a self-determined life. By definition, the recovery process must be self-directed by the individual, who defines his or her own life goals and designs a unique path towards those goals. • Individualized and Person-Centered: There are multiple pathways to recovery based on an individual’s unique strengths and resiliencies as well as his or her needs, preferences, experiences (including past trauma), and cultural background in all of its diverse representations. Individuals also identify recovery as being an ongoing journey and an end result as well as an overall paradigm for achieving wellness and optimal mental health. • Empowerment: Consumers have the authority to choose from a range of options and to participate in all decisions—including the allocation of resources—that will affect their lives, and are educated and supported in so doing. They have the ability to join with other consumers to collectively and effectively speak for themselves about their needs, wants, desires, and aspirations. Through empowerment, an individual gains control of his or her own destiny and influences the o rganizational and societal structures in his or her life. • Holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. Recovery embraces all aspects of life, including housing, employment, education, mental health and healthcare treatment and services, complementary and naturalistic services (such as recreational services, libraries, museums, etc.), addictions treatment, spirituality, creativity, social networks, community participation, and family supports as determined by the person. Famil ies, providers, organizations, systems, communities, and society play crucial roles in creating and maintaining meaningful opportunities for consumer access to these supports. • Non-Linear: Recovery is not a step-by step process but one based on continual growth, occasional setbacks, and learning from experience. Recovery begins with an initial stage of awareness in which a person recognizes that positive change is possible. This awareness enables the consumer to move on to fully engage in the work of recovery. • Strengths-Based: Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. By building on these strengths, consumers leave stymied life roles behind and engage in new life roles (e.g., partner, caregiver, friend, student, employee). The process of recovery moves forward through interaction with others in supportive, trust-based relationships. • Peer Support: Mutual support—including the sharing of experiential knowledge and skills and social learning—plays an invaluable role in recovery. Consumers encourage and engage other consumers in recovery and provide each other with a sense of belonging, supportive relationships, valued roles, and community. • Respect: Community, systems, and societal acceptance and appreciation of consumers —including protecting their rights and eliminating discrimination and stigma—are crucial in achieving recovery. Self-acceptance and regaining belief in one’s self are particularly vital. Respect ensures the inclusion and full participation of consumers in all aspects of their lives. • Responsibility: Consumers have a personal responsibility for their own self-care and journeys of recovery. Taking steps towards their goals may require great courage. Consumers must strive to understand and give meaning to their experiences and identify coping strategies and healing processes to promote their own wellness. Hope: Recovery provides the essential and motivating message of a better future— that people can and do overcome the barriers and obstacles that confront them. Hope is internalized; but can be fostered by peers, families, friends, providers, and others. Hope is the catalyst of the recovery process. The National Consensus Statement on Mental Health Recovery is available at SAMHSA’s National Mental Health Information Center at www.mentalhealth.samhsa.gov or 1-800-789-2647. SAMHSA, is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation’s substance abuse prevention, addictions, treatment, and mental health services delivery system. Roger "Doc".
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