Saturday, December 16, 2006

Drug Addiction: Neurobiology of Disrupted Free Will

Nora Volkow, the Director of NIDA gives a talk about the neurobiology of addiction. (RealVideo)

UPDATE: I watched the entire video and, while it can be a challenge to follow, it is well worth the time. Her talk adds a lot to the brain research of the last decade, presenting a model that includes the cumulative effects of at least three brain areas/functions.
  • The role of the primitive limbic and reward systems in directing survival drives toward drug use.
  • The role of memory circuits in determining the importance/power of the expected reward. She explains the importance of this in development of addiction and relapse. In the context of relapse, she talks about the power that neutral stimuli can have on dopamine levels and activating the limbic system.
  • The role of impairment in the orbital frontal cortex in determining the contextual costs and benefits. This impairment can even tilt the scales toward the reward when it risks survival and competing limbic drives should be protecting the addict. (Explaining the experience of the addict who says "I don't want to do it anymore. I don't enjoy it anymore and I know it's ruining my life. I don't understand why I keep doing it.")
Like I said above, it's well worth the time. She appears to have enough direct clinical experience with addicts that she is able to illustrate the neurobiology with real world clinical examples. Also, On several occasions I recalled Big Book passages that fit perfectly with what Dr. Volkow described.

Hat tip: New Recovery

1 comment:

Anonymous said...

Martin Nicolaus made two observations about the Addiction Video by Nora Volkow that are worthy of comment. First, addicted individuals both want and do not want to use the drug. That is, addicts typically have an internal conflict about their addiction. What was not stated but should have been is the following: this internal conflict within the addict further adds to the cycle of dependency experienced by the addict. In short, the more guilt and shame the addict experiences, the more the addict will, in many instances, drink to drown out these negative emotions.

And second, that it is important to use the addict’s own inner sober strivings as a system of positive reinforcement. That is, if the addict has expressed a desire to become sober, find out the addict’s reasons for these desires. Once these reasons are identified, use them and reinforce them.