Study in rats suggests moderate alcohol consumption improves recall

Moderate alcohol consumption may actually improve memory:

Among the normal rats, the animals that consumed moderate amounts of alcohol fared better on both tests compared with the teetotalers. Rats on a heavy alcohol diet did not do well on object recognition (and, in fact, showed signs of neurotoxicity), but they performed better than their normal brethren on the emotional memory task.

Bad news if you recently experienced something that you don't want to remember too vividly, like trauma:

"People often drink to 'drown sorrows,'" Kalev says. "Our results suggest that this could actually paradoxically promote traumatic memories and lead to further drinking, contributing to the development of alcoholism."

Technorati Tags: alcohol, brain, memory, trauma

Powered by ScribeFire.

Drugs, Brains, and Behavior: The Science of Addiction

From NIDA:

"Drugs, Brains, and Behavior: The Science of Addiction" was unveiled today by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health. The 30-page full-color booklet explains in layman's terms how science has revolutionized the understanding of drug addiction as a brain disease that affects behavior. NIDA hopes this new publication will help reduce stigma against addictive disorders.

"Thanks to science, our views and our responses to drug abuse have changed dramatically, but many people today still do not understand why people become addicted to drugs or how drugs change the brain to foster compulsive drug abuse," said NIDA Director Dr. Nora D. Volkow. "This booklet aims to fill that knowledge gap by providing scientific information about the disease of drug addiction in language that is easily understandable to the public."

The "Science of Addiction" booklet discusses the reasons people take drugs, why some people become addicted while others do not, how drugs work in the brain, and how addiction can be prevented and treated. Like diabetes, asthma or heart disease, drug addiction is a chronic disease that can be managed successfully. Treatment helps to counteract addiction's powerful disruptive effects and helps people regain control of their lives. The new booklet points out that just as with other chronic diseases, relapses can happen. The publication further explains that relapse is not a signal of treatment failure - rather, it indicates that treatment should be reinstated or adjusted to help the addict fully recover.

A Small Part of the Brain, and Its Profound Effects

More on the insula and nicotine addiction. (Requires free registration. If you don't wish to register, you can use www.bugmenot.com.)

According to neuroscientists who study it, the insula is a long-neglected brain region that has emerged as crucial to understanding what it feels like to be human.

They say it is the wellspring of social emotions, things like lust and disgust, pride and humiliation, guilt and atonement. It helps give rise to moral intuition, empathy and the capacity to respond emotionally to music.

Its anatomy and evolution shed light on the profound differences between humans and other animals.

The insula also reads body states like hunger and craving and helps push people into reaching for the next sandwich, cigarette or line of cocaine. So insula research offers new ways to think about treating drug addiction, alcoholism, anxiety and eating disorders.

Of course, so much about the brain remains to be discovered that the insula’s role may be a minor character in the play of the human mind. It is just now coming on stage.

The activity of the insula in so many areas is something of a puzzle. “People have had a hard time conceptualizing what the insula does,” said Dr. Martin Paulus, a psychiatrist at the University of California, San Diego.

If it does everything, what exactly is it that it does?

For example, the insula “lights up” in brain scans when people crave drugs, feel pain, anticipate pain, empathize with others, listen to jokes, see disgust on someone’s face, are shunned in a social settings, listen to music, decide not to buy an item, see someone cheat and decide to punish them, and determine degrees of preference while eating chocolate.

Damage to the insula can lead to apathy, loss of libido and an inability to tell fresh food from rotten.

More on the insula and smoking

I posted earlier on an exciting study on the relationship between the insula and nicotine addiction. Here's an article with a little more detail.
[via: New Recovery]

Spot in brain may control smoking urge

A stroke patient may have revealed a key to understanding craving:

Damage to a silver dollar-sized spot deep in the brain seems to wipe out the urge to smoke, a surprising discovery that may shed important new light on addiction. The research was inspired by a stroke survivor who claimed he simply forgot his two-pack-a-day addiction - no cravings, no nicotine patches, not even a conscious desire to quit.

"The quitting is like a light switch that went off," said Dr. Antoine Bechara of the University of Southern California, who scanned the brains of 69 smokers and ex-smokers to pinpoint the region involved. "This is very striking."

Clearly brain damage isn't a treatment option for people struggling to kick the habit.

But the finding, reported in Friday's edition of the journal Science, does point scientists toward new ways to develop anti-smoking aids by targeting this little-known brain region called the insula. And it sparked excitement among addiction specialists who expect the insula to play a key role in other addictions, too.

"It's a fantastic paper, it's a fantastic finding," said Dr. Nora Volkow, director of the National Institute on Drug Abuse and a longtime investigator of the brain's addiction pathways.

"What this study shows unequivocally is the insula is a key structure in the brain for perceiving the urges to take the drug," urges that are "the backbone of the addiction," Volkow added.

Why? The insula appears to be where the brain turns physical reactions into feelings, such as feeling anxious when your heart speeds up. When those reactions are caused by a particular substance, the insula may act like sort of a headquarters for cravings.

Substance abuse in women: Does gender matter?

The Psychiatric Times runs a helpful review of gender differences in substance misuse. It covers several areas including epidemiology, comorbidity, diagnosis, course and neurobiology. From the section on treatment:

A number of studies indicate that women are less likely than men to enter treatment.¹ Reasons for lower rates of treatment entry may include sociocultural factors (eg, stigma, lack of partner/family support to enter treatment), socioeconomic factors (eg, child care), pregnancy, fears concerning child custody issues, and complexities associated with increased rates of co-occurring psychiatric disorders and the availability of appropriate dual-diagnosis treatments.^1,30,46 Furthermore, as previously stated, many women seek treatment at settings or clinics other than substance abuse clinics (eg, primary care, mental health).¹⁸

Those women who do enter substance abuse treatment receive similar benefits to those received by men. There are few, if any, consistent gender differences in treatment outcome, retention rates, or relapse rates across various types of substances, treatment settings, and types of treatment.^1,47,48 In studies that have found gender differences, women typically have better outcomes than men. For example, women have been found to have higher rates of abstinence at 6-month follow-up (79.3% of women vs 54% of men) and at 5 years (odds ratio, 1.9).^24,49,50 Women also demonstrate greater improvement in other domains (eg, medical problems⁵¹), have shorter relapse episodes,⁵² and are more likely to seek help following a relapse.^52,53

Medication Nation

The Washington Post published a review of the recently published book, The Cult of Pharmacology by Richard DeGrandpre. DeGrandpre presents a pretty provocative premise:

Why isn't Nicorette gum a street drug? The Food and Drug Administration considers nicotine highly addictive. Tobacco companies seem to share this view when they manipulate the level of nicotine in cigarettes. But the gum, which packs a goodly dose of nicotine, appeals to almost no one. While we're at it, if nicotine dependence is what stands in the way of quitting, why do patched smokers -- their brains well-supplied with the substance -- still crave the next drag?

If these questions have an answer, it is that addiction is not a simple matter of chemical and receptor. Habit, ritual, social context and the means of delivery all affect how the brain processes a drug and how we experience it. As a result, drug research is replete with paradox.

...

Psychoactive compounds, he writes, function "as mere stimuli, with more or less the same, potentially great, powers as other stimuli one experiences and gives meaning to." DeGrandpre derides a set of beliefs that he groups under the infelicitous name "pharmacologicalism." This false ideology, he writes, holds that "drugs contain potentialities that lie within the drug's chemical structure . . . and when taken into the body, these potentialities take hold of and transform both brain and behavior." According to DeGrandpre, drugs do not work in any consistent, predictable way -- and we've been brainwashed if we think that they do.

The prevailing ideology, DeGrandpre argues, has another, equally insidious side. It causes us to attribute different powers to substances that are effectively identical. We demonize cocaine, a natural stimulant, but sanctify its synthetic counterpart, Ritalin. This benefits the "medicopharmaceutical industrial complex," which favors what can be patented and profited from. Ultimately, our confused beliefs lead to forms of social control, causing us to drug our children with stimulants while imprisoning consenting adults for taking nearly identical substances such as crystal meth.

The reviewer writes a thoughtful and effective critique of DeGrandpre's arguments:

The problem with DeGrandpre's argument is that he, more than his imagined opponents, ignores context. The findings of behavioral pharmacology are not unique; in medicine, environment often modifies physiology. Interferon, a medication used to treat certain cancers, causes depression, but it does so less in people who have social supports and more in patients who have had past depressive episodes. To show that the response is multifactorial hardly invalidates the claim that the drug triggers mood disorders.

Expectancy is powerful. Acupuncture is effective in pain relief. But so is sham acupuncture -- using shallow needles inserted at random points. Pain responds to placebos. It does not follow that pain lacks anatomical roots or that the use of aspirin for pain management amounts to a conspiracy.

Our drug policies, arising from puritanical moralizing as much as from the needs of corporations, are often irrational. Still, not every choice is without foundation. Like cocaine, Ritalin modulates dopamine transport in the brain. But schoolchildren who take Ritalin by mouth generally experience no high and develop no craving, while snorting cocaine famously does cause a rush. And crystal meth's minor chemical distinction -- it is water soluble and therefore easy to inject -- makes a major practical, and addictive, difference. That we allow Ritalin to be prescribed suggests that, as a nation, we pay attention both to drugs' chemical properties and to their customary usage -- hardly a sign of ideological rigidity.

It's too bad he throws in the drug policy statement. The suggestion that the motivations for U.S. drug policy are two-faceted and wholly insidious reveals his own ideology.

Memory’s Link to Recovering from Addiction

A pretty clear explanation of one of the neurobiological mechanisms of addiction:

New research on the brain is showing that addiction is a matter of memories, and recovery is a slow process in which the influence of those memories is diminished...

Studies have shown that addictive drugs stimulate a reward circuit in the brain. The circuit provides incentives for action by registering the value of important experiences. Rewarding experiences trigger the release of the brain chemical dopamine, telling the brain “do it again.” What makes permanent recovery difficult is drug-induced change that creates lasting memories linking the drug to a pleasurable reward.

Chocolate and naloxone

I heard about this tonight while watching Super Size Me and immediately looked it up because I was skeptical.

Drewnowski tested the theory on 41 women, bingers and normal eaters. They were offered their favorite foods, from pretzels and jelly beans to chocolate chip cookies and chocolate ice cream. Half received injections of naloxone, a drug used to treat heroin overdoses because it blocks brain opiate receptors. The rest got a placebo of salt water.

Naloxone made bingers eat notably less - 160 fewer calories per meal, Drewlowski reported in the American Journal of Clinical Nutrition. Their chocolate consumption dropped in favor of lower-fat foods like popcorn. When asked to rate their favorite foods again, chocolate dropped.

It makes sense but it sounds too good to be true and I couldn't believe I hadn't heard it before. Here's the original article. It seems that everything discussing the matter points to this single article. Does any one know if it's been replicated?

Experience Sculpts Brain Circuitry to Build Resiliency to Stress

A sense of mastery (real or perceived) not only affects the response to that stressor, but also future stressors.

It's long been known that experiencing control over a stressor immunizes a rat from developing a depression-like syndrome when it later encounters stressors that it can't control. Now, scientists funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), have unraveled the workings of the brain circuitry that inoculates against such hard knocks – the circuitry of resilience.

Control not only activated the brain's executive hub, the prefrontal cortex, but also altered it so that it later activated even when the stressor was not controllable. This activation turned off mood-regulating cells in the brainstem's alarm center. The immunizing effect was so powerful that even a week later, when confronted with an uncontrollable stressor, the cells behaved as if the stressor was controllable and the rat was protected.

"It's as if the original experience with control leads the animal to later have the illusion of control even when it's absent, thereby producing resilience in the face of challenge," explained NIMH grantee Steven Maier, Ph.D., University of Colorado. "The prefrontal cortex is necessary for processing information about the controllability of stressors as well as applying this information to regulate responses to subsequent stressors."

I wonder if this helps explain two phenomena that we all witness in treatment and recovery:

• The description of "lack of control over a stressful situation" describes the life of an addict experiencing loss of control. We are all aware of the understandable symptoms of depression and the demoralization in which many people enter recovery. Maybe this explains one of the mechanisms for this depression and one of the mechanisms of the emotional rehabilitation that happens in recovery. We've all heard sponsors and counselors tell newcomers to "do the next right thing" in spite of their fear.
• Second, I wonder if this helps explain those that appear to be relatively immune to stress. We've all seen addicts who face death and disaster and walk away relatively stress-free. They fail to experience that motivational crisis, "moment of clarity" or deflation necessary to take stock and decide to pursue a radical change in course. Could perceived mastery over early stressful experiences create excessive resiliency?

[via TxDirector.com]

Brain repairs alcohol damage, scans suggest

More evidence that cognitive functioning improves with abstinence.

Who's Next: Nora Volkow--Newsweek

Nora Volkow, the Director of NIDA, made Newsweek's Who's Next list for the year. The article gives an overview of her work.

She talks a little about the role of dopamine and the effects of stress on the number of dopamine receptors. When I posted her talk this weekend I forgot to mention this. It provokes some interesting questions about the role of stress in relapse and addiction onset.

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