Present at the Future by Ira Flatow Read Free Book Online Page A

us what feels really good, what is rewarding, what is important for our survival. And we now know that all these different drugs of abuse act on this specific circuit in these specific brain areas.” One of the key chemical messengers in the brain circuits is a substance called dopamine. “It’s a substance we term a neurotransmitter, and it turns out that all these different addictive substances increase the actions or the release of dopamine.” And while the effects and actions of dopamineare just now being understood, the release of dopamine in certain brain structures tells the person that this substance is reinforcing or rewarding.
    “And then, for certain genetically vulnerable individuals, there are long-lasting changes in these circuits that lead the person to believe that the pursuit of this substance is the most important thing in their life.” These long-lasting changes occur in the connections between nerve cells, called synapses. “So the communication between individual nerve cells that are part of this circuit starts to change. There are molecular changes in these cells that are part of these circuits. We’re beginning to learn a reasonable amount about what are these changes in specific connections between nerve cells. And that’s the first step towards trying to understand how to reverse those changes.”
    Because reversal is the key to drug addiction. As Mark Twain once said about his own addiction, “I don’t have much trouble giving up smoking. I’ve done it a hundred times.” In many cases it’s possible to stop the addiction, give up the cigarettes or cocaine. But what happens is that people go back to smoking or snorting. They can’t stay away. Once those chemical and neurological changes take place in the brain, reversing them is not very easy. The addiction has rewired the brain and, very importantly, brought into that rewiring the part of the brain that encodes memories, so that a relapse may occur without the person even being exposed to the addictive substance but simply to the memory of that exposure.
    “It’s extraordinarily important,” says Volkow, “in the terms of why it’s so difficult to treat addiction and why people, despite the fact that they face catastrophic consequences—not negative, catastrophic—and they don’t want to take the drug anymore, they relapse. It’s almost like a reflex.” Volkow is very clear and determined on this important point. She wants to make sure you understand just how difficult it is for someone to not relapse when exposed to that memory. It’s almost like uncontrolled salivating when you think about a great dessert.

    “Inside your brain, there is a release of dopamine when the person that’s addicted sees stimuli associated with the drug that activates the motivational circuit almost in a reflexlike way. And that drives him or her to do that behavior. And that’s evidently one of the mechanisms why relapse occurs and it’s so difficult to ‘kick the habit.’”
    So finding a way to erase that emotional circuitry is one of the great challenges. “Indeed, that’s one of the strategies that we’re now trying to encourage investigators to look at: the development of medications that can either erase those memories associated with the drug or, alternatively—very important—can create stronger memories that can overcome those learned responses. So that your behavior is not driven by what we call conditioning, but by these new learned experiences.”
    There is ongoing research to erase those neurological pathways, but so far only in lab animals. “But there are some real interesting positive results that suggest that this strategy may, in fact, prove beneficial in helping people through the therapeutic process.”
    But what about other addictions that do not start out with well-known street drugs such as nicotine or alcohol but instead with addictive behavior about activities such as gambling, eating, or playing video games.