Addiction is the extreme situation regarding substance abuse. Addiction is defined as a compulsive behavior, with no self-control, despite the serious negative consequences.

          A person with an addictive behavior successively focalizes his /her attention towards obtaining and using drugs, despite the consequences such as getting sick, losing friends, and life failure. This attitude can be misinterpreted by the family, as being a self-destructive attitude.

          It is very important to consider the increased risk of relapse, even after a long period of abstinence. The relapse appears because of 2 factors: stress and environmental signals – external or internal – intrusive repetitive thoughts of constantly searching for drugs, which also appears in obsessive-compulsive disorder.

          Imagery studies have shown that many cerebral areas are activated, such as: prefrontal cortical region, accumbens nucleus and the limbic system amygdala (PET and fMRI studies).

          Recent researches have shown that drugs determine through direct or indirect pathways, an increase regarding the dopamine level, by blocking dopamine receptors from the striat. This mechanism is strongly correlated with “getting high”, sensation achieved after cocaine or methylphenidate consumtion. In general, dopamine is necessary to reward the body or to emphasize the reward, which proves us the acute need for reward and the addiction initiation.

          Contemporaneous literature suggests that there are two dysfunctional systems involved with addiction: anterior cingulate and orbitofrontal cortex (two frontal regions), with an important role in controlling the behavior and reward related behavior. The same areas are also involved in obsessive-compulsive behavior disorder.

          Addiction stages

          There are three addiction stages, which involve a psychological complex where every stage has a specific neuronal mechanism.

          The first stage is the wait, or motivation for initial consume, because of the desire to experience new feelings, or to replace a certain mood with “getting high”.

          The second is represented by memorization of drug consume, consolidated by the life experience, through reward stimulated by dopamine release, as a result of drug consume. This dopamine release correlates drug abuse with the learning process, by inducing pleasure. This learning mechanism is different from the normal learning mechanism because it involves the limbic system that determines an emotional involvement and the appearance of pleasure.

The third stage of addiction is sensitization or the habit, because of the drug’s main effect (pleasure or dysphoria), effects that start to develop the habitude. For substances such as alcohol, nicotine and heroin, the pleasure can be substantially reduced by medical complications. After many abuses, the person’s body becomes more and more tolerant with the substance in order to produce pleasure, but it also increases the feeling of extreme sickness or agitation when the substance consume stops. 

          The neurobiology of addiction

          Genetics – many researches related to addiction genetics suggest the tendency of inheritance (referring to alcoholism – Cloninger 1999). This tendency can be a result of altered gene functionality, which leads to cerebral proteins alteration. When these proteins are abnormal, the genes are abnormal and they also damage the neurotransmitters’ function. For example, dopamine synthesis or metabolism is dependent on these enzymes, and their concentration can modify the level of cerebral dopamine. Also, the cerebral dopamine’s answer to the environmental alteration is individual, and it requires different quantities of dopamine. These can lead to an abnormal function of the mesolimbic system, that leads to emotional state distortion; basically that means that a small quantity of pleasure is produced as a result of a positive experience, and a disproportional quantity of pain appears as a result of negative interactions. A person with the above genetic defect can be particularly susceptible to cocaine abuse in order to increase the level of his/her cerebral dopamine, that is almost normal.

          Cerebral chemistry – neurotransmitters are specific chemical cerebral massagers with a certain addictive potential (for example, cocaine is similar to dopamine because its main effect is the increase of dopamine level). Heroin and endorphin are alike, the latter being the brain’s natural morphine, because heroin mimics the endorphin’s effect on specific receptors. Alcohol is similar to many key neurotransmitters, such as: serotonin, glutamate, GABA, acetylcholine, endorphins and many others. Although the effect is complex, involving more neurotransmitters, researchers have shown that there is a common final path for substances that determine addiction: the dopaminergic path (Koob 1998). These addictive substances break through indirect ways into the dopaminergic path, and increase dopamine levels and damage the dopamine’s action on the receptor. What is very important is the fact that this path sends ramifications to the frontal lobe, interacting with pleasure, emotion, memory of the emotional event, as well as with the ability to make decisions regarding the emotional event.

          Sensitization – people that become addicted at an early age, and after a short term exposure to addictive substances, develop an increased genetic predisposition; they have a decreased ability to release normal quantities of dopamine, or dopamine is released in normal quantities, but it is metabolized faster than normal. That is the reason why, a singular exposure to cocaine can dramatically alter people’s lives. Cocaine increases rapidly the dopamine levels because it blocks the dopamine’s degradation, releases the dopamine from the receptor and then reconnects it, thus resulting in a high quantity of dopamine in the synaptic space in a short period of time.

          The persons with a dopamine genetic deficit have difficulties when dealing with normal emotional experiences, and “getting high” sensation produced by drug consume can be the first time they experience a normal dopamine level. This path becomes more active with drug abuse, and that is the reason why they deal with a stronger and stronger desire to use drugs. Other substances require more months to become addictive.

          Increased dopamine levels are followed by a decrease under the normal limits, after a short period of time from the moment the addictive substances were consumed.

          Emotional learning – is based on the limbic system, involving the amygdala in adjusting the emotional memory, by recording the signification prior to drug abuse, which plays an important role in the chemical development of the addiction.

          Knowing all these action mechanisms, as well as the brain’s chemical alterations, we can understand why classic therapy can be only partially efficient; a general reset of the cerebral activity can lead to normalization of the deficit and it can change the life of an addicted person, also by balancing the secretion of cerebral neurotransmitters. It is also important for them to change their way of life and eating habits, as well as integrating all these changes into their day to day life.

          As a therapy for addictions, neurofeedback replaces gradually the need for obtaining reward by using drugs, with reward obtained by dopamine release within the normal learning process. It also replaces disfunctionalities from addictions with the physiological self-adjusting process of cerebral functions, through various elaborated techniques and multiple clinical studies throughout the years (alpha technique introduced by Green in 1975, alpha-theta technique introduce by Peniston and Kulkosky in 1989, LENS technique introduced by Len Ochs in 1990 and others).

Previous page