Joanna Fowler: What our images show is that addiction is really a disease of the brain and not a moral weakness.
Joanna Fowler is a chemist at Brookhaven National Laboratory and winner of the prestigious 2009 National Medal of Science. She studies the chemistry of drug addiction using what are called tracers – radioactive molecules attached to minute quantities of drugs such as cocaine.
Joanna Fowler: For example, we can put a carbon 11 atom in a drug molecule and use it to image where the drug goes or how long it stays in the brain.
Fowler said that all the drugs humans abuse activate what she called the ‘reward’ center, located deep inside every brain. She said that this ‘reward’ center is essentially the system that gives us a sense of well-being.
Joanna Fowler: Cocaine addicts, alcohol abusers, meth abusers – all of these show an understimulated reward system. So we think that what’s going on in addiction is that people who are addicted do not have the same pleasures at natural reinforcers like food, so they take drugs to compensate.
In other words, their ‘reward’ centers aren’t functioning well, so they seek the extraordinary stimulation of a drug high. Fowler also found that, in addicts, the brain’s frontal cortex is less active than in a typical brain.
Joanna Fowler: It’s the part of the brain that allows you to terminate behavior and anticipate consequences of behavior.
She explained what she sees when she looks at Positron emission tomography or PET scans, which is the machine she uses to monitor the activity of her radioactive tracers. PET is a nuclear medicine imaging technique which has the capacity to create a three-dimensional image of the internal workings of the body.
Joanna Fowler: So the reward center in a non-addicted brain – say you use a rainbow colored scale – the parts of the brain which are the reward center would be red, and say an addicted brain would be tending down toward orange or yellow.
In other words, she said, there’s a 20-30% decrease in function in the elements of the reward system. She said this helped illustrate the appeal of drugs to someone with a low-functioning reward system.
Joanna Fowler: All of the drugs that are abused by humans release a huge amount of dopamine in the brain, and this causes a very large stimulation, and we think this is what brings about the high. Drugs are just a very, very powerful stimulator of the reward system.
She said the same things happen in the brain of compulsive overeaters as drug addicts.
Could this be associated with hormone levels? I am wondering if young people may have an underdeveloped reward center due to hormones.
I have heard that the hormone such as testosterone is a desire control, those who have had testosterone shots have a strong desire, which may be connected to the reward system of the brain, your desire may be linked to the rewards that you get form the desire. How someone would test that would be have a huge success in something that they really strongly desired, and see also if those who have lower rewards even enjoy this success, which may be hard for someone who has only had rewards though drugs. however if the person does have a strong reward with somethings that the person desires maybe it would be a way to train that brain to have stronger synapses in the reward system. This would be the psychological approach to solve it, or give the person a “GOVERNMENT SAFETY APPROVED” testosterone shot, which there are many problems with vs. using amphetamines. I am not really sure if it was to much failure or not enough positive rewards that allows the weakening of the brain, maybe a educational or development flaw in the system of childhood?
Hormones may play a role because of the rapid changes from childhood to adolescence to adulthood which is a time period when individuals are most vulnerable to experimentation with drugs. In addition, there are documented differences in gender in addictive behavior again likely to be linked to hormonal differences. For more information, see a recent review article (Frontiers in Neuroendocrinol. 2008 Jan;29(1):36-47. Epub 2007).
Do you think the “reward center” of the brain becomes altered through the use of addictive substances? In other words, do you think a normal center changes over time in someone who is using a substance known to be addictive?
For obvious reasons, we don’t have such ‘before’ data for addicted humans. However there are preclinical studies where the status of the dopamine reward system is measured before the animals self administer drugs like cocaine, and then again after long terms exposure. In this case the activity of some elements of the reward system in the brain does diminish. However, the same study reports that some but not all elements of the dopamine system do recover after a prolonged abstinence (Neuropsychopharmacology. 2009 Apr;34(5):1162-71. Epub 2008 Sep 3).
Is there any possibility of treatment of addiction through medication which would bring the response of the “reward center” into a normal range?
To my knowledge there have been no human studies in addicted individuals reporting that medications bring the reward system into a normal range though such studies are certainly possible using imaging technology. Overall exercise and calorie restriction and social engagement generally are associated with brain health. There is also evidence in preclinical models showing that exercise specifically decreases the rewarding effects of stimulants such as MDMA (Behav Brain Res. 2008 Feb 11;187(1):185-9. Epub 2007 Sep 16). Also preclinical studies have shown that changing environment can produce profound biological changes that have important behavioral associations, including vulnerability to cocaine addiction (Nat Neurosci. 2002 Feb;5(2):169-74.).
Layman that I am, my question/comment may be stupid. You say the reward area of the brain reports diffferently using pet that that of a non addicted person, but in this you say infer addicts are already addicted. Could this be the result of the drug use??? Have you any evidence that a non addicted person might be a potential addict because the pet detected malfunction before addiction. I am reminded of “The Days of Wine and Roses”.
Good question. We do not have “before” images of the human addicts brain. We can only compare groups of addicted individuals to age-matched groups of non-addicted individuals and that is where we can show clear differences in the reward systems of these two groups (J Clin Invest. 2003 May;111(10):1444-51). However, preclinical studies measuring baseline images of the dopamine system before long term self administration of cocaine show that cocaine exposure decreases the availability of dopamine receptors which are the reward transmitting elements of the dopamine system. This does not exclude the possibility that people with low dopamine receptors may be more vulnerable to addictive behavior and there is evidence that they are. However, addiction is complicated with environment playing at least as important a role as biology and genetics (for a summary see Am J Psychiatry. 2005 Aug;162(8):1473-82).
I spoke with Dr. Fowler yesterday, and encouraged her to comment. I believe she will.
Dr. Fowler, during our interview, defined addiction as a loss of control.
The vast majority of addicts aren’t born addicts – they become addicts. But, like a lot of other diseases of the brain – and body – it sounds like you can be born with a predisposition to addiction. In other words: addiction just needs to be activated, whether by some kind of experience, or substance.
Addiction, over time, might just amplify the \\\’reward system\\\’ problems that were there in the first place.
I\\\’m hoping Dr. Fowler weighs in. Thank you all for your thoughts,
Beth
Im sure proof that regardless of the condition of the reward center from birth, i was predetermined to be an addict at one time in my life. But that is only because of our current social structure and the system that has contorted its power to include population control as a means of keeping a broken system intact. Rebute if you will. But im sure that any person alive will tell you at some point in there life they did something based on what they percieved the rest of the worlds opinions may be of their actions. That kind of preasure is not bred from within on a genetic level, but from the outside world. If you want to cure the addicts of the world, maybe the thought should be not what can be done for them on the inside. But what their individual needs might be to treat them in a positive progressive manner. Everyone’s own immune system will heal ones mind. That is something which i hope and feel is within the power of the human body. We have seen proof of it in pieces and parts all over the world. SO in conclusion, i hope this moves you to make the system help the individual to heal, not push them to the edge of survival. … … …
Addiction, violence, civil liberties,crack cocaine, poverty, 2010 Olympics, drugs, prostitution, heroin, homelessness; and their impact on Vancouver’s Black Eye, The Downtown Eastside.
More than 2 million syringes are handed out free every year. Clean mouthpieces for crack pipes are provided at taxpayers’ expense. Around 4,000 opiate addicts get prescription methadone. Thousands come to the injection site every year.
addiction is a state in which the body relies on a substance for normal functioning and develops physical dependence, as in drug addiction. When the drug or substance on which someone is dependent is suddenly removed, it will cause withdrawal, a characteristic set of signs and symptoms. Addiction is generally associated with increased drug tolerance common usage of the term addiction has spread to include psychological dependence. In this context, the term is used in drug addiction and substance abuse problems
Impelled by the horror show of the Downtown East Side, prodded by activists and convinced by reams of academic studies, the police and city government have agreed to provide hard drug users with their paraphernalia, a place to use it and even, for a few, the drugs themselves.
The Harsh Reality of Drug Addiction
Not for the faint-hearted, this video is graphic and shocking and shows the depths of depravity that the human soul can descend to.
After 11 months of sobriety from cocaine, heroin, methamphetamine and other drugs this individuals mental state has sunk to an almost animal-like existence.
http://www.2010homelesschampions.ca/reality_of_drug_addiction.htm
2010 Homeless Champions supports The Servants of Hope Recovery House
a proven model of recovery recently acknowledged by Operation Phoenix and the Vancouver Province Newspaper
This website is dedicated to telling the stories of the unfortunate individuals living in the Downtown Eastside of Vancouver in the hope that awareness of this problem will spur people to get involved, to let all levels of government know that something has to be done to alleviate this misery rooted in addiction, homelessness and depravity. To point the way to recovery from addiction, which we believe is the root of most of this situation. With the 2010 Olympics coming to Vancouver it is our mandate to record the transition and the extreme changes that are even now occurring and will continue to unfold in the Downtown Eastside.
http://www.2010homelesschampions.ca
Regarding the molecular structure of drugs are there any specific molecules which would be likely to result in a drug being addicitive??
I have a chronic pain condition- Fibermyalgia, Pain id decreased when my doctor put me on methadone, then he added vicoden in then which i became depended on, i told him to take the viccoden away..instead he took me off as a patient all together, even after weeks of withdraw from cold turkey and fightint the pain of fibermyalgia things in my head “just dont feel right” its hard to explain. I am trying to find a new doctor, one who cares and can help me, but if i get back on the low dose of methadone to treat my pain is that a bad idea? When I am pain free and take the medication i am “me” I can function and see clear and dont have as many pain attacks, I do not abuse the medication, im a young single mom back in college, my daughter has disability problems, i need to be “me” again..I feel lost..
This finding will greatly motivate people to find help for their addiction. As psychologist Viktor Frankl once said (and I am paraphrasing here): Part of the reason why many mental problems (in this case, addictions) are difficult to eradicate is because people are ashamed to admit they have one and therefore do not seek help.
Their assumption, of course, is that it’s a moral issue. Now we know better.
I was dismayed to hear this interview, because it takes very weak inference and translates it into a message that is quite harmful in placing the power over an addict’s behavior with drug companies (did they fund this research?) rather than with the individuals who are addicted. What would be stronger evidence? An association between a poorly activated pleasure center (the amygdala?) and later drug use would be better evidence – in other words, a longitudinal study showing that activation levels are good predictors of future drug use. But to draw this conclusion in a situation where there is no demonstration of cause and effect – the users could have low activation because they use drugs – perhaps the people whose activation is not suppressed by drugs die or have such terrible physiological and behavioral responses that they end up in treatment – this could just as easily explain these results as the hypothesis this scientists chooses to argue for. “We believe” is a dangerous statement when addressing the public, and does not reflect the suite of alternative hypotheses suggested by the data. This would be okay, if it did not suggest a purely physiological cause for something that undoubtedly has cognitive, psychological, and behavioral elements. Any suggestion that human behavior is a disease should be examined thoroughly, analyzed fully, and treated with significant skepticism, requiring the highest possible standards of evidence – if for no other reason than that the drug companies (and scientists funded by them) stand to glean immense profits from the assertions that it does.
Hi, I am 33. I started using drugs in college and I have battled heavy drug addiction since my mid twenties. I’m a professional with good career and good friends and family. I’ve been so lucky that I’ve never gotten into trouble although I have severe emotional problems from so many years of MDMA, marijuana, cocaine, ghb, and methamphetamine addiction. My friends and family don’t know I am still addicted to meth. Anyway, I’ve been able to stop a few times with a lot of willpower for a few months at a time. I thought I was finally done with my addiction last year in summer when I had completed six months of being clean but I messed up in august and now over a year later I’m back on meth for about 3 to 4 days per week. I’ve slowed down recently and I’m praying that I can quit soon again. Next week, I will start to take prescription testosterone shots due to my very low testosterone level. I hope this will help ms feel better about myself and stay away from meth but I’m very scared that this will just be an additional drug I will get hooked on. Any suggestions on testosterone supplementation?