A Site Dedicated to Understanding Addiction and Recovery

With descriptions of SMART Recovery, LifeRing, Rational Recovery, Women for Sobriety, 12-Step and alternatives to 12-Step, secular models and spiritual models.  Recovery is not a one size fits all process.

 

My cortex sits atop my brain like my head sits atop my body like the whale rider sits atop the whale. When a destination is reached, the whale rider insists that it was his planned destination all along, and believes it to be so.  

The pleasure centers of your brain don’t have to control you. Short term thinking does not have to guide your decisions. With motivation and a few simple tools you can take control of your life, honor your values and attain your long term goals.

©  Jim Dickey

I am a trained SMART Recovery facilitator, and have been facilitating SMART Recovery meetings since 2010.

A good description of SMART Recovery and some of it’s tools:

I have been in recovery since August 16, 1989 and am interested in helping others overcome their addictions. This first page is devoted to an overview of the site and a short explanation of what steps a person must take to embrace a lasting recovery. More information is available on the following pages:

Reptile Brain?   A  brief  explanation  of why this site is called Reptile Dysfunction                                                                                                                       The Divided Mind  How can brains be so stupid? They’re not. That’s the wrong question.                                                                                                         Are You Addicted?  How to tell if you or someone you care about is addicted.                                                                                                                             Why Them?   An explanation of how smart people can continue making bad decisions.                                                                                                 Now What?  OK. I’m an addict. So, now what should I do about it?       Site Administrator  A little about myself and how I got here.                 Arrival  I have broken the cycle of addiction, but how do I stay clean?

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How To End An Addiction

 

  1. Become aware of the addiction.
  2. Evaluate how the addiction is affecting your life and decide whether or not you want to end the addiction.
  3. Learn what’s going on in your brain when you are engaged in the addictive behavior.
  4. Gain control over the addictive behavior.
  5. Learn techniques to avoid relapses.
  6. Lead a satisfying life to reduce the attractiveness of the addictive behavior.

 

Become aware of the addiction

If you don’t perceive a problem, there will be no problem to solve. See how the scientific community defines addiction here: 1 and  and  3  or  4  or  5

 

Evaluate how the addiction is affecting your life and decide whether or not you want to end the addiction

You will have to evaluate how the addiction is affecting your life before you will be motivated to change your routines. Routines are comforting and safe: we know what to expect from them. What we have become used to doing day after day in the past is a very good predictor of what we will do today. When we change these routines there is a short period of uncomfortableness we must go through before we are at ease again. A good tool for this is the Cost Benefit Analysis (CBA), which can guide you in understanding both what you are getting out of your addiction and the costs/risks of the behavior. Read more here:  1  and  2  or  3  or  4  or  5  or  6  or  7

Learn what’s going on in your brain when you are engaged in the addictive behavior.

It is important to understand why addictions can control or radically influence our behavior. People do not choose to destroy or damage their lives and relationships; their behavior is out of control. Once you understand this, you can forgive yourself for the past, embrace a few simple tools to stop the addiction and resist urges, and live a fruitful and healthy life. For a fuller explanation, go here:  1  and  2  or  3  or  4  or  5  or  6

Gain control over the addictive behavior.

Write out a Cost/Benefit Analysis every day for the first month. It will only take you five or ten minutes. Pick a date around two weeks in the future to actually stop and between now and then, mentally prepare yourself for stopping. Find a peer support group that is compatible with your belief system and makes sense to you. Tell your loved ones and/or friends you are ending your addiction and enlist their support. Make a list of your values and a list of goals you would like to accomplish. If you think an outpatient or inpatient group is indicated and you can afford to attend one, then, by all mean, make arrangements to do so. More on this can be found here: 1  or  2  or  3  or  4  or  5  or  6  or  7

Learn techniques to avoid relapses.

Learn how to interrupt reptile brain commands. You want your logical mind to be running things during this period of your life. Put a rubber band on your wrist and every time you think about the addictive behavior, snap it. If you are still experiencing craving, take 10 long, slow breaths. Promise yourself you will do a Cost/Benefit Analysis before you act on the craving. Read about all the other diversionary techniques which can help here:  1  and  2  or  3  or  4  or  5 

Lead a satisfying life to reduce the attractiveness of the addictive behavior.

You want to end this addiction so you and your loved ones can lead a happy, satisfying life. Spend time thinking about what you would like to do in the future. When you become upset or angry, get a handle on your emotions by filling out an ABC. Start leading a life you can be proud of. These things will not happen instantly, but they will not happen at all if you don’t move towards them. Become productive and find people to be with whose company you enjoy.  Some ideas can be found here:  1  and  2  or  3  or  4

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News From the Field of Addiction:

Picture from HBO.com

Hijacked Brain Dopamine 2 Receptors lower

From HELPGUIDE.org which had “Adapted with permission from the Harvard Mental Health Letter and Overcoming Addiction, a special health report published by Harvard Health Publications”

Understanding Addiction:  How Addiction Hijacks the Brain  

What Is Addiction?

Key Points

    1. Addiction involves craving for something intensely, loss of control over its use, and continuing involvement with it despite adverse consequences.
    2. Addiction changes the brain, first by subverting the way it registers pleasure and then by corrupting other normal drives such as learning and motivation.
    3. Although breaking an addiction is tough, it can be done.

The word “addiction” is derived from a Latin term for “enslaved by” or “bound to.” Anyone who has struggled to overcome an addiction—or has tried to help someone else to do so—understands why.

Addiction exerts a long and powerful influence on the brain that manifests in three distinct ways: craving for the object of addiction, loss of control over its use, and continuing involvement with it despite adverse consequences.

For many years, experts believed that only alcohol and powerful drugs could cause addiction. Neuroimaging technologies and more recent research, however, have shown that certain pleasurable activities, such as gambling, shopping, and sex, can also co-opt the brain.

Although a standard U.S. diagnostic manual (the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition or DSM-IV) describes multiple addictions, each tied to a specific substance or activity, consensus is emerging that these may represent multiple expressions of a common underlying brain process.

New insights into a common problem

Nobody starts out intending to develop an addiction, but many people get caught in its snare. Consider the latest government statistics:

Nearly 23 million Americans—almost one in 10—are addicted to alcohol or other drugs.

More than two-thirds of people with addiction abuse alcohol.

The top three drugs causing addiction are marijuana, opioid (narcotic) pain relievers, and cocaine.

In the 1930s, when researchers first began to investigate what caused addictive behavior, they believed that people who developed addictions were somehow morally flawed or lacking in willpower. Overcoming addiction, they thought, involved punishing miscreants or, alternately, encouraging them to muster the will to break a habit.

The scientific consensus has changed since then. Today we recognize addiction as a chronic disease that changes both brain structure and function. Just as cardiovascular disease damages the heart and diabetes impairs the pancreas, addiction hijacks the brain. This happens as the brain goes through a series of changes, beginning with recognition of pleasure and ending with a drive toward compulsive behavior.

Pleasure principle

The brain registers all pleasures in the same way, whether they originate with a psychoactive drug, a monetary reward, a sexual encounter, or a satisfying meal. In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens, a cluster of nerve cells lying underneath the cerebral cortex (see illustration). Dopamine release in the nucleus accumbens is so consistently tied with pleasure that neuroscientists refer to the region as the brain’s pleasure center.

All drugs of abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine in the nucleus accumbens. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release.

Even taking the same drug through different methods of administration can influence how likely it is to lead to addiction. Smoking a drug or injecting it intravenously, as opposed to swallowing it as a pill, for example, generally produces a faster, stronger dopamine signal and is more likely to lead to drug misuse.

 

Brain’s Reward Center

Graphic from Get Real Recovery

 The-Hijacked-Brain-Jan-2011-2

Addictive drugs provide a shortcut to the brain’s reward system by flooding the nucleus accumbens with dopamine. The hippocampus lays down memories of this rapid sense of satisfaction, and the amygdala creates a conditioned response to certain stimuli.

Learning process

Scientists once believed that the experience of pleasure alone was enough to prompt people to continue seeking an addictive substance or activity. But more recent research suggests that the situation is more complicated. Dopamine not only contributes to the experience of pleasure, but also plays a role in learning and memory—two key elements in the transition from liking something to becoming addicted to it.

According to the current theory about addiction, dopamine interacts with another neurotransmitter, glutamate, to take over the brain’s system of reward-related learning. This system has an important role in sustaining life because it links activities needed for human survival (such as eating and sex) with pleasure and reward.

The reward circuit in the brain includes areas involved with motivation and memory as well as with pleasure. Addictive substances and behaviors stimulate the same circuit—and then overload it.

Repeated exposure to an addictive substance or behavior causes nerve cells in the nucleus accumbens and the prefrontal cortex (the area of the brain involved in planning and executing tasks) to communicate in a way that couples liking something with wanting it, in turn driving us to go after it. That is, this process motivates us to take action to seek out the source of pleasure.

Do you have an addiction?

Determining whether you have an addiction isn’t completely straightforward. And admitting it isn’t easy, largely because of the stigma and shame associated with addiction. But acknowledging the problem is the first step toward recovery.

A “yes” answer to any of the following three questions suggests you might have a problem with addiction and should—at the very least—consult a health care provider for further evaluation and guidance.

  • Do you use more of the substance or engage in the behavior more often than in the past?
  • Do you have withdrawal symptoms when you don’t have the substance or engage in the behavior?
  • Have you ever lied to anyone about your use of the substance or extent of your behavior?

Development of tolerance

Over time, the brain adapts in a way that actually makes the sought-after substance or activity less pleasurable.

In nature, rewards usually come only with time and effort. Addictive drugs and behaviors provide a shortcut, flooding the brain with dopamine and other neurotransmitters. Our brains do not have an easy way to withstand the onslaught.

Addictive drugs, for example, can release two to 10 times the amount of dopamine that natural rewards do, and they do it more quickly and more reliably. In a person who becomes addicted, brain receptors become overwhelmed. The brain responds by producing less dopamine or eliminating dopamine receptors—an adaptation similar to turning the volume down on a loudspeaker when noise becomes too loud.

As a result of these adaptations, dopamine has less impact on the brain’s reward center. People who develop an addiction typically find that, in time, the desired substance no longer gives them as much pleasure. They have to take more of it to obtain the same dopamine “high” because their brains have adapted—an effect known as tolerance.

Compulsion takes over

At this point, compulsion takes over. The pleasure associated with an addictive drug or behavior subsides—and yet the memory of the desired effect and the need to recreate it (the wanting) persists. It’s as though the normal machinery of motivation is no longer functioning.

The learning process mentioned earlier also comes into play. The hippocampus and the amygdala store information about environmental cues associated with the desired substance, so that it can be located again. These memories help create a conditioned response—intense craving—whenever the person encounters those environmental cues.

Cravings contribute not only to addiction but to relapse after a hard-won sobriety. A person addicted to heroin may be in danger of relapse when he sees a hypodermic needle, for example, while another person might start to drink again after seeing a bottle of whiskey. Conditioned learning helps explain why people who develop an addiction risk relapse even after years of abstinence.

Recovery is possible

It is not enough to “just say no”—as the 1980s slogan suggested. Instead, you can protect (and heal) yourself from addiction by saying “yes” to other things. Cultivate diverse interests that provide meaning to your life. Understand that your problems usually are transient, and perhaps most importantly, acknowledge that life is not always supposed to be pleasurable.

Adapted with permission from the Harvard Mental Health Letter and Overcoming Addiction, a special health report published by Harvard Health Publications. —– For more information about the pleasure centers of the brain, please see “The Compass of Pleasure” by David J. Linden

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Judges:  Give Defendants A Choice

If you are involved in the criminal justice system and have any role to play in mandating attendance at recovery meetings, please view the following informational video. For anyone else, you will find it contains another good description of SMART Recovery.

 FIGURE 1. Some of the brain structures affected by drugs of abuse. From the following article: Drug addiction: bad habits add up Trevor W. Robbins and Barry J. Everitt Nature 398, 567-570(15 April 1999) doi:10.1038/19208 The mesolimbic dopamine system originates in the ventral tegmental area (VTA) of the midbrain, and projects to the nucleus accumbens (NA). The amygdala (A), hippocampus (HC) and medial prefrontal cortex (PFC) send excitatory projections to the nucleus accumbens. C, caudate nucleus (striatum). FIGURE 2. Neural systems of addiction. From the following article: Drug addiction: bad habits add up Trevor W. Robbins and Barry J. Everitt Nature 398, 567-570(15 April 1999) doi:10.1038/19208 A dopamine-releasing neuron from the ventral tegmental area (VTA) is shown innervating a medium spiny neuron dendritic spine in the nucleus accumbens (NA). The dopamine transporter (DAT) is a main site for cocaine and amphetamine action. These drugs inhibit the re-uptake of dopamine by the VTA neuron, where it is initially produced from the amino acid tyrosine. Dopamine is shown acting at the two main families of dopamine receptor (D1 and D2). These are coupled to guanine-nucleotide-binding proteins (Gsand Gi), components of the intracellular cyclic AMP system, which also includes adenylyl cyclase (AC) and cAMP-dependent protein kinase (PKA). Possible substrates for this kinase include ion channels and the nuclear transcription factors CREB, Fos and Jun. A, amygdala; HC, hippocampus; PFC, prefrontal cortex; EAAR, excitatory amino-acid receptor; Glu, glutamate. (Adapted from ref. 16.)

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The video tells us a little about where the current uptick in heroin addiction has come from and also highlights how our perceptions, as a society and a government, concerning who is being affected by this problem determine what we think we should do about it. If “they” are overdosing or suffering then it’s not such a big deal, but when “we” and “ours” are in pain, people suddenly become concerned. It’s the same thing that happened during the AIDS epidemic, when government and public opinion concerning what to do about the contagion changed when heterosexuals started getting the disease.  

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From SMART Recovery:

The Overcoming Addictions Webcourse is a confidential and interactive web-based course that can help you achieve and maintain abstinence from addictions using SMART’s 4-Point Program.  The program has parallel but separate modules for addiction recovery from alcohol, marijuana, opioids, stimulants and compulsive gambling. Details and registration information for this newly released webcourse are available here.

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Administrator’s Disclaimer: I am not a doctor nor am I licensed in the mental health field.
m4s0n501

Are You Tired of Your Addictions Running Your Life?