Until recently, the field of addiction research has considered addiction a genetic disease: our genes predispose us more or less to addiction and then a trigger can start the slide toward dependence. New research in the field shows this traditional view tells only part of the story. Rather than a disease like diabetes that is written in our genes and then triggered, it seems as if addiction is in large part a disorder of decision-making. Unfortunately, due to the brain’s ability to rewire itself, potentially addictive decisions we make and activities we engage in eventually become written in the very structure of the brain, creating an addiction feedback loop that can be extremely difficult to circumvent.
Understanding the Role of Genes in Addictive Behavior
Let’s take a quick look at the understood half of the story.
“Genetics is the basis for everything,” says Constance Scharff, PhD, Director of Addiction Research at Cliffside Malibu Addiction Treatment Center. “If genes didn’t allow it, you wouldn’t have eyes. But that doesn’t mean that genes ‘cause’ addiction.” The parallel is that certainly the potential for addiction is written in genes. However, Scharff sees this genetic predisposition less like diabetes and more like obesity: “Due to genes that control things like metabolism, some people gain weight easily and others less easily, but given the right circumstances everyone can gain weight. Similarly, it might be easier or harder for someone to become an addict, but it can happen to anyone.”
This means that addiction needn’t require a genetic predisposition, as many believe. In fact, evidence for the ability of anyone—with or without genetic predisposition—to become addicted is seen in the recent epidemic of prescription drug use. For example, this study shows that the use of criminalized drugs tends to run in families, implying the possibility of a genetic component. But there is no genetic predisposition when it comes to using prescription drugs. And yet addiction to these pharmaceuticals is becoming a national health crisis.
If not entirely genes and a trigger, what creates addiction? Now we’re into the less understood portion of the story.
Patterns of the Brain
“Imagine you walk in a circle over and over on a carpet. Eventually you wear a track into that carpet along this path,” Scharff says. This is a strong analogy for the process of neuroplasticity, or the brain’s ability to change its shape. You’ve probably heard the phrase ‘neurons that fire together, wire together’ and this is what it means: the pathways in your brain that you use become more efficient over time, making them easier and easier to access.
Like wearing a path into a carpet, thoughts and patterns of behavior literally wear paths of least resistance into your brain, reinforcing these ways of being.
The more you make the decision to use, the more the ease of this pathway thumbs the scale of your future decisions, making it increasingly likely you will make the same decision in the future. Addictive decisions lead to addictive decisions.
“Brain scans show that once you create this neural-pathway, it remains forever. That’s why, even after 20 years sober, people who relapse almost immediately go back to their last using pattern,” Scharff says. “So instead of ‘breaking’ this feedback loop or somehow ‘curing’ the addicted person, the secret to prolonged recovery is to write new neural-pathways.” Scharff calls this new way of thinking the recovery feedback loop.
“It’s not easy to create new neural-pathways. It doesn’t happen in 28 days,” Scharff says.
The Long Term Recovery Brain Benefits
But studies show that over time, we can rewrite the baselines that our brains use to make decisions. For example, a study published in the journal Current Opinions in Psychiatry says that “recent neuroimaging studies have also demonstrated that psychotherapy significantly changes functions and structures of the brain.”
“When we use psychotherapy along with complementary therapies to get at the root causes of addiction—generally pain or trauma—we are actually rewiring the brain,” Scharff explains. “Quality, long-term treatment creates a recovery feedback loop.” Happily, some experts—including Scharff and the Cliffside Malibu research team—are actively seeking academic partners to collaborate on the design and implementation of fMRI studies to demonstrate this recovery feedback loop.
Image courtesy of BradfordHealth