Addiction is a highly complex issue that affects tens of millions of people in the U.S., and countless others worldwide. This debilitating condition has long been considered a moral failing or a lack of willpower. However, recent advances in neuroscience have shed light on the biological basis of addiction, revealing that it is, in fact, a brain disease; and, a modifiable one at that! Substance use disorders alter the brain’s circuitry, impacting decision-making, reward and motivation systems, and emotional regulation.
At APEX Brain Centers, we recognize the importance of integrating neuroscience findings into our treatment approaches to addiction recovery. By understanding the brain’s role in addiction, we are better equipped to develop innovative techniques and interventions that address the underlying neurological issues associated with substance use disorders. Our brain-based approach, alongside the great work of our trusted counselors and recovery programs in the national community, focuses on helping individuals regain control over their lives, address the underlying learning and behavioral issues associated with addiction, heal from the physical damage caused by addiction, and achieve long-lasting recovery.
In our practice, we emphasize functional neurology, low-level laser therapy, hyperbaric oxygen therapy, and neurofeedback. Additionally, we utilize balance and vestibular therapies, eye movement rehabilitation, frequency-based modalities, metabolic and nutritional therapies, and home care programs to support recovery and promote optimum mental health. By addressing addiction from a brain-based perspective, we strive to revolutionize the way substance use disorders are approached, managed, and ultimately overcome.
Current Understanding of Addiction
Defining Substance Use Disorder
Addiction is a complex condition characterized by the compulsive use of a substance, despite its negative consequences. Addiction can also involve behaviors one is unable to refrain from, such as technology/internet/pornography consumption and thrill-seeking through high-risk activities. Substance Use Disorder (SUD) is a treatable mental disorder that affects a person’s brain and behavior, leading to their inability to control their use of specific substances like legal or illegal drugs, alcohol, or medications. At APEX Brain Centers, we recognize that SUD involves a combination of genetic, environmental, and neurological factors that contribute to its development and persistence. Neuroscientific research has provided valuable insights into the mechanisms underlying addiction, allowing us to better address the needs of individuals with SUD.
Genetics and Environment Influences
Both genetic and environmental factors contribute to the development of SUD. Research has shown that genetic factors account for approximately 40%-60% of a person’s vulnerability to addiction. However, with addiction and many other mental health issues, there is a saying that “the apple doesn’t fall far from the tree”; meaning, when one is brought up in an environment plagued with addiction and/or mental health disorders, one’s environment becomes a key factor in developing these tendencies. That said, environmental factors, such as childhood and early adulthood trauma (both physical and emotional), exposure to drugs, family and social dynamics, and early life experiences, also play a significant role in the development of SUD. At APEX Brain Centers, we believe that a comprehensive approach, taking into account both genetic and environmental influences, is crucial for effectively helping individuals with addiction.
The Role of Stress and Anxiety
Stress and anxiety are critical factors in the development and persistence of SUD. The presence of these factors can increase the likelihood of drug use and the risk of developing addiction. When one is anxious, they will seek substances (both medical and recreational), to make them feel more relaxed. Our experience for the past 2 decades shows that mental health services become significantly more impactful when combined with functional neurology assessments and interventions. In our practice, we focus on addressing the emotional and neurological aspects of addiction, using therapies such as neurofeedback and biofeedback, to help individuals manage stress and anxiety, and support their recovery process.
Established Addiction Models
Our understanding of addiction has evolved over the years, and one of the most significant advancements has been the brain disease model of addiction. This model recognizes that addiction is a chronic brain disorder, characterized by changes in neural systems and structures; whether prior to, or during/after, substance usage. These changes impact an individual’s cognitive, emotional, and behavioral functioning, contributing to the compulsive nature of drug use.
By addressing the underlying neurological factors in addiction, we can provide comprehensive care to individuals with SUD and enhance the effectiveness of their recovery process.
Addiction and Brain Functioning
Role of Neurotransmitters
In addiction, disruptions in neurotransmitters play a crucial role in the brain’s functioning. One such neurotransmitter is dopamine, which is responsible for regulating the brain’s reward circuit and mediates pleasurable effects. This reward circuit is important as it motivates us to pursue activities that are essential for survival, like eating and socializing. When addictive substances are consumed, dopamine levels in the brain elevate, giving us a pleasurable experience. Over time, the brain becomes desensitized to the substance, and neurotransmitter levels adapt, causing the individual to need more of the substance for the same effect.
Regions and Structures of Interest
Several regions, networks, and structures within the brain are involved in addiction. Some of the most critical areas include the prefrontal cortex, basal ganglia, extended amygdala, nucleus accumbens, and the ventral tegmental area. These structures are interconnected and form the brain’s reward circuit, which is responsible for the desire to repeat pleasurable experiences and avoid negative ones. The ventral tegmental area, for instance, is vital for releasing dopamine when we are rewarded, and the nucleus accumbens mediates the pleasurable effects of substances. Further, newer understanding of the insular cortex and it’s connection with the nucleus accumbens shows that alterations in one’s monitoring of their internal states has a profound impact on the ability to mitigate substance use.
Phases of Addiction Cycle
There are three main phases in the addiction cycle: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. During the binge/intoxication phase, an individual consumes the substance in quantities high enough to experience intense pleasure, or to numb pain. The brain’s plasticity plays a role in this phase, causing changes in brain function and structure due to the substance’s impact. The brain remembers!
In the withdrawal/negative affect phase, after enough usage (varies depending on the substance), the individual experiences withdrawal symptoms when not consuming the substance. Anxiety, stress, and emotional pain can arise as a result, compelling the individual to seek out the substance to alleviate these feelings.
In the preoccupation/anticipation phase, the brain’s reward system is focused on seeking out the substance, and the individual engages in potentially risky behaviors to acquire and use it. The prefrontal cortex, which is responsible for decision-making and impulse control, becomes less active or absent during this phase, contributing to the cycle of addiction.
In our practice at APEX Brain Centers, we focus on providing comprehensive care to address the needs of individuals with learning and behavioral disorders, such as addiction; as well as other conditions highly associated with substance use, such as brain injury.
Behavioral Patterns and Addiction
At APEX Brain Centers, we recognize that addiction is a complex disorder involving disruptions in the brain’s reward, learning, and habit formation processes. This section will discuss the habit-formation process and the impact of addiction on social and emotional health.
The Habit-Formation Process
Habit formation is an essential aspect of human behavior that allows us to adapt and respond efficiently to our environment. However, when individuals engage in compulsive behaviors involving addictive substances, the habit formation process can become maladaptive. Addictive substances often hijack the brain’s reward and associated impulse control systems, leading to impulsivity and compulsivity in seeking and using these substances.
In our practice, we emphasize the importance of addressing the brain’s executive function, which plays a crucial role in impulse control and decision-making. We combine functional neurology assessments and interventions to help individuals develop healthier habits and overcome addiction.
Impact on Social and Emotional Health
Addiction not only has a profound effect on an individual’s brain function but also on their social and emotional well-being. Binge and intoxication phases often lead to social isolation, while preoccupation and anticipation can strain relationships and hinder social interaction.
Alcohol and Addiction
Adolescence and Binge Drinking
At APEX Brain Centers, we often encounter the negative impact of binge drinking on adolescent brain development. Binge drinking is defined as consuming a large amount of alcohol in a short period, typically leading to heavy intoxication. It is a common behavior among teenagers and young adults, which poses serious risks to their brain health and cognitive function.
Alcohol has been shown to have a significant impact on the developing brain, particularly during adolescence, a critical period characterized by substantial neural growth and reorganization. In fact, we know that the brain is growing and developing into our twenties. Heavy drinking during this stage can disrupt the delicate balance of neurotransmitters and may lead to damage in critical brain areas responsible for memory, learning, and decision-making. Additionally, binge drinking during adolescence can increase the risk of developing alcohol use disorder later in life.
Alcohol Use Disorder and the Brain
Alcohol use disorder (AUD) is a chronic condition characterized by a problematic pattern of alcohol use leading to significant impairment or distress.
Alcohol’s effect on the brain is complex and multifaceted. It alters the brain’s reward processing system, leading to the release of dopamine and other neurotransmitters that create feelings of pleasure, at least initially. At the same time, alcohol can reduce the activity of brain systems responsible for negative emotions such as stress, anxiety, and emotional pain, making it a dually reinforcing substance [1].
Chronic heavy drinking can lead to changes in brain structure and function. Prolonged exposure to alcohol can result in desensitization of reward circuits, weakening an individual’s ability to feel pleasure and their motivation to pursue everyday activities [2]. It can also cause damage to the prefrontal cortex, an area of the brain responsible for self-control and decision-making, leading to decreased capacity to control alcohol consumption and to perform routine activities of daily living at home, school, and work.
In our practice at APEX Brain Centers, we have observed that mental health services become significantly more impactful when combined with functional neurology assessments and interventions. By addressing the neurobiological aspects of AUD, and working with counselors and recovery programs far and wide, we are better equipped to help our patients overcome the vicious cycle of addiction and achieve long-lasting recovery.
Process and Challenges in Addiction Recovery
Relapse: Causes and Prevention
Relapse is a common challenge faced by individuals in addiction recovery, particularly with the long-standing and growing wave of opioid usage in this country. The journey to sobriety is often marked by brain changes associated with withdrawal and negative affect, which create a difficult environment for maintaining the path to recovery. Negative emotional states and brain stress systems can trigger craving and lead to relapse.
We believe in addressing these challenges comprehensively. At APEX Brain Centers, our personalized addiction recovery brain rehabilitation program promotes healing, restores brain function, and supports long-term recovery in concert with mental health therapies.
Effective Treatment Approaches
Addiction recovery requires a combination of positive reinforcement and, in some cases, negative reinforcement strategies in order to be effective. Evidence-based treatments are crucial components of a successful addiction recovery process.
In our practice, we focus on three primary areas of admission: brain injury (traumatic and acquired), cognitive impairment, and learning and behavioral disorders (OCD, anxiety, ADHD, addiction, etc.). Addictive and compulsive behaviors run rampant in these populations, causing many to seek us out to address the underlying issues associated with their SUD and other addictive and compulsive behaviors.
Our foundational neurological and metabolic rehabilitative therapies make most other therapies more effective. By offering comprehensive care that addresses the needs of individuals with brain injuries, we can help prevent relapse, aid in the recovery process, and promote optimum mental health in our patients.
Future Directions in Addiction Recovery
At APEX Brain Centers, we recognize the importance of staying up-to-date with the latest advancements in addiction recovery. In this section, we will explore two key areas shaping the future of addiction treatment: incorporating new research findings and the prospects of personalized treatment.
Incorporating New Research Findings
Recent advancements in addiction research have provided new insights into the neurobiology of substance use and addiction, which is helping to reshape the traditional brain disease model of addiction; that is, that the disease itself causes the addiction. Researchers are investigating the role of specific biomarkers in the development and maintenance of substance use disorders, as well as the potential of using these markers to tailor treatment approaches.
In our practice at APEX Brain Centers, we focus on providing comprehensive care to address the needs of individuals with addiction. Our approach includes an emphasis on functional neurology, low-level laser therapy, hyperbaric oxygen therapy, and neurofeedback. We also utilize balance and vestibular therapies, eye movement rehabilitation, frequency-based modalities, metabolic and nutritional therapies, and home care programs to support recovery and promote optimum mental health.
We believe that incorporating new research findings into our treatment approaches not only enhances the effectiveness of our programs but also aligns us with the evolving scientific understanding of addiction.
Prospects of Personalized Treatment
The long-standing and (often outdated) field of addiction recovery is gradually moving towards a more personalized approach to treatment, recognizing that each individual’s experience with addiction is unique. This shift is being driven by advances in data collection and analysis, which allow for a more detailed understanding of the underlying causes and contributing factors of addiction at an individual level.
Epidemiological studies and large-scale data sets are providing valuable insights into how different risk factors and protective factors contribute to substance misuse and recovery outcomes. Increasingly, the scientific community and funding agencies are recognizing the importance of investing in research aimed at tailoring treatments to individual patients.
In the future, we believe that personalized treatment plans based on a more in-depth understanding of each individual’s neurology, biology, genetics, and environmental factors will become the norm in addiction recovery. This tailored approach will lead to better treatment outcomes, reduced rates of relapse, and improved patient satisfaction.
At APEX Brain Centers, we are committed to staying at the forefront of these advancements and incorporating the latest research findings into our practice to help individuals achieve lasting recovery from substance use disorders.
