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Science Solidifying the Neurobiology of Addiction

A team at The Scripps Research Institute has found significant evidence regarding the neurobiology of addiction that a specific neurotransmitter system, the endocannabinoid system that includes the most common CB1 receptors, is active in the brain region that plays an important role in appetite, memory, mood/ emotion, and addiction. The study, which was recently published in Neuropsychopharmacology, also found that endocannabinoid system can inhibit the effects of alcohol, thus offering promise for future prevention and rehabilitation strategies.

According to a professor of the neurobiology of addiction at Scripps Research, this is the first study to show a “direct cellular interaction between endocannabinoids and alcohol in the brain.” (Science Daily)

The study abates a paper published in 2001 in the Journal of Neuroscience, in which a European group asserted that endocannabinoid receptors (CB1 receptors) did not exist in the brain region known as the central amygdala (which is part of the limbic / reward system of the brain). This paper’s conclusions were widely accepted by the the field. However, the scientists at The Scripps Research began to suspect that the presence of CB1 receptors in the central amygdala had somehow been missed. Especially since, as many of the scientists at Scripps, said that they began studying the endocannabinoid system in the central amygdala because of addiction. And they found that CB1 receptors are very abundant throughout the brain.

One of the scientists reiterated that there has been numerous behavioral studies on substance abuse, but a very limited amount on the physiology of addiction. And aside from the 2001 study, even less on the physiology in the central amygdala (a region of the brain that is key in understanding the drug and alcohol abuse).

Using electrophysiological techniques in brain slices to test the response of brain cells from the central amygdala in rats, the scientists found compelling evidence that CB1 receptors were active there. They also determined that alcohol and CB1 agonists have opposing effects on GABA (which is a main inhibitory neurotransmitter in the brain that fine-tunes signaling throughout the nervous system. GABA plays a key role in alcohol dependence and other addictions.) The scientists concluded that because there is such a wide presence of CB1 receptors, there is a greater possibility of inhibiting the effects of alcohol.

Women’s Health Week: “It’s Your Time”

In an effort to build positive awareness about women’s health, it’s important to address the gender-specific issues surrounding drug and alcohol addiction and recovery. May 9-15, 2010 is the 11th Annual National Women’s Health Week, initiated by the U.S. Department of Health and Human Services’ Office. The week-long, nationwide celebration/ health observance encourages communities and organizations to combine efforts in educating and rally women to take steps towards improving their physical and mental health. The theme of the week is “It’s Your Time,” which is a reminder to women that although “they are often the caregivers for children, spouses, and parents, they need to make sure they take the time to focus on their own health.” (SAMHSA)

While the rate of retention for women in substance abuse treatment programs is similar to men, it’s necessary to discuss the gender-specific variables that may significantly influence the long-term success of rehabilitation and recovery.

In this respect, women’s treatment issues and needs often vary a great deal from men’s (let alone on an individual basis). With this in mind, such issues in need of addressing may include: the role of relationships (including family and partners); parenting issues and treatment needs (including pregnancy and children); and possible co-occurring disorders (anxiety, mood, or eating disorders) that are prevalent among women and may need attention during substance abuse treatment. Trauma and trauma-related symptoms may also need significant consideration when designing the treatment protocol. Here is a link to the SAMHSA/ CSAT Treatment Improvement Protocols: Chapter 7: Substance Abuse Treatment for Women.

As we’ve discussed before, alcohol affects women differently than men because of the difference in body make-up and chemistry. Such factors as women’s bodies having more fat and less water than men’s and women processing less alcohol in the stomach than men, contribute not only to women becoming more intoxicated faster than men, but to higher risk factors for women’s overall health. “Effects of Alcohol on Women” (Women and Alcohol – SMAHSA) is a great, quick breakdown of the situation.

Mapping Dopamine: New Insight to the Addicted Brain

Researchers at the U.S. Department of Energy’s Brookhaven National Laboratory have developed a new mapping protocol that allows them to visualize the activity of dopamine, the brain’s reward circuitry, in both healthy individuals and those addicted to drugs and alcohol. This new dopamine mapping technique may offer better insight into why people partake in the use of drugs and alcohol as well as determine which treatment protocols may be the most effective.

Using positron emission tomography (PET), which is medical imaging technology used in identifying brain diseases, and radioactive tracers that bind to dopamine receptors. The PET scan highlights the movement of the tracers in the brain. This is then used to reconstruct real-time 3D images of the dopamine system at work. (Medical News Today)

Although it’s understood by the scientific community that drug addiction is a complex process consisting of many biological and environmental factors, it’s clear that the role of dopamine is central to the understanding substance abuse. Dopamine is the chemical that regulates reward and pleasure in the brain. The study found that the addicted individuals had 15-20 percent fewer dopamine receptors than those in the control group (healthy individuals). (Medical News Today)

One of the scientists at Brookhaven explained that individuals suffering from the disease of addiction all have “blunted dopamine response.” This understanding reinforces previous notions that addicts “experience diminished feelings of pleasure, which drives their continual drug [and alcohol] use” and furthers the damage to the reward center of the brain. The study looked at the results of various types of drugs. And although each operated by unique mechanisms, they all shared one thing in common: the dopamine receptors in addicted brains demonstrated an under-stimulated reward system.

Therapies such as Neurotransmitter Restoration (NTR) support the findings of this study in understanding the key role of dopamine in addiction and addiction recovery. NTR is a medical nutritional therapy that bathes the neuronal cells in an optimal, nutritional environment, stimulating dopamine receptors to induce repair and accelerate the brain’s healing process.

Researchers hope that the real-time aspect of the new imaging protocol may prove to be valuable because it doesn’t require looking at individuals while they are under the influence of drugs or alcohol, but rather when they aren’t. This will allow for examining how different coping strategies of rehabilitation and abstinence work best.

The Race for the “Safe” Opioid

Despite a $634.5 million settlement (one of the largest penalties imposed on a drug company) against Oxycontin in 2007 that found executives guilty of misleading the public about the opioid drug’s safety, pharmaceutical companies continue to race for ways to make highly dangerous pain killers more marketably “safe” against abuse. The news about a “safe” opioid is disturbing, especially at a time when addiction of prescription drugs is at epidemic proportions.prescription bottle

Earlier this month, the Food and Drug Administration (FDA) approved a new formula for the time-release OxyContin, which is intended to prevent the pills from being cut, broken, chewed, crushed or dissolved to release more medication. The FDA noted that such an improvement in the drug may lead to less overdose risk due to tampering. However, a pharmacist with Prescriptionaddictionradio.com has argued that the drug company has yet to present a study about the effects of heat on the drug, and that tampering could become even easier than before. And it’s known that the drug can still be abused or misused if people take more doses than recommended.

In fact, it’s after FDA approval and after the drug is released to the public that the drug company is required to conduct a study on whether the “new” formula actually reduces abuse of the drug.

Along side this news, is a report that a drug known as Acurox is looking for approval from the FDA. Acurox is a drug that contains the B vitamin niacin to oxycodone in order to combat abuse due to the fact that large doses of niacin can cause uncomfortable flushing. However, the FDA has concerns about the use of niacin as it appears to worsen the medication’s side effect profile in pain patients that weren’t abusing their dosage. The drug company also said that in addition to the niacin, other added ingredients are designed to cause burning in the nose if abuser attempts to crush and snort the drug. And the drug turns to gel if added to water or other solvents to discourage injection.

However, many are saying that it’s a lot too little and too late for drugs that has been so destructive. And that the only “safe” formula is to remove these drugs completely from the market.

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Newborn Neurons, a Key to Prevention?

A recent study by the University of Texas reports one of the most exciting neuroscience discoveries to date regarding prevention, as reported by the Scientific American, that addresses why some people are more prone to drug and alcohol addiction than others. What they found: there are new neurons born in the adult brain. This study, which was published in the Journal of Neuroscience, could hold key insight to prevention mechanisms and future models of studying addiction.

To show that a lack of neurogenesis, or birth of new neurons, can actually cause drug or alcohol addiction, the researchers blocked neurogenesis, the production of new neurons, in the hippocampus region of the brain of rats. They found the rats with fewer newborn neurons were more likely to become addicted and more likely to relapse after withdrawal or detox periods. The researches speculated that this may be the reason some people are more at risk when it comes to substance abuse. Based on the study’s results and evidence from other studies on addiction and the hippocampus, the research suggests that newborn neurons may inhibit the release of dopamine (a major chemical messenger of rewards signals in the brain). Also, people with fewer newborn neurons may get a bigger dopamine rush with the use of drugs or alcohol than others.

This is the strongest evidence to date in support of there being real biological reasons as to why some people might be more vulnerable to addiction than others. And it gives a better idea of the role of newborn neurons in the brain. Neuroscience research on addiction has mainly focused on the role of the reward centers in the brain, more increasingly, the hippocampus. In light of now knowing that new neurons are born in the hippocampus, recent research has sought to understand how adult neurogenesis is involved in addiction. The researchers concluded that there is a direct correlation between neurogenesis and addiction.

Ultimately this theory could lead to testing individuals for the presence of newborn neurons and may predict their predisposition or increased risk of addiction. This could prove to be an invaluable prevention and rehabilitation tool.

Prescription Drug Overdoses Up 65 Percent

Prescription Drug Overdoses Up 65 PercentAre prescription drug overdoses on the rise? According to a report released by Reuters Health on April 6, the number of annual U.S. hospital admissions due to poisoning by prescription opioids, sedatives and tranquilizers rose from about 43,000 to 71,000 between 1999 and 2006, respectively. This 65 percent increase is nearly double the amount observed in admissions due to the poisoning by other drugs and medications.

According to Dr. Jeffrey Coben of West Virginia University School of Medicine, most Americans see the headlines related to stars such as Heath Ledger, Michael Jackson, and Anna Nicole Smith and think that such tragedies pertain only to Hollywood. Coben and his colleagues who performed the study, said this assumption was to the contrary. The reality is research across the country is seeing “very significant increases in serious overdoses associated with prescription drugs.”

The most predominant prescription drugs associated with these overdoses are opioids, such as morphine, methadone, Oxycontin and the active ingredient in Percocet. These powerful narcotic painkillers have been found to be habit-forming. Also, sedatives or tranquilizers such as Valium, Xanax, and Ativan are the reason for the increase in admissions.

When asked why there has been such a rise in poisoning by prescription drugs, Coben and his team noted that there wasn’t any single cause. But rather a number of variations such as the increase in availability of powerful prescription drugs, as well as the attitude toward the use, or abuse, of prescription drugs tends to be different than ones toward using other drugs. This is especially true among young people, who say that prescription drugs are easy to obtain and they see them as less addictive and less dangerous than street drugs such as cocaine and heroin.

However, the rate of accidental, or unintentional, poising by opioids, sedatives and tranquilizers nearly doubled during the seven year study period. With unintentional poisoning now the second-leading cause of unintentional injury death in the United States.

The study, which was published in the April 2010 issue of the American Journal of Preventative Medicine, also found that urban, middle-aged women seem especially vulnerable to prescription drug overdoses. And that hospitalizations for methadone poisoning increased more than any other drug during the seven-year period.

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