Biochemistry of the Addicted Brain
We are electrochemical beings. Emotions are the result of an electrical pulse zipping down a nerve fiber, stimulating the release of chemicals into a space called a synapse.
The chemicals float across the synapse toward nearby endings of other nerves. Each chemical only fits on specific sites designed for it called receptor sites. When the receptor sites receive the chemical messenger they forward the message down the receiving nerve and into another space and into another nerve and so on through the nervous system. If the messenger chemical lands on a dock that doesn’t fit, nothing happens. It bounces off and floats around in the synapse perhaps to find the right fitting receptor site somewhere else or, after a certain amount of time, to be sucked back into the source nerve to be torn apart and reused for something else or sent out again later. That process of returning to the source nerve is called reuptake. Receptor sites and reuptake are critical words in the story of addiction.
Other words you need to know are these five neurotransmitters: serotonin, dopamine, norepinephrine, GABA, and endorphins. One or more of these five neurochemicals are the messengers that every single person on a legal or illegal psychoactive drug is seeking to increase by taking their drug of choice. And those clients who are polydrug users are simply doing their best to balance out the dramatic effects on the neurotransmitter system that has been bombed by their drug of choice.
Practitioners of the healing arts who aren’t really interested in working with people who use methamphetamine or cocaine or other illegal drugs of abuse will, during their next full work day, be seeing at least one patient who is on a drug to manipulate this system because while one in 10 Americans is on an antidepressant, one in 4 women aged 40-50 is on an antidepressant drug.
And that antidepressant is either an SSRI that manipulates just serotonin or an SNRI that manipulates both serotonin and norepinephrine. In addition, all drugs and everything we do to make ourselves feel better is influenced by our system’s innate level of the third neurochemical, dopamine.
This may be a new way to think about drug addiction.
All human beings are born with a default setting set by both their family genetic code and their parents’ life conditions. Famine, poor food choices, emotional trauma, and toxic chemical exposures all influence the health of the fetus not just for one generation but for generations. My second book was on preventing birth defects and writing it I read research about the effect of a grandmother’s life on the incidence of asthma in her grandchild. So many factors influence how vibrant and vigorous the level of neurotransmitters is in each of us.
If a boy is born with too few catecholamines, which is the umbrella word for the stimulating neurotransmitters dopamine, norepinephrine, and epinephrine, he will feel not comfortable inside and need to do something to generate more catecholamines.
There is an area of our brain called the ventral tegmental area or VTA. It’s deep in our midbrain, the mesolimbic area which is our lizard brain that is the source of all core life processes like eating, drinking, sex, and mothering. Here we produce dopamine.
Dopamine leaves the VTA and moves up through the mesolimbic pathway to the nucleus accumbens. This pathway is also called the reward pathway because as you recall dopamine is our source of feeling a sense of reward, of pleasure in our life. From the VTA dopamine also moves forward into the prefrontal cortex. This is why people who have been using drugs since they were young teens act like they never grew up. The prefrontal cortex is the source of our higher thinking, our spirituality, our rationality, and our ability to understand consequences.
Dopamine is our major reward chemical. We want it. We seek it. When it is secreted we feel happy. Productive. Living is worthwhile. When we lack it we feel depressed, flat emotionally, bored, unable to focus or concentrate, are probably diagnosed ADD, are unable to generate energy or enthusiasm to do anything. We drink coffee to get going in the morning. We drink energy drinks to keep going in the afternoon. We wiggle. We swing our legs. We don’t feel comfortable being simply still.
The child with too little dopamine or the other catecholamines will talk and fidget in class. He can’t concentrate on the work. After school he will ramp up his levels by daredevil sports activities. He will be the one who does the hardest tricks on his skateboard, chooses parkour over soccer, and later joins the paratroopers. He’s the one put on Ritalin at age 9 and chooses methamphetamines or cocaine at age 20. He might also use alcohol but will tell you it’s for stimulation, not sedation. And if a child is diagnosed with ADHD, attention deficit hyperactivity disorder, he or she is probably also low in serotonin.
If a child has too few serotonin neurotransmitters she’s depressed, worried, irritable, moody, has panic attacks and phobias, tics, low self esteem, obsessive-compulsive behavior, afternoon cravings, and can’t sleep at night. If she’s diagnosed ADHD and doesn’t have a focusing problem she’s most likely low in serotonin, not catecholamines and, by the way, a 25mg 5HTP from LifeLink will often turn the child’s behavior around.
She seeks relief from candy, bread, chocolate, Ecstasy (MDMA), marijuana, and alcohol. She will tell you the alcohol is for chilling out at night not to dance on the table.
Some of the body’s serotonin originates in the midbrain and brainstem and moves to many areas of the brain, but also much of it, actually 95% of it, is produced and stored in your gut. If you want to know more about this fascinating fact you can read The Second Brain by Michael Gershon, MD, professor in the department of pathology and cell biology at Columbia University and the father of neurogastroenterology.
When the cells of the nucleus accumbens receive signals from arriving dopamine, along with other signals, the nucleus accumbens releases GABA. Dopamine is a stimulatory neurochemical. GABA is a calming neurochemical. Balance is the name of the game of life. In terms of Traditional Chinese Medicine, GABA is yin and dopamine is yang.
If a child has too few GABA neurotransmitters she’s an anxious wreck full of muscle tension from feeling overwhelmed and burned out.
She seeks relief from sedatives, tranquilizers, sweets, starches, and alcohol.
When the body is stressed the part of the brain called the hypothalamus sends a chemical messenger to the pituitary which releases a chemical to deal with pain. That chemical is called beta-endorphin because it is endogenous (or found in the body) morphine. This beta-endorphin is also synthesized by some of our immune system cells like lymphocytes, monocytes, and macrophages. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104618/)
If she has too few endorphins, she suffers from emotional or physical pain, depression, and cries easily even watching a commercial on TV. She loves loves loves chocolate or something else that she eats or does to excess.
It might be that her childhood or young adult abuse is too painful to bear and that is why she buries her memories under the blanket of Oxycontin or heroin or marijuana, or becomes obese from eating her way through any uncomfortable feeling that gets anywhere close to reminding her nervous system of the real trauma in the Pandora’s Box she carries inside.
Because the symptoms of deficiency are clearly differentiated with these four neurotransmitter systems it is easy to figure out what your clients need by asking them to give a number from 1 to 10 to every symptom that relates to them on a chart developed by Julia Ross, MFT, who wrote a bible of neuronutrition, The Mood Cure. It needs to be in your resource library.
Acupuncture releases endorphins so it will help anyone to calm down and feel more relaxed. It works in tandem with a pro-recovery diet and amino acids, which are the raw materials the body uses to produce those important neurotransmitters GABA, serotonin, dopamine, and endorphins. Anyone working in the field of addictive and mental health disorders will find clients improving quickly and feeling well in a deeply satisfying way once their nutritional deficiencies are satisfied along with their emotional needs. With amino acids and nutrients a person will notice cravings for drugs disappearing in fifteen minutes and over several months of care they can correct a system that has been deficient from birth. Three talented practitioners, Christina Veselak, LMFT, Charles Gant, MD and Julia Ross, MFT, have training programs for professionals. Gant, Ross, and Joan Mathews Larson, PhD, also have excellent books useful for nonprofessionals and professionals alike.
Christina Veselak, LMFT, CN www.christinaveselak.com
Julia Ross, MFT The Mood Cure or The Diet Cure www.dietcure.com
Joan Mathews Larson, PhD Seven Weeks to Sobriety and Depression-Free, Naturally www.healthrecovery.com
Charles Gant, MD, PhD End Your Addiction Now www.charlesgantmd.com