The Latest Brain Research on Addiction

Please welcome Lisa Frederiksen, from Breaking the Cycles, who shares her important information about the latest brain research on addiction.

Can you please introduce yourself to readers who don’t know you?

I am a researcher, writer, speaker, consultant, and most recently the author of my seventh and eighth books If You Loved Me, You’d Stop! and Loved One In Treatment? Now What!

I have explored a wide range of topics over the course of my writing and speaking career, including civil and women’s rights issues, results-oriented workplace initiatives, women’s history month celebrations, poetry, and biography writing workshops, career search, and job hunting techniques and voter registration and empowerment. Sometimes it felt too scattered, but the driving force in all of it is my desire to really understand the various aspects of an issue or problem that has either directly affected my life or has had significant ramifications on public policy decisions because of society’s limited understanding of the overall picture.

I am a big supporter of understanding the history of an issue. So it generally starts with my sorting through the history to find the narrative, and from there, the additional questions that if answered would help make sense of the current issue. Once I start digging, I’m usually hooked — researching, writing and rewriting until I understand the issue or problem and know that I have the most current information and qualified sources. Then I like to share what I’ve learned in easy-to-understand books and articles and/or PowerPoint presentations.

In addition to what I do with BreakingTheCycles.com and addiction-related issues, I also continue to work in areas related to women’s history and women’s issues (which are family issues) and to consult to and write for businesses and non-profits. On a personal note, I live in northern California and have two wonderful daughters, both in their early twenties.

What can readers hope to gain from your books, Loved One In Treatment? Now What! and If You Loved Me, You’d Stop!?

To begin to answer this question, I would like your readers to look at the following statements and see if any sound familiar:

Why won’t she just stop?

It’s just marijuana so what’s the big deal?

We give him money and pay his rent, but it doesn’t seem to help him get on his feet. I don’t know what he does all day!

My husband doesn’t think our daughter’s drinking is that bad. I do, but I can’t stop her if he’s always giving in to her.

Who’d ever think of drinking and driving?

I know he doesn’t mean to yell at the kids; it only happens when he drinks, anyway.

I don’t think my wife’s an alcoholic. I mean she has a couple of drinks in the evening and sometimes in the afternoon, but she’s under a lot of stress with the kids and all.

If your readers find these kinds of statements familiar or they are the family member or friend of a person whose drinking or drug use is a source of concern, they will find my books helpful as they answer so many questions, such as:

— What causes addiction? Why do some people become alcoholics or drug addicts and others do not?

— Who among family members and friends can help a loved one get treatment? Or can they?

— What if you can’t get them to stop or seek help?

— How is it possible that addiction is a disease when they are choosing to drink or use drugs?

— Is someone who drinks a lot but still goes to work really an alcoholic?

— What is an effective treatment? Is recovery different than treatment?

— What about family members and friends? What is available to help them?

Best of all, both books are short, just at or slightly over 100 pages. I chose that length because I know when I started down this road, myself (see #3), I was overwhelmed with what was out there. I wrote them from the perspective of what I wished I could have found.

What inspired you to write books?

In 2003, one of my loved ones entered treatment for alcoholism, and I found myself plunged into a world with terms like addiction, alcohol abuse, alcoholism, alcoholism as a disease, adult children of alcoholics, codependency, dual-diagnosis, and on it went. [I soon understood and acknowledged that I’d experienced decades of coping/fighting with family members and friends’ alcohol abuse and/or alcoholism.]

At the time, my books and presentations were focused on women’s history and the civil rights movement. True to my nature, I then shifted my research and writing to all things addiction, and immersed myself in my own recovery work (e.g., therapy with a therapist trained in addiction and its impact on family members and 12-step programs for family members) and research to answer my most pressing questions namely, How could it possibly be a disease; they choose to drink? and Why have I put up with it for so long!? One thing about research is that every answer seems to raise a new question!

In the course of all this, I found an explosion in discoveries about the human brain, its development, it’s functioning, what changes it, what can heal it, its ability to regenerate, and more. Much of this explosion has occurred in just the 21st century, and all of it is nothing short of profound. These discoveries are due in large part to advances in imaging technologies, such as PET, SPECT, and fMRI technologies that allow scientists and medical professionals to study the live human brain in action and overtime.

With my first book, If You Loved Me, You’d Stop!, it was my desire to share this new research against the backdrop of my own journey in the hopes that I could help other family members/friends who struggle with a family member’s drinking and to help all of us, as a society, end the stigma and shame that surrounds and perpetuates the disease.

With the second book, Loved One In Treatment? Now What!, I wanted to provide a check-list of how to get through that initial period after a loved one enters treatment OR is contemplating treatment OR you, as the family member/friend, are wondering what treatment is all about.

This book expands on the brain research of addiction but goes more deeply into what happens in the brains of family members and friends repeatedly coping with a loved one’s substance misuse and how family members and friends can use all of this research to help themselves, whether their loved one seeks or succeeds in treatment and recovery, themselves. And, as I mentioned, it provides a checklist of next steps to help someone new to all of this find a way to focus and calm their fears, anxiety, confusion, and desperation.

Five key findings with regards to the brain that are/were of particular interest to me, include:

1) neural networks in the brain control everything we think, feel, say and do,

2) the brain is not fully developed until one’s early 20s, often not until age 25, with critical periods of neural network wiring and brain development occurring from ages 1 — 3, 4-10, and 12 — 25,

3) that what happens to an individual via biological, environmental and developmental influences over the course of their brain’s development deeply influences how that person’s neural networks wire and therefore everything that person thinks, feels, says, and does — the very quality of that individual’s life,

4) a person can change their brain (their thoughts, feelings, reactions, coping skills) by changing their neural networks, and

5) untreated substance abuse, addiction, and secondhand hand drinking/drugging (the impacts on family members of a loved one’s drinking/drugging behaviors (described in #4) changes a person’s neural networks and thus how their brain works and thus what they think, feel, say, and do.

Why is it important for people to know that addiction is a brain disease?

In my opinion, understanding and accepting this one fact — that addiction (whether to illegal or prescription drugs or alcohol) — is a chronic, often relapsing brain disease can be life-changing. It allows the person who loves a drug addict or alcoholic to finally understand what happened, why their loved one can’t “just stop,” and why they can’t help their loved one by continuing to use the methods of help they’ve been using (e.g., deal-making, nagging, blaming, arguing). The family member/friend can finally let go of their anger, frustration, resentments, and feelings of not being important enough.

And, here is why addiction is a brain disease.

Everything about our body — what we can see and what we cannot see — is made up of cells. Diseases change cells in our body — that’s what makes a disease a disease. A disease might change cells in body organs (like the heart or liver or eyes) or in body organ systems (meaning several organs working together), like metabolism or cardiovascular. For example, the disease of breast cancer attacks cells in the breast, and the disease of diabetes attacks cells in the metabolic system.

The diseases of addiction (drug addiction or alcoholism) change cells in the brain, thereby changing how the brain works. Because neural networks in the brain control everything we think, feel, say and do, these brain changes get in the way of a person’s ability to act normally and make good decisions.

It can cause that person to do things like: starting fights with friends, yelling at or hitting family members, missing work, carrying on rambling arguments, accusing family members or friends of doing things they haven’t done, driving while under the influence, being super nice, not getting to work on time, not being able to fully concentrate when at work or school, or continuing to use/drink after promising not to.

We call these “things” drinking/drugging behaviors. These behaviors are the result of a person drinking or using more of a drug/alcohol than their brain and body can process, thereby changing how their brain works. They are not the “person.” Additionally, alcoholism and/or drug addiction often change cells in several other body organs, as well, such as the liver, heart, and kidney. As true with other diseases, if untreated or during a lapse in management of the disease, a person can die from alcoholism or drug addiction, just as people die from other diseases.

No part of this understanding of addiction as a brain disease is to understand what causes it — the answer to your next question.

What causes addiction?

It starts with substance abuse. In fact, all drug addicts/alcoholics go through a period of substance abuse, but not all substance abusers become addicts/alcoholics. Substance abuse is what starts the chemical and structural changes in the brain. So, when explaining alcohol abuse, for example, it is defined as one or more of the following occurring within a 12-month period:

• Recurrent alcohol use resulting in failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; or neglect of children or household).
• Recurrent alcohol use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine).
• Recurrent alcohol-related legal problems (e.g., arrests for alcohol-related disorderly conduct, DUI).
• Continued alcohol use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the alcohol (e.g., arguments with spouse about consequences of intoxication or physical fights).
• Recurrent binge drinking, which is defined as 5 or more standard drinks on an occasion for men and 4 or more for women.

While both substance abuse and addiction (aka substance dependence) cause chemical and structural changes in the brain and thus changed behaviors, there are five key risk factors that contribute to a person developing the brain disease of addiction.

These risk factors include: genetics (if it runs in the family, genetic predisposition); social environment (where heavy drinking or drug use is viewed as “normal,” causing a person to drink or use heavily, which given their brain/genetic make-up, may lead to substance abuse and/or addiction); childhood trauma (verbal, physical, emotional abuse, which “wires” unhealthy coping skills and brain changes); early use (critical brain development ages 12-early 20s makes the brain especially vulnerable to brain changes caused by substance misuse), and mental illness (e.g., depression, anxiety, ADHD, PTSD, bipolar — which also cause brain changes and often a tendency to “self medicate” with alcohol or drugs).

The more risk factors, the more susceptible a person is to the possibility of “crossing the line” from abuse to addiction.

In addition to reading my books, this website, www.hbo.com/addiciton, is an EXCELLENT resource on addiction and is produced by HBO in collaboration with NIAAA, NIDA and the Robert Wood Johnson Foundation.

Both substance abuse and addiction cause brain changes, which in turn cause drinking/drugging behaviors. The disease of addiction (whether it’s to alcohol or illegal or prescription drugs), however, has four characteristics that make it different than substance abuse. These include cravings, loss of control, tolerance, and physical dependence.

An addiction craving, for example, can be five times stronger than our instinctual, hardwired drive to eat food when hungry because of the neural networks that are compromised. These powerful cravings override all other “thought” and are what cause an alcoholic or drug addict to lie and steal and do whatever it takes to drink or use. Addiction cravings and these other characteristics (loss of control, tolerance, and physical dependence) are more fully explained in my books.

Is treatment for substance abuse different than it is for addiction?

Yes. With substance abuse, abuse patterns may be modified to fall within “normal” limits (that’s a whole other question and answer for another time) although for some people, “modification” is to stop altogether. With addiction, the substance must be stopped altogether.

There is no amount that a person who is addicted can “safely” use or drink, ever. Why this is so and how to do it [and there are many options besides AA and NA, for example] are covered in my books — especially Loved One In Treatment? Now What!. The image below, however, will help your readers understand that the brain can change when substance abuse is stopped or the disease of addiction is treated.

You talk about secondhand drinking/drugging (SHDD) in your second book, Loved One In Treatment? Now What!. What is it?

When a friend or family member is on the receiving end of someone’s drinking/drugging behaviors and/or on the receiving end of someone’s reactions to those drinking/drugging behaviors (i.e., a non-drinking spouse trying to control a husband/wife’s drinking behaviors), that person experiences SHDD (like the idea of secondhand smoke).

Examples of secondhand drinking impacts include the consequences for others as a result of a person’s DUI, drunk arguments, blackouts, problems at work related to drinking or recovering from heavy drinking bouts, or having unprotected or unwanted sex.

A person experiencing repeated SHDD wires unhealthy coping skills in order to accommodate, deal with, excuse, and/or rationalize unacceptable behaviors as if they were somehow acceptable or excusable or something to be tolerated.

A person experiencing repeated SHDD can also experience physical and emotional problems, such as headaches, stomach ailments, depression, work or school-related problems (due to being distracted or exhausted from the worry or fights about the drinking/drug misuse, for example), and anxiety.

Can you tell us about your blog, Breaking The Cycles.com?

Basically, it is to provide new information written by myself, guest authors, people leaving comments, shares of new research from key agencies (e.g., NIDA, NIAAA, SAMHSA, WHO, ASAM) and research centers, scientists, psychologists, therapists, recovering addicts/alcoholics, family members… so that we can change the conversations surrounding addiction, mental illness, underage drinking, DUIs, dual diagnosis (co-occurring disorders), issues of importance to the family members, SHDD — really, anything, as long as it is addiction-related.

I invite, encourage, would love your readers to add their thoughts. Societally, we have changed so many situations, disease treatments, safety issues just by sharing and talking about new science and research studies. In the early 1970s, for example, most people smoked cigarettes, drove cars without seat belts, road bicycles without helmets and hadn’t heard of an infant car seat.

Yet, new information and talking about these activities convinced millions of Americans to stop smoking cigarettes and outlaw smoking in public places. New information and talking about it led to the passage of laws to require bike helmets until age 18, seat belts for everyone, and car seats for children ages 4 and under.

And when you think about HIV/Aids and how it was viewed and treated in the early 1980s compared to today — you can see where the power of talking about this — humanizing it, focusing on the science — can be a groundswell for change.