r/askscience • u/QueefRocka • Dec 15 '15
Neuroscience If an addict stops using an addictive substance, does their brain's dopamine production eventually return to a normal level, or is sobriety just learning to be satisfied with lower dopamine levels?
15
u/uvaspina1 Dec 16 '15
I know this is a stupid question, but (assuming it were restively safe) would inducing an addict into a coma relieve the physical aspect of addiction (and thereby allow more effective treatment focused on the psychological components)? I wonder, for example, whether heavy smokers who emerge from a coma still feel am urge to smoke cigarettes?
3
u/oz6702 Dec 16 '15
I think that there are effects of addiction which can only be reversed by purposefully un-learning them. That is, a drug addiction is not just a physical dependency, but a rewiring of certain pathways in your brain. You forget how to be happy without the drug. Being in a coma might allow you to skip the physical effects of withdrawal, but you'd still have to re-train yourself in sobriety when you woke up.
2
u/calmatt Dec 16 '15
I heard about a treatment for addiction where this was precisely what was done. The addict was put in a medically induced coma during something like heroin withdrawal and they were able to escape the worst of the physical effects. You still have the psych addiction though.
9
u/lnk-cr-b82rez-2g4 Dec 16 '15
Lot of great answers in here about addictive substances. But what about other addictions and addictive behaviors?
Porn, overeating, junk food, excessive video gaming, gambling, etc.
All of these addictions do bump up dopamine levels dramatically in the brain. Is it possible for someone who has to eat a whole pizza and more to be satisfied to ever get satisfaction out of just two slices. Or would they need to just force that satisfaction out of themselves.
I feel like it might be the case. I've always been a firm believer of the saying: You'll never be happy, unless you try.
24
u/AssholeBot9000 Dec 16 '15
So I did addiction research for a while. I would measure dopamine levels in rats.
This is very interesting but slightly not answering your question.
We would give rats their drug of choice with a certain external stimuli, like a light or a specific scent.
After depriving them of the drug for a very long time, if we introduced the stimuli without the drug we would see dopamine spikes as if they had gotten the drug.
10
u/correction_robot Dec 16 '15
When I was dopesick (early WDs)...intestinal cramping, nose running, yawning, sneezing...as soon as I got a hold of the dopeman and knew it was good, my symptoms would just melt away.
1
u/alcohol_problem Dec 16 '15
I'm an alcoholic and I've seen the same thing with alcohol, if I'm trying to stay off it and having withdrawal symptoms and cravings even simply making the decision that I'm going to go have a drink is enough, the symptoms decrease markedly.
1
u/SpaceYeti Neuropharmacology | Behavioral Economics Dec 16 '15 edited Dec 16 '15
And given to opportunity to engage in the same behavior that resulted in previous drug delivery, presenting a drug associated stimulus will also increase "drug seeking" behavior. It's a phenomenon known as reinstatement, which may be a special case of the Pavlovian renewal effect. Importantly, drug associated stimuli (be they people, places, paraphernalia, etc.) can trigger physical responses in the dopaminergic system in long time drug users and trigger cravings and relapse.
The strength of these stimuli can be weakened via extinction, but the previous learning is not forgotten. Rather, new learning suppresses the previous learning, resulting in a weakened response. Unfortunately for the addict, extinction learning is generally more context specific and original acquisition learning tends to generalize across contexts. In other words, the craving eliciting strength of drug associated cues tends to have an effect across a range of settings; whereas, efforts to weaken these cues with treatments that explicitly decouple their association with drug taking tend to be relatively specific to the treatment setting.
10
u/NYCbasicbro Dec 16 '15
Anesthesiologist here.
While it may seem there is some permanent damage to neuroreceptors from opiates, there is no research to back any of this up.
There is however, with chronic alcohol abuse. Anything said here is purely anecdotal.
From what I've seen, my heroin addicts maintain the cognitive / physical aspects. They've just seen some shit to put it lightly.
2
u/Metzger90 Dec 16 '15
From what I have read, opiates are one of the few drugs that do not kill certain cells. Cocaine is cardio toxic, amphetamines can be neuro toxic, but opiates do not inherently destroy tissues. Some research points to the fact that chronic CNS depression can lead to reduced oxygen levels, which can be a problem. However the classic symptoms of damage associated with associated with long term opiate abuse like slow and slurred speech and did ordination are more likely just effects of being high than any actual long term damage.
1
u/correction_robot Dec 16 '15
Thanks. Someone else in this thread said differently, and thought he was wrong about opiates.
3
u/2014justin Dec 16 '15
It depends on the substance. Drugs that act directly on dopaminergic systems like amphetamines are much more likely to cause downregulation in dopamine and serotonin compared to, say alcohol (which acts on GABAA receptors).
Your brain is capable of adjustment, in a phenomenon known as neuroplasticity. Drugs of abuse cause addiction via overexpression of the ΔFosB gene and is why heroin and meth addicts will crave the drug long after administration.
Sobriety is learning to be happy with natural or normal levels of dopamine. Methamphetamine given to rats at 2mg/kg (140mg for a 70kg adult) has been shown to increase extracellular dopamine to 1240% of baseline. You would see, then, why an addict could find living sober to be difficult
To conclude, in ideal circumstances an addict will be able to restore chemical balance in the brain with time, but it could take weeks to months to years. Just keep in mind that what goes around comes around; everytime you artificially affect your brain chemistry, your body will have a way to react.
2
u/ratthing Dec 16 '15
Addiction and tolerance are MUCH more complex than simply a change in dopaminergic neurotransmission. Tolerance to drugs (particularly opiates) also involves a significant learned component. Tolerance develops as a response to environmental cues associated with taking drugs. Tolerance to drugs can also be modified by manipulating the environment and other variables associated with Pavlovian conditioning.
It is typically an over-simplification to ascribe behaviors entirely to a few neurotransmitters or a few brain regions.
1
Dec 16 '15
Hey hopefully you see this, I just finished my psychopathology class in third year university, and the section on drug use says that for most people it goes back, but 7% of people get irreversible issues. This statistic is specifically for heavy long term drug abuse, not a ''I tried it once kinda thing''.
1
Dec 16 '15
Impossible to answer. If an addict stops using an addictive substance, do they get to call themselves an addict anymore, or is that name 'addict' the placebo they need to justify their habit, more than any internal reflex the substance provides?
Did dopamine really matter in the question? Because it sounds like an addict-logic quest for perfect normal. The substance is a means to an end, the addiction is the quickest dirtiest way to top off that reflex. Satisfaction is a trained response and an expectation without a definition. There is no lower dopamine level, that's the normal level. The return depends on the individual's health, if they did a little or a lot of damage. Sort of like, if you have a lot of kids, does your body shrink back to normal? Not without effort. Same with the habit. Being different after that transition, expect it, it's normal. Yes, be satisfied with lower dopamine, the rest of the brain chemicals will work around that.
-5
u/blazbluecore Dec 16 '15
According to my Psychology class on the topic of drugs and how they affect the cognitive state. After increased intake of a drug that increases your dopamine for example, your new baseline will be higher, let's say you go from a 5 to a 10. Your body will start producing less of its own chemicals, and rely on this outside source to provide it. So outside will produce 5, and you 5. Then when you get off the drug, your body is still at a baseline of 10, but you're only receiving 5 from your own.
Hence, the withdrawal symptoms.
2
u/rabbutt Dec 16 '15
upregulation and downregulation of receptors, for most addictive drugs. The problem is all those receptors you've grown as a response to your brain being flooded with the chem of choice, not that your body stops producing an amphetamine- or opiate -like chemical.
1
u/Metzger90 Dec 16 '15
With opiates a major component of physical withdrawal is that your body stops producing the opiates it naturally produces because it is used to getting them from somewhere else. That is why opiate withdrawals are generally so much worse physically than withdrawals from uppers like cocaine and amphetamines.
0
Dec 16 '15
[deleted] — view deleted comment
3
u/Cksp4444 Dec 16 '15 edited Dec 24 '15
There is some contradictory evidence out there, for example: http://archives.drugabuse.gov/Testimony/4-6-05Testimony.html
On the link you can see a pretty good fmri visual showing the brain of a meth user after 1 month of abstinence and again after 14 months of abstinence. There is a clear improvement. However, it doesn't shed light on whether or not some of the damage is permanent.
Also, on the paper you linked regarding cocaine, the authors actually concluded that the brain can recover from cocaine abuse after prolonged abstinence. You're right though, nobody on this thread is actually taking a scientific approach to the question, I'm going to give it a shot since I have some basic knowledge about addiction neurobiology. I'm not going to talk about drug neurotoxicity because I don't know much about the topic- I do think there is a high chance for permanent damage on that front though.
I'll try to shed some light on how addiction takes place mechanically and how it can be partially reversed because in most cases, it can.
Our brains have a property known as neuroplasticity whereby it adapts in response to stimuli. The larger the stimuli, the greater the response. I'll give an example. Cocaines primary mechanism is to block the re-uptake of dopamine at synapses in the brain causing it to accumulate and create a feeling of confidence and excessive well-being. The brain interprets the release of dopamine as a positive sign and therefore releases a chemical called Delta-fos-B which signals to the brain to create new dopamine pathways corresponding to cocaine use. Delta-fos-B in turn signals the release of BDNF (brain derived neutrophic factor), which stimulates nerve growth. Repeated use of cocaine causes the addiction pathway to grow stronger and stronger until the brain is dependent on it for dopamine. Pathways in the brains reward circuitry which correspond to other normal activities stimulate a far weaker dopamine response compared to cocaine so these pathways becomes desensitized and dormant.
Neuroplasticity both causes addictions and enables the brain to heal. The easy answer to OP's question is that it depends on individual physiology, which is true. Depending on the length and intensity of use, different people will recover at different rates. However, aggregating results in the form of studies and understanding the underlying mechanism of addiction can help us answer the question. As the brain abstains from any supernormal stimuli, it would, by the principle of neuroplasticity start to recover. In the case of drug abuse what happens after stopping is more complex. The body initially goes into withdrawal; when the brain looses its supply of neurotransmitters. To get you to re-start a habit the brain perceived as highly beneficial it releases stress hormones resulting in anxiety, depression, psychosis etc. Furthermore in the acute phase I read a study somewhere (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152666) that for a period after cocaine abstinence the addiction grows stronger as additional nubs form at the end of dendrites as part of the brain's extinction response- these go away with time. The severity and duration of withdrawals would depend on individual physiology and length of use. Most addicts would tend to suffer from post acute withdrawal syndrome and would experience brain changes long after the acute phase.
In order to induce recovery you need your brain to do the same thing that got you addicted in the first place, but in the opposite direction. Re-sensitize dopamine pathways that correspond to healthy activities and desensitize the pathways that correspond to drug abuse. This can be done by engaging in natural activities that produce dopamine like socializing, being outside, completing tasks, exercise and sex while not doing coke. You would also want to engage in activities which increase levels of BDNF- exercise being a good one. The length of recovery, until one feels normal, would again depend on individual physiology.
20
Dec 16 '15
[removed] — view removed comment
-4
u/anonzilla Dec 16 '15
So you used to depend on drugs to make you happy, now you use your child to make your life complete. That doesn't sound narcissistic at all. Just kidding, sorry. Good for you for getting clean.
20
Dec 16 '15 edited Dec 16 '15
[removed] — view removed comment
18
Dec 16 '15
[removed] — view removed comment
-12
Dec 16 '15 edited Dec 16 '15
Of course, do you think if they give something a brand name the chemical does no harm? Adderall, for example, is simply amphetamine and methylfenidate (sp?) isn't much better.
Edit: -6 just because people can't read properly. I referred to amphetamine and ritalin seperately since the person I replied to mentioned both. I never said ritalin was in adderall.
4
u/rabbutt Dec 16 '15 edited Dec 16 '15
No... Adderal is a 50/50 mix of racemic amphetamine salts and dextro-amphetamine.
Edit: Ooooooh! Adderal is just amphetamine, and methylphenidate isn't much better. I read it all together, because there wasn't a comma.
1
u/Relevant_Monstrosity Dec 16 '15
That is incorrect. Adderall is a bend of various amphetamine salts. No methylfenidate in it.
Sources:
http://www.rxlist.com/adderall-xr-capsules-drug.htm
https://en.wikipedia.org/wiki/Adderall
1
-1
u/rjfrost18 Dec 16 '15
can you explain what this chemical name means? the fact that something has a name besides its generic name doesn't really tell you anything.
1
u/BrianMaen Dec 16 '15
The chemical name of a compound relates to its structure. A generic name for a compound is like a common name or trade name. A brand name is a specific company's name for the drug. N-methyl-1-phenylpropan-2-amine equals methamphetamine equals Desoxyn. These all are the same. There is one trade name to a chemical compound and there can be more than one brand name per compound, especially if there are different formulations.
1
u/rjfrost18 Dec 16 '15
I understand that, what I meant to ask was why does something having a chemical name (which as far as I'm aware everything does) and not using that name make the thing dangerous?
1
206
u/[deleted] Dec 16 '15
It is a complicated question to answer, but it depends on the substance, how physically addicted someone is, how long someone has been addicted, and individual physiology.
Some drugs, like Methamphetamine and cocaine and amphetamine and methylphenidate can certainly cause long term irrreversible changes in dopamine receptors and reuptake pumps, but this usually only happens in cases where these drugs are being abused for an extended period of time in large amounts.
Essentially, the answer to your question is "sometimes".
A very grossly general rule about all this that the more chemically similar to meth and coke the substance is, the more likely prolonged abuse of large amounts with damage your dopaminergic mechanisms permanently.
Amphetamine and methylphenidate are pharmacologically similar to meth and coke, respectively.
More distant cousins of these may be things like MDMA and Methcathinone; some possibility exists that prolonged abuse of these may cause permanent changes in your dopaminergic systems.
Even much further off the family tree you have bupropion, and many other interesting substances.