For anyone who has struggled with addiction or loved an addict, the number one question most people want answered is, Why can't they stop?
Dr. Anna Rose Childress, a professor who specializes in brain behavior at the Pennsylvania VA Addiction Treatment Research Center, has been using the latest scientific technology to study addicts' brains and determine what happens when a person is struggling with substance abuse.
To see what's going on inside the brain, Dr. Childress takes pictures of an addict's brain reacting to images both related and unrelated to drug use. Then, the researchers compare the way the brain reacts to each cue to determine the areas that are affected.
Since the study began, Dr. Childress has worked with cocaine, marijuana, nicotine and heroin addicts. The substances may vary, but the results do not. Dr. Childress says that in most cases, the brain was "compromised."
"The person [who is addicted] is actually not making choices in the rational way," she says. "This brain is a different brain, and we think the brain may be different when you walk into the world in terms of your ability to manage some of your impulses. But certainly after it's been exposed to drugs, there are important changes."
The brain functions that are affected are the same ones that help us maintain relationships and seek out the things we need to survive, like food and sleep. "That kind of strong, strong desire is a part of this system in the brain that now gets upturned," Dr. Childress says. "It gets inverted. It gets hijacked, essentially. So the drug does have a direct impact on the brain."
William is one of the addicts who participated in Dr. Childress's study. While examining William's brain, she flashed cocaine cues—images of people he had used the drug with or things that reminded him of cocaine—onto a screen for just 33 milliseconds at a time. Most people wouldn't even be able to recognize what they were seeing, but William's brain was well aware.
"For someone with a history of cocaine, there's an intense arousal that sets up in milliseconds," Dr. Childress says. "These cues say, 'This is more important than your children, than your spouse, than your job…pursue this.' From the brain's perspective, this is the important thing."
Photos of William's brain show that there was a surge of chemicals released when he saw the powerful cues, which Dr. Childress calls the "go state." For the first time in human history, researchers can now see what's happening inside the brain, identify the targets and see what they need to address.
"We're really excited that we can both calm down the go state, but also bolster the brakes," she says. "One of the things that we've been able to see is that people with addictions—their brakes aren't so good. So [there are] two ways that you can help the car—one is to take your foot off the accelerator. Another way is to put on the brakes."
Dr. Childress's goal is to treat addiction with medications that curb the craving. "Instead of it being so compelling and something that would cause you to go away from your family and your children, with medication, you can get a brain now that's sort of back down to, 'This is not so exciting. I can take this or leave this,'" she says.
It may be years before experimental treatments and prescription medications are available to all mothers, fathers and friends struggling with an addiction. For now, Dr. Michael Dennis, a psychologist who specializes in teen addiction at the Lighthouse Institute in Bloomington, Illinois, says the sooner you intervene, the better.
Although there isn't one answer or solution for every addict, Dr. Dennis says 90 percent of the people who become dependent on a drug started using when they were under 18. Fifty percent of addicts began using drugs when they were 15 years old…or younger.
If someone you love suffers a relapse, Dr. Dennis says his or her chances of recovery increase the sooner you reintervene.
Even if someone has completed a rehabilitation program, triggers in the outside world can cause a relapse. "Rehab is just a tool," Rick says. "The doors open up and you walk out. If you're just holding a tool, and no one's out there to help you support it, you're going to fall right off the wagon."
After years of lying and manipulating, many addicts end up divorced and estranged from their loved ones…even their children.
"You actually end up believing your own lies. You become part of them," William says. "They become your reality, actually, after a while."
Resisting drugs or alcohol is a daily struggle for most addicts, but Rick says there's one thing that's even more difficult than staying clean.
"Even harder than quitting the drug, getting off the drug, is forgiving yourself," Rick says. "I'm almost eight years clean, and I still loathe myself at times because of what I did years ago. I may be out helping kids every day and speaking at schools. … But I still go home at night and say, 'It's not enough. I don't forgive myself yet.'"
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