Neurotransmitters and Addiction

Outline• Definition of Addiction• Causes• The Three Culprits • Dopamine and the Reward Center• Dopamine’s role in addiction• Treatment for dopamine-related addictions• Serotonin• Serotonin’s role in addiction• Treatment for serotonin-related addictions• Noradrenaline• Noradrenaline’s role in addiction• Treatment for noradrenaline-related addictions• Recap of The Three Culprits. • A note about genetics• A note about the craving effect• Summary• Bibliography

What is Addiction?• Addiction is a compulsive seeking, and then obtaining, of a

substance while behavior increasingly becomes out of control (Spiga, Lintas, and Diana 1).

• Three types of neurotransmitters play an important role in addiction by indicating which drug a person is most likely to become addicted to: dopamine, serotonin, and noradrenalin. **Some sources focused solely on dopamine or a dopamine varient, while others credited the neurotransmitters gamma- aminobutyric acid (GABA), glutamate, and opioids as playing roles in addiction as well. Two sources mentioned dopamine, serotonin and noradrenalin, so I will proceed with those while cautioning that it is not entirely agreed upon. It is more likely that all the neurotransmitters listed play some sort of role in addiction- their roles are just not fixed in scientific knowledge yet.

Causes of Addiction• Addiction has now been recognized as a medical disease, but no specific

cause has been found. Instead, addiction is caused by a combination of genetics, environment and stress (Kipper and Whitney 62).

• The three main neurotransmitters involved in addiction- serotonin, noradrenalin, and dopamine- exist in a balance (Kipper and Whitney 22) . We all are born with a genetic tendency towards a slight imbalance between these three neurotransmitters, however the more off-balance the relationship between these neurotransmitters are, the greater risk that person carries for addiction (Kipper and Whitney 30).

• What the person is most likely to be addicted to is dependent on what neurotransmitter is the most out of balance ( Kipper and Whitney 29).

• Stress is a key trigger for most addictions. Stress throws off the brains‘ homeostasis (natural balance) and significantly increases the risks that the person will turn to addictive self-medicating behavior (Kipper and Whitney 30).

Dopamine and the Reward Center• All addictive substances studied cause a change in dopamine levels (The

Hyjacked Brain).• Dopamine is the neurotransmitter in charge of pleasure. When you

experience something pleasurable, dopamine is released to the reward center (the nucleus accumbus) of your brain. The pleasure pathway is called the dopaminergic pathway. Neurotransmitters are then sent to the memory center (the temporal lobe). The memory center then triggers the behavior center, also in the temporal lobe, to repeat the experience. Reward highways are built from highly pleasurable one-time experiences or less pleasurable experiences that are repeated. The more pleasure an experience gives or the more an experience is repeated, the stronger the reward highway becomes. The stronger the reward highway, the more the brain wants to repeat the experience that created the reward highways. This is how addiction begins.

• The most addictive drugs are plant based, and the chemicals the plant produces so closely mimic dopamine that the brain thinks it is receiving the equivalent of massive amounts of dopamine (The Hyjacked Brain).

Dopamine and Addiction• An excess of dopamine in children causes behaviors ADD and ADHD. In

adults and older adolescents, excess dopamine can cause mania and bipolar disorders. If the person with excess dopamine chooses to experiment with drugs, s/he is most likely to become addicted to stimulants that mimic dopamine (Kipper and Whitney 36).

• Cocaine’s chemical formula mimics dopamine’s formula. Cocaine blocks the reuptake of dopamine, which then accumulates in the synapse to stimulate receptors further and cause the person to feel extremely good (Tomkins and Sellers 818). Once the cocaine wears off, the brain is used to having that quantity of dopamine and triggers the need for more, resulting in the person using more cocaine. Over time, more and more cocaine is needed to produce the same effect and the person begins to use cocaine merely to function (The Hyjacked Brain).

• Other drugs that may mimic dopamine are methamphetamine, Dexedrine, Ritalin and Adderol (Kipper and Whitney38).

• Less harmful stimulants such as caffeine and sugar are also accepted as dopamine mimics (Kipper and Whitney 38).

Treatment of Dopamine-related addictions

• Patients addicted to drugs that mimic dopamine can be treated with other less harmful drugs that mimic dopamine to ease withdrawal symptoms and prevent cravings. These drugs will also help prevent problematic behaviors that could have caused the harmful addiction in the first place (Kipper and Whitney 53).

• Safer dopamine-mimicking drugs for short-term use during detox include Neurontin, Klonopin, Xanax, Valium, Seroquel, Zyprexa, and Depokota. Drugs suitable for long-term stabilization for ADHD are Adderall, Ritalin, Wellbutrin, Dexedrine, Strattera, Concerta, and Provigil. Drugs for long term stabilization of bipolar disorder are Zyprexa, Seroquel, Abilify and Lamactil. Some of these drugs are addictive themselves, but without the severe side effects of cocaine, meth and other harmful drugs (Kipper and Whitney 54).

Serotonin

• Serotonin is the neurotransmitter primarily responsible for regulating moods and emotions (Kipper and Whitney 33).

• A lack of serotonin can lead to depression and/or obsessive, compulsive behaviors (Kipper and Whitney 33).

Serotonin and Addiction

• For people with low serotonin levels, the drugs they are most likely to get addicted to are alcohol and opiates (heroin, Oxycontin). Both mimic serotonin and lead to a temporary increase in serotonin levels, making the person feel better (Kipper and Whitney 42).

Treatment for serotonin-related addictions

• Treatment for opiates is a bit more complex than treated for dopamine-related drugs.

• For short-term opiate withdrawal, drugs such as Buprenorphine are suitable. To calm anxiety short-term, Klonopin, Ativan, Xanax, Neurontin, and Seroquel would help. For sleep, Ambian, Lunesta, Sonata, Vistaril and Benadryl would all be suitable as short-term candidates (Kipper and Whitney 54).

• To help with alcohol withdrawal, Neurontin, Lyrica, Xanax, Klonopin, Ativan and Librium would help at first (Kipper and Whitney 54).

• However, for long term stabilizing medication, serotonin and noradrenalin reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs) should be given. SNRIs include Prozac, Zoloft, Lexapro, Celexa and Paxil. SSRI’s include Pristiq, Savella, Effexor and Cymbalta (Kipper and Whitney 54). These drugs will block the reuptake of serotonin in the brain and cause serotonin to remain in the syntax, where it can stimulate receptors.

Noradrenalin• Noradrenalin is the neurotransmitter that is in

charge of keeping is informed of potential threats and signals our flight, fight or freeze response (Kipper 31-32).

• An overabundance of noradrenalin leads to anxiety. A massive overabundance leads to extreme anxiety about even the smallest situations, and extreme anxiety can lead to panic (Kipper 32).

• An overabundance of noradrenalin also plays a role in sleep disorders (Kipper 32).

Noradrenalin and Addiction• Having constant or extreme anxiety can lead to

people making bad decisions about how to treat it, often turning to drugs whose affects lessen anxiety. These include Valium, Xanax, Ativan, Klonopin, marijuana or nicotine (Kipper and Whitney 32).

• Endorphins also quiet the need for soothing anxiety (Kipper and Whitney 32). This can lead to people becoming addicted to physical exercise since during exercise the brain receives an endorphin rush.

Treatment for Noradrenalin-related addiction

• For short term detox treatment off Valium, Xanax, Ativan and Klonopin, Phenobarbitol can be used or the amount of the addicted substance can simple be decreased over time (Kipper and Whitney 54).

• For long-term treatment, SNRIs, SSRIs, beta-blockers such as Inderol, and Lyrica, Neurotonin and Seroquil can be used (Kipper and Whitney 54).

Recap of the Three Culprits• When the brain is imbalanced in one of the three neurotransmitter

amounts attributed to addiction, it signals a desire for that imbalance to be corrected. An excess of dopamine translates to ADD, ADHD, mania and bipolar disorder. In trying to reduce their hyperactivity, some people may turn to drugs. Because of their dopamine imbalance, the drugs they are most likely to become addicted to are dopamine mimics such as cocaine.

• A lack of serotonin can lead to depression, and/or obsessive compulsive behavior. Drugs that mimic serotonin and provide a needed boost are alcohol and heroin, which in turn become the drug the user is most likely to become addicted to.

• An excess of noradrenalin causes anxiety, and anti-anxiety medications like marijuana, Xanax and Valium become the abused substances.

A Note About Genetics• You are born with an imbalance in one of these three

neurotransmitters, but the choices you make determine whether or not this will lead to addiction.

• However, genes have been linked to certain addictions. If you know your family has a history of abusing a certain drug, it is advisable to avoid it because the risk of becoming addicted is much higher.

• Children of alcoholics have a four-fold increase in the likelihood of becoming alcoholics themselves compared to children born to non-alcoholics (The Hijacked Brain).

A Note About Craving

• The brain’s pleasure highways are formed from well-repeated patterns of behavior. For an addict, even the sight of a place or object they have used to receive or do drugs can send release dopamine down the pleasure highway (The Hijacked Brain). Odors can trigger the same response. Once the response is triggered, the brain wants the real deal- this is craving (The Hijacked Brain).

• Almost all relapses begin with a craving.

Summary• You are born with a genetic tendency towards an

imbalance of either dopamine, serotonin and noradrenalin which can determine which drug you are more likely to become addicted to. Study your family history and stay away from substances that your family has a history of abuse with. In dealing with an addict or a recovering addict, remember that craving can be triggered by something as simple as seeing a street corner they were dealt the drug on. Relapse is a trademark of addiction, so be patient and supportive if the addict is otherwise trying to recover.

Bibliography

• Kipper, David and Steven Whitney. The Addiction Solution. New York: Rodale, 2010. Print.

• Spiga, Saturnino, Alessandra Lintas and Marco Diana. “Addiction and Cognitive Function.” Annals of the New York Academy of Sciences 1139 (2008): 299-306. Ebsco. Web. 27 Feb. 2010.

• The Hijacked Brain. Dir. Bill Moyers. Public Affairs Television, 2004. DVD.