Using Brain Science to Treat Substance Use Disorder
Using brain science to treat substance use disorder (SUD) can be a HUGE help. Why? Because substance use disorder (aka alcoholism, addiction, alcohol or other drug abuse) is now understood to be a brain disorder, sometimes referred to as a brain disease. As Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA) explains:
As a result of scientific research, we know that addiction is a medical disorder that affects the brain and changes behavior. We have identified many of the biological and environmental risk factors and are beginning to search for the genetic variations that contribute to the development and progression of the disorder. Scientists use this knowledge to develop effective prevention and treatment approaches that reduce the toll drug use takes on individuals, families, and communities. “Drugs, Brains, and Behavior: the Science of Addiction, Preface“(July 2020)
How Brain Science Helps
Current brain science debunks some of society’s long-held beliefs, such as:
- our brains are hardwired around the time of puberty and that from then on, they were in a long, slow process of decline;
- heavy drinking or other drug use “killed” brain cells; or
- you only used a very small percentage of your brain’s capacity.
Current brain science explains:
- The brain controls everything we think, feel, say, and do. If our brain doesn’t work, our heart can’t pump, our lungs can’t breathe, and our limbs can’t move. If our brain doesn’t work, we couldn’t develop a substance use disorder, nor could we read, drive a car, walk, feel pain or love, experience stress—you get the picture.
- The brain exerts this kind of control through an electrochemical signaling process. This is how brain cells talk to one another and then to and from other neurons throughout the body via the nervous system. This process is commonly referred to as neural networks, neural circuitry, or, more simply, brain wiring. Alcohol and other drug chemicals interrupt/change this electrochemical signaling process.
- Neural connections frequently used, in turn, “wire together” to form what are called brain maps. Brain maps are basically our routine thoughts, feelings, and behaviors—our habits—like the examples of reading, driving, or developing a substance use disorder listed above.
- The brain is incredibly “plastic,” meaning it can heal, repair, and rewire to change and/or form healthier brain maps. In other words, it can successfully recover from a substance use disorder with the right kind of treatment for that particular brain.
- This wiring and mapping of routine thoughts, feelings, and behaviors occurs over the course of the brain’s development, which takes about 2.5 decades. 2.5 decades! Influencing these wiring and mapping processes are genetics, environment and what’s happening to and in the brain during the early childhood and adolescent developmental periods.
Brain Development in Early Childhood
As for what happens during the early childhood developmental period, I urge you to read the National Institute on Drug Abuse (NIDA)’s “Why is Early Childhood Important to Substance Use Prevention” to understand the childhood developmental stage.
As for what happens during the adolescent brain development period, please find the following.
Brain Development During Adolescence
Understanding brain development helps one understand how to use brain science to treat substance use disorder.
The brain goes through three key developmental periods during adolescence to an average age of 22 for girls/women and 24 for boys/men. These periods are puberty (starting around age twelve), continued wiring in the cerebral cortex (starting around age sixteen), and the pruning and strengthening process (adolescence through young adulthood). This image gives you a visual of how much change occurs during these developmental periods. Be sure to read the fine print.
- Puberty
Puberty-related brain changes are “designed,” if you will, to drive adolescents to take risks, turn to their peers and reproduce. I’ll let my video, “Thanks to puberty, just say ‘No’ can be difficult for tweens and teens,” explain what’s going on and why. - Continued wiring in the cerebral cortex
This refers to development in the “thinking” part of the brain, especially that which occurs in the prefrontal cortex. This is the “executive center” of the brain. It is this continued wiring in the cerebral cortex, especially the prefrontal cortex, that allows a young person to engage in sound reasoning, good judgment, complex planning, and appropriate impulse control, as well as weighing the consequences of their actions and learning from their mistakes (source link). This continued wiring also serves as the brakes on the risk-taking behaviors that started with puberty.
- The “pruning and strengthening” process
This process allows the brain to organize itself more efficiently. To do this, the brain pays attention to and “strengthens” the neural connections being frequently used. These become a person’s routine thoughts, feelings, behaviors—their habits. The neural connections not being frequently used get “pruned.” It’s not that they “die,” necessarily. Rather, the brain misses some important wiring, mapping, and strengthening opportunities. If an adolescent or young adult is using alcohol or other drugs routinely—especially if it’s to counter anxiety, stress, depression, not fitting in, fitting in, etc.—this process can cause that person to “map” (develop) a substance use disorder.
Dr. Frances Jensen, co-author author of “The Teenage Brain: A Neuroscientist’s Survival Guide to Raising Adolescents and Young Adults,” gives an excellent description of what happens in the adolescent brain in this short video.
As for a more complete explanation of brain development, check out this PDF excerpt of the “Basic Bain Facts” chapter from my latest book.
How to Use Brain Science to Treat Substance Use Disorder
Using brain science to treat substance use disorder means getting the right kind of help to treat and/or help the person understand how they developed SUD.
Understanding the five key risk factors, for example. These key risk factors for developing SUD include genetics, early use during adolescence, childhood trauma, social environment and mental illness (mental health disorder).
The right kind of help means identifying the things that happened to or were inherent in a person’s brain (e.g, key risk factors) as it was developing and then using targeted treatments to change those that are negative and strengthen those that are positive.
To give you an idea of what these targeted substance use disorder treatments might be, check out these resources on effective treatment for alcohol or other substance use disorders created by the National Institute on Drug Abuse (NIDA). One is for adults, titled Principles of Drug [and Alcohol] Addiction Treatment: A Research-Based Guide (Third Edition). The other is for adolescents, titled “Principles of Adolescent Substance Use Disorder Treatment.” It’s important to understand a person can change their brain at any age.
And as always, feel free to contact me via an email to LisaF@BreakingTheCycles.com to arrange a free Zoom of phone call to talk about/answer your specific questions.
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Some of these concepts were first shared in my May 18, 2020 blog post for MomPower.org, titled: “Using the Power of the Brain to Treat Substance Use Disorder.”
Lisa Frederiksen
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