Momi Afelin

 

 

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What makes your life worth living? Is it spending time with family, eating good food, or having great sex? How do you prioritize these? Imagine if none of these things mattered to you anymore, that your life had been consumed by a single desire to be high.

For the 1.5 million Americans who abuse cocaine, this is very much a reality. Cocaine hijacks the brain’s motivation and reward system so that an addict’s only priority is getting more cocaine. This is what happened to my friend Caleb. While my friends and I prioritized school and our families, Caleb prioritized cocaine over everything, even eating regularly. Current cocaine addiction treatments reduce motivation for cocaine, but do not address motivation for an addict’s former priorities in life. This leaves them in a bleak, dull state where they are not their holistic healthy selves. For this reason, these treatments were not best option for Caleb.

New techniques, however, propose a way to simultaneously decrease motivation for cocaine while reigniting the motivation for regular activities and necessities such as food.

Many addiction treatments target the brain’s motivation and reward center and dopamine. Dopamine is a neurotransmitter, or tiny chemical molecule in the brain, that provides the motivation for obtaining rewards. These techniques lack specificity in the motivation and reward that they affect. However, recent research by Rouaud et al is changing how we approach addiction treatment.

Through studying patients with damage to the brain’s motivation and reward center, scientists found that a specific region called the Sub Thalamic Nuclei (STN) has two systems for processing motivation and reward. The STN distinguishes between natural rewards, such as food, sex, and social life, and unnatural rewards, such as drugs. Using this knowledge, they have developed a technique called Deep Brain Stimulation, or DBS, to treat cocaine addiction. This treatment delivers small electric currents to the STN via an electrode to inhibit the system for unnatural rewards and successfully reduces cocaine craving. DBS simultaneously stimulates the STN system for natural rewards increasing, and thereby restoring the normal motivation an addict would have had for things like food, sex, and hanging out with friends. Since the brain is not capable of feeling anything, this treatment is entirely painless.

DBS is a scientifically proven treatment that addresses drug addiction in a multi-faceted manner to account for both natural and unnatural motivations and rewards in rats. There is, however a tested human version of DBS. TMS, or Transcranial Magnetic Stimulation, also excites or inhibits cells of the STN to successfully reduce cocaine craving and restore the motivation for normal, enjoyable activities and necessities. TMS is an emerging therapy for drug addicts like Caleb. If you or a friend are suffering with addiction, consider finding a TMS clinical trial!

 

 

References: Rouaud, T., Lardeux, S., Panayotis, N., Paleressompoulle, D., Cador, M., &  Baunez, C. (2009). Reducing the desire for cocaine with subthalamic nucleus deep brain stimulation.Proceedings of the National Academy of Sciences,107(3), 1196-1200. doi:10.1073/pnas.0908189107

Abuse, N. I. (n.d.). What is the scope of cocaine use in the United States? Retrieved March 10, 2017, from https://www.drugabuse.gov/publications/research-reports/cocaine/what-scope-cocaine-use-in-united-states

Camprodon, Joan. “One Session of High Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) to the Right Prefrontal Cortex Transiently Reduces Cocaine Craving.” Drug and Alcohol Dependence 86.1 (2007): n. pag. Web. 21 Apr. 2017.

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