addiction

Does Science Show What 12 Steps Know?
Jarret Liotta
National Geographic
August 9, 2013

...Newberg said that "large-scale, existential-type crises" such as Wilson's can
bring instant changes to the brain. New neuronal pathways are activated or
reactivated. This instant rewiring, Newberg said, generates a sudden and
intense "aha" moment.

Newberg speculates that such an event may occur because of differences
between the brain's left and right hemispheres, which approach problems
differently. The left side struggles to work through a problem from an
analytical, black-and-white perspective.

But the right side may suddenly kick in and apply a very different, more
holistic solution. In such a moment, the neurons of the brain are immediately
realigned, spurred on by intense emotion relating to the crisis.

This same experience, sometimes described as a "eureka!" moment—or a cognitive
insight phenomenon—is often referenced in relation to creative breakthroughs.One
2008 study found that when the left side of the person's brain dwells on a problem, it
produces an excessive amount of obstructive gamma waves. The more the person
ruminates on the problem, the harder it becomes to solve.

Conversely, when concentration is relaxed—or as Newberg said, when the person
manages to quiet the left side of the brain and involve the right—the sudden
appearance of new answers and insights can feel profound.

...Power of Dopamine Receptors [and enriched environment]

D2 dopamine receptors connect dopamine, a key neurotransmitter, to neurons. When
these receptors are not functioning—or there are too few of them available to connect
the dopamine to neurons—memory, mood, and thinking may all be impaired.

A shortage of D2 receptors, some researchers surmise, could predispose a person to
addiction.

Nora Volkow, NIDA's director, led two studies that involved artificially increasing the
number of D2 receptors in rats by administering adenoviral vectors directly into their
brains. Viral vectors transmit their genetic material and makeup into foreign cells, in
this case increasing the number of D2 receptors in the new cells to match their own.

In one study involving rats and alcohol, the increased number of D2 receptors led the
rodents to consume less alcohol, compared with their baseline intake.

In the other study, the D2-receptor increase caused rats to significantly reduce their
intake of cocaine.

Michael Nader, a researcher at Wake Forest University, is investigating ways to raise
D2-receptor levels naturally. One experiment he helped conduct focused on five
separate groups of four monkeys. Each had been self-administering cocaine to the
point of habit and were then deprived of the drug for an eight-month period. To create
a picture of D2-receptor availability, the monkeys were given a radioactive tracer that
competes with dopamine for receptors.

The monkeys were then randomly put in social groups of four and given the
opportunity to self-administer the drug again.

Positron emission tomography (PET) imaging of the monkeys over time showed
fluctuations in dopamine levels, which allowed the researchers to estimate the
changing numbers of available D2 receptors. After only three months, the socially
dominant monkeys in each group had naturally increased their numbers of D2
receptors.

There was no increase in the subordinate monkeys. Further, the subordinate
monkeys reverted to using cocaine at much higher levels than the dominant monkeys.

"There is an interesting relationship between D2-receptor numbers and vulnerability
to drug addiction," Nader said. "It appears that individuals with low D2 measures are
more vulnerable compared to individuals with high D2-receptor numbers."

Why did the socially dominant monkeys show D2-receptor increases? "One
hypothesis," Nader said, "is environmental enrichment." For the monkeys, it seems,
being dominant was the enriching trigger.

One physiological consequence of involvement in 12-step meetings, therefore, could
be an increase in the natural production of D2 receptors. "That's another whole area
to be studied beyond the animal world," Shurtleff said.

Need for Attachment

Philip Flores, author of Addiction as an Attachment Disorder, said the human need for
social interaction is a physiological one, linked to the well-being of the nervous system.

When someone becomes addicted, he said, mechanisms for healthy attachment are
"hijacked," resulting in dependence on addictive substances or behaviors.

Some believe that addicts, even before their disease kicks in, struggle with knowing
how to form emotional bonds that connect them to other people. Co-occurring
disorders, such as depression and anxiety, make it even harder to build those
essential emotional attachments.

"We, as social mammals, cannot regulate our central nervous systems by ourselves,"
Flores said. "We need other people to do that."

While it's commonly understood that early childhood attachments to parents and
family are necessary for healthy development, Flores maintains that emotional
attachments remain necessary throughout adulthood.

This is where a 12-step program becomes valuable.

It's not enough, Flores said, to remove the addiction, which in itself has become an
object of unhealthy emotional and physical attachment. To achieve long-term well-
being, addicts need opportunities for forging healthy emotional attachments.

"What A.A. does on the basic level is what good psychotherapy does," Flores said. It
provides "a community for people to break their isolation and to start to connect on an
emotional level with other people."

Helping Heals

Lee Ann Kaskutas, a scientist with the Alcohol Research Group, has faced skepticism
from colleagues for studying A.A., in part because of the numerous spiritual
references that go with the 12-step program. It puts A.A. on "the fringe" in the minds
of many scientists, Kaskutas said.

Kaskutas, a self-proclaimed atheist, said that the 12 steps bear fruit regardless of
one's spiritual beliefs. "If you don't believe in God, the way it weasels in is in the help
and behaviors that the 12-step group inculcates."

Helping others, Kaskutas said, "is the internal combustion engine of A.A. I think that is
the connection to spirituality."

People feel better about themselves after helping someone else, Kaskutas said. "So
it's reinforcing—when you help somebody, I think your brain chemistry changes."