Have you ever wondered what causes addiction? Scientists have understood for some time that the brain’s reward system plays an important role in addictive behavior. In an article from the Huffington Post blog, Dr. Lloyd Sederer, Medical Director of the New York State Office of Mental Health, explains the neuroscience behind the complicated disease of addiction, and why a multi-faceted approach to treatment has the best chance for success.
Sederer outlines the areas of the brain affected by substance use, and how the brain’s reward system works. In summary:
Ventral tegmental area and nucleus accumbens: These areas of the brain activate to produce a spike of dopamine in response to pleasurable events; in this case, in response to substance use. Most current medications for addiction target this reward activation system in order to control cravings.
Orbital frontal cortex: This area of the brain drives behavior repetition. Motivational interviewing is an effective strategy for targeting this area.
Prefrontal cortex: This area of the brain controls judgement and reason, and is best supported through social interventions like mutual help groups and support from family and friends.
Amygdala and hippocampus: These areas of the brain store memories of what caused the feeling of reward; this is the domain of what are commonly called cues or triggers. Cognitive Behavioral therapy (CBT) is a strategy to control cue response which targets this area.
Sederer includes a link to a video of psychiatry resident Dr. Chris Karampahtsis, who illustrates the workings of an addicted brain. Karampahtsis shows that one can utilize this understanding of the brain and its reward system to make a comprehensive, individualized treatment plan for overcoming addiction.