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Understanding Addiction : The Difference Between "Tolerance" and "Sensitization"

Discussion in 'General Addiction discussion' started by TheDevil, Oct 31, 2010.

  1. TheDevil

    TheDevil Titanium Member

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    This research and information was derived from Norman Doidge's acclaimed book on neuroscience/neuroplasticity, "The Brain That Changes Itself". I have paraphrased and summarized the relevant portions of the book regarding this topic.

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    Not all addictions are to drugs or alcohol. People can be seriously addicted to gambling, even to running. All addicts show a loss of control of the activity, compulsively seek it out despite negative consequences, develop tolerance so that they need higher and higher levels of stimulation for satisfaction, and experience withdrawal if they can't consummate the addictive act.

    Almost all illegal drugs make the pleasure-giving neurotransmitter dopamine more active in the brain. Dopamine is called the reward transmitter, because when we accomplish something our brain triggers its release.By hijacking our dopamine system, addictive substances give us pleasure without our having to work for it.

    A single dose of many addictive drugs will produce a protein, called AFosB (pronounced "delta Fos B"), that accumulates in the neurons. Each time the drug is used, more AFosB accumulates, until it throws a genetic switch, affecting which genes are turned on or off. Flipping this switch causes changes that persist long after the drug is stopped, leading to damage to the brain's dopamine system and rendering the individual far more prone to addiction.

    The usual view is that an addict goes back for more of his fix because he likes the pleasure it gives and doesn't like the pain of withdrawal. However, addicts take also drugs when there is no prospect of pleasure.They may know that they have an insufficient dose to make them high, but will still crave more even before they begin to withdraw.

    Wanting and liking are two different things. An addict experiences cravings because his plastic brain has become sensitized to the drug or the experience. Sensitization is different from tolerance. As tolerance develops, the addict needs more and more of a substance to get a pleasant effect; as sensitization develops, he needs less and less of the substance to crave it intensely. So sensitization leads to increased wanting, though not necessarily liking. It is the accumulation of AFosB, caused by exposure to an addictive substance or activity, that leads to sensitization.
     
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  2. catseye

    catseye Gold Member

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    Very interesting summary, SWIDevil - catty has read a bit about epigenetic regulation/drug induced plasticity, but isn't it true thus far it has only been observed in animal models? (see attached article by McQuown & Wood for refs, if interested).
    Human addiction is a varied and complex thing, and one of the main issues with the delta fosB theory is that factors such as varied drug intake amounts, poly drug use and psychiatric comorbidity are far too complex at this time to control for in human studies. Catty knows there has been some limited but interesting postmortem research done comparing human and animal data, but is SWIY aware of anything more applied in terms of addiction treatment or human modelling?
    Catty 100% agrees that there is a major biological component to addiction/dependency, but is wary of theories that apply underdeveloped ideas to complex issues, and by putting the onus on genes, removes some of the social and personal responsibilities tied up in both dependency & recovery. Of course catty is an anthropologist and blames everything on society :laugh:
    What does SWIY think? :)
     

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  3. TheDevil

    TheDevil Titanium Member

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    Hi Catseye,

    Since you have mentioned "plasticity", I am going to assume you are fairly versed in the area of neuroplasticity and the implications it has towards addiction and also recovery.

    Regarding you point on "putting the onus on genes", I would like to quote a passage in the book "The Brain That Changes Itself", which I think is relevant to your query.

    With regard to effective studies and involving treatment of humans for addiction and dependency, there is also an entire section in the book that deals with this subject matter. The treatment for addiction chronicled in the book deals with pornographic addiction. Even though the addiction in question isn't drug-based, the principles and concepts on neuroplasticity and its application towards addiction recovery I feel are identical. Perhaps the added biological effect of drug use might make it more difficult to enact plastic change to recovery, but the theory is nevertheless sound.

    "Love" has also been suggested as being a potentially very helpful component in dealing with addiction and recovery. I have saw it fit to deal with this separately in another thread, which can be found here: https://www.drugs-forum.com/forum/showthread.php?t=146747

    Hopefully this helps in answering your queries.

    Cheers mate.
     
  4. catseye

    catseye Gold Member

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    Thank you TheDevil,
    I do believe that the added biological effect of drug use would certainly make it more difficult (or at least more complex and challenging) to enable plastic change in recovery. Whilst addictions to behaviours such as gambling or pornography will no doubt ingrain reward pathways via endogenous chemical release, I'd argue that the exogenous influence of chemical substances would have significant biological effects that can't yet be accounted for by neoroplasticity...but maybe we aren't far off...which would be a wonderful thing for treatment and recovery :thumbsup: So thanks for the food for thought!

    oh, btw - check your link, it just redirected me back to this thread ala "time becomes a loop" :laugh: I found the thread on love and recovery and think that is fabulous and very uplifting - catty would absolutely agree with it :)