Question

How would you challenge behaviors and thoughts that are not recovery promoting and how would you provide information to them relating to substance use disorder and treatment?

Answer 1

The Reward Pathway plays a very important role in understanding the effects of drugs on the brain. It is a pathway that involves different parts of the brain namely; the Ventral Tegmental Area (VTA), Nucleus Accumbens and Prefrontal Cortex which are stimulated when substance is injected, snorted, smoked or ingested. When activated by any rewarding stimulus, the information is first received at VTA, then travels from Nucleus Accumbens to the Prefrontal Cortex and then dopamine is released.

Substance use stimulates the Nuclues Accumbens for release of Dopamine which is also known as the happy hormone. It is majorly responsible for an individual to feel ecstatic and euphoric. In the absence of substance, the Nucleus Accumbens is activated with increased impulses, which means it craves for a stimulator (substance) in order to achieve trance. When the body gets used to this substance, an individual can no longer experience pleasure and positive reinforcement through natural rewards which are capable of making any person happy. In order to experience the same high an individual keeps going back to it. Depression is one of the major symptoms of withdrawal syndrome when a person is trying to stay clean and off any substance.

All addictive drugs work by causing release of dopamine in the Nucleus Accumbens. The brain reacts to all kinds of pleasures the same way, be it from an addictive drug like cocaine, heroin or morphine to monetary pleasures, sexual encounters or maybe even a big nice satisfying meal. The Nucleus Accumbens is also known as the brain's "pleasure center". It is responsible in releasing Dopamine every time an individual indulges in any kind of pleasurable activity.

An effective treatment is needed for a person to abstain from drugs. There are umpteen options of treatments available based on theoretical models and current research. The following are a few:

1. Aversion Therapy: Aversion therapy which is a form of behavioural therapy. An individual is conditioned in a way, where he/she is exposed to a stimulus while simultaneously being exposed to something which causes discomfort to a person and he/she develops an aversion (dislike) to the stimulus. For instance, a person is given a little alcohol to drink, which is accompanied by a shock therapy after 2 minutes. When alcohol is followed by a shock, the individual develops an aversion towards stimulus (alcohol) because he anticipates something discomforting accompanied with the shot of alcohol.

2.Cognitive-Behavioural Therapy: In this kind of a therapy, a person is made to change the way she/he thinks. Cognitive behavioural therapy works on the concept of how thinking affects an individuals behaviour. A person is asked to focus on situations that bring stress with them and lead to use of drugs. Once a person discovers it for himself, he is more likely to be careful and avoids letting a situation arise that leads to use of drugs.

3. Contingency Management: It is a form of operant conditioning. A desirable behaviour is reinforced. If a person abstains from drugs and alcohol, he gets positively rewarded which motivates him to continue producing a behaviour that leads to being rewarded.

4. Medication: Medication-Assisted-Treatment is used for an individual to abstain from drug abuse. These medications help chemicals in the brain to work differently to reduce the craving of a certain drug. Some medications also help a person to cope up with withdrawal symptoms which are usually responsible for a relapse.

5. Peer and Familial Support: Any kind of positive support provided by friends and family helps a person recover from substance abuse. Kind words, love and care does the trick sometimes. An emotional support by loved ones indeed helps better in recovery.