Addiction Code in Brain

Addiction researchers who met this summer to study treatment methods are close to crafting a new approach to preventing relapse,
“The goal is to crack the addiction code — and the code lies in the basic working of the brain,” said Dr. George Augustine, a researcher at Duke University Medical Center. “We don’t know how addiction happens. It’s been a complete black box until recently. Now, there’s a crack of light.”
Researchers said treatment success lies in a targeted approach. For instance, cocaine addiction could be treated with customized psychotropic drugs targeting specific areas of the brain. “Our objective is to revolutionize drug development and provide a completely new view of psychiatry,” said Dr. Hans Breiter, a psychiatrist and researcher at Massachusetts General Hospital in Boston.
Breiter, an expert on brain imaging, and his research partner, Dr. Greg Gasic, recently received a $7.9 million federal grant for an imaging and DNA study. The clinical trial will include a total of 900 cocaine-addicted individuals, depressed individuals, and a control group of people neither addicted nor depressed. The purpose of the study is to identify brain patterns that may reveal individuals who are susceptible to addiction. Researchers want to link genetic similarities and brain circuitry to depression and drug use to create an individualized approach to treatment.
“The issue is not to develop medication that changes the genes,” said Breiter, “but to move addicts back to a place where their genes are in balance.”
Additional researchers also are examining the links between psychiatric disease and addiction. “People with psychiatric disorders have a much higher propensity to use drugs,” said Dr. Bertha Madras, a professor and researcher who works with non-human primates at Harvard Medical School. “Between 55 percent and 75 percent of cocaine users have psychiatric problems at birth.” Since addictive drugs cause molecular changes in the reward circuitry of the brain, researchers also want to pinpoint which molecules have been altered by drug use and find ways to reverse the effects.
“A major cause of relapse is the long-lasting adaptations that have occurred in the brain in response to drugs of abuse,” said Stanford University psychiatrist Dr. Robert Malenka. “What commonly happens is that someone who has a problem with addiction is abstinent, but will be exposed to some environment where they used the drug or some person they’ve used the substance with. Then, they get these overwhelming memories we call cravings that become so powerful they have to start using drugs again.”