04 Aug Researchers Say Drug Cravings Can Be Overcome by Training Your Brain
Anyone who smokes knows just how difficult it is to quit—and stay abstinent. Of the 46 million Americans who smoke, about 70% want to quit, 40% actually try to quit, and only 5% are able to quit on their own. Thanks to the greater availability of cessation therapies, 25% of smokers who try to quit using nicotine replacement therapy (known as NRT, a treatment method which combines the use of nicotine patches and behavioral therapy) are able to remain abstinent. What makes NRT more effective than trying to quit cold turkey? Researchers at Yale University’s psychiatry department are saying that standard therapeutic techniques are actually the key to cessation success.
In their study, published online in the Proceedings of the National Academy of Sciences journal, lead researcher Dr. Hedy Kober and colleagues discovered that cognitive behavioral therapy can reduce cravings in two separate regions of the brain in nicotine-dependent smokers. Because nicotine remains the leading cause of preventable death in the U.S. and is the most widespread substance of abuse, researchers chose to focus on nicotine-dependent individuals for their study to better understand the neural systems responsible for regulating cravings. In their study, researchers used functional brain imaging to examine neural activity in cigarette smokers while they engaged in cognitive behavioral therapy to help them manage their cravings.
One region, generally known as the prefrontal cortex, contains the dorsomedial, dorsolateral, and ventrolateral prefrontal cortices. Smokers who were undergoing cognitive behavioral therapy for managing their cravings showed increased activity in this region, which is responsible for regulating emotions, cognitive control, and rational thought.
Secondly, smokers who were taught cognitive strategies for regulating their cravings showed decreased activity in the brain region that contains the ventral striatum, subgenual cingulate, amygdale, and ventral tegmental areas. This region of the brain is associated with controlling cravings and the ‘reward system’ circuitry.
After learning cognitive strategies for managing smoking cessation, the smokers reported experiencing less severe cravings for cigarettes. Researchers linked the smokers’ decreased cravings with their increased activity in the dorsolateral prefrontal cortex and their reduced activity in the ventral striatum area as they underwent therapy.
Generally, doctors may consider the prefrontal region in substance abusers to be damaged after their brains have been exposed to repeated and increasing amounts of an illicit substance. Once dependency on a substance is established, neurotransmitters fail to work properly and cause impairment to normal brain function. However, in the researchers’ study, the prefrontal region was not found to be damaged, at least not in the brains of cigarette smokers. Instead, these smokers were able to increase activity in their prefrontal region, helping them to control their emotions and rational thinking. By receiving cognitive behavioral therapy, these nicotine-dependent individuals were able to improve the region of the brain that was affected by their substance use once their reward system circuitry took over.
These cognitive techniques, in fact, helped decrease the region that is responsible for "rewarding" nicotine intake and upped the individual’s ability to regain control. The researchers suggest that when the brain is prompted, it has the ability to ignite the prefrontal cortex to help control cravings. This means that when a substance abuser is taught how to control this region, they are increasing their ability to combat their substance addiction.
Cognitive behavioral therapy is standard to modern intervention, prevention, and mental health treatment. It has proven effective not only in the treatment of psychological disorders, but also in the treatment of substance abuse disorders. Based on their study’s findings, the researchers are hoping to encourage the inclusion of cognitive behavioral therapy as a standard technique in not just smoking cessation treatment, but also in the treatment of individuals who are dependent on other substances of abuse.
Source: Medical News Today, Researcher Finds That Our Brain Can Be Taught To Control Cravings, August 3, 2010
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