03 Dec Brains Changed by Cocaine Addiction May Never Fully Heal
Significant neurological changes underlie the intense physiological and psychological cravings that plague recovering drug addicts and alcoholics. Brain alterations are a powerful side effect of regular drug use, and even after sobriety has been achieved it can take a long time for those corrupted adaptations to return to normal.
That is assuming, of course, that the mind is actually capable of restoring itself to its former state following a prolonged battle with drug abuse. But what if it isn’t? What if, at least in some instances, the neurological changes associated with extended drug use can’t be reversed? It would mean that in a very real sense drug addiction could be a life sentence, and that the cravings a drug user experiences during recovery might never completely fade away with time.
This sounds like a nightmare scenario for addicts, but according to a recent report published in the journal Biological Psychiatry this may be exactly the situation cocaine addicts in particular are facing. In a study sponsored by the Institute of Living/Hartford Hospital in Connecticut, researchers monitored brain activity in three sets of people, made up of current cocaine addicts, recovering addicts and non-drug users recruited to be a part of a control group. The purpose of this neural surveillance was to see if brain abnormalities could be found that might be exclusively related to repeated drug consumption, and to see how those abnormalities might change or persist once sobriety had been obtained. Each of the 124 people who participated in the study were asked to perform tasks that simulated an online bidding experience of the type familiar to users of eBay, and as they did so their brain states were examined and analyzed to see if dysfunctional activity could be detected.
Unsurprisingly, current cocaine users exhibited unusual activation patterns in a number of brain regions that are involved with reward processing (get a treat, feel happy), and they also showed reduced levels of impulsivity control that seemed to be directly linked in some way to these other abnormal brain responses. Naturally, these odd patterns were not found in the brains of control group non-drug users, but it was notable that the recovering cocaine addicts showed out-of-the-ordinary activations in a quite a few of the very same sub-regions that were functioning in an off-kilter manner in the brains of the practicing cocaine users. At the time of this study, the members of the abstinent group had been cocaine-free for four years on average, so their brains certainly had ample time to regenerate lost functioning and return to normal operation, if such a thing were possible. But apparently it was not; as it appears that at least some of the brain changes regular cocaine users undergo are either permanent or supremely resistant to change.
The current trend is to speak of addicts who are no longer using as being in recovery rather than being cured. This is a concession to the fact that addiction is now recognized as a chronic brain disease that can perhaps be subdued with determined, consistent effort but never entirely eliminated. This new research verifies that there is indeed a tangible physical aspect to addiction that is perfectly consistent with the chronic disease model, and it shows that the cravings cocaine addicts often continue to report even after entering recovery probably involve more than just remnants of psychological dependency.
Some sources claim that the brain can physically recover from cocaine addiction in a period of one to two years. However, if such a positive change does occur it is apparently only partial. Assuming the results of this new study are accurate, it is likely that persistent patterns of abnormal neural activation combined with greater degrees of impulsiveness leave recovering cocaine addicts vulnerable to relapse long after they have successfully transitioned to sobriety.
Because both former and current cocaine users in the Hartford Hospital study registered high readings on the impulsivity scale, the researchers involved in the project concluded that these individuals must have been at least partly predisposed to developing a cocaine addiction even before they ever started using the drug. But as previously mentioned, correlations were found between high impulsivity and certain unusual neural activation patterns associated with cocaine dependency, so it seems that impulsivity plays a more complex role in cocaine addiction than previously thought: not only are impulsive people more likely to try illegal drugs, but once they start using them, they are also much more likely to manifest the types of abnormal activations in the reward processing sections of the brain that are known to be associated with physical dependency to cocaine. This connection may very well hold for other illegal drugs with psycho-stimulating effects (i.e., methamphetamines), although further study will be required to verify this deduction.
Fighting the Power of Denial
One would hope that research such as this that clearly demonstrates the capacity of addiction to change the brain forever would give even causal drug users pause for thought. After all, if drug addiction can create lasting alterations in brain functioning that make the hold of dependency all but inescapable, why would anyone with a lick of sense want to put her health and her future at risk by consuming these substances in even modest amounts?
Despite the rhetorical nature of this question, it is difficult to be optimistic about how this new research—or any other that comes along to back it up—will be received. Addictive drugs prey on reckless and short-sighted individuals who seldom think beyond the concerns of the immediate moment, and precious few drug consumers are likely to be persuaded to step back from the ledge simply because certain long-term health risks are more significant than had previously been imagined. Drug users build up impenetrable walls of rationalization and denial to convince themselves that they are not at risk of addiction even if others are, and this is highly unfortunate because once someone starts consuming mind-altering intoxicants, there is in fact no way to predict ahead of time if she will be able to control her drug use before it starts controlling her. Taking illegal drugs with highly addictive qualities, such as cocaine, is the equivalent of playing with matches on a windy day while wearing a suit doused in kerosene, and the burns that a drug addict will sustain once her entire life goes up in flames may very well leave neurological scars that will last a lifetime.
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