Finding the Brain’s Addiction Switch | Steven Laviolette | TEDxWesternU

addiction is an aspect of the human

addiction is an aspect of the human condition that’s probably going to

condition that’s probably going to

condition that’s probably going to affect everyone in this room either

affect everyone in this room either

affect everyone in this room either directly or indirectly depending on the

directly or indirectly depending on the

directly or indirectly depending on the personal experiences we have in our

personal experiences we have in our

personal experiences we have in our lives of addiction or the experiences

lives of addiction or the experiences

lives of addiction or the experiences that one of our loved ones has with

that one of our loved ones has with

that one of our loved ones has with addiction we can come up with all sorts

addiction we can come up with all sorts

addiction we can come up with all sorts of different rationalizations to explain

of different rationalizations to explain

of different rationalizations to explain why addictive behaviors take place okay

why addictive behaviors take place okay

why addictive behaviors take place okay so we can think of addiction as a bad

so we can think of addiction as a bad

so we can think of addiction as a bad habit so something that we’ve fallen

habit so something that we’ve fallen

habit so something that we’ve fallen into due to circumstances in our lives

into due to circumstances in our lives

into due to circumstances in our lives beyond our control may be addiction is

beyond our control may be addiction is

beyond our control may be addiction is just a personal choice is addiction may

just a personal choice is addiction may

just a personal choice is addiction may be a moral failing is to do to some sort

be a moral failing is to do to some sort

be a moral failing is to do to some sort of intrinsic personality flaw well

of intrinsic personality flaw well

of intrinsic personality flaw well recently we’ve been thinking about

recently we’ve been thinking about

recently we’ve been thinking about addiction in terms of it being a disease

addiction in terms of it being a disease

addiction in terms of it being a disease state now I’m a neuroscientist I’ve been

state now I’m a neuroscientist I’ve been

state now I’m a neuroscientist I’ve been studying the neurobiology of addiction

studying the neurobiology of addiction

studying the neurobiology of addiction for almost 20 years now I’ve come to

for almost 20 years now I’ve come to

for almost 20 years now I’ve come to appreciate the importance of how we

appreciate the importance of how we

appreciate the importance of how we conceptualize addiction because it

conceptualize addiction because it

conceptualize addiction because it really addresses how we approach the

really addresses how we approach the

really addresses how we approach the issue of addiction in terms of our

issue of addiction in terms of our

issue of addiction in terms of our research and in terms of how we treat

research and in terms of how we treat

research and in terms of how we treat people that are suffering from addiction

people that are suffering from addiction

people that are suffering from addiction now the disease model of addiction is

now the disease model of addiction is

now the disease model of addiction is probably one that everyone in this room

probably one that everyone in this room

probably one that everyone in this room is familiar with it sort of thinks of

is familiar with it sort of thinks of

is familiar with it sort of thinks of addiction as being an organic brain

addiction as being an organic brain

addiction as being an organic brain state sort of akin to what we think of

state sort of akin to what we think of

state sort of akin to what we think of typical brain disease diseases like

typical brain disease diseases like

typical brain disease diseases like Parkinson’s or Alzheimer’s it’s also

Parkinson’s or Alzheimer’s it’s also

Parkinson’s or Alzheimer’s it’s also suggesting that addiction should be

suggesting that addiction should be

suggesting that addiction should be thought of as a permanent state of brain

thought of as a permanent state of brain

thought of as a permanent state of brain pathology the idea that once an addict

pathology the idea that once an addict

pathology the idea that once an addict always an addict sort of encapsulates

always an addict sort of encapsulates

always an addict sort of encapsulates this idea that addiction might be best

this idea that addiction might be best

this idea that addiction might be best represented as a disease state but I’m

represented as a disease state but I’m

represented as a disease state but I’m gonna argue today that this is probably

gonna argue today that this is probably

gonna argue today that this is probably not the best way for us to be

not the best way for us to be

not the best way for us to be approaching addiction or to be thinking

approaching addiction or to be thinking

approaching addiction or to be thinking about addiction and I’m going to suggest

about addiction and I’m going to suggest

about addiction and I’m going to suggest that there’s an alternative way to think

that there’s an alternative way to think

that there’s an alternative way to think of addiction more as a disorder of

of addiction more as a disorder of

of addiction more as a disorder of reward and memory pathways in your brain

reward and memory pathways in your brain

reward and memory pathways in your brain now some of the implications of this

now some of the implications of this

now some of the implications of this model of addiction suggest that

model of addiction suggest that

model of addiction suggest that addiction is rather a plastic series of

addiction is rather a plastic series of

addiction is rather a plastic series of brain adaptation it’s a dynamic process

brain adaptation it’s a dynamic process

brain adaptation it’s a dynamic process in the brain rather than a permanent

in the brain rather than a permanent

in the brain rather than a permanent state of brain pathology it’s something

state of brain pathology it’s something

state of brain pathology it’s something that we can reverse and finally decide

that we can reverse and finally decide

that we can reverse and finally decide that addiction might be controlled by

that addiction might be controlled by

that addiction might be controlled by specific molecular mechanisms in the

specific molecular mechanisms in the

specific molecular mechanisms in the brain that can actually take you from a

brain that can actually take you from a

brain that can actually take you from a healthy non-addicted state to an

healthy non-addicted state to an

healthy non-addicted state to an addicted state okay so the well-known

addicted state okay so the well-known

addicted state okay so the well-known addiction cycle all drugs of abuse begin

addiction cycle all drugs of abuse begin

addiction cycle all drugs of abuse begin by producing very strong rewarding

by producing very strong rewarding

by producing very strong rewarding effects in my field of a my field of

effects in my field of a my field of

effects in my field of a my field of study we look at the rewarding effects

study we look at the rewarding effects

study we look at the rewarding effects and the addictive properties of opiate

and the addictive properties of opiate

and the addictive properties of opiate class drugs so this includes drugs like

class drugs so this includes drugs like

class drugs so this includes drugs like heroin morphine and more recently

heroin morphine and more recently

heroin morphine and more recently prescription narcotics and we’ve had a

prescription narcotics and we’ve had a

prescription narcotics and we’ve had a tsunami of addictions related to drugs

tsunami of addictions related to drugs

tsunami of addictions related to drugs like vicodin percocet oxycodone costing

like vicodin percocet oxycodone costing

like vicodin percocet oxycodone costing us billions of dollars not to mention

us billions of dollars not to mention

us billions of dollars not to mention the horrendous social cost associated

the horrendous social cost associated

the horrendous social cost associated with addiction to these substances

with addiction to these substances

with addiction to these substances now if we take these drugs over an

now if we take these drugs over an

now if we take these drugs over an extended period of time

extended period of time

extended period of time what happens is we start developing

what happens is we start developing

what happens is we start developing adaptations in our brain changes in the

adaptations in our brain changes in the

adaptations in our brain changes in the brain happened in terms of our neural

brain happened in terms of our neural

brain happened in terms of our neural chemistry the molecular substrates

chemistry the molecular substrates

chemistry the molecular substrates controlling these pathways and even

controlling these pathways and even

controlling these pathways and even structural differences in various brain

structural differences in various brain

structural differences in various brain regions finally we develop psychological

regions finally we develop psychological

regions finally we develop psychological and physiological dependence on the drug

and physiological dependence on the drug

and physiological dependence on the drug after a period of exposure to the drug

after a period of exposure to the drug

after a period of exposure to the drug of abuse now this is especially true

of abuse now this is especially true

of abuse now this is especially true with opium class drugs we have this very

with opium class drugs we have this very

with opium class drugs we have this very strong physiological dependence syndrome

strong physiological dependence syndrome

strong physiological dependence syndrome that develops with opiate class drugs

that develops with opiate class drugs

that develops with opiate class drugs now once the drug is taken away from us

now once the drug is taken away from us

now once the drug is taken away from us we almost inevitably are going to go

we almost inevitably are going to go

we almost inevitably are going to go through a period of withdrawal and

through a period of withdrawal and

through a period of withdrawal and that’s accompanied by these very strong

that’s accompanied by these very strong

that’s accompanied by these very strong feelings of craving you’ve got to get

feelings of craving you’ve got to get

feelings of craving you’ve got to get this drug back into your system to

this drug back into your system to

this drug back into your system to alleviate those feelings of withdrawal

alleviate those feelings of withdrawal

alleviate those feelings of withdrawal that you’re experiencing now finally

that you’re experiencing now finally

that you’re experiencing now finally sort of the fourth part of this chain

sort of the fourth part of this chain

sort of the fourth part of this chain and we argue is actually extremely

and we argue is actually extremely

and we argue is actually extremely important and one that’s been under

important and one that’s been under

important and one that’s been under looked for a long time is the importance

looked for a long time is the importance

looked for a long time is the importance of memory induced relapse so if I were

of memory induced relapse so if I were

of memory induced relapse so if I were to inject myself with heroin right now

to inject myself with heroin right now

to inject myself with heroin right now and experience these profound rewarding

and experience these profound rewarding

and experience these profound rewarding effects and then I forgot about it in 20

effects and then I forgot about it in 20

effects and then I forgot about it in 20 minutes

minutes

minutes chances are I’m not gonna become

chances are I’m not gonna become

chances are I’m not gonna become addicted what happens when we experience

addicted what happens when we experience

addicted what happens when we experience the rewarding effects of a drug of abuse

the rewarding effects of a drug of abuse

the rewarding effects of a drug of abuse our brain forms associations between

our brain forms associations between

our brain forms associations between those effects of the drug and all of the

those effects of the drug and all of the

those effects of the drug and all of the environmental cues so for example

environmental cues so for example

environmental cues so for example someone that was addicted to heroin and

someone that was addicted to heroin and

someone that was addicted to heroin and has been clean for 10 even 15 years

has been clean for 10 even 15 years

has been clean for 10 even 15 years walking down the street they see some

walking down the street they see some

walking down the street they see some sort of – in their environment that re

sort of – in their environment that re

sort of – in their environment that re triggers those addiction memories and

triggers those addiction memories and

triggers those addiction memories and they fall right back into relapse so you

they fall right back into relapse so you

they fall right back into relapse so you can see when we look at it in terms of

can see when we look at it in terms of

can see when we look at it in terms of this chain of events to effectively

this chain of events to effectively

this chain of events to effectively treat addiction we need to break at

treat addiction we need to break at

treat addiction we need to break at least one of these links so in a

least one of these links so in a

least one of these links so in a nutshell we can sort of think of

nutshell we can sort of think of

nutshell we can sort of think of addiction as being importantly

addiction as being importantly

addiction as being importantly controlled by reward systems in the

controlled by reward systems in the

controlled by reward systems in the brain and memory systems in the brain

brain and memory systems in the brain

brain and memory systems in the brain now in terms of explaining addiction

now in terms of explaining addiction

now in terms of explaining addiction based on many years of animal-based

based on many years of animal-based

based on many years of animal-based research and clinical research as well

research and clinical research as well

research and clinical research as well there were two sort of general theories

there were two sort of general theories

there were two sort of general theories of addiction that were sort of popular

of addiction that were sort of popular

of addiction that were sort of popular at the time when I began this sort of

at the time when I began this sort of

at the time when I began this sort of research about 15 20 years ago one set

research about 15 20 years ago one set

research about 15 20 years ago one set of theories were the dopamine reward

of theories were the dopamine reward

of theories were the dopamine reward theories and this was based on the idea

theories and this was based on the idea

theories and this was based on the idea that almost every single drug of abuse

that almost every single drug of abuse

that almost every single drug of abuse activates dopamine neurons you get this

activates dopamine neurons you get this

activates dopamine neurons you get this release of dopamine in the brain so

release of dopamine in the brain so

release of dopamine in the brain so logically we thought that ok drugs would

logically we thought that ok drugs would

logically we thought that ok drugs would use activate dopamine so that’s why I

use activate dopamine so that’s why I

use activate dopamine so that’s why I become addicted we activate our dopamine

become addicted we activate our dopamine

become addicted we activate our dopamine system and that’s why we keep taking

system and that’s why we keep taking

system and that’s why we keep taking drugs now on the other side of the

drugs now on the other side of the

drugs now on the other side of the spectrum theories sort of focus more on

spectrum theories sort of focus more on

spectrum theories sort of focus more on the darker side of the addiction process

the darker side of the addiction process

the darker side of the addiction process withdrawal and these sorts of theories

withdrawal and these sorts of theories

withdrawal and these sorts of theories suggested that the reason we keep taking

suggested that the reason we keep taking

suggested that the reason we keep taking drugs of abuse is because we go through

drugs of abuse is because we go through

drugs of abuse is because we go through the draw and we need to seek out those

the draw and we need to seek out those

the draw and we need to seek out those drugs in our environment to alleviate

drugs in our environment to alleviate

drugs in our environment to alleviate those unpleasant feelings of withdrawal

those unpleasant feelings of withdrawal

those unpleasant feelings of withdrawal that we’re experiencing so when you

that we’re experiencing so when you

that we’re experiencing so when you think about these theories for a second

think about these theories for a second

think about these theories for a second you sort of realize that there’s some

you sort of realize that there’s some

you sort of realize that there’s some obvious problems with both of them in

obvious problems with both of them in

obvious problems with both of them in terms of dopamine well as the years went

terms of dopamine well as the years went

terms of dopamine well as the years went by we realized that dopamine is not as

by we realized that dopamine is not as

by we realized that dopamine is not as simple as we thought dopamine tomorrow

simple as we thought dopamine tomorrow

simple as we thought dopamine tomorrow more complicated so for example dopamine

more complicated so for example dopamine

more complicated so for example dopamine is activated even during unpleasant

is activated even during unpleasant

is activated even during unpleasant experiences the other problem

experiences the other problem

experiences the other problem theory is that it does a good job

theory is that it does a good job

theory is that it does a good job explaining why we take drugs in the

explaining why we take drugs in the

explaining why we take drugs in the first place but we know that when we

first place but we know that when we

first place but we know that when we continue taking drugs of abuse they’re

continue taking drugs of abuse they’re

continue taking drugs of abuse they’re rewarding effects tend to decline over

rewarding effects tend to decline over

rewarding effects tend to decline over time even the dopamine response can

time even the dopamine response can

time even the dopamine response can sometimes get lower and lower so how

sometimes get lower and lower so how

sometimes get lower and lower so how does it account for why we continue

does it account for why we continue

does it account for why we continue taking drugs of abuse for years and

taking drugs of abuse for years and

taking drugs of abuse for years and years and years now on the other side of

years and years now on the other side of

years and years now on the other side of the equation

the equation

the equation withdrawal based theories do a good job

withdrawal based theories do a good job

withdrawal based theories do a good job of explaining why we fall into a relapse

of explaining why we fall into a relapse

of explaining why we fall into a relapse to addiction but they don’t do such a

to addiction but they don’t do such a

to addiction but they don’t do such a good job of explaining why we started

good job of explaining why we started

good job of explaining why we started taking drugs with use in the first place

taking drugs with use in the first place

taking drugs with use in the first place so an obvious question is

so an obvious question is

so an obvious question is is there some sort of link between the

is there some sort of link between the

is there some sort of link between the brain mechanisms that control these

brain mechanisms that control these

brain mechanisms that control these early rewarding effects of drugs and

early rewarding effects of drugs and

early rewarding effects of drugs and these later effects of withdrawal and I

these later effects of withdrawal and I

these later effects of withdrawal and I want to present this idea of an

want to present this idea of an

want to present this idea of an addiction switch that can essentially

addiction switch that can essentially

addiction switch that can essentially serve as a a mechanism to account for

serve as a a mechanism to account for

serve as a a mechanism to account for the transition from the healthy

the transition from the healthy

the transition from the healthy non-addictive brain state to the

non-addictive brain state to the

non-addictive brain state to the addictive bracelet we know that

addictive bracelet we know that

addictive bracelet we know that addiction fundamentally changes the

addiction fundamentally changes the

addiction fundamentally changes the brain I talked about a couple of those

brain I talked about a couple of those

brain I talked about a couple of those changes they have been at the molecular

changes they have been at the molecular

changes they have been at the molecular level or chemical level structural level

level or chemical level structural level

level or chemical level structural level and more importantly looking beyond the

and more importantly looking beyond the

and more importantly looking beyond the brain addiction fundamentally changes

brain addiction fundamentally changes

brain addiction fundamentally changes the cell it changes your personality

the cell it changes your personality

the cell it changes your personality changes your cognition it changes your

changes your cognition it changes your

changes your cognition it changes your behavior and anyone who has watched a

behavior and anyone who has watched a

behavior and anyone who has watched a loved one go through the horrible

loved one go through the horrible

loved one go through the horrible effects of addiction one of the things

effects of addiction one of the things

effects of addiction one of the things that stands out in your mind is you

that stands out in your mind is you

that stands out in your mind is you remember how much that person’s

remember how much that person’s

remember how much that person’s personality and their behavior changes

personality and their behavior changes

personality and their behavior changes while the while they’re under the

while the while they’re under the

while the while they’re under the influence of the drugs of abuse now in

influence of the drugs of abuse now in

influence of the drugs of abuse now in terms of opiates one of the most

terms of opiates one of the most

terms of opiates one of the most addictive drugs that are potentially

addictive drugs that are potentially

addictive drugs that are potentially available we knew a couple important

available we knew a couple important

available we knew a couple important things about opiates that suggested that

things about opiates that suggested that

things about opiates that suggested that there might be some sort of switching

there might be some sort of switching

there might be some sort of switching mechanism going on between these we knew

mechanism going on between these we knew

mechanism going on between these we knew that in the naive state so before you

that in the naive state so before you

that in the naive state so before you became addicted to opiates the effects

became addicted to opiates the effects

became addicted to opiates the effects of opiates could be mediated through a

of opiates could be mediated through a

of opiates could be mediated through a dopamine independent pathway so you

dopamine independent pathway so you

dopamine independent pathway so you don’t need dopamine to experience the

don’t need dopamine to experience the

don’t need dopamine to experience the rewarding effects of opiates when you’re

rewarding effects of opiates when you’re

rewarding effects of opiates when you’re first starting out taking the drugs

first starting out taking the drugs

first starting out taking the drugs obviously in the naive state there’s an

obviously in the naive state there’s an

obviously in the naive state there’s an absence of withdrawal mechanisms in the

absence of withdrawal mechanisms in the

absence of withdrawal mechanisms in the brain there’s a very minimal amount of

brain there’s a very minimal amount of

brain there’s a very minimal amount of molecular changes that are taking place

molecular changes that are taking place

molecular changes that are taking place but then we looked at the effects of

but then we looked at the effects of

but then we looked at the effects of opiates in the addicted State and we saw

opiates in the addicted State and we saw

opiates in the addicted State and we saw a profound difference so first of all we

a profound difference so first of all we

a profound difference so first of all we noticed that the rewarding effects of

noticed that the rewarding effects of

noticed that the rewarding effects of opiates once you’re addicted opiates

opiates once you’re addicted opiates

opiates once you’re addicted opiates activate the dopamine system so you need

activate the dopamine system so you need

activate the dopamine system so you need to have a switch to a dopamine system

to have a switch to a dopamine system

to have a switch to a dopamine system there is very strong feelings of

there is very strong feelings of

there is very strong feelings of withdrawal and craving there’s obviously

withdrawal and craving there’s obviously

withdrawal and craving there’s obviously profound molecular alterations and

profound molecular alterations and

profound molecular alterations and various brand reward pathways that are

various brand reward pathways that are

various brand reward pathways that are very important so the question that was

very important so the question that was

very important so the question that was posed when I actually began looking at

posed when I actually began looking at

posed when I actually began looking at this question about about 15 years ago

this question about about 15 years ago

this question about about 15 years ago back

back

back University of Toronto was whether or not

University of Toronto was whether or not

University of Toronto was whether or not we can find this elusive hypothetical

we can find this elusive hypothetical

we can find this elusive hypothetical switching mechanism in the brain that

switching mechanism in the brain that

switching mechanism in the brain that controls this transition from a

controls this transition from a

controls this transition from a non-addictive state to an addicted state

non-addictive state to an addicted state

non-addictive state to an addicted state so without going through the minutia and

so without going through the minutia and

so without going through the minutia and the years of research that led to these

the years of research that led to these

the years of research that led to these conclusions what we were able to find

conclusions what we were able to find

conclusions what we were able to find was that when we focus on an area of the

was that when we focus on an area of the

was that when we focus on an area of the brain called the ventral tegmental area

brain called the ventral tegmental area

brain called the ventral tegmental area neuro Anonymous like coming up with

neuro Anonymous like coming up with

neuro Anonymous like coming up with these unpronounceable words but we’re

these unpronounceable words but we’re

these unpronounceable words but we’re just going to call it the VTA for the

just going to call it the VTA for the

just going to call it the VTA for the sake of simplicity this is an area in

sake of simplicity this is an area in

sake of simplicity this is an area in the middle part of your brain sort of

the middle part of your brain sort of

the middle part of your brain sort of the base your brain and it contains the

the base your brain and it contains the

the base your brain and it contains the dopamine system and it’s very important

dopamine system and it’s very important

dopamine system and it’s very important for drugs of abuse because almost all

for drugs of abuse because almost all

for drugs of abuse because almost all drugs of abuse produce their effects

drugs of abuse produce their effects

drugs of abuse produce their effects through the VTA so in a very simplified

through the VTA so in a very simplified

through the VTA so in a very simplified explanation of this what we found was

explanation of this what we found was

explanation of this what we found was that gaba-a receptors which is a type of

that gaba-a receptors which is a type of

that gaba-a receptors which is a type of inhibitory receptor located in that area

inhibitory receptor located in that area

inhibitory receptor located in that area of the brain was actually able to serve

of the brain was actually able to serve

of the brain was actually able to serve as a molecular switching mechanism

as a molecular switching mechanism

as a molecular switching mechanism between a non addicted state and in it

between a non addicted state and in it

between a non addicted state and in it an addicted state so normally you can

an addicted state so normally you can

an addicted state so normally you can think of the GABA a receptor as

think of the GABA a receptor as

think of the GABA a receptor as controlling the bio electrical

controlling the bio electrical

controlling the bio electrical properties of a neuron they control

properties of a neuron they control

properties of a neuron they control whether a neuron is on or off and

whether a neuron is on or off and

whether a neuron is on or off and remarkably what we found was that in the

remarkably what we found was that in the

remarkably what we found was that in the non addicted state the gob a receptor

non addicted state the gob a receptor

non addicted state the gob a receptor acted normally it produced inhibitory

acted normally it produced inhibitory

acted normally it produced inhibitory signals to the neuron it shut down

signals to the neuron it shut down

signals to the neuron it shut down neurons but once we looked at an

neurons but once we looked at an

neurons but once we looked at an addicted brain the function of GABA a

addicted brain the function of GABA a

addicted brain the function of GABA a receptor switched to an excitatory State

receptor switched to an excitatory State

receptor switched to an excitatory State so essentially we’re looking at a

so essentially we’re looking at a

so essentially we’re looking at a mechanism that controls reward signaling

mechanism that controls reward signaling

mechanism that controls reward signaling for a non-addictive grant award pathway

for a non-addictive grant award pathway

for a non-addictive grant award pathway versus a system that is switched on in

versus a system that is switched on in

versus a system that is switched on in the addicted state and transfers reward

the addicted state and transfers reward

the addicted state and transfers reward signals through an addiction brain

signals through an addiction brain

signals through an addiction brain reward pathway so that’s great we found

reward pathway so that’s great we found

reward pathway so that’s great we found this hypothetical switching mechanism in

this hypothetical switching mechanism in

this hypothetical switching mechanism in the brain but remember that I said that

the brain but remember that I said that

the brain but remember that I said that addiction is more than reward we also

addiction is more than reward we also

addiction is more than reward we also need to experience memory we’re talking

need to experience memory we’re talking

need to experience memory we’re talking about it

memory is a very critical component of

memory is a very critical component of addiction so for example as I mentioned

addiction so for example as I mentioned

addiction so for example as I mentioned before we need to form these associate

before we need to form these associate

before we need to form these associate memories in our brain in order to

memories in our brain in order to

memories in our brain in order to continue that addiction cycle and we

continue that addiction cycle and we

continue that addiction cycle and we next look at an area of the brain called

next look at an area of the brain called

next look at an area of the brain called the basal lateral amygdala and then

the basal lateral amygdala and then

the basal lateral amygdala and then another one of these unpronounceable

another one of these unpronounceable

another one of these unpronounceable terms we’re just going to call it the

terms we’re just going to call it the

terms we’re just going to call it the VLA now this is an area of the brain

VLA now this is an area of the brain

VLA now this is an area of the brain located in your temporal lobes and it’s

located in your temporal lobes and it’s

located in your temporal lobes and it’s extremely important for your ability to

extremely important for your ability to

extremely important for your ability to form associative memories between the

form associative memories between the

form associative memories between the effects of drugs of abuse and their

effects of drugs of abuse and their

effects of drugs of abuse and their related environmental cues so we looked

related environmental cues so we looked

related environmental cues so we looked at this region of the brain called the

at this region of the brain called the

at this region of the brain called the PLA to see if this might serve as a

PLA to see if this might serve as a

PLA to see if this might serve as a memory switch between the non addicted

memory switch between the non addicted

memory switch between the non addicted state and what we found was that in the

state and what we found was that in the

state and what we found was that in the non addicted brain the ability to form

non addicted brain the ability to form

non addicted brain the ability to form opiate addiction reward memories

opiate addiction reward memories

opiate addiction reward memories depended on a receptor substrate called

depended on a receptor substrate called

depended on a receptor substrate called the d1 and it modulated a downstream

the d1 and it modulated a downstream

the d1 and it modulated a downstream molecule we’re just gonna call it earth

molecule we’re just gonna call it earth

molecule we’re just gonna call it earth so a non dependent drug naive molecular

so a non dependent drug naive molecular

so a non dependent drug naive molecular mechanism in the BL a controlling

mechanism in the BL a controlling

mechanism in the BL a controlling addiction memories in the naive state we

addiction memories in the naive state we

addiction memories in the naive state we looked at the addicted brain and what we

looked at the addicted brain and what we

looked at the addicted brain and what we found was that there was a switch

found was that there was a switch

found was that there was a switch between this d1 receptor mechanism to a

between this d1 receptor mechanism to a

between this d1 receptor mechanism to a completely different brain reward

completely different brain reward

completely different brain reward mechanism for the formation of addiction

mechanism for the formation of addiction

mechanism for the formation of addiction memories and now we were dealing with a

memories and now we were dealing with a

memories and now we were dealing with a system that relied on a type of receptor

system that relied on a type of receptor

system that relied on a type of receptor called the d2 receptor and an entirely

called the d2 receptor and an entirely

called the d2 receptor and an entirely different molecular downstream signaling

different molecular downstream signaling

different molecular downstream signaling pathway both cam kinase 2 so again just

pathway both cam kinase 2 so again just

pathway both cam kinase 2 so again just like in terms of processing the

like in terms of processing the

like in terms of processing the rewarding effects of drugs of abuse when

rewarding effects of drugs of abuse when

rewarding effects of drugs of abuse when we look at the difference between the

we look at the difference between the

we look at the difference between the addictive state and a non-addictive

addictive state and a non-addictive

addictive state and a non-addictive state the ability to form drug addiction

state the ability to form drug addiction

state the ability to form drug addiction memories is also under the control of a

memories is also under the control of a

memories is also under the control of a discrete switching mechanism and the

discrete switching mechanism and the

discrete switching mechanism and the really cool thing about this is that we

really cool thing about this is that we

really cool thing about this is that we were able to target those molecules in

were able to target those molecules in

were able to target those molecules in the amygdala and switch the brain back

the amygdala and switch the brain back

the amygdala and switch the brain back and forth from an addicted state to a

and forth from an addicted state to a

and forth from an addicted state to a non addicted state so this is really

non addicted state so this is really

non addicted state so this is really exciting because to suggest that instead

exciting because to suggest that instead

exciting because to suggest that instead of thinking of addiction as this chronic

of thinking of addiction as this chronic

of thinking of addiction as this chronic permanent irreversible state we can

permanent irreversible state we can

permanent irreversible state we can actually go into these brain areas we

actually go into these brain areas we

actually go into these brain areas we can target these molecular pathways and

can target these molecular pathways and

can target these molecular pathways and we can actually switch the brain from a

we can actually switch the brain from a

we can actually switch the brain from a non-addictive state to an addicted state

non-addictive state to an addicted state

non-addictive state to an addicted state and back and forth so this really calls

and back and forth so this really calls

and back and forth so this really calls into the question the need for us to do

into the question the need for us to do

into the question the need for us to do a new paradigm for conceptualizing

a new paradigm for conceptualizing

a new paradigm for conceptualizing what’s really going on in addiction we

what’s really going on in addiction we

what’s really going on in addiction we know that in the non dependence state

know that in the non dependence state

know that in the non dependence state we’re dealing with an entirely different

we’re dealing with an entirely different

we’re dealing with an entirely different set of molecular and neuroanatomical

set of molecular and neuroanatomical

set of molecular and neuroanatomical mechanisms that control how you perceive

mechanisms that control how you perceive

mechanisms that control how you perceive the rewarding effects of a drug like

the rewarding effects of a drug like

the rewarding effects of a drug like heroin for example but once you become

heroin for example but once you become

heroin for example but once you become addicted to that drug something switches

addicted to that drug something switches

addicted to that drug something switches in your brain there’s a switch two

in your brain there’s a switch two

in your brain there’s a switch two entirely separate molecular and neuronal

entirely separate molecular and neuronal

entirely separate molecular and neuronal systems in the brain that control how

systems in the brain that control how

systems in the brain that control how you perceive that rewarding effective

you perceive that rewarding effective

you perceive that rewarding effective drugs of abuse so this is really

drugs of abuse so this is really

drugs of abuse so this is really thinking of addiction much more in terms

thinking of addiction much more in terms

thinking of addiction much more in terms of a plastic dynamic process that allows

of a plastic dynamic process that allows

of a plastic dynamic process that allows us to go back and forth between these

us to go back and forth between these

us to go back and forth between these different states so where do we go from

different states so where do we go from

different states so where do we go from here I think one of the most important

here I think one of the most important

here I think one of the most important questions to ask let’s go back to the

questions to ask let’s go back to the

questions to ask let’s go back to the beginning and address the issue of

beginning and address the issue of

beginning and address the issue of whether or not the disease model of

whether or not the disease model of

whether or not the disease model of addiction has really served us well and

addiction has really served us well and

addiction has really served us well and I’m going to argue that no it hasn’t

I’m going to argue that no it hasn’t

I’m going to argue that no it hasn’t really been an effective model for us in

really been an effective model for us in

really been an effective model for us in terms of our ability to understand

terms of our ability to understand

terms of our ability to understand what’s going on in the brain and more

what’s going on in the brain and more

what’s going on in the brain and more importantly in terms of developing

importantly in terms of developing

importantly in terms of developing effective treatments for addiction

effective treatments for addiction

effective treatments for addiction because remember after many decades and

because remember after many decades and

because remember after many decades and many thousands and thousands of research

many thousands and thousands of research

many thousands and thousands of research papers from all sorts of disciplines we

papers from all sorts of disciplines we

papers from all sorts of disciplines we have yet to develop a truly effective

have yet to develop a truly effective

have yet to develop a truly effective treatment for dealing with the

treatment for dealing with the

treatment for dealing with the devastating effects of addiction the

devastating effects of addiction the

devastating effects of addiction the problem with the disease model of

problem with the disease model of

problem with the disease model of addiction is twofold

addiction is twofold

addiction is twofold the first problem is that it doesn’t

the first problem is that it doesn’t

the first problem is that it doesn’t take into account these dynamic

take into account these dynamic

take into account these dynamic processes that are happening in your

processes that are happening in your

processes that are happening in your brain as you go from a non-addictive

brain as you go from a non-addictive

brain as you go from a non-addictive state to an addictive state because I

state to an addictive state because I

state to an addictive state because I said at the outset we think of diseases

said at the outset we think of diseases

said at the outset we think of diseases as these sort of permanent static

as these sort of permanent static

as these sort of permanent static processes as opposed to these more

processes as opposed to these more

processes as opposed to these more dynamics switching mechanisms that go on

dynamics switching mechanisms that go on

dynamics switching mechanisms that go on in the brain the second problem is that

in the brain the second problem is that

in the brain the second problem is that when we use a disease model of addiction

when we use a disease model of addiction

when we use a disease model of addiction whether we’re talking about forming

whether we’re talking about forming

whether we’re talking about forming questions for our research or developing

questions for our research or developing

questions for our research or developing more effective cycle therapies for

more effective cycle therapies for

more effective cycle therapies for treating addiction we tend to focus more

treating addiction we tend to focus more

treating addiction we tend to focus more on the effects of addiction we focus on

on the effects of addiction we focus on

on the effects of addiction we focus on the symptoms of a dish instead of the

the symptoms of a dish instead of the

the symptoms of a dish instead of the underlying causes of addiction now

underlying causes of addiction now

underlying causes of addiction now having said that I think that there’s

having said that I think that there’s

having said that I think that there’s enough evidence out there it’s Jess

enough evidence out there it’s Jess

enough evidence out there it’s Jess that a better way of thinking of

that a better way of thinking of

that a better way of thinking of addictions are that we’re dealing with

addictions are that we’re dealing with

addictions are that we’re dealing with an altered but reversible state of the

an altered but reversible state of the

an altered but reversible state of the brain it’s controlled by a series of

brain it’s controlled by a series of

brain it’s controlled by a series of molecular mechanisms that control the

molecular mechanisms that control the

molecular mechanisms that control the switch of a non-addictive state an

switch of a non-addictive state an

switch of a non-addictive state an addicted state and as I said before

addicted state and as I said before

addicted state and as I said before what’s most exciting about this that

what’s most exciting about this that

what’s most exciting about this that allows us to go into the brain target

allows us to go into the brain target

allows us to go into the brain target these molecular pathways and potentially

these molecular pathways and potentially

these molecular pathways and potentially develop more effective pharmacal

develop more effective pharmacal

develop more effective pharmacal therapeutics or more effective

therapeutics or more effective

therapeutics or more effective psychotherapeutic approaches to dealing

psychotherapeutic approaches to dealing

psychotherapeutic approaches to dealing with addiction by appreciating some of

with addiction by appreciating some of

with addiction by appreciating some of these dynamic mechanisms so as I said at

these dynamic mechanisms so as I said at

these dynamic mechanisms so as I said at the outset one of the important things

the outset one of the important things

the outset one of the important things about addiction in terms of

about addiction in terms of

about addiction in terms of understanding how it processes the

understanding how it processes the

understanding how it processes the rewarding effects of drugs of abuse is

rewarding effects of drugs of abuse is

rewarding effects of drugs of abuse is this idea that we can identify a switch

this idea that we can identify a switch

this idea that we can identify a switch and ultimately turn off the effects of

and ultimately turn off the effects of

and ultimately turn off the effects of addiction in the brain