Keys to Fighting Addiction

By: Jon Grant, M.D., M.P.H., J.D.

People can become addicted to many things: sex, alcohol, and stealing, to name a few. But do you ever wonder how addiction happens? Or why some people are more prone to it than others?

The human brain is complex and responsible for many things. Certain parts function for judgment, others function for physical coordination and processing motivation and rewards. When a person develops an addiction to a substance or behavior, the reward-motivation circuitry is usually off. If someone finds a particular reward to be exceedingly great, his or her motivation and drive is stronger toward getting that reward again. And when people’s needs or desires for reward are greater than their abilities to resist the cravings, addiction happens.

Any person may be susceptible to addiction. It crosses all demographics, education levels, and cultures. Oftentimes we see addiction in adolescence. This is because the brain isn’t fully matured until age 24, and the last portion of the brain to develop is the frontal lobe, which is our judgment. 

Addiction can impact people in many ways. It may cause problems in personal relationships if a person spends too much time with his addictive behavior instead of with his loved one. It can also cause financial problems, as they all cost money. In severe cases, addiction can lead a person to feel isolated from all people and things that are not associated with the addicted behavior. 

Fortunately, psychotherapy coupled with particular medications show promise for treating addictions. Recently we have been using a technique called imaginal desensitization to help people fight addictions. In short, we’ll audio record a person describing his addiction and how good it makes him feel. Then, we’ll send that sound bite home with the patient and have him listen to it over and over again. The more he listens to it, the more desensitized he becomes to the rush and urge to repeat his behavior. 

Also, my colleagues and I recently found that by listening carefully to how a person describes his or her addiction, we are better able to prescribe particular medications that will impact different parts of the brain. For example, if a person tells me she needs to gamble, we may administer medication that will alter her glutamate and/or dopamine levels, lowering her strong desires. If she reports being unable to stop gambling even with little or no desire, we may give her medication that will increase her serotonin levels. Serotonin tends to work in the front part of the brain and helps us inhibit behaviors. 

If you or a loved one is battling addiction, seek help. In addition to seeing a therapist and taking medications, attend programs or join a support group. Take advantage of all of the resources available to help fight addiction. 

Jon Grant, M.D., M.P.H., J.D., is associate professor of psychiatry at the University of Minnesota Medical School.