Specialty
Addiction,
Brain Chemistry, and Parenting
Several weeks ago, there was a Public Broadcasting System (PBS) series on addiction. Much of it was quite unsettling, with a strong message that drug addiction is devastatingly persistent. On the positive side, there is new insight about why. On the negative side, there is little available as a proven means of recovery.
The insights about the role of our brain in the process of addiction centers on something called neurotransmitters. These are chemicals that impact on the electrical messages being transmitted in the brain from one neuron to another. It is these messages that determine our thoughts and feelings. We are still in our infancy in understanding this process, yet in just my lifetime as a psychologist, our knowledge has grown infinitesimally. Advances in the uses of medications to help treat a variety of disorders such as depression, anxiety, hyperactivity, and schizophrenia have all been leaning heavily on increasing knowledge about neurotransmitters. In turn, we have learned that even the non-medical treatment process of psychotherapy can alter brain chemistry.
The PBS special explained that when a person ingests an addictive drug, the brain is flooded with a neurotransmitter called dopamine which is strongly related to the experience of pleasure. Normally, when we experience something pleasurable, the brain releases more dopamine. The current thinking is that the problem with chronic use of addictive drugs is that flooding the brain with dopamine causes it to begin to generate less of its own in an effort to maintain some kind of chemical balance. Thus, the chronic user of addictive drugs loses his ability to experience pleasure from the normal life experiences creating the dependency on the drug to experience pleasure. Ultimately, it can become a ceaseless craving for the drug.
Thus, regardless of what factors led to the initial use of the drug, it begins to take on a life of its own, leading to the experience observed by many of the repeated failure of drug-addicted people to break the pattern of addiction. Yet, despite this high rate of recidivism (getting "cured", then returning to drug use), there are always many examples of people who are successful in breaking free from their dependency, some after decades of chronic drug abuse. We are struggling to understand what creates these "successes" so more effective treatments can be developed. What we do need to remember is that even though part of the brain has been "hijacked" by the effects of the addiction, it is still only a part of the brain, not all of it. In other words, we must continue to appeal to and work with the healthy parts of the addict to try to enable him to make the powerful, persistent commitment necessary to get "clean." The addict is still responsible for what he is doing, even if we know that brain chemistry is a driving force in maintaining the addiction. The addict still has the option of seeking help and trying to learn ways to combat the craving and slowly change the brain's chemistry back to normal. However, one of the messages here is that this is an extremely difficult process and is likely to result in many failures before achieving success. I have worked with adolescents and adults who have gone to detox centers several times before finally breaking free. Sadly, I have also worked with adults who continued to relapse, sometimes after a couple of years of successful, drug-free living. And, of course, there are the sadder stories of those who end up dead as a result of their addictions.
So where does the role of the parent come into this? There is increasing research evidence that children who have strong bonds with their parents are much less likely to abuse drugs. This bonds result from finding ways to enjoy your child in one-on-one contacts, from playing together to quiet conversations at bedtime to making sure you are available to be a good listener when you child wants to talk. It also comes from parents who are willing to try to learn about their teenager's world with a minimum of judgment, lecturing, and nagging. It comes from being an authoritative parent, clear rules enforced in a collaborative manner with some flexibility, instead of an authoritarian parent, rigid rules imposed on children in an absolute fashion.
It is also important for parents to become knowledgeable about drugs which leads to a critical need for collaboration between community and family. Schools, town youth programs, police and legal systems, and religious organizations need to work together in obtaining and distributing accurate information (as opposed to distorted propaganda) that serves as a common source of information that is shared with children in the home as well as in the community. Parents should make sure that their community is active in developing these resources and take every opportunity to get educated.
One piece of research is especially important. Children who begin experimenting with drugs before the age of 16 are significantly more likely to develop an addiction than those who begin using at age 16 or older. Given the trend in our society for "adolescence" to begin earlier and earlier, this should be a wake-up call to parents of preteens and younger adolescents to be more aware of where your children are and what they are doing and to help them combat the peer and societal pressures to grow up too quickly. The key to this, again, is to make sure that your role as a parent includes being one of your child's friends.
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