Doctor with an MRI scan of the BrainThose who are struggling with sex addiction or porn addiction have absolutely no doubt that they are in the grip of a real addiction.

They cannot seem to control their sexual impulses, they decide repeatedly to stop but can’t, they experience irresistible cravings and their behavior seriously impacts their functioning.  Sex is their drug.

The brain science of addictions

Studies over the last 10 years have suggested that behavioral addictions like gambling and sex addiction may affect the brain in the same ways as chemical addictions.

Addictions involve overuse of the pleasure centers in the brain that produce dopamine which in turn ends up shrinking the cells that produce dopamine and decreasing the amount of available dopamine.  This increases the craving for chemicals or activities that cause dopamine release.

The evidence is that the same process decreases and disrupts the frontal lobes ability to use higher level thinking in relation to exerting self control, weighing risks and evaluating consequences.  This lessened cognitive connectivity further increases the impulsiveness of the addictive behavior.  An online article from a  Massachusettes General Hospital publication states:

“Drugs of abuse confuse these pathways, thus leading to compulsive drug-seeking and the lack of inhibitory control that contribute to an addict’s relapse.” and

“Although a standard U.S. diagnostic manual (the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition or DSM-IV) describes multiple addictions, each tied to a specific substance or activity, consensus is emerging that these may represent multiple expressions of a common underlying brain process.”

Some researchers have questioned whether there is solid evidence for the notion that the brain effects of behavioral addictions like porn addiction are identical to those of chemical addictions and future research will clarify the processes involved in various addictions.

But data continue to come in.  Another recent study reportedly found that cannabis users had lower levels of dopamine production and that dopamine levels were lowest for those who started earlier and those who smoked more cannabis.  The authors postulate that this could explain the “amotivational syndrome” sometimes claimed to be a result of cannabis use.  They also point to the parallel between their results and those relating to altered dopamine systems in cocaine and amphetamine users.

Ritalin

A recently reported study using Ritalin on cocaine addicted people measured its effects on the brain in those areas involved in addiction.  According to a review of the study the researchers at Brookhaven National Laboratory in New York quoting one of the researchers: “The orally administered methylphenidate (Ritalin) increases dopamine in the brain, similar to cocaine, but without the strong addictive properties.”  The study used functional magnetic resonance imaging (fMRI) to measure the strength of connectivity in the brain circuits that play a role in addiction.  The review summarizes the results of the study.

“Methylphenidate decreased connectivity between areas of the brain that have been strongly implicated in the formation of habits, including compulsive drug seeking and craving…” and “strengthened connectivity between several brain regions involved in regulating emotions and exerting control over behaviors…”

The lead author is quoted as stating:

“Using fMRI, we found that methylphenidate did indeed have a beneficial impact of the connectivity between several brain centers associated with addiction.”

Can the addict brain rewire itself?

If dopamine balance in the brain and the functioning of the dopamine system becomes regulated then it is thought to be possible for the brain to recover from the damaging effects of the addiction on the pleasure centers and for the connectivity in the brain to begin to allow greater cognitive control over things like cravings and impulses.

Although it appears that treatment with Ritalin has promise in terms of damping down the cravings associated with the altered brain structure and chemistry in addiction, it is unclear to what extent the brain will repair itself.  There is reason to believe that the brain’s plasticity, its ability to create new connections means that the addict brain can be rewired.  Yet the Mass General article states:

“Whether the brains of addicts can ever return to normal is an open question. “It seems to be highly variable,” says Volkow of NIDA, who has been following methamphetamine and cocaine addicts after sobriety. “Some brains recover, while others don’t. It probably depends on how long someone has been taking the drug, how frequently and the age at which he or she began. The earlier you start, the greater the likelihood the brain changes will be longer lasting.”

It seems it is only a matter of time until we will fill in the gaps in scientific knowledge.  An article in the National Institute on Drug Abuse archives stated the vision well:

“Ultimately, researchers envision a two-stage process for helping restore drug abusers’ impaired abilities.  Interventions will be used first to stop ongoing brain damage and repair damaged brain cells, and then to retrain the brain.”

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource