One of the hallmarks of drug and alcohol addiction is a tendency toward impulsive behaviour. Addicts tend to live in the world of the ‘here and now’ with very little thought about how the future is impacted by today’s decisions. Often times it is thought that the leading cause of self-destruction among addicts is this tendency to impulsiveness. However, new research is now causing experts to ask whether that same impulsive tendency can be used as a treatment for addiction.
Virginia Tech’s (Blacksburg, Virginia, USA) Dr Warren Bickel has been studying how the brain reacts to persistent drug use. He has been specifically looking at the various portions of the brain and how these might be used to bring about recovery. What he has learned from his research is remarkable.
It turns out that the dorsal lateral prefrontal cortex, the portion of the brain responsible for long-term decision-making, is less active in chronic drug users. Part of the loss of activity is directly related to a reduction in the size of the cortex as a result of certain kinds of drugs killing off brain cells. As the activity in this cortex is reduced, an individual loses self-control. This explains why addiction progresses the way it does.
Dr Bickel believes it is possible to gradually increase the brain activity in question by way of a reward programme based on impulsive behaviour. His theory takes advantage of something known in the psychological community as ‘delay discounting’.
The concept of delay discounting can best explained by an example. If a rational person were offered £100 today or £150 a week from now, he or she would likely be willing to wait seven days for the extra £50. However, in a large enough group, there would be one person whose impulse for self-gratification was strong enough to get him or her to take the lesser amount of money in order to be satisfied today. This is the classic definition of delay discounting.
Dr Bickel’s research concentrates on using this principal in order to encourage addicts to make the right choices in the short term. He believes that enough correct, short-term decisions strung together could give the brain the time it needs to regenerate new brain cells that would restore the size and activity of the dorsal lateral prefrontal cortex.
Bickel and his fellow researchers conducted five separate studies looking at addicts and how they responded to various types of decision-making strategies. After analysing and re-analysing the data, they made a startling discovery: those who had the strongest sense of delay discounting at the start of the study gradually became the least impulsive as the studies progressed. These individuals essentially learned to become less impulsive by making impulsive decisions.
The results of the study contradict what most of the experts currently believe about addiction recovery. And rightly so. Previous studies used various treatment methods that did not necessarily take advantage of delay discounting in the same way Bickel’s research did. The results of those previous studies were not very favourable. However, Bickel’s approach was different. More importantly, his studies achieved an impressive 80% to 90% abstinence rate among those who completed treatment.
His approach was to selectively apply psychotherapeutic treatments according to how each patient dealt with delay discounting, rather than throwing every possible treatment option out there. By responding to each individual separately, Bickel was able to focus the delay discount tendency to the specific treatment that was likely to work best.
What Dr Bickel and his team have learned certainly bears more research. If future trials prove his theory to be correct, it could be possible to take one of the negative effects of long-term drug abuse and turn it around for something good. That would be truly revolutionary.
If you need more information on addiction or are planning interventions for a close one, ask our professional advisors for assistance.
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