[Dr. K's Deep Dive into Addiction](https://www.youtube.com/watch?v=WuKeZKIs9_A&ab_channel=HealthyGamerGG) - Substance Use Disorders (SUDs) - Behavioural Addictions - Addiction: Is B causing impairment in function of life? - Sometimes impairment of function is hard to see - Compulsive thinking: can’t get thing out of mind - Continued engagement despite the negative consequences. - Denial: EG: “I’m still in a happy marriage, I’m still working, so what’s the problem?” - Behaviour, damages you, can’t / don’t stop. - Why does someone get addicted (Stress-diathesis model) - Heritability - EG: alcohol: GABA receptor, neuronal membrane. - Environment - Can really activate and propagate addiction - Changing environment  big step - Functional understanding of neuroscience of addiction. - Thalamus: sensory gateway to brain. When addicted, alters what thalamus lets through. Cravings triggered by associated sensory stimuli (eg seeing people drink) - Amygdala - Addictions take away pain. Increase pain when taken away. - Negativity returns after stopping addictive behaviour. - Natural negative emotion meant to motivate corrective action. - Removing negativity short circuits motivation for changing/improving things. - Addiction can stop you growing in life. - Overwhelming negative emotion encourage addiction vicious circle - EG: Alcohol de-activates fear neurons in amygdala. - People often like the version of self they are on alcohol. Liquid courage, social lubricant. - Withdrawal isn’t necessary for addiction. - Constantly suppressing amyg, leads to increased sensitivity of amygdala - Limbic system: access to social emotions (shame, guilt, pride) - Emotions impair higher cognition. - NAcc (Nucleus Accumbens) - Pleasure: - Anticipation: - Behavioural reinforcement: - Develops tolerance of current level of dopamine. More dopamine you activate, less dopamine works - Technology use produces such consistent dopamine. Leads to anhedonia. - Sequence of addiction: great, removes negative, baseline becomes negative = dependent on addiction to return to neutral. - Chasing dopamine impossible for sustained happiness - Frontal lobes: executive function; working memory. - Predictive error processing impaired: less able to predict consequences. - Gen - Human brain full of conflicting stimuli. - Justifications based on incorrect predictions. - Insufficient plan to escape. - Circuits are built to return to neutrality / baseline from detoxing. - Not recoverable: direct damaging effects of substances themselves. EG DNA dmg, liver cancer - Q&A - Difference to food: Have craving for food doesn't mean addicted. - Not same for antidepressants. - Different circuitry involved. All addictions activate NAcc - Industries have found new ways to make gambling addicts addicted. - Intermittent reinforcement increases dopamine release as expectation decreases dopaminergic release. - Addiction is increasing as pleasure has been separated from sustenance. - How to Fix? - Environment Changes: - Social: if community into same addiction. - Brain associates environment / behaviours with addiction (through thalamus) - Creatures of habit. Subjective wanting shaped by the environment. - Rehab has less triggers for addiction. + less negative emotion produced. - Emotional regulation: - Present emotions: making negative emotions go away without substances/behavioural addiction. - BUT: those things suck at regulation. - Problem with addictions, is they are really good solutions to emotional regulation. - People used to addictions are used to instant relief. - Dormant emotions: - Built up and suppressed over time. - HALT Stressors: hungry, angry, lonely, tired - Self-care tends to drop off 2-3 months before a relapse. - Purpose: can override all over brain circuitry. - Purpose has to be more powerful than addiction - Can use very powerful imagery for this. - Suicide/Addiction isn’t the answer, building a better life is. - Withdrawal: do with a medical professional. - Post acute withdrawal syndrome: can last for months. - Adaptations built on addiction need to be recalibrated. - Asking for help: - Using help accelerates growth. Doesn’t impede it.  - Institutions that help people attempt to avoid dependence. - Thinking: the addicts brain - Denial - Deal making: “I’ll stop when…” - The weakness trap: see addiction as a weakness - I’m weak; I need to be strong; I need to conquer my addiction. - Overcoming an addiction isn’t “being strong” it’s about performing important maintenance. - Saying: you are as sick as your secrets. - Addiction requires lying. - To others - To self: - Lying gives fertile soil to addiction. - Easiest way not to be caught in a lie is to be in denial.  - Recovery circle: a group of people you can be completely honest with. - Last rule: don’t bend the rules: - Addiction like a poisonous gas will seep through cracks. #Addiction