Disconnected Brains: How isolation fuels opioid addiction - Rachel Wurzman - Part 2

As both a researcher who studies differences in how individuals' brains wire and rewire themselves, and as a Tourette or with other related diagnoses, I have long been fascinated by failures of self regulation on the impulsive and compulsive behavioral spectrums, because so much of my own experience of my own body and my own behavior has existed all over that map. So with the spotlight on the opioid crisis, I really found myself wondering lately, where on the spectrum of unvoluntary behavior, do we put something like abusing opioid painkillers or heroin?

By now, we all know that the opioid crisis, an epidemic is out of control. 91 people die every day in this country from overdose, and between 2002 and 2015 the number of deaths from heroin increased by a factor of six. And something about the way that we treat addiction isn't working, at least not for everyone. Relapse rates among heroin users exceed 59% Within the first week and are about 80% within the first month. It is a fact that people suffering from addiction have lost freewill when it comes to their behavior around drugs, alcohol, food or other reward systems.

Stimulating behaviors that addiction is a brain based disease state is a medical neurobiological reality. But how we relate to that disease. Indeed, how we relate to the concepts of disease when it comes to addiction makes an enormous difference for how we treat people with addictions.

So we tend to think of pretty much everything we do was entirely voluntary, but it turns out that the brain's default state is really more like a car idling and drive than a car in park. Some of what we think we choose to do is actually things that we have become programmed to do when the brakes are released. Have you ever joked that your brain was running on autopilot? Guess what? It probably was, okay. And the brain's autopilot is in a structure called the striatum. So, the striatum detects emotional and sensory motor conditions. And it triggers it knows to trigger whatever behavior you have done most often in the past under those same conditions.

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