Is Addiction a Choice?

November 2, 2011

The conundrum of addiction is that, in most cases, an addict knows what decision they “should” make regarding drugs and alcohol – that is, they should avoid them or drink only in moderation – nevertheless, they are repeatedly compelled to make choices that often carry with them dire consequences. UC Berkeley researchers wanted to understand the differences in the brain of an addict as compared to that of a nonaddicted person and what compels them to make decisions that lead to losing loved ones, ending marriages, pushing away children, damaging hard-earned careers and a plethora of other harmful results.

Neuroscientists at UC Berkeley believe they have located a major region in the brain responsible for these poor decision-making abilities that addicts demonstrate. They concluded in their study, published in Nature Neuroscience, that two areas located in the frontal lobe (the part of your brain right behind your forehead), known as the orbitofrontal and anterior cingulate cortexes, have the power to control our decision-making abilities.

How Did They Find the Area of the Brain Controlling Addictive Choices?

The scientists had a hunch that the orbitofrontal and anterior cingulate cortexes played a large role in the irresponsible choices of those involved in substance abuse based off of previous brain research, but the exact mechanism was still unknown. Using macaque monkeys, they designed a decision-making exercise and watched changes in the monkey’s brain activity. They specifically analyzed how the macaques calculate the risk, benefit and cost of a variety of choices presented to them.

From their investigation, the UC Berkeley neuroscientists found the orbitofrontal cortex manages the risk associated with choices. When there is a malfunction in this region, such as during the addiction process, the activity no longer fluctuates based on the gravity of a given decision. For example, what to eat for lunch would be given the same amount of significance as who to marry. This miscalculation can have profound effects on the quality of an individual’s decision-making ability.

Simultaneously, the cingulate cortex they discovered is calculating whether a decision corresponds to our expectations. If this function is not in place we will not learn from our experiences. In effect, we could keep making the same reckless choices without any recognition that we are having a repeated problem.

Ramifications of Finding the Mechanism Behind Unhealthy Addictive Choices

The hope through this type of research is to find the brain regions responsible for different aspects of addiction in order to find appropriately directed treatments. The development of a variety of different therapies, from psychotherapy to pharmaceutical, potentially could be aimed at the decision-making aspects in the brain responsible for choices during addiction to help in the progress towards a sustained recovery.

If you know someone who is struggling with addiction we can help on the path to recovery. Give us a call and we can connect you with successful evidence-based treatment programs around the US. Call today.

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