Disconnected Brains: How isolation fuels opioid addiction

Dr. Rachel Wurzman, TEDxMidAtlantic, October 2017

science owl

Addiction is an maladaptation to an unhealthy social environment.

Even more than our primate cousins, homo sapiens have complex genetic and neurochemical factors that incentivize social connection. We have an evolutionary advantage for social behavior, social connection, and forming group bonds in order to survive and build civilizations and complex social structures. There’s a lot of complex neurochemistry happening to drive those behaviors, and

opioid compounds specifically are implicated in the neurochemistry of human social bonding.

It turns out that naturally-occurring opioid compounds are intricately involved in the reward systems our brains use to reinforce social connection. These naturally occurring opioids make social connection literally feel good: in a part of the brain called the striatum.

Research Study: Blocking opioids attenuates physical warmth-induced feelings of social connection

Gabor Maté, MD, Advisor to SeekHealing Program Development

Gabor Maté, MD

Advisor to SeekHealing Program Development

Bestselling Author of In the Realm of Hungry Ghosts

A renowned speaker, and bestselling author, Dr. Gabor Maté is highly sought after for his expertise on a range of topics including addiction, stress and childhood development. Rather than offering quick-fix solutions to these complex issues, Dr. Maté weaves together scientific research, case histories, and his own insights and experience to present a broad perspective that enlightens and empowers people to promote their own healing and that of those around them.

For twelve years Dr. Maté worked in Vancouver’s Downtown Eastside with patients challenged by hard-core drug addiction, mental illness and HIV, including at Vancouver’s Supervised Injection Site. With over 20 years of family practice and palliative care experience and extensive knowledge of the latest findings of leading-edge research, Dr. Maté is a sought-after speaker and teacher, regularly addressing health professionals, educators, and lay audiences throughout North America.

As an author, Dr. Maté has written several bestselling books including the award-winning In the Realm of Hungry Ghosts: Close Encounters with Addiction; When the Body Says No: The Cost of Hidden Stress; and Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder, and co-authored Hold on to Your Kids. His works have been published internationally in twenty languages.

Dr. Maté is the co-founder of Compassion for Addiction, a non-profit that focusses on addiction. He is also an advisor of Drugs over Dinner.

Dr. Maté has received the Hubert Evans Prize for Literary Non-Fiction; an Honorary Degree (Law) from the University of Northern British Columbia; an Outstanding Alumnus Award from Simon Fraser University; and the 2012 Martin Luther King Humanitarian Award from Mothers Against Teen Violence. He is an adjunct professor in the Faculty of Criminology, Simon Fraser University.

Rachel Wurzman, PhD, SeekHealing Director of Science

Rachel Wurzman, PhD

SeekHealing Director of Science

Postdoctoral Fellow at the University of Pennsylvania

Dr. Rachel Wurzman is a Fellow with the Center for Neuroscience and Society, and a Postdoctoral Research Fellow in Neurology with the Laboratory for Cognition and Neural Stimulation at the University of Pennsylvania, Philadelphia, PA, USA. Previously, Rachel served as an Intern in the Science Division of the Office of Science and Technology Policy in the Executive Office of the President of the United States, an Independent Contractor for the World Technology Evaluation Center (dba WTEC, Inc.) in support of the National Nanotechnology Coordinating Center, a Neuroscience Scholar Program Fellow with the Society for Neuroscience, and a Researcher in Residence in the Neuroethics Studies Program of the Pellegrino Center for Clinical Bioethics at Georgetown University.

Rachel is the author of over 20 peer reviewed journal articles and book chapters on various topics in developmental, cognitive, and systems neuroscience, neuroethics, and science policy. Throughout her career, Rachel has investigated neurodevelopmental mechanisms for plasticity in brain circuits whose wiring, and sometimes mis-wiring, contribute to neuropsychiatric disorders on the addiction, obsessive-compulsive, and autistic spectrums. Her current research in the field of neurorehabilitation at the University of Pennsylvania seeks to understand mechanisms for neuroplasticity in brain networks, using non-invasive brain stimulation techniques, neuroimaging, and network neuroscience methods. Additionally, ongoing research in neuroethics addresses the implications of a biopsychosocial and systems-oriented perspective on neuropsychiatric spectrum phenomena (such as addiction) for research, treatment, and social policy.

Rachel received her PhD in Neuroscience from Georgetown University’s Interdisciplinary Program in Neuroscience, where her she was an NIH Ruth L. Kirschstein National Research Service Award Fellow. She received her M.S. in Physiology and Biophysics from Georgetown University, and her B.A. in Neuroscience from Smith College.

By Dr. Rachel Wurzman

Most people know that medical science considers addiction to be a disease. They say this because we know that the cycle of addiction starts with the brain and gets locked in by the brain. But that’s not the whole story. We know that the brain is plastic, which means that it is constantly being wired and re-wired by the way we experience the world around us. Science tends to think about how technologies like medications or physical brain stimulators can help encourage the brain to rewire itself away from neurological and psychological illness states and towards healthier ones. But we also know that there are some conditions— and addiction is one— where the most effective treatments known are things that help to change thoughts and behavior.

In studying brain plasticity, we use technology to help put brains in more plastic states. But we’re discovering something very interesting. It turns out that it’s not just about nudging the brain to start rewiring that induces healing— it matters very much what the person is doing when we’re tinkering about in there. What do I mean by this? I mean that the experiences that we have when the brain is primed to change determine what the very effect of that technology has. Our brains are very accommodating. If our thoughts and behaviors give us socially isolating experiences, our brains become set in that mode. But that doesn’t mean that we or our brains work well in that mode. Quite the opposite.

Let me tell you about another exciting thing that neuroscience is discovering. It turns out that certain brain networks are responsible for more than one type of experience or perception or behavior. And lately, three different sub-fields in neuroscience have come from different directions but recently have found themselves in the same space, zeroing in on this one critical system that’s essential for what they focus on.

One of the fields is addiction neuroscience. The neuroscience of addiction has long since identified the system responsible for drug and alcohol addiction, called the Reward System. This is the system that is hijacked so effectively by opiates like heroin.

Another sub-field is neuro-spirituality, or the study of how the brain processes spiritual experiences. It turns out that certain chemical pathways in the reward system are also activated when we have profound experiences of connectedness to something outside of ourselves and greater than ourselves, which makes us feel well and peaceful and whole and joyful. Spiritual experiences tend to create conditions in the brain that look like states where the brain becomes more plastic. In other words, we are starting to suspect that things that trigger spiritual experience herald a brain that can more easily rewire itself.

But the most surprising convergence comes from the field of Social Neuroscience, which studies how our cultural and interpersonal experiences are driven by brain, and why certain experiences have certain effects on the brain. It turns out that the brain system that drives mammals, and especially human, to form social bonds is— you guessed it— the reward system.

Certain hormones like oxytocin, which people have called the love hormone and the trust hormone, and other chemicals like endorphins and enkephalins, act on parts of those same reward circuits to make social interaction rewarding. This is a system that makes sure that we’re are ok— that we are going to survive as the puny, weak, limited biological creatures that humans are. We form groups, we support each other, we pick up the slack for the more vulnerable members of our group so that the group can get the nourishment it needs to survive and thrive. This system is so important to human survival, and other mammals that need to come together in groups to raise offspring, that we are hardwired to experience pain in the absence of connection.

Let me say that again. The same brain circuit that gives us experiences of profound connectedness also gives us very physical feelings of pain and emotional— even existential— suffering when we don’t have connection to things outside of ourselves. And guess what those physical feelings resemble? Withdrawal from opiates. Stomach upset. Muscle aches. Our skin crawls. We feel restless irritable discontent, and emotionally hopeless about our lives continuing. We feel like we’re dying because the truth is, we ARE dying.

We tend to think that in modern society, we don’t need tribes of humans to survive, because we have farms that grow food predictably and in luckier places in the world, we came just go to the grocery store to buy food. But the life-threatening epidemics in our society like opiate addictions, or obesity and diabetes from food and sugar addiction, and suicide rates resulting from depression and anxiety and PTSD tell us otherwise. Our society increasingly lacks ways to AUTHENTICALLY connect to other people and to experiences of something transcendent and beyond the boundaries of our small selves and limited minds. This state of affairs acts through the brain’s reward system to make life literally painful.

That pain drives us to bond to whatever we can. Like food, like electronics, and for too too many people— to drugs. Opiates are the most vicious hijackers of this system because they can directly produce the brain states that social and spiritual connection are supposed to give us. It’s a biological imperative— it is a neural process that is linked to our drive to do things to survive. And people who become addicted feel like they need the objects of their addiction to survive, and it becomes the thing that their strongest behavioral imperative. The drive to get high overwhelms our ability to consider risks of ruin or death. When we are bound to opiates and other drugs, we can’t bond to others, or to anything beyond ourselves. And trapped inside ourselves, we die. Heroin and fentanyl kill us most quickly of all.

Science has spent a lot of time looking at how technology can save us from the effects of our brains locked in states of addiction and depression, which are states that block us from connecting to anyone or anything else. Seek Healing is one of the first organizations to think differently. With your help, we are creating social and spiritual technologies. We are going to create scalable structures online and in the real world where people can access the spiritual and social connections they need to survive. Medicine can help people detox. But once the physical effects of the addiction fade, we must ensure that people have easily accessible opportunities to connect socially and spiritually— and not just in the confines of our bedrooms on our computers and phones. The systems for spiritual connection and social connection are so overlapping that social connection is a spiritual experience, and spiritual experiences and socially binding. This means we must have SHARED experiences, together, in each other’s company, not just reading words but hearing voices or seeing faces. It means we have to come together for authentic connection.

Drug Rehab is tragically incomplete unless it is followed by something that boosts connection. Seek Healing is going to fix this problem. And if we are successful, we will be building platforms for connections that can heal a lot of other social epidemics. But first, we need to save the lives of our friends, families, and neighbors who are dying fast from drug overdoses.