Olivia Newton-John, my ex-girlfriend had a request for this blog, she said: "let's get physical, physical, let me hear your body talk, your body talk" So today that is what we are going to do, we are going to get physical and hear what the body of a person experiencing homelessness, mental illness and a drug addiction might be saying. I am going to try and not be as technical as I would want to be, because 1. I don't understand all of it myself 2. I don't want you to think, "I'm not going to get anything out of this because I'm not a science geek" I will link you all of the primary research articles that I am getting my information from, if you want to check to see if I'm bsing, or if you want to read more and get a more comprehensive understanding of the material presented in this blog. Throughout this blog I will refer to "patient x" as way to simply address the population focus: those experiencing homelessness who are suffering from a drug addiction.
What first struck my interest in the field of Neuroscience/Neuropsychopharmacology (The study of the action of drugs on the brain and behavior) was when I first began interacting with seriously ill people on the streets. I was unable to carry out a simple conversation with them. There were random bursts of yelling, their thoughts were very tangled and it was often hard to decipher where they were emotionally. When I began taking biology and chemistry classes I often pondered what was going on at the molecular level of these friends that I had made on the street. To no surprise, there is quite a lot going on at that level. Mental illness and drug addictions are a REAL THING my friends. Real in the sense that we have clear evidence that shows the biochemical differences between such patients and unaffected people of drugs and mental illness. It was a fascinating idea to think that a collection of subatomic particles, interacting in a way that they weren't normally could radically change the ability of a person to have a stable conversation with me, but it was also terrifying. Terrifying because you can't simply tell an electron to stop behaving that way. But you can certainly manipulate certain variables and create new boundaries for that electron. Similar to when a child is disobedient, you don't simply yell at them and tell them to stop (unless you are a bad parent), you give them a reason to, you change the circumstances so that the child behaves in a manner that is right, this is in a sense the goal of Neuropsychopharmalogical research with regards to drugs.
Relatively recent technology such as the PET and fMRI allow us to visually study the effects of such elements. A special scan, called the pharmacoMRI (phMRI) allows us to understand the effects of drugs on patients, and how that effects their psychology, behavior and problem solving skills through various tests. (*1) We are at the point in our science where we can scan a patients brain and see how their circuitry works. It is very clear that there has been a physical change in how patient x's create, maintain and conduct action potentials in the brain (our brains way of communicating and conducting the symphony of thought and command)
One of the ways in which addictive drugs work on the brain is by something known as Neuroplasticity. Neuroplasticity is the phenomenon in which drug addiction has one of it's most dangerous effect. At the onset of drug use and through it's continual usage, the patient begins to experience a physical change in the pathophysiology of their neurons. This change occurs at the level of protein expression regulation, neurotransmitter regulation and neuronal conductance (*2). You can think of it like this: You are in route to a family vacation. When planning the trip you choose a specific path that will take you to your desired location. That path that the "normal" person takes is consistent with any trip he takes, they will avoid crowded freeways, they will stick to the road and stop periodically for breaks. Patient x's roadmap will begin to change as a result of the drugs. They won't take the same path as the normal patient, they won't drive at the same rate and they won't prepare in the same way that will bring them to point A safely, and often times they won't ever reach their destination because of this newly developed roadmap.
Why is the idea of Neuroplasticity so important? Well, it shows that you can't simply and easily just stop taking the addictive drugs. There has been a physiological shift in how patient x's biochemistry regulates their homeostasis. Not taking the drug for a few days messes with the roadmap that their brain has developed in response to the drug.
One of the effects of this new roadmap of patient x's brain and why drugs such as cocaine, crack, meth and many others are considered addictive drugs is because of their action on neurocircuitry. The action of these drugs begin to effect various areas of the brain and create a nasty cascade of events that lead to 3 specific events as noted by Koob and Volkow (*3). 'binge/intoxication', 'withdrawal/negative affect', and 'preoccupation/anticipation'. Each of these three stages act on different regions of the brain, but collectively they form the addictive patterns of the effected patient.
What does the effect of addictive drugs on neurocircuitry tell us? There is a sequential list of events that work together to create a new system, one in which is heavily dependent on these drugs. But why though?
Homeostasis. I mentioned this word earlier. Homeostasis is what we are here on this planet to do (Sorta joking/not entirely/I apologize/I digress). Every single cell, every protein, every atom every reaction in our body exist to maintain homeostasis. Homeostasis is the character of a system to maintain a specific level of conditions. Our body is constantly responding to changes in our environment to always maintain that homeostasis. At the onset of drug use our body will do everything in it's power to reject what was just taken up by our body. It doesn't like it, because the drug is messing with our homeostasis. (hangovers)
Confession time: My senior year of high school, for the first time I drank an excessive amount of alcohol. The result wasn't pretty, it was a lot of vomit on the floor and bathroom of my prom dates house. My body rejected the large amount of alcohol, and since that point my body will continue to have that same reaction past a certain point. I have a threshold of how much alcohol I can consume, if I reach it, vomit. I had a very good response to alcohol actually, my experience with it was so bad, that I believe there was a neuroplastical (not sure if that's word it is now though) event that occurred, one that shifted in positively rejecting future large alcohol consumptions.
How does this relate to patient x? I believe the same scenario could occur, that at the onset of drug use would cause patient x to well never become patient x, that their homeostatic controls would react in such a strong way that they would never want to touch that needle again. So why don't they? Unique circumstances. Some of which I mentioned earlier. Here are some that I think are potentially important.
What first struck my interest in the field of Neuroscience/Neuropsychopharmacology (The study of the action of drugs on the brain and behavior) was when I first began interacting with seriously ill people on the streets. I was unable to carry out a simple conversation with them. There were random bursts of yelling, their thoughts were very tangled and it was often hard to decipher where they were emotionally. When I began taking biology and chemistry classes I often pondered what was going on at the molecular level of these friends that I had made on the street. To no surprise, there is quite a lot going on at that level. Mental illness and drug addictions are a REAL THING my friends. Real in the sense that we have clear evidence that shows the biochemical differences between such patients and unaffected people of drugs and mental illness. It was a fascinating idea to think that a collection of subatomic particles, interacting in a way that they weren't normally could radically change the ability of a person to have a stable conversation with me, but it was also terrifying. Terrifying because you can't simply tell an electron to stop behaving that way. But you can certainly manipulate certain variables and create new boundaries for that electron. Similar to when a child is disobedient, you don't simply yell at them and tell them to stop (unless you are a bad parent), you give them a reason to, you change the circumstances so that the child behaves in a manner that is right, this is in a sense the goal of Neuropsychopharmalogical research with regards to drugs.
Relatively recent technology such as the PET and fMRI allow us to visually study the effects of such elements. A special scan, called the pharmacoMRI (phMRI) allows us to understand the effects of drugs on patients, and how that effects their psychology, behavior and problem solving skills through various tests. (*1) We are at the point in our science where we can scan a patients brain and see how their circuitry works. It is very clear that there has been a physical change in how patient x's create, maintain and conduct action potentials in the brain (our brains way of communicating and conducting the symphony of thought and command)
One of the ways in which addictive drugs work on the brain is by something known as Neuroplasticity. Neuroplasticity is the phenomenon in which drug addiction has one of it's most dangerous effect. At the onset of drug use and through it's continual usage, the patient begins to experience a physical change in the pathophysiology of their neurons. This change occurs at the level of protein expression regulation, neurotransmitter regulation and neuronal conductance (*2). You can think of it like this: You are in route to a family vacation. When planning the trip you choose a specific path that will take you to your desired location. That path that the "normal" person takes is consistent with any trip he takes, they will avoid crowded freeways, they will stick to the road and stop periodically for breaks. Patient x's roadmap will begin to change as a result of the drugs. They won't take the same path as the normal patient, they won't drive at the same rate and they won't prepare in the same way that will bring them to point A safely, and often times they won't ever reach their destination because of this newly developed roadmap.
Why is the idea of Neuroplasticity so important? Well, it shows that you can't simply and easily just stop taking the addictive drugs. There has been a physiological shift in how patient x's biochemistry regulates their homeostasis. Not taking the drug for a few days messes with the roadmap that their brain has developed in response to the drug.
One of the effects of this new roadmap of patient x's brain and why drugs such as cocaine, crack, meth and many others are considered addictive drugs is because of their action on neurocircuitry. The action of these drugs begin to effect various areas of the brain and create a nasty cascade of events that lead to 3 specific events as noted by Koob and Volkow (*3). 'binge/intoxication', 'withdrawal/negative affect', and 'preoccupation/anticipation'. Each of these three stages act on different regions of the brain, but collectively they form the addictive patterns of the effected patient.
What does the effect of addictive drugs on neurocircuitry tell us? There is a sequential list of events that work together to create a new system, one in which is heavily dependent on these drugs. But why though?
Homeostasis. I mentioned this word earlier. Homeostasis is what we are here on this planet to do (Sorta joking/not entirely/I apologize/I digress). Every single cell, every protein, every atom every reaction in our body exist to maintain homeostasis. Homeostasis is the character of a system to maintain a specific level of conditions. Our body is constantly responding to changes in our environment to always maintain that homeostasis. At the onset of drug use our body will do everything in it's power to reject what was just taken up by our body. It doesn't like it, because the drug is messing with our homeostasis. (hangovers)
Confession time: My senior year of high school, for the first time I drank an excessive amount of alcohol. The result wasn't pretty, it was a lot of vomit on the floor and bathroom of my prom dates house. My body rejected the large amount of alcohol, and since that point my body will continue to have that same reaction past a certain point. I have a threshold of how much alcohol I can consume, if I reach it, vomit. I had a very good response to alcohol actually, my experience with it was so bad, that I believe there was a neuroplastical (not sure if that's word it is now though) event that occurred, one that shifted in positively rejecting future large alcohol consumptions.
How does this relate to patient x? I believe the same scenario could occur, that at the onset of drug use would cause patient x to well never become patient x, that their homeostatic controls would react in such a strong way that they would never want to touch that needle again. So why don't they? Unique circumstances. Some of which I mentioned earlier. Here are some that I think are potentially important.
- When you are already out on the street, alone, cold, hungry, without friends, social interactions, without feeling loved.
- Lack of support from family and friends.
- Without goals, purpose, a tangible reason to continue maintaining homeostasis.
- Genetic predispositions.
- Mental illness
When these unique circumstances are present with an individual, not limited to just one, I believe something special and unfortunate happens. Our natural response to reject something that is knowingly harmful to us changes. The natural rejection to a drug is overcome by these unfortunate circumstances, leading to a continued use and an eventual shift in the homeostatic regulation of ones body. Neuroplastic events happen and there is a new ruler of homeostasis, the addictive drug. Just like how "normal" peoples day to day activities are a culmination to maintain homeostasis, so will those of patient x's newly maintained homeostasis. What has happened now is, NOT taking the drug will mess with the newly set level of conditions. Of course these are just my observations/theory. I will work on developing some REAL Mendelian science and prove these things to you (or not).
My first reaction to all of this was saddening. This is a really complex issue with so many layers. It is as real as breaking a bone. You can't just simply go to therapy and have someone tell you that logically what you are doing is harmful and well "duh" don't do it. There is a whole new neuronal world that we MUST address and find ways to dance with it.
As we continue this blog we will look at amazing ways in which research has furthered our ability to help those addicted to drugs, including inventive ideas such as the first ever "addictive drug vaccine" to help against cocaine addiction. (A COCAINE VACCINE? ARE YOU FREAKING KIDDING ME? LET'S FREAKING GOOOOOO)
Next week we will take a slight shift from all of this nerdy science stuff and begin to examine big picture holistic community developement. Guest speaker will be, Jesus, the greatest community development pioneer ever.
(*1): Imaging
(*2): Neuroplasticity
(*3): Neurocircuitry
Other useful articles:
(now dance a little!)
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