I recently wrote of an informative NBC News article of June 2, 2013 (see part 1 here). Investigative reporter Rebecca Ruiz laid out medical research evidence pointing toward non-genetic alterations in brain chemistry — that is, organic changes in the brain’s chemistry after birth.
Specifically, Ruiz’s article was centered around the behavioral concept of resiliency. She provided medical research and testimony, as well as case study, that early formative experiences may produce structural adaptations to genes
Amazing, that early experiences can have such an impact on the developing physical brain. But what about later in life? Short of the eventual physical decline of aging in the brain structure, are there other experiences which significantly alter the actual organic brain?
Drink and drugs immediately come to mind… But these affect functioning ability, no?
Not much evidence existed until recently to support claims that receptors in the brain can be significantly physically altered from what they were at birth due to genetics.
But good evidence of late can be found by studying the methodology behind a treatment program for addicts — Suboxone prescription/maintenance. Suboxone is a drug prescribed mainly to heroin addicts who have struggled to stay clean. It originated as a more viable alternative to methadone, which has worse side effects.
Suboxone, which combines buprenorphine with naloxone (Narcan), works in similar fashion to Antabuse (disulfiram) for alcoholism. It is an “agonist” — once in the system, narcotics are rejected by the body and they are not even desired.
Why is this? One of the best (and visually interesting) depictions of the normal vs. addicted brain is provided in accompanying literature to the drug Suboxone by Richard I. Gracer, M.D., whose clinic in California administers it:
Visualize a rectangular green meadow… mildly sloped with the left side being higher. This represents the area of the brain in which narcotic receptors are found. At left edge is a box the size of a hockey goal. This is the endorphin factory from which a steady stream of low weight, slippery bowling balls (the endorphins) emerge. (Endorphins are natural compounds we all produce that act as the body’s own painkiller, and fill the same receptor sites that narcotics do.
There are bowling ball sized indentations in the meadow which are the sites of [the pain-killing] receptors. We all need a significant percentage of these to be filled to be comfortable. Since the balls are low in weight they do not cause their new indentations and because they are slippery they do not stay in place of the receptor holes for long before going off the right edge of the meadow.
There are sensors under the meadow, which measure the weight and number of balls and how many receptor holes are filled. When there are a lot of balls the sensors slow down [ and vice versa].
Under normal circumstances of pain, there is an increase in endorphin production… If a narcotic is taken, a large quantity of much heavier balls are released which cover almost all of the receptor site holes. Because they are so predominant and heavy, they stop endorphin production and the factory becomes dormant. They also make new holes with their weight, which now have to be filled for the person to stay out of drug withdrawal.
If drug use persists, the factory is dismantled and can lose its ability to produce any natural endorphins. It may take a very long time for it to regenerate and in some cases may never be able to function at its former level.
Addicts who end up taking suboxone are usually folks less likely to thrive in a 12-step support program. Their will, their drive for self-help might be called into question. But the research behind the effectiveness of suboxone treatment suggests otherwise. The structural components of their brains, muted by long-term drug abuse, have been indelibly changed.
Our mental health is not a matter of simple nature vs. nurture — but instead nature and nurture, both, affecting our very brain chemistry.
Gracer, Richard I., M.D. (2006). How Buprenorphine Works. San Ramon, Calif.: Gracer Medical Group.