Addicted Brains

A neuroscientist examines life on drugs.

Narcotics Anonymous Groups Give Out Opioids

Human contact releases opioids, and that's how it substitutes for heroin.

Several years ago, a study by Coan and colleagues (2006) showed that hand-holding can diminish people's response to threat. Fifteen women who reported high quality marriages were put into an fMRI scanner, with their husbands and the experimenter remaining outside in the room. The women were shown cues on a screen several seconds before an electric shock was administered to their ankles -- on some trials but not on others. The cue was expected to elicit anxiety, because it announced that a shock might or might not come. 

This experimentally-induced state of stress or anxiety is, of course, meant to simulate real-life stress. And I think that's fair enough. Now let's get specific about the stress that comes with opiate addiction: How bad will the withdrawal symptoms get? Will I be able to resist temptation? Or will I feel so shitty that I'll have no choice? And if that happens, will I be able to keep it from my girlfriend? Can I get it from you-know-who, or will I have to go down to the ghetto? Being an opiate addict, even in recovery, maybe especially in recovery, is being in a state of stress. And the only relief may be…a shot of heroin (or pills, or whatever) OR a visit to your local NA (Narcotics Anonymous) group. Groups make you feel better. That's why you go.

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Little did we know that the group makes you feel better for the same reason (at the cellular level) as a shot of heroin.

Some very prominent emotion scientists have theorized that opioids (made inside our brains) are at the root of human attachment. Mother's milk is rich with opioid molecules. In other words, nature found a surefire way to soothe the baby with its mother's milk, using the same chemical formula that's responsible for the soothing feeling of heroin. Jaak Panksepp theorizes that all social attachment is based on the release of opioids within the brain. Here's a quote from him, referring to his early attempts to publish this work, cited in a very nice review for the non-scientist:

"When we first tried to publish our paper on the role of opioids in social attachment in three species, we submitted it to Science,” he said. When he asked the editor [why the paper was rejected, he was told], “‘We decided it was too hot to handle. If love and attachment ride on the same system as narcotic addiction, that’s too scary...’ ”

The review goes on to show how parents also get opioids from their kids. They feel great gobs of love and mush because their own brains produce a glut of opiods just at the sight of those sweet little faces. But let's get back to Coan and colleagues' experiment.

When the woman in the scanner was holding her husband's hand, through a little hole in the side of the machine, many brain regions involved in stress and negative emotion showed reduced activation. On some trials, the hand she held was not her husband's but that of the experimenter, a friendly male stranger. Even on those trials, many of the same brain regions showed reduced activation. Now here's the kicker: The brain regions that got calmed down by hand-holding (including regions of the ventral ACC, ventral prefrontal cortex, striatum, and insula) are the same brain regions that have a high density of opioid receptors. The authors speculate (and I think it's very likely) that opioid release is what causes the deactivation of these emotional hot spots. The subjects also reported less unpleasantness when they were holding hands while anticipating the shock. 

Thanks for the opioids, dear.

In my last post, I told of my recent experience of the warmth and caring provided by NA group members for one another, and I take that feeling of caring as fundamental to the success of some (not all) of these groups. Indeed, members of NA or AA see their group experience -- with or without hand-holding -- to be the most powerful antidote to their feelings of anxiety, stress, loneliness, and all the other negative variants that can lead to relapse. Now we can point to a very concrete, biological mechanism responsible for the soothing function of the group: when you are in close contact with people who care about you (even a little), your own brain releases opioids. And, in a sense, those opioids replace the opioids you'd otherwise be buying on the street.

Note! This is not some cheap trick the brain is playing on you. Internal opioids are not like methadone maintenance. Opioids have been nature's way of soothing our pain and our stress, for tens of millions of years of evolution! That's why we need them. That's why we like them. NA, and other forms of intimate group experience, help us to get them from our connections to other humans (something we've perhaps forgotten how to do) rather than the guy on the street corner. And that's what nature intended.

 

Marc Lewis, PhD has been a professor of developmental psychology and neuroscience for over 20 years and is the author of Memoirs of an Addicted Brain. 

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