Nothing frustrates the friends and family of an addict like continued substance abuse even in the face of obviously detrimental consequences. University of Melbourne researchers say that the reason for this behavior is not a lack of willpower...but rather the result of brain changes in the frontal cortex that make it a whole lot harder to just say no.

Will power isn’t enough…anyone who has really struggled with addiction can tell you this; and it's hard to explain to people who have never endured the trials of addiction why we can’t simply just choose not to use.

Some new research coming out of the University of Melbourne in Australia is helping somewhat to better explain why this is so.

The university researchers wanted to better understand why drug addicted people, even those in recovery, have such a difficult time controlling drug taking impulses even in the face of adverse consequences to continuing use. The area of the brain that we use to control impulsive behaviors is the frontal cortex, and this is also the area of higher order thinking and problem solving; and this is the area of the brain that Melbourne researchers investigated for its relationship to drug taking behaviors.

The researchers looked at two groups of people, both opiate using and non opiate using participants, and had both groups perform a task in which they had to control an impulsive or instinctive response to a stimulus, and instead perform an alternative response. During the performance of this task the researchers monitored the brain activity within the frontal cortex using brain imaging equipment.

What they found helps to explain why drug addicts have such a tough time resisting the temptations and impulses towards continuing usage behaviors. They found that those people who had been using opiates (heroin in this study) had a much harder time ignoring the impulsive reaction in the test, and had to exert much greater mental effort to override this normal impulsive response. They also found that the brain cells within the frontal cortex of the drug users were working inefficiently, and not performing as well as the brains of the non opiate using group of participants.

The researchers concluded that this likely explains why using and recovering addicts have such a difficult time resisting temptation, and speculate that this newfound knowledge could lead to better pharmacological and psychosocial treatments for addiction recovery.

The researchers acknowledge that they do not yet know whether the drug abuse caused the brain damage, or whether the brain cell deficiencies induced the addiction. If the drugs had caused the brain cell inefficiencies, the researchers also wondered whether the brain cells would recover after a period of abstinence from opiate use.

This study really resonates with me, and perhaps explains a mental process (lack of process?) that I experienced during my period of use. I used to have the best of intentions not to take pills or buy that case of beer…but I would invariably just find myself doing it anyways. It always felt afterwards almost as if I had been doing it instinctively, and without truly thinking it through…as if part of my brain was turned off for the duration of the drug seeking behavior.

Whether this occurred due to transient or permanent damage in my frontal cortex I can’t say for sure, but it was a significant factor in my continuing use and abuse.

Hopefully with better a understanding of the bio chemical and cerebral mechanisms of addiction, more effective and targeted treatments will emerge to the benefit of addicts and society as a whole. Existing psychosocial therapies and treatments are beneficial, and can even help people with lowered impulse control resist the temptations of drugs or alcohol; but I think that to really make a breakthrough in addiction treatments, better medications need to be developed that will allow people the strength of resistance to really make better use of these psychosocial therapies and training.