The good and the bad of abstinence

The nucleus accumbens, a key region involved in reward processing and addiction. Credit: Zou et al. (2015)
The nucleus accumbens, a key region involved in reward processing and addiction. Credit: Zou et al. (2015)

Consumption of addictive drugs changes your brain and these changes underlie the consequent dependence. It is very difficult to quit, and certainly it is not a matter of lack of will power that the majority of drug users have such a great difficulty in trying to quit. But what happens to the brains of the lucky few who managed to kick the addiction out the window? Are their brains reverting to their pre-addiction states? As the paper below shows, sadly, no. But there is hope.

Zhou et al. ( 2015) used resting state fMRI (which means scanning your brain without requiring you to perform any task) to investigate the brains of 30 healthy controls and 30 heroin-addicts who were abstinent from the drug for more than 3 years. Specifically, they looked to see if the connectivity of certain brain regions involved in addiction is different after such a long abstinence time.

The bad news is that the abstinents still had some abnormal connectivity (for specialists: “stronger functional connectivity between the nucleus accumbens and the right ventromedial prefrontal cortex and relatively weaker connectivity between the nucleus accumbens and the left putamen, left precuneus, and supplementary motor area” p. 1697).

The good news: the longer the abstinence time, the greater the strength of the connection between nucleus accumbens and putamen (first structure involved in reward processing, the second in habit-learning), suggesting a partial neural recovery.

The study has some limitations: technical (did not control for heartbeat and respiration), methodological (most of the heroin abstinents were smokers, another addiction) and theoretical (one brain area does not support only one function, so its connectivity shouldn’t be over interpreted). With the caveat that the connectivity differences observed do not in any way point to a cause and effect relationship – that is we don’t know if these differences existed before the first heroin intake and caused it or they appeared after as a result of drug consumption, I think the paper is still is worth reading.

Reference: Zou F, Wu X, Zhai T, Lei Y, Shao Y, Jin X, Tan S, Wu B, Wang L, Yang Z (November 2015, Epub 17 Aug 2015). Abnormal resting-state functional connectivity of the nucleus accumbens in multi-year abstinent heroin addicts. Journal of Neuroscience Research, 93(11):1693-702. doi: 10.1002/jnr.23608. Article | FREE PDF

By Neuronicus, 9 October 2015