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17. Neuroscience, brain pharmacology support long-term treatment

Neuroscience offers insight into the physical brain changes depicted by the scans. The "high" experienced on alcohol or drugs results not from coke, or pot, or opiates interacting with brain cells, but from chemicals generated in the brain interacting with brain cells. The way drugs alter brain function is by stimulating the glands in the brain to change the chemical make-up of the brain. The "high" comes when glands in the brain overproduce or under recover naturally occurring brain chemicals after the glands are tricked into doing so by the chemicals from the street or bottle. Normally, glands in the brain produce chemicals that regulate sense of well-being, fight-or-flight mechanism, need for sleep, arousal, anxiety, etc. When enough of the chemical has been produced, a healthy brain removes or "uptakes" the chemical to maintain a balanced brain chemistry. Some drugs interact with brain cells by inhibiting the uptake of brain chemicals and leaving the brain awash in the chemicals, which should have otherwise been removed under usual circumstances.

Drugs and alcohol "trick" the brain into over producing the chemical, or into blocking the uptake, or both, depending on the substance. This trick on the brain produces a heightened and extend sense of wellbeing, arousal, sleepiness, etc. Following repeated over-use, however, the user's brain becomes deficient in these brain chemicals. The glands are over worked and need time to recover. Furthermore, when there is no uptake, the chemicals remain in the brain too long and adversely affect brain chemistry. The diseased brain needs time to recover. Before the addict's brain recovers, he is impeded in his recovery by his own sick and ineffective mind. If the addict wanders out of treatment or falls out of sobriety while the brain is recovering, there is a strong likelihood of a complete fall-down skid row relapse. Drug courts focus on preventing relapse by observing any behavior which is averse to recovery and pushing the addict back into treatment. Quickly. The drug court does not wait for the backslider to bring himself back to treatment. The court mandates that the addict be placed in a drug-free environment for long enough to get back on track. Like the hook on the Good Shepherd's staff pulls sheep back toward the foal, drug courts nudge addicts back into recovery. Unlike drug court participants, addicts in traditional therapy stay in therapy only as long as they chose to do so. Drug courts, on the other hand continue to nudge addicts back in therapy for as long as they remain in the drug court.

                    Links to scholarly and professional articles on pharmacology of addiction and recovery:

Wilkie Wilson, a Duke Professor of pharmacology wrote a 10-page layperson friendly article for a scholarly journal. See: "How Addiction Hijacks our Reward System."

Another Duke Medical Center study is summarized in one-page article titled "Duke Medical Center Study Shows Alcohol Damages Learning more in Young Brains." See:

A National Institute of Drug Abuse publication of 5 pages (with pictures and brain scans) titled "Drugs, Brains and Behavior: The Science of Addiction" appears at:

An MD" s article titled "Addiction and the Brain's Pleasure Pathway: Beyond Willpower" appears at:

The National Association of Drug Court Professionals web sites are and National Institute of Drug Abuse, NIDA, publishes research as well.