Disconnected Brains: How isolation fuels opioid addiction | Rachel Wurzman | TEDxMidAtlantic

[Applause] what does it mean to be normal and what does it mean to be sick I've asked myself this question from the time I was about seven when I was diagnosed with Tourette's syndrome Tourette's is a neurological disorder characterized by stereotyped movements I perform against my will called tics now taiks are technically involuntary in the sense that they occur without any conscious attention or intention on my part but there's a funny thing about how I experience tics they feel more unvoluntary than involuntary because I still feel like it's me moving my shoulder not some external force also I get this uncomfortable sensation called premonitory ordered right before tics happen and particularly when I'm trying to resist them now I imagine most of you out there understand what I'm saying but unless you have Tourette's you probably think you can't relate but I bet you can so let's try a little experiment here and see if I can give you a taste of what my experience feels like alright ready don't blink no really don't blink and besides dry eyes what do you feel phantom pressure eyelids tingling a need are you holding your breath uh-huh that's approximately what my texts feel like now ticks and blinking neurologically speaking are not the same but my point is is that you don't have to have Tourette's to be able to relate to my experience of my premonitory urges because your brain can give you similar experiences and feelings so let's just the conversation from what it means to be normal versus sick so what it means that a majority of us are both normal and sick because in the final analysis we're all humans whose brains provide for a spectrum of experiences and everything on that spectrum of human experiences is ultimately produced by brain systems that assume a spectrum of different states so again what does it mean to be normal and what does it mean to be sick when sickness exists on the extreme end of a spectrum of normal as both a researcher who studies differences and how individuals brains wire and rewire themselves and as a torretta with other related diagnoses I have long been fascinated by failures of self-regulation on the impulsive and compulsive behavioral spectrums because so much of my own experience of my own body and my own behavior has existed all over that map so with the spotlight on the opioid crisis I really found myself wondering lately where on the spectrum of unvoluntary behavior do we put something like abusing opioid painkillers or heroin by now we all know that the opioid crisis and epidemic is out of control ninety-one people die every day in this country from overdose and between 2002 and 2015 the number of deaths from heroin increased by a factor of six and something about the way that we treat addiction isn't working at least not for everyone relapse rates among heroin users exceed 59% within the first week and are about 80 percent within the first month it is a fact that people suffering from addiction have lost free will when it comes to their behavior around drugs alcohol food or other reward systems stimulating behaviors that addiction is a brain based disease state is a medical neurobiological reality but how we relate to that disease indeed how we relate to the concept of disease when it comes to addiction makes an enormous difference for how we treat people with addictions so we tend to think of pretty much everything we do is entirely voluntary but it turns out that the brains default state is really more like a car idling and drive than a car in park some of what we think we choose to do is actually things that we have become programmed to do when the brakes are released have you ever joked that your brain was running on autopilot well guess what it probably was okay and the brain's autopilot is in a structure called the striatum so the striatum detects emotional and sensory motor conditions and it triggers it knows to trigger whatever behavior you have done most often in the past under those same conditions do you know why I became a neuroscientist because I wanted to learn what made me tick thank you thank you I've been wanting to use that one in front of an audience for years so in graduate school I studied genetics actors that orchestrate wiring to the striatum during development and yes that is my former license plate for the record I don't recommend any PhD student get a license plate with their thesis topic printed on it unless they're prepared for their experiments not to work for the next two years I eventually did figure it out so my experiments were exploring how mis wiring in the striatum relates to compulsive behaviors meaning behaviors that are coerced by uncomfortable urges you can't consciously resist so I was really excited when my mice developed this compulsive behavior where they were rubbing their faces and they couldn't seem to stop even when they were wounding themselves okay excited is the wrong wrong word okay I I actually felt I felt terrible for them I thought that they had tics evidence of stride Ulm is wearing and they were compulsive but it turned out on further testing that these mice showed an aversion to interacting and getting to know other unfamiliar mice which was unusual it was unexpected the results implied that the stride in which for sure is involved in compulsive spectrum disorders is also involved in human social connection and our ability to not human social connection but our ability to connect so I delved deeper into a field called social neuroscience and that is a newer interdisciplinary field and there I found reports that linked the striatum not just to social anomalies and mice but also in people as it turns out the social neuro chemistry in the striatum is linked to things you've probably already heard of like cytosin which is that hormone that makes cuddling feel all warm and fuzzy but it also implicates signaling at opioid receptors there are naturally occurring opioids in your brain that are deeply linked to social processes experiments with naloxone which block opioid receptors show us just how essential this opioid receptor signaling is to social interaction when people are given naloxone it's an ingredient in narcan that reverses opioid overdoses to save lives but when it's given to healthy people it actually interfered with their ability to feel connected to people they already knew and cared about okay so something about not having opioid receptor binding makes it difficult for us to feel the rewards of social interaction now for the interest of time I've necessarily gotten rid of some of the scientific details but briefly here's where we're at the effects of social disconnection through opioid receptors the effects of addictive drugs and the effects of abnormal neurotransmission on involuntary movements and compulsive behaviors all converge in the striatum and the striatum an opioid signaling in it has been deeply linked with loneliness when we don't have enough signaling at opioid receptors we can feel alone in a room full of people we care about and love who love us social neuroscientists like doctor patchy oppo at the University of Chicago have discovered that loneliness is very dangerous okay it increases the risk of early death even more than chronic excessive alcohol consumption and it predisposes people to entire spectrums of physical and mental illnesses think of it like this when you're your hungriest pretty much any food tastes amazing right so similarly loneliness creates a hunger in the brain which hyper sensitive is neurochemically hyper sensitive our reward system and social isolation acts through receptors for these naturally occurring opioids and other social neurotransmitters to leave the striatum in a state where its response to things that signal reward and pleasure is completely completely over the top and in this state of hypersensitivity our brains signal deep dissatisfaction we become Restless irritable and impulsive and that's pretty much when I want you to keep the bowl of Halloween chocolate entirely across the room for me because I will eat it all I will and that brings up another thing that makes social disconnection so dangerous if we don't have the ability to connect socially we are so ravenous for our social neuro chemistry to be rebalanced we're likely to seek relief from anywhere and if that anywhere is opioid painkillers or heroin it is going to be a heat-seeking missile for our social reward system is it any wonder people in today's world are becoming addicted so easily social isolation contributes to relapse studies have shown that people who tend to avoid relapse tend to be people who have broad reciprocal social relationships where they can be of service to each other where they can be helpful being of service lets people connect if we don't have the ability to authentically connect our society increasingly lacks this ability to authentically connect it used to experience things that are transcendent and beyond ourselves we used to get this transcendence from a feeling of belonging to our families in our communities but everywhere communities are changing and social and economic disintegration is making this harder and harder I'm not the only person to point out that the areas in the country most economically hard-hit where people feel most desolate about their life's meaning are also the places where there have been communities most ravaged by opioids social isolation acts through the brain's reward system to make this state of affairs literally painful so perhaps it's this pain this loneliness this despondence that's driving so many of us to connect with whatever we can like food like handheld electronics and for too many people to drugs like heroin and fentanyl I know someone who overdosed who was revived by narcan and she was mostly angry but she wasn't simply allowed to die imagine for a second how that feels that state of hopelessness okay but the striatum is also a source of hope because the striatum gives us a clue of how to bring people back so remember that the striatum is our autopilot running our behaviors on habit and it's possible to rewire to reprogram that autopilot but it involves neuroplasticity so neuroplasticity is the ability of brains to reprogram themselves and rewire themselves to a we can learn new things and maybe you've heard the classic adage of plasticity neurons that fire together wire together right so we need to practice social connective behaviors instead of compulsive behaviors when we're lonely when we are queued to remember our drug we need neuronal firing repeated experiences in order for the striatum to undergo that necessary neuroplasticity that it allows it to take that go find heroine autopilot offline and with the convergence of social neuroscience addiction and compulsive spectrum disorders in the striatum suggests is that it's not simply enough to teach the striatum healthier responses to compose of urges we need social impulses to replace drug cute compulsive behaviors because we need to rebalance neurochemically our social reward system and unless that happens we're going to be left in a state of craving no matter what besides our drug we repeatedly practice doing I believe that the solution to the opioid crisis is to explore how social and psycho-spiritual interventions can act as neuro technologies in circuits that process social and drug-induced rewards one possibility is to create and study scalable tools for people to connect with one another over a mutual interest in recovery through psycho-spiritual practices and as such psycho spiritual practice could involve anything from people getting together as mega fans of touring jam bands or parkour jams featuring shared experiences of vulnerability and personal growth or more conventional things like recovery yoga meetups or meetings centered around more traditional conceptions of spiritual experiences but whatever it is it needs to activate all of the neurotransmitter systems in the striatum better involved in processing social connection social media can't go deep enough for this social media doesn't so much encourage us to share as it does to compare studies show that people actually tend to feel more isolated from social media it's the difference between having superficial small talk with someone and a CENTAC deeply connected conversation with eye contact and stigma also keeps us separate there's a lot of evidence that it keeps us sick and stigma often makes it safer for addicts to connect with other addicts but recovery groups centered around reestablishing social connections could certainly be inclusive of people who are seeking recovery for a range of mental health problems my point is when we connect around what's broken we connect as human beings we heal ourselves from the compulsive self-destruction that was our response to the pain of disconnection when we think of neuropsychiatric illnesses as a spectrum of phenomenon that are part of what make us human then we remove the other nests of people who struggle with self-destruction we remove the stigma between doctors and patients and caregivers we put the question of what it means to be normal versus sick back on the spectrum of the human condition and it is on that spectrum where we can all connect and seek healing together for all of our struggles with humaneness thank you for letting me share [Applause]

Channel: TEDx Talks

Views: 209,349

Keywords: TEDxTalks, English, Health, Biology, Brain, Communication, Community, Drugs, Neurology, Neuroscience, Science, Society

Id: m7fGPGj2kaY

Length: 18min 43sec (1123 seconds)

Published: Tue May 08 2018