Home » Disconnected Brains: How Isolation Fuels Opioid Addiction: Rachel Wurzman (Transcript)

Disconnected Brains: How Isolation Fuels Opioid Addiction: Rachel Wurzman (Transcript)

Think of it like this: when you’re at your hungriest, pretty much any food tastes amazing, right? So similarly, loneliness creates a hunger in the brain which neurochemically hypersensitizes 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 neurochemistry 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 — excuse me — 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.

So if we don’t have the ability to authentically connect, our society increasingly lacks this ability to authentically connect and experience things that are transcendent and beyond ourselves. We used to get this transcendence from a feeling of belonging to our families and 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.

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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 that she wasn’t simply allowed to die. Imagine for a second how that feels, that state of hopelessness, OK?

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, so 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 cued to remember our drug. We need neuronally firing repeated experiences in order for the striatum to undergo that necessary neuroplasticity that allows it to take that “go find heroin” autopilot offline.

And what 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 compulsive urges. We need social impulses to replace drug-cued 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 psychospiritual interventions can act as neurotechnologies in circuits that process social and drug-induced rewards.

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One possibility is to create and study scalable tools for people to connect with one another over a mutual interest in recovery through psychospiritual practices. And as such, psychospiritual practice could involve anything from people getting together as megafans 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 that are 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. It’s the difference between having superficial small talk with someone and authentic, 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.

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