Dear Dr. Levy: Is there any evidence that cravings and urges to use drugs are physical as opposed to psychological? I ask because urges can be so intense and powerful that they feel physical.
A: You ask a great question. You are correct that urges and cravings often feel physical..A huge task, particularly in early recovery, is for a person to learn how to deal with powerful urges to use drugs.
As we learn more about the brain, it is becoming clearer that those urges do have a physical basis. This is not too surprising because if we think of a person holistically, the mind and body go together and most, if not all, mental experiences probably have a physiological basis.
A huge focus of research in the addiction field is trying to learn more about how drugs and alcohol interact with the brain. From what is learned, medications then can be developed to target these processes and help in the treatment of addiction.
Recently, using magnetic resonance imaging techniques, researchers have demonstrated that when images of cocaine are subliminally shown to cocaine addicts, activity occurs in their limbic system, which is a part of the brain involved in emotional responses. Researchers believe that the activation of circuits in this part of the brain may play a role and be responsible for driving drug-seeking behavior.
The goal over time is to develop medications that reduce the brain's sensitivity to such cues and help addicts to better deal with urges and cravings.
Dear Dr. Levy: Can you tell me what buprenorphine is?.My son, who is 19, has been buying it from one of his friends..He says it isn't addicting, but I am still upset that he is using any drugs..How dangerous is this?
A: Buprenorphine, or its trade name, Suboxone, is a partial opiate agonist, which means it acts like an opiate-type drug, or painkiller, but another part of the drug has an opposite effect, as an opiate antagonist. Due to these properties, both the opiate agonist and antagonist agents bind to opiate receptor sites in the brain. So, while a person can get a "high" from taking this drug, the drug goes only so far and a person can get only so "high."
This medication is being prescribed by doctors for the treatment of opiate addiction. It can cause dependence and for some people, can lead to addiction..No one should take this drug unless it is prescribed by a physician. Your son is taking this drug illegally, and he should not be doing this..
Regarding its dangerousness, while a person will not overdose on buprenorphine, taken in combination with other drugs, such as anti-anxiety medications, it can be quite dangerous. I would strongly encourage your son to stop taking this drug..If he has trouble doing so, I would refer him for treatment..
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Send questions about addictions or related problems to: Take The First Step, c/o The Gloucester Daily Times, 36 Whittemore St., Gloucester, MA 01930; or send an e-mail to michael_levy@cabhealth.org. Questions will be answered in confidence by a clinical team led by Dr. Michael Levy, director of clinical treatment services at CAB Health & Recovery Services in Peabody and author of "Take Control of Your Drinking ... and You May Not Need to Quit."
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