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Addiction overlap with brain diseases key to treatment

WASHINGTON - Could a once-a-month alcoholism shot keep some of the highest-risk heroin addicts from relapse? A drug that wakes up narcoleptics treat cocaine addiction? An old antidepressant fight methamphetamine?

This is the next frontier in substance abuse: Better understanding of how addiction overlaps with other brain diseases is sparking a hunt to see whether a treatment for one might also help another.

We're not talking about attempts just to temporarily block an addict's high. Today's goal is to change the underlying brain circuitry that leaves substance abusers prone to relapse.

It's "a different way of looking at mental illnesses, including substance abuse disorders," says Dr. Nora Volkow, National Institute on Drug Abuse director, who urged researchers at the American Psychiatric Association's annual meeting Monday to get more creative in the quest for brain-changing therapies for addiction.

Rather than a problem in a single brain region, scientists increasingly believe that psychiatric diseases are a result of dysfunctioning circuits spread over multiple regions, leaving them unable to communicate properly and work together. That disrupts, for example, the balance between impulsivity and self-control that plays a crucial role in addiction.

These networks of circuits overlap, explaining why so many mental disorders share common symptoms, such as mood problems. It's also a reason that addictions - to nicotine, alcohol or various types of legal or illegal drugs - often go hand-in-hand with post-traumatic stress disorder, depression, schizophrenia and other mental illnesses.

Think of it as if the brain were an orchestra, its circuits the violins, the piano and brass section, all smoothly starting and stopping their parts on cue, Volkow said. "That orchestration is disrupted in psychiatric illness," she explains. "There's not a psychiatric disease that owns one particular circuit." So NIDA, part of the National Institutes of Health, is calling for more research into treatments that could target circuits involved with cognitive control, better decision-making and resistance to impulses.

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