The Brain Is Key: You Can Bet On It.

the brain is the key to drug and alcohol abuse treatment
The Brain is the Key

According to some experts, alcoholism, substance use disorders, process addictions and behavioral addictions like pathological gambling may affect the brain in the same way, reflects Lizzie Parry in her article “Cure for Alcoholism Now One Step Closer.” Research at Imperial College London has, in MRI studies, identified two areas of the brain that scientists believe cause pathological gambling. The study showed that the connections in the brain responsible for impulse control may be weaker in problem gamblers.

“Gambling addiction can have a devastating effect not just on patients, but also their families.” notes Dr. Henrietta Bowden-Jones, Director of the National Problem Gambling Clinic and Imperial research Team.


This new research identifies key areas of the brain, and will aid in the development of targeted treatments to help prevent cravings and relapse. When pathological gamblers experienced cravings, researchers discovered two areas of the brain that became highly active. These are the insula and the nucleus accumbens, which are located deep within the brain and are key to decision making and reward and impulse control. These are the same areas of the brain that have previously been linked to substance abuse and alcohol addictions.

The Imperial study was carried out using 19 problem gamblers and 19 healthy volunteers. MRI scans were utilized to monitor the brain activity of each individual as they were shown pictures of gambling activities; they were then asked to rate their cravings while viewing each image.

Researchers found that the insula and nucleus accumbens were highly active when the problem gamblers experienced cravings induced by the images. Interestingly, the team also found that weaker connections between the nucleus accumbens and an area called the frontal lobe were associated with greater craving.

The frontal lobe, which presides over behavioral control and decision making, may also keep the insula in check by controlling impulses, explained Professor Anne Lingford-Hughes, coauthor of the Imperial College London research paper.

“Weak connections between these regions have also been identified in drug addiction. The frontal lobe can help control impulsivity; therefore, a weak link may contribute to people being unable to stop gambling, and ignoring the negative consequences of their actions. The connections may also be affected by mood – and be further weakened by stress, which may be why gambling addicts relapse during difficult periods in their life.”

Because the frontal lobe can help control impulse, it makes sense that a weakness there may contribute to individuals being unable to stop gambling or to ignore negative consequences of their actions when gambling.

Recently, the Surgeon General’s “Key Findings: The Neurobiology of Substance Use, Misuse, and Addiction” has defined addiction as a chronic brain disorder that has potential for both recurrence and recovery. Research in neuroscience suggests that the process of addiction is a three-stage cycle: binge/intoxication, followed by withdrawal/negative effect, and culminating in preoccupation/anticipation. Progressively, the cycle will worsen and become more severe with continued abuse. Changes in brain function are dramatic and reduce the ability to control the addiction.

There are disruptions in the basal ganglia, the extended amygdala, and the prefrontal cortex that enable cues to trigger substance seeking, heighten activation of stress systems of the brain and reduce brain sensitivity systems in the experience of reward and pleasure. These disruptions also reduce the executive control systems of the brain that control decision-making actions and emotions and impulses.

Despite the risks and negative consequences involved, individuals are motivated to continue in their addictions by euphoric or pleasurable feelings. Continued misuse of substances cause neuroadaptations, a process whereby the body compensates for the presence of a chemical in the body so that it can continue to function normally. For people who abuse drugs or alcohol, this neuroadaptation leads to tolerance and dependence on a substance and can foster cravings that can lead to relapse.

Dr. Daniel Amen from the Amen Clinic is one of the leading experts in the world on brain imagery and understanding changes in the brain. He has been involved in over 125,000 brain SPECT scans, which look at blood flow and activity in the brain. Dr. Amen uses SPECT brain imagery, which illustrates how the brain actually works, blood flow and activity. His research has shown that addiction changes the brain; emotional trauma can be distinguished from physical trauma; the brain can improve; every brain is affected differently; and past brain trauma can lead to addiction and many other repercussions. Dr. Amen’s research also showed that marijuana smokers had lower blood flow to the brain and lower brain activity than nonsmokers.

Dr. Amen says that brain SPECT imaging helps to

  • Break through denial.
  • Determine if there are coexisting conditions requiring treatment.
  • Increase treatment and recovery program compliance.
  • Help people realize that addiction is a brain disease, not a personal weakness or character flaw.
  • Help patients gain a better understanding of their brain through visuals.
  • Determine if treatment is working correctly.

Amen has identified six different types of addiction-prone brain patterns: Compulsive Addicts, Impulsive Addicts, Impulsive-Compulsive Addicts, Sad or Emotional Addicts, Anxious Addicts and Temporal Lobe Addicts. Pathological gambling fits most neatly in Type 1 or Compulsive Addicts. These individuals tend to get stuck or locked into one course of action and don’t see other options. Most commonly, this type of brain SPECT finding shows increased anterior cingulate gyrus activity, which is usually caused by low serotonin levels.

Even though the six types of brain patterns have some commonality of symptoms, each type has its own set of symptoms and specific treatments. According to Dr. Amen, “One size does not fit all: what works for one person with addiction may not work for another, or could even make the symptoms worse!”

It’s an exciting time in the addiction recovery field with all the advances in neuroscience, technology, treatment, recovery coaching and aftercare. It’s clear that brain health is as important as the health of any other part of the body, perhaps more important. Each individual is unique, and testing such as SPECT imagery can help treatment professionals know how to best help each person.

The key to treating pathological gambling is the brain; you can bet on it!

Rev. Dr. Kevin T. Coughlin, PhD, bestselling author, writer, speaker and consultant, is a CIP Interventionist, International Master Addictions Coach and instructor, pastoral counselor and therapist. His books are on sale at and Barnes & Noble.

Help and support is within reach for you or a loved one battling addiction. Explore InRecovery’s national addiction treatment center directory now.
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