Dr. Stacey Daughters - Reward Processing and the Intersection between Neuroscience and Psychosocial Treatments
Sep 11, 2023
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Dr. Stacey Daughters discusses reward processing in substance use disorders and the intersection with neuroscience and psychosocial treatments. She emphasizes the importance of individualized addiction treatment, substance-free rewards, and anticipatory motivation. The chapter also explores efficiency, progress, and individual goals in treatment, changing definitions of recovery, and advice for trainees and early career individuals in research.
Understanding changes in reward processing can provide critical insights into bolstering recovery from substance use disorders.
Individualized assessment and treatment plans are crucial to address specific factors that contribute to treatment outcome.
Combining brain stimulation, such as transcranial alternating stimulation, with psychosocial treatments can enhance engagement and improve treatment outcomes in individuals with substance use disorders.
Deep dives
The Importance of Targeting Neural Mechanisms for Substance Use Disorder Treatment
The podcast episode discusses the intersection between neuroscience and psychosocial treatments for substance use disorders. It emphasizes the need to target neural mechanisms in order to enhance the efficacy of current psychosocial treatments. The main focus is on two specific areas: distress tolerance and reward processing. Distress tolerance refers to an individual's ability to tolerate stress and manage emotions, which plays a crucial role in substance use disorders. Reward processing, on the other hand, refers to an individual's motivation for substance-free rewards and engagement in enjoyable activities without relying on substances. The podcast highlights that while evidence-based psychosocial treatments exist, there are still challenges and limitations in achieving successful outcomes. Therefore, the episode explores the potential of using brain stimulation, such as transcranial alternating stimulation, to target specific neural mechanisms associated with distress tolerance and reward processing. The aim is to enhance engagement in treatment and improve overall treatment outcomes.
Current Challenges and Success Rates of Substance Use Disorder Treatment
The podcast acknowledges that despite the availability of evidence-based treatments for substance use disorders, overall success rates are modest at best. The success rates vary, with estimates of 30% to 70% of individuals returning to substance use within a year after treatment. This highlights the need for further improvements in treatment approaches. The podcast also emphasizes that frontline treatment centers often lack adequate training and resources to deliver evidence-based treatments effectively. Additionally, the episode notes that treatment providers often face challenges in individualizing treatment plans and assessing specific factors that contribute to treatment outcome. The focus on individualized assessment and treatment is crucial to address barriers such as low distress tolerance, executive control deficits, and motivation for substance-free rewards. By better understanding these factors and developing targeted interventions, the podcast suggests that treatment outcomes can be improved.
Exploring the Potential of Combining Brain Stimulation and Psychosocial Treatments
The podcast discusses the potential of combining brain stimulation, specifically transcranial alternating stimulation (TACS), with psychosocial treatments to enhance treatment outcomes. The podcast suggests that brain stimulation can provide a boost to individuals in early stages of treatment, where engagement and learning new skills may be challenging due to various executive control deficits. By targeting specific oscillation patterns in the brain associated with distress tolerance and reward processing, the aim is to provide a more individualized and effective treatment approach. The podcast also emphasizes the importance of conducting further research to determine the long-term effectiveness and feasibility of brain stimulation in combination with psychosocial treatments. The ultimate goal is to develop a comprehensive and personalized approach to substance use disorder treatment that addresses both the neural mechanisms and psychosocial factors contributing to successful outcomes.
Understanding the Impact of Substance Use on the Brain
Research on distress tolerance and reward processing in individuals with substance use disorder showed that low distress tolerance is associated with reduced neural response during stress tasks and altered connectivity between brain networks. This sheds light on the impact of substance use on the brain and the connection to reduced motivation for non-substance rewards. Understanding these mechanisms can help inform treatment strategies to rebalance focus and time spent on substance use versus non-substance rewards.
The Importance of Progress and Individualized Approaches in Substance Use Treatment
The podcast episode emphasizes the need for individualized approaches in substance use treatment and a focus on progress rather than perfection. Practitioners should prioritize identifying individual needs and tailor treatments accordingly to improve outcomes. The episode also highlights the importance of incorporating scientific findings into policies and guidelines for substance use treatment. Underserved populations should be aware of effective approaches and ask questions about their treatment options, knowing that progress is important and failure is not defined by setbacks.
Despite some consequences, substances can provide immediate and certain reward in the different forms, including but not limited to euphoria, pain relief, energy, alleviation of emotional suffering, and social connection. These rewards can compete with non-substance activities that are enjoyable and rewarding, and understanding changes in reward processing over the course of substance use disorder severity may provide critical insights into how to bolster recovery. Dr. Stacey Daughters provides an overview of reward processing in substance use disorders, and explores ways in which neuroscience treatment techniques may complement existing evidence-based psychotherapy treatments to bolster outcomes for people recovering from substance use disorders. Dr. Daughters is a professor in the Department of Psychology and Neuroscience at the University of North Carolina, at Chapel Hill.
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