Unlocking the autistic mind for addiction treatment
- addictionfrontline
- Apr 5, 2015
- 3 min read
Autism spectrum disorder might hold the key for better addiction treatment. Despite low comorbidity rates, addiction and ASD share similar executive malfunctions: disorganization, social awkwardness, irrational behavior, compulsiveness and a defining empathy deficit.
Prefrontal cortex abnormalities disrupt executive functioning, consequently hindering emotional development. The stagnant emotional development results in alexithymia.
“Alexithymia is a condition characterized by a reduced ability to identify and describe one’s own emotion, which results in reduced empathy and an impaired ability to recognize the emotions of others,” states a Translational Psychiatry abstract on nature.com.
The alexithymia comorbidity rate within the addiction population occurs at 67 percent, according to Elements Behavioral Health.
For the ASD adult population, the alexithymia comorbidity rate occurs between 40- and 65 percent, according to Translational Psychiatry.
In both addiction and ASD, the PFC damage manifests into several executive function disorders: ADHD, compulsion, depression and anxiety.
Despite similar attributes, the addiction and ASD rarely overlap. Teens with ASD actually appear less at risk for addiction than teens without ASD, according to the U.S. National Library of Medicine National Institutes of Health.
While the addiction population acts out executive malfunctioning through risk-taking, the search for novel experiences and impulsive decision making, the ASD population general seems aversive to impulsive behavior and novel experiences. One population desperately needs brakes while the other population’s brakes appear stuck. Neither population wants to talk about it – a frustration for loved ones and a challenge for treatment.
Science might have found hope within the nature of ASD processing, a byproduct called resilience.
“Resilience expresses functional redundancies in brain networks and suggests a process of dynamic rerouting of brain signals,” according to Advances in Neuroscience. “The phenomenon of cognitive resilience, that is, the dynamical preservation of normal functions despite neurological disorders, demonstrates that cognition can be highly robust to devastating brain injury.”
The ASD brain may circumvent the connection damage responsible for addictive behavior.
“Network analysis—an emerging branch of cognitive neuroscience—showed a quality called ‘resilience’ in children with autism,” states an article on treatment4addiction.com. “This quality allows for the ability to find multiple ways to get from point A to point B through redundant pathways.”
A Boston Children’s Hospital study showed the ADS brain sends signals through short-range pathways with several connections in an open grid, according to the treatment4addiction.com article.
Within the general population, the brain sends signals through long pathways passing through specific hubs. In the case of addiction, the PFC pathways display disconnections. The dopamine 2 pathway – a dopamine speed bump – malfunctions. The stimuli – drugs, gambling or sex – send signals through the default pathway – dopamine 1 - activating a dopamine release.
Individuals without addiction process narcotic stimulation through the dopamine 2 pathway, or indirect pathway.
“Under cocaine exposure, naturally resilient animals have greater activity in the indirect pathway, which acts as a brake on addictive behavior, even in animals that have experienced exposure to drugs of abuse,” states an ASAMagazine article describing a rat study. “More importantly, this study shows that increasing signaling within the indirect pathway can rescue animals with addiction, and make them resilient to the rewarding effects of cocaine.”
Addiction and ASD share a prefrontal malfunction: a hypoactive superior frontal gyrus. In addiction, the SFG fails to signal to the striatum, the region processing reward. In ASD, resilience allows signaling through small pathway alternatives, instead of forcing signals through a default direct pathway. Unlike addiction, ASD signals have more options to reroute away from the damaged dopamine 2 pathway, despite a suffering from the same hypoactive SFG.
“Identifying the factors that influence resilience and vulnerability could lead to strategies to prevent the development of addiction, and may even lead to new treatment approaches for substance use disorders,” states the ASAMagazine article.
Studies show short brain pathways appear in children and adolescents with ASD. Brain scans reveal adults with ASD have longer pathways and fewer connections than
children and adolescents with ASD, according to Frontiers in Human Neuroscience.
Regardless, the addiction disease begins around adolescence, the age when the dopamine 2 begins to deplete. The ability to bypass the depletion provides resilience against the direct pathway’s dopamine influx.
Sometimes, the most misunderstood minds offer an unspoken wisdom.
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