Neurofeedback Treatment in Substance Use Disorder
Thank you for joining us today. Today, we’re going to explore an exciting topic that can transform lives – that is, Neurofeedback and its benefits as an additional treatment option in addiction medicine. My name is Dr. Shobha Sinha and I’m a Neuropsychiatrist at the Sinha Clinic in St. Charles. I have been a Neurofeedback provider for many decades and I was asked to speak on the principles Neurofeedback and its role in helping to regulate brainwave activity in positive ways. There is considerable research and literature regarding the use of Neurofeedback in Mental Illnesses including Substance Use Disorders.
Let’s get started!
To start off, let’s understand what neurofeedback is. It is the a type of Behavioral Modification Strategy that utilizes Operant Conditioning to train the brain to function more efficiently and effectively. Operant Conditioning is a method of learning that uses rewards and punishments to modify mood, behavior and cognition. It’s a therapeutic technique that allows us, as humans, to learn to modulate our responses. It bypasses the conscious part of the brain and focuses on the “learning networks”. Think of it as a workout for the brain, where we can train it to learn to function the way it should function. How does this occur?
By definition, Neurofeedback is a “learning” model that uses specialized technology to provide positive feedback when a desired mental state is achieved. This is computer-driven feedback, which is either auditory, visual and at times, tactile in nature.
Neurofeedback occurs by supplying positive feedback. The brain learns by stimulation or input of certain special senses ( light, colors, sounds, touch). When a patient is being monitored for treatment, electrodes are attached to the scalp and tracings of brain wave activity are evaluated. Corrections to any aberrant variation is made. For example, we know that certain regions of the brain that are involved with attention tasks require the signaling input of 8-12 Hz. When the brain recognizes it, it is rewarded by certain lights, colors and sounds and/or touch. This feedback excites the brain to learn that creating this frequency receives a reward. The more often the brain gets this positive feedback, the more “learning” of a task consolidates the pattern. It reinforces the existing neural networks, and also, creates new ones. Therefore, the brain learns a new way to respond.
The Science Behind Addiction
Substance Use Disorder (SUD) is a complex condition of the brain, in which there is uncontrolled use of a substance despite harmful consequences. The most severe of these states are considered addictions. It affects millions of people, and the earlier the exposure the more consolidated the behavior becomes. Symptoms of (SUD) are: Impaired control, Social problems, Risky use and Drug effects. often there exists comorbid mental illnesses. In a National Survey on Drug Use conducted by SAMHSA in 2021, 61.2 million people or 21.9 %, used illicit drugs ( in ages 12 yrs +).
How Addiction Impacts the Brain
Addiction can affect not those experiencing the disease, but also their family and can affect the community. Addiction alters the brain’s morphology, chemistry, and action potential causing imbalances that lead to impulsive behavior, heightened stress, and decreased self-control.
The 4 major Dopamine Pathways include: Mesocortical, Mesolimbic, Niagrostriatal, and Tuberinfundibular. The Mesolimbic Pathway is the primary pathway of the reward system. Increasing Dopamine transmission leads to increases in reward and then consolidation of learning.
Major Mechanisms for Relapse:
- Compulsive Drive States: priming, drug cues, craving and stress. All 4 Dopamine Pathways are involved in the changes.
- Inhibitory Dyscontrol: downregulation of all involved pathways, including Dopamine, Glutamate, Opiate and at least another 20 pathways
Treatment Strategies
The purpose of treatment is to reduce mortality and morbidity. Current treatment strategies are: Inpatient Detox, Residential Treatment, Intensive Outpatient, Treatment, and Ongoing Outpatient Treatment.
The role of Neurofeedback is to retrain the brain by using the Principles of Operant Conditioning. It is an outpatient treatment strategy that requires a high level of motivation.
Outpatient Neurofeedback Benefits
Neurofeedback benefits are:
- Self-Regulation: Neurofeedback teaches individuals to self-regulate their brainwaves, promoting emotional stability and self-control – crucial tools for overcoming addiction.
- Reduced Cravings: By rewiring neural connections, neurofeedback can reduce cravings, making it easier to resist addictive substances or behaviors.
- Improved Mood: Addiction often leads to anxiety and depression. Neurofeedback can help regulate mood-related brainwaves, promoting a sense of well-being.
- Enhanced Focus and Attention: Neurofeedback improves the brain’s executive functions, such as focus and decision-making, which are often impaired by addiction.
The Neurofeedback Process
How does the neurofeedback process work?
- Assessment: We begin by understanding your brain’s current state through qEEG (electroencephalogram) brain mapping.
- Training: Based on the assessment, personalized neurofeedback sessions are designed. Sessions involve engaging with visual or auditory feedback that encourage desired brainwave patterns.
- Expand more on how it might feel to be trained, length of time and approximate sessions needed.
- Progress Tracking: Overtime, we track your progress and make adjustments as needed. Additional qEEG brain mapping will monitor results from neurofeedback sessions and create tracking baselines.
- Main takeaway is that consistency is key to promote long term change.
Integrating Neurofeedback into Recovery
It’s important to note that neurofeedback isn’t just a standalone option. Neurofeedback can restore balance to the brain and complements other forms of therapy and recovery strategies. By integrating neurofeedback with counseling, support groups, and healthy lifestyle changes, we create a holistic approach to recovery and long-term achievable results.
Success Stories
Neurofeedback offers those suffering from addiction a chance to regain control over their lives, break free from the cycle of addiction, and build a brighter future.
Let’s take a look one of our success stories:
Christina presented to the Sinha Clinic with complaints of loss of interests in activities she once enjoyed, chronic fatigue, depression and high anxiety.
For her, neurofeedback offered an affordable, alternative, holistic approach to treat her depression and anxiety, without potential drug interaction with medications prescribed by her family physician. Christina now describes to have more energy and states that “prior to [neurofeedback] therapy, I didn’t want to leave the house! I had absolutely no energy and was constantly anxious. Now, I am always looking for new things to do and try!”
Thank you all for your time and attention today. Neurofeedback presents a promising path toward overcoming addiction, and we’re here to support our youth and adults in the community on this journey. If you have any further questions or would like to learn more, please don’t hesitate to reach out by the information presented on the screen. Together, we can make a difference in the lives of those struggling. Remember consistency is key. Recovery takes one day at a time.