Marihuana Anónimo utiliza los Doce Pasos básicos de la. Recuperación establecidos por Alcohólicos Anónimos, porque se ha probado que el programa de. El paso 8 de los 12 pasos del Programa para la recuperación de adicciones se centra en la búsqueda del perdón. “Redacte una lista con los. Narcóticos Anónimos es una confraternidad o asociación sin ánimo de lucro compuesta por hombres y mujeres para quienes las drogas se habían convertido .
A proposed mechanism of action for the Twelve steps of Alcoholics Anonymous. Among peer-support groups for alcoholics, Alcoholics anonymous AA is by far the most widespread and successful with tens of thousands of groups all around the world. Advances in understanding the neuroscience of addiction have allowed the identification of two brain areas that, among others, explain the irrational and self-destructive behavior of alcoholics. First, alcohol hijacks the reward systems of the midbrain in pasis of detecting and experiencing pleasure through the release of dopamine in the nucleus accumbens and the ventral tegmental area with a pleasurable stimulation that far exceeds the normal pleasures of life such as eating and sexual reproduction.
These pleasurable experiences are essential for the survival and qnonimos of the pasox.
Nature has cleverly linked pleasure with survival, and it is exactly this link. Therefore, the reward system senses the effect of alcohol as essential for the survival of the alcoholic. In addition, the prefrontal cortex perhaps the only area of the brain that could allow us to understand and prevent the dangers of the excessive and compulsive alcohol use is also affected by this intoxicant.
The Twelve Steps of AA help alcoholics reverse these effects.
First, through steps 1 to 3, it encourages the use of a Surrogate Decision-Maker often, it is the AA group itself that acts as such. Lying, stealing, dishonesty and manipulation are not intrinsic personality defects of the alcoholic: Alcoholism, alcoholics anonymous, addiction. Alcoholics have been gathering in self-help groups trying to achieve sobriety for over years.
The Temperance Movement dates back to the s. The Total Abstinence Society was founded in the s. All these groups relied on some form of self-support and promoted full abstinence from alcohol. None survived the passage of time. However, sincethe most successful self-help group in the history of alcohol treatment, Alcoholic Anonymous, AA continues to thrive and expand.
AA is, without a doubt, the largest over 2 million members and most widely available over countries of all self-help groups.
The consistent widespread success of AA merits an in-depth look at the possible mechanism of action of its core proposal, the Twelve Steps. Twelve steps programs have been the cornerstone of addiction treatment in the US for over 70 years. Bob has now an international presence with tens of thousands of groups regularly meeting around the world.
It has been criticized and misunderstood, yet voices against AA have failed to slow down barcoticos progress and success. Patients can easily understand why an antibiotic is needed to treat an infection, or why surgery is needed to remove a tumor. However, alcoholics cannot understand, on face value, why they need to embrace and practice the Twelve Steps of AA in order to stay sober.
This represents an obstacle for prospective members since it is not intuitive or straightforward to understand why following the steps can help maintain sobriety.
We can easily understand why an antibiotic works when we treat bacterial pneumonia or why radiation therapy treats cancer. narcotjcos
In the case of the Steps, however, there is no coherence between our understanding of how addiction affects the brain and why the Steps could help. To understand how the Twelve Steps may operate, it is first necessary to understand what are they trying to fix; that is, what the effects of alcohol are in the brain. Knowing what alcohol does to the brain makes it easier to understand how the Steps might counteract these effects.
Alcohol belongs to a group of chemicals collectively known as intoxicants. Members of this group are able to generate abuse and dependence among users. There are about 30 million chemical compounds known to man, yet only about of them are intoxicants such as alcohol, opioids, benzodiazepines, barbiturates, cocaine, hallucinogens, solvents, etc.
What do the intoxicants have in common, and how do they affect the brain? What mechanisms of narcotcos drive their ability to generate abuse and dependence? Through different biochemical pathways, intoxicants share a common final mechanism of action in the brain: The NAc and the VTA are the core components of the reward system of the brain, and dopamine is the neurotransmitter that, when narcotiocs in these nuclei, gives animals a positive, rewarding effect 2,3. This positive effect is salient, recognized and remembered by the brain, and the animal is eager to repeat the behavior that produces it.
Nature has cleverly coupled the reward system with the survival of the individual and with evolutionary success. Throughout millions of years of evolution, animals have relied on their reward systems to recognize what feels good and to repeat it. This prompts the animal to eat regularly, guaranteeing their survival.
During sex, dopamine levels in the reward system double, making the animal eager paaos repeat intercourse and ensure the survival of the species.
Paso 8: La búsqueda del perdón
In the narcoticcos of the intoxicants known to man, the amount of released dopamine is typically anonjmos higher than the paasos released by common pleasurable behaviors such as eating or sexual activity. Intoxicants therefore usurp and hijack narcotkcos reward system of the brain, giving the organism powerful reasons to repeat using them despite negative consequences.
Over millions of years of evolutionary history, repeating what feels good is synonymous with success. Animals who eat feel good, their brains remember it, and they eat repeatedly. Repeated sexual activity pasis good and, by engaging in intercourse, animals pass on their genes and promote the pasoa of the species. When the nuclei composing the reward system unaware of any negative evolutionary consequences of dopamine surges sense a dramatic increase of dopamine above and beyond what food or sex produce they immediately equate it with survival and evolutionary success.
For the addict, the drug is survival. Throughout evolutionary history, animals have consistently found evolutionary success in repeating behaviors that cause dopamine surges in the reward system. Repeatedly using intoxicants is what the reward system senses as evolutionarily correct. In the case of humans, the quest of the reward system to make addicts repeatedly use intoxicants results in the development of maladaptive behaviors lying, cheating, stealing, being selfish, etc.
These maladaptive behaviors ppasos symptoms of the illness and not life-long character defects. Addicts are not intrinsically bad people; they have bad behaviors as a result of their addictive illness. In a way, these maladaptive behaviors serve well the evolutionary goal to repeat what feels good. Addicted animals are doomed narcoticks use intoxicants repeatedly even if this repetition leads to death by causing animals to neglect real survival needs such as food or water.
A given species is likely to disappear if its members neglect anonioms behaviors in favor of using drugs, since drugs produce a more pleasurable effect. The reward system lacks the ability to calculate and ponder the danger of using intoxicants; it is simply determined to make the animal repeat pleasurable activities since this strategy has millions of years of established success.
Humans, unlike other species, have very developed frontal lobes. It is in the frontal lobes that higher cognitive functions take place. It is the frontal lobes that, in humans, may be able to logically and reasonably assess the natural consequences of using intoxicants.
The frontal lobes are what make humans the only species can overcome addiction through logic and reason. Can the human frontal lobes, then, narcotics the urges of the reward system? Unfortunately, the frontal lobes are a primary target of the intoxicants, often rendering them too impaired to make a connection between the use of intoxicants and their negative consequences. The chronic use of addictive drugs results on hypofrontality. Studies consistently show that frontal lobe activity especially the prefrontal cortex is decreased among addicted individuals, and that hypofrontality persists long months or even a few years after the individual enters a state of abstinence.
Hypofrontality contributes to impulsivity and disinhibition which in turn makes drug or alcohol consumption more likely to happen. The frontal lobes are the seat anohimos higher cortical functions planning, organizing, morals and a sense of right and wrong.
Hypofrontality is therefore essential for the denial and rationalization with which addicts justify their drug use, and helps us understand their lack of insight and immunity to the devastating consequences of drug use for themselves and their loved ones.
Why might AA help reverse the intoxicant usurpation of the reward system and the resulting hypofrontality? I would like to propose a framework for how AA may accomplish this change. This framework will be better paxos if we review Dr.
We admitted we were powerless over alcohol – that our lives had become unmanageable. Came to believe that a Power greater than ourselves could restore us to sanity. Made a decision to turn our will and our lives to the care of God as we understood him. Made a narcoficos and fearless moral inventory of ourselves. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings. Made a list of all persons we had harmed, and became willing to make amends to them all. Made direct amends to narcoticls people wherever possible, except when to do so would injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it. Sought through prayer and meditation to naroticos our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs. As can be seen, the first Step evolved into Steps 1, 2 and 3. The second Step evolved into Steps 4 to 11, and the 3 rd Step remained unchanged in principle as the twelfth Step.
Coherence between the steps and what we know about the neurobiology of the narcotticos brain narcoticks therefore be explained as follows: Addicts narcotcios often unable to use logic and reason to work their way out of their addiction.
Due to drug-induced hypofrontality, actively addicted individuals paoss insight into their condition and its severity. They are using their prefrontal cortex to help correct a defect in their prefrontal cortex, a very difficult task. Therefore, they benefit from having a trusted Surrogate Decision-Maker. AA presents, through the first 3 steps, the idea of a Surrogate Decision-Maker.
The usurped reward system and the co-occurring hypoactive frontal lobes result in the development of maladaptive traits among addicts lying, cheating, deceiving, being selfish, anobimos. These maladaptive traits are actually quite useful to the reward system when trying to accomplish its main goal, repeating what feels good, which it equates with success for the individual and for the species. Steps and step 12 promote the practice of opposite, compensatory behaviors: This Behavioral Compensation is therefore a form of behavioral rehabilitation that disarms the reward system of the tools maladaptive behaviors necessary to promote the use of intoxicants.
An interesting point can be added regarding step 11 which promotes prayer and meditation. Numerous neuroimaging studies of the brain at work show that different narvoticos of meditation results in an increase in blood flow to the frontal lobes which can also be seen as a way of reversing the hypofrontality seen in addiction. In summary, the Twelve Steps of AA show coherence with our current knowledge of the neurobiology of pass disease of addiction because:
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