Substance abuse and addiction might sound like straightforward conditions to diagnose. Those who seek help usually know that they have become powerless over the substance(s) and that their lives have become unmanageable. However, their friends, family, co-workers and community have often known or suspected it long before the addicted individual seeks treatment. Although the physical manifestations of addiction and withdrawal can be apparent to the least astute observer, diagnosis can be rather complicated for a number of reasons. First, depression and anxiety can lead to substance abuse or can result from it. Second, comorbid psychopathological diagnoses might or might not be present. Third, substance abuse often results in abnormal brain anatomy and neurophysiology. Therefore, comprehensive assessment is crucial for accurate diagnosis and successful treatment.
A noninvasive test with limitations
Addiction specialists typically diagnose people based on case history, standardized questionnaires, physical examination, laboratory evaluation, and the American Psychiatric Association’s criteria for substance abuse defined in the Diagnostic and Statistical Manual-5 (DSM-5). Recently, new branches of neurology, such as connectomics and neuroinformatics, have been established toward objectively mapping the brain using a wide variety of methods. One such method is quantitative electroencephalography (qEEG).
The qEEG is a relatively inexpensive, noninvasive test. Scalp sensors record the brain wave activity (delta, theta, alpha and beta) and quantify the recording in several ways (timing, phase, amplitude, asymmetry and coherence). These data are sent through a software program which transposes the brain wave patterns through color codes to brain images. The program compares the data to averages that represent the “normal” population. Patterns of abnormality have been associated with specific disorders, such as attention deficit/hyperactivity disorder, schizophrenia, and addictions, such as alcoholism, methamphetamine abuse, and many others. However, research study methodological limitations and common sense suggest diagnosis and treatment decisions should not be made by qEEG alone.
Tailored diagnostic and therapeutic strategies
Other brain mapping methods that are applied to addiction medicine research and practice include functional magnetic resonance imaging, magnetic resonance spectroscopy, positron emission tomography and others. In addition to enabling diagnosis, these modalities can help clinicians tailor therapeutic strategies, such as neurofeedback, individual and group therapy, medication regimen and cognitive-behavioral therapy.
Brain mapping can also help to detect cravings prior to discharge by measuring dopaminergic activity. This information could transform long-term outcomes by identifying high-risk patients before relapse occurs. Customized treatment programs can guide people out of addiction to a lasting recovery and a bright and healthy future.
About Sovereign Health of California
Sovereign Health of California offers dual diagnosis and treatment for those suffering from substance abuse and addiction. We understand that many factors contribute to illness. We are committed to identifying the underlying illness(es) by treating each person as a whole. To find out about our programs that include brain mapping, call us at 866-524-5504.
Written by Dana Connolly, Sovereign Health Group writer