Neurofeedback: An effective tool in addiction recovery
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neurofeedback effective tool in addiction recovery

It has been said that drug and alcohol addiction is a brain disease. According to research out of the University of Louisville School of Medicine and the University of Tennessee, substance addiction can be described as a mental disorder with specific behavioral, cognitive and psychosocial features.

“Drug addiction can take control of the brain and behavior, activating behavioral patterns that are directed excessively and compulsively toward drug usage,” Gregory L. Gerdeman, Ph.D., wrote.

One of the most dynamic areas of adjunct therapy for treating substance use disorders is brain training, or neurofeedback. Complimenting traditional treatments, such as cognitive behavioral therapy, multiple studies are showing neurofeedback to be effective.

Neurofeedback is a type of biofeedback, utilizing electroencephalography (EEG) to teach the brain how to function at a more optimal range. Measuring the alpha, beta, delta and theta brain waves, clinicians can identify deviations from the norm and design neurotherapy accordingly.

Sensors are attached to specific areas of the head and real-time brain activity is displayed on a monitor. The patient sits quietly for a period of time, usually 20 to 40 minutes, and is asked to relax, focus and remain still while the software program subconsciously teaches, via a reward system, how to better regulate thoughts and feelings.

Differing patterns based on substance dependence

After brain mapping, each patient could have a different problematic area identified based on their specific substance dependence and/or comorbid mental health conditions. However, certain protocols have been established for treating the alcoholic, which differ for various drug addictions, like cannabis, heroin or methamphetamine, because past studies identified certain trends in brain wave activity based on the different substance dependencies. In other words, different drugs are associated with different patterns of EEG abnormalities.

For example, the alcohol-dependent patient will typically have a significantly different EEG map than an individual addicted to meth. In the alcoholic, EEG alterations typically occur in the beta frequency. The decreased power in slow bands (delta/theta) might indicate chronic brain damage, and the increase in the beta band might relate to factors such as family history of alcoholism, hallucinations or medication use. Because alcohol dependence can be genetic, scientists are finding in an alcoholic’s non-alcoholic relatives that certain GABA-receptor genes related to EEG patterns are associated with the risk to develop alcohol dependence.

Contrast this with a meth addict’s EEG maps, which show a significant power increase in the delta and theta bands. EEG studies of methamphetamine addiction align with other neurocognitive studies showing that meth abuse is associated with psychomotor slowing and frontal executive deficits.

Developing protocols

Two primary neurofeedback protocols are used, depending on the condition being treated. One is called the Peniston Protocol, developed by Eugene Peniston in the late 1980s. This approach employs auditory feedback of two slow brain wave frequencies, alpha and theta, while the patient, with eyes closed, conjures up “success” images of being sober, resisting relapse and living confidently. This approach has been successful with alcoholics, but not as effective for cannabis or stimulant drug dependencies.

The introduction of work by Scott and Kaiser in the late 1990s added EEG biofeedback protocols used for treating patients with ADD, focusing on the beta waves, leading to the Scott-Kaiser modification of the Peniston Protocol. This approach substantially improved success rates for patients with certain drug dependencies. Scott went on to develop BrainPaint, a software system, which utilizes this modification and is considered user friendly among clinical professionals.

Neurotherapy usually constitutes a series of 20 or 30 sessions, depending on the diagnosis. By the repetition of the process over the series of sessions, the addict will learn coping skills and healthy response mechanisms by retraining the brain patterns that have caused dysfunction.  Neurofeedback teaches an individual’s brain to operate in a calm, rational state, even when confronted with stressful situations.

Research shows that more than 85 percent of patients who train with neurofeedback improve their ability to focus, regulate behavior and reduce impulsive behaviors. Studies have shown that treatment programs which integrate neurofeedback therapy into their programs have a higher success rate and lower relapse rates. Many patients notice improvement in their coping mechanisms within 10 sessions.

Retraining the brain

Benefits from neurofeedback can vary, depending on the patient and the level of substance dependence. Levels of efficacy for all treatments are outlined in the Guidelines for Evaluation of Clinical Efficacy of Psychophysiological Interventions, which are accepted by both the Association for Applied Psychophysiology and Biofeedback (AAPB) and the International Society for Neurofeedback and Research (ISNR). The criteria range from Level 1, not empirically supported, to Level 5, efficacious and specific.

Using these criteria and reported study data, alpha-theta brain training (Peniston Protocol) with alcoholics can be classified as Level 3, probably efficacious, when combined with traditional rehabilitation treatment modalities. Similarly, using these criteria, the Scott-Kaiser modification can also be classified as probably efficacious when combined with residential rehabilitation treatment modalities in stimulant users.

Neurofeedback appears to be an effective tool for training an addict’s brain over time to process stressors in a more calm and controlled manner. Because addicts are a diverse group with a multitude of variants, including co-occurring mental health conditions, a wide array of tools and approaches are needed in a treatment setting. Programs offering the most diversified treatment modalities have a better chance of addressing the multitude of factors associated with addiction.

Sovereign Health of California is an addiction, mental health and dual diagnosis treatment provider, offering several locations in California as well as centers in Utah, Arizona and Florida. For more information on treatment for drugs and alcohol dependence, including neurofeedback, please call (866) 819-0427.

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