Mental Health and Addictions. Modern Challenges and Horizons of Hope

Mental health and addictions represent huge global challenges. Although additctions and mental conditions are often considered chronic diseases that require ongoing management throughout life, it is crucial to understand that, while there is not always a “cure” in traditional terms, there are effective treatments that can transform people’s lives. Mental conditions and addictions usually occur together, strengthening each other and making ever harder to address them. Interestingly, despite the fact that substance use is common, only 10 to 30 percent of those who use them develop dependence or addiction, suggesting the existence of protective factors, both physical and mental. Fortunately, we have some evidence-based therapies and approaches that not only can dramatically improve patients’ quality of life, but may also facilitate their full social reintegration. While the road to recovery can be long, and currently about half the people achieve significant improvement, there is still a vast field of research for scientists and clinicians. Our goal is to continue developing treatments that not only relieve symptoms, but in the not-so-distant future, may allow us to talk about a true cure.

In the Neuropsychiatry and Translational Neurotoxicology Laboratory that I lead, my group is dedicated to exploring various aspects of mental health and addictions. We focus particularly on the search for non-invasive “markers” and on the development of new treatment strategies. Non-invasive markers are signals or indicators that we can detect in the body without the need for surgical procedures, and magnetic resonance imaging (MRI) is one of our main tools. This advanced technology allows us to observe the brain in detail, both in people and in animal models such as rats and mice, without causing them any harm. The innovation of our approach lies in translational research: we conduct studies in both humans and animals, and the findings of one group inform and enrich the other. This synergy will allow us to better understand the complex mechanisms of addictions and ultimately design more effective treatments. 

One of our main lines of research focuses on deciphering how drugs affect the brain and why some people (and rodents) are more vulnerable to developing an addiction. Traditionally, studying the brain in small animals with techniques such as microscopy forced us to choose in advance which specific regions to analyze, limiting our vision. Today, in collaboration with the National Magnetic Resonance Imaging Laboratory, we have implemented images of a rat’s entire brain non-invasively, observing its structure and function simultaneously. This is like having a complete map of the brain in action. Once we identify areas of interest with this global vision, we can drill down with microscopy techniques to understand the details at the cellular level. 

Our studies in rats have revealed fascinating findings. We have observed the structural and functional changes that occur when a rat develops dependence on alcohol, morphine, or methamphetamine. We have managed to differentiate the brain regions most involved in dependence, those related to consumption and toxicity, and others linked to alterations in behavior. A key finding is that some brain regions can recover once the use of the substance ceases, while others suffer permanent damage. These changes may be due to brain cell death or, surprisingly, increased inflammation in the brain. In fact, we have found that most drugs elicit an inflammatory response, leading to an increase in immune cells in the brain called microglia. In addition, these studies have allowed us to identify brain regions that seem to be key in the “craving” or intense desire to consume a substance. If we can understand and eventually modulate these areas, we could significantly reduce relapses in people with addiction, offering real hope for lasting recovery. 

Another promising area in our research and clinical practice is Transcranial Magnetic Stimulation (TMS). It is a non-invasive neuromodulation technique, which means that it uses magnetic fields to influence brain activity without the need for surgery. Since its approval by the United States’ Food and Drug Administration (FDA) in 2008 for the treatment of drug-resistant major depression, TMS has been the subject of intense research for a wide range of neurological and psychiatric conditions, including addictions. The European Commission has already validated its use for addiction treatment and the FDA for nicotine addiction, although we are still deepening our understanding of its mechanism of action and its real long-term effect. 

STUDIES IN RODENTS PROVIDE US WITH VALUABLE INSIGHTS INTO THE BIOLOGICAL AND PHYSICAL CHANGES WE MIGHT EXPECT TO SEE IN THE HUMAN BRAIN

UNAM’s Institute of Neurobiology has founded a Neuromodulation Unit where we offer clinical TMS services for various conditions such as major depression (from the age of 15), obsessive-compulsive disorder, anxiety disorders, and, of course, addictions. In addition, we also carry out intensive research work. We study the effects of neuromodulation in both human patients and animal models. Studies in rodents provide us with valuable insights into the biological and physical changes we might expect to see in the human brain, while clinical trials in people give us a direct view of the actual efficacy of TMS in reducing substance use, preventing relapse, and relieving associated symptoms such as depression. Our preliminary findings are encouraging: we have identified brain regions that, when stimulated with TMS, could reduce the desire to use substances for periods of up to six months, opening up new avenues for treatment and hope for sustained recovery.

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