Neuronal Re-sensitization
Exactly how and why the brain diminishes the number of active nicotinic-type acetylcholine receptors (down-regulation) after nicotine use ends is still poorly understood. What we do know is that once use ends, that in many brain regions we temporarily have far too many active receptors.
Early recovery can bring us face-to-face with physical evidence of nicotine's influence upon the brain's hard-wired priorities control center. Again, in terms of withdrawal, unless experiencing a higher priority, it's entirely normal to notice that the brain's desire circuitry is temporarily out of whack.
But once nicotine's arrival ends, the brain begins working its butt off to diminish the number of active receptors and restore natural sensitivities. Almost as quickly as you begin noticing that your sense of smell and taste is enhanced, brain command and control sensitivity restoration is happening too.
SPECT stands for Single Photon Emission Computed Tomography. It is a scan during which a radioactive substance is put into the bloodstream and followed via pictures as it works its way through the body.
A camera capable of detecting gamma radiation is then rotated around the body, taking pictures from many angles. A computer is then used to put the images together and create a picture of activity within a specific slice of the body or brain.
A 2007 study used SPECT scans to follow dynamic changes in acetylcholine receptor down-regulation binding during smoking cessation. It compared those finding to receptor activity inside the brains of non-smokers.[1] It found that within four hours of ending nicotine use that acetylcholine receptor binding potential had already declined by 33.5 percent.
The good news is that natural binding rebounded by 25.7% within ten days of ending nicotine use, and then "decreased to levels seen in non-smokers by around 21 days of smoking cessation."
We don't need to put radiation into our bloodstream or do a SPECT scan of our brain to know that the de-sensitized period sensed during recovery is temporary, normal, and expected.
It's enough to know that what we are sensing and feeling is happening inside a brain that's working hard to readjust to functioning without nicotine. Why fear a healing brain? Savor it.
Symptoms
Within reason and common sense, if going cold turkey, it is fairly safe to blame withdrawal for most effects felt during the first three days, but not always. Pay close attention to what your body is telling you and if at all concerned contact your doctor.
While reviewing the symptoms which follow, keep in mind that I am not a physician. I am a nicotine cessation educator. The below information is intended to support not replace the relationship that exists between you and your doctor.
Do not rely upon any information in this book to replace individual advice from your physician or other qualified health care provider.
Every recovery is different. The variety and intensity of effects experienced vary from person to person, and even between each person's own cessation experiences.
Over the years we've seen thousands of new ex-users surprised to find that they experience few symptoms, if any, while others were confronted with multiple symptoms.
By understanding some of the symptoms, how often they occur, and how long they last, it may be possible, in some instances, to minimize their impact by action or thought.
As we just learned, brain dopamine pathway sensitivities can take up to 3 weeks before fully restored. Although physical withdrawal symptoms normally peak within the first 3 days, a 2007 study reviewed all symptom studies and found that recovery symptoms pass with 2 weeks for most but not all. The study found that if symptoms remain "slightly elevated" beyond 2 weeks that they should fully resolve within 3-4 weeks.[2]
Even so, within 2 weeks the ongoing process of restoring and fine-tuning natural sensitivities reaches a point where most begin experiencing confidence-building glimpses of the flavor of life beyond.
A serious concern with symptoms lists such as this is that "smokers with higher levels of perceived risk may find it more difficult to stop and remain abstinent due to higher levels of anticipated or experienced withdrawal symptoms."[3]
As mentioned, they provide a "junkie-mind" looking for relapse justifications with a rich source of fuel for accentuating or highlighting something that may otherwise have remained minor, secondary, suppressed, or ignored. But how can we not notice symptoms?
If we have a toothache at the same time as a headache, the one that will receive the most attention and focus is the one generating the greatest pain or discomfort. As soon as the discomfort from our primary concern falls below that of our secondary concern, our focus immediately shifts to what was our secondary concern.
We do the same type of primary/secondary refocusing with the effects of withdrawal and layers of recovery. Sometimes we don't even notice a particular symptom until a prior one subsides.
Although the intensity of each remaining effect is likely far less significant than the one preceding it, the mind of the uneducated recovering drug addict is impatient. And some are actually on the lookout for that perfect excuse to relapse and get their drug back.
Upon the decline of initial symptoms (if any), recovery remains continuous, yet at times may be so gradual that - like trying to watch a rosebud open - it almost becomes impossible to notice change.
Reading symptom lists such as this may tend to cause the mind to look for and expect symptoms to occur. In fact, mental expectations are capable of generating physical symptoms. This phenomenon - known as psychological or functional overlay - is very real.
Few starting home will experience the majority of the symptoms listed below. So why even share this list? You may very well experience one or more symptoms. Knowing how often they occur and how long they normally last offers the potential to diminish anxieties, thus increasing your chances of success.
This list is shared to alert you to symptoms commonly seen and to hopefully motivate you to communicate with your doctor regarding any symptom, whether listed or not, that's causing you ongoing concern.
But don't allow a symptoms list such as this one to sell you on the belief that beginning your journey home will be horrible or intense. Instead, relax, strive to dump irrational fears, maintain a positive attitude, and keep your reasons for wanting to break free at the forefront of your mind.
Also, abandon unrealistic victory standards such as "stopping forever." Instead, adopt a totally do-able standard such as celebrating after each hour, challenge, or day of freedom and healing.
Avoid needless symptoms by eating smaller and healthier portions of food more frequently, by not skipping meals, by sipping on some form of natural fruit juice for the first three days, and if a big caffeine user, by considering a modest reduction of up to one-half of normal daily caffeine intake.
Try to get plenty of rest while following these simple rules, and this adventure has the possibility of becoming the most deeply satisfying personal experience of your entire life!
As mentioned, some withdrawal symptoms have roots in the absence of nicotine, and the time needed for the mind to physically adapt to functioning without it. The brain isn't just down-regulating the number of receptors associated with dopamine pathway stimulation. It's resuming full control of all neurochemicals that were influenced by nicotine.
While it may take science decades to untangle, measure and quantify all cessation sensitivity interplays, researchers are already cataloging subjective symptom reports from tens of thousands who have attempted cessation. As with the SPECT scan, they're also using brain-imaging studies and other non-invasive exams to discover how the brain is physically altered by nicotine's absence.
Homeostasis is defined as "the ability or tendency of an organism or cell to maintain internal equilibrium by adjusting its physiological processes."[4] It's the body's tendency to return home.
Our enslaved mind had no choice but to adapt and learn to function within a sphere of nicotine normal. Once nicotine's arrival ends, the brain's grand design will cause it to re-adjust, as maintaining homeostasis is a critical part of our ticket home.
References:
2. Hughes, JR, Effects of abstinence from tobacco: valid symptoms and time course, Nicotine and Tobacco Research, March 2007, Volume 9(3), Pages 315-327.
3. Weinberger AH, et al, Relationship of perceived risks of smoking cessation to symptoms of withdrawal, craving, and depression during short-term smoking abstinence, Addictive Behaviors, July 2008, Volume 33(7), Pages 960-963.
4. Homeostasis. The American Heritage Science Dictionary. Retrieved July 12, 2008, from Dictionary.com website: http://dictionary.reference.com/browse/homeostasis
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