I wanted to talk about addiction. I have a background in psychology. I am actually quitting smoking tomorrow, and cutting down today. I’ve been around the drug scene. Some of my friends are in various health services as well. So, it’s not just dry science to me.
Old school mentalities toward addiction include the likes of the disease model. Basically that’s like being branded in a way. You’re stuck with it. But there are many other models of recovery and addiction itself. Rational Recovery for example pits the higher mind against the animal brain – in a manner perhaps comparable to cognitive behavioural therapy.
Which leads me nicely along to the piece of research I’d like to talk about. [i]
Coked up Marsupials
Basically they got some cocaine addicted rats. Rats that would endure pain to get cocaine. Okay, so they aren’t in PETA. They targeted an area of the brain associated in humans with inhibition and decision making. By targeting this region, in the addicted rats, they reduced compulsive drug taking behaviour. Pretty cool, right?
The region targeted in rats, was half as sensitive to electrical impulses as a normal rat – the region of the brain had become underactive. It was this reduced ability for brain activity here, at least in part, that caused the rats to struggle with their drug use. Which has some implications I’ll get to below.
If we see from this ‘higher’ versus ‘lower’ brain point of view the study examines, then is moderating, or quitting; is it simply a firm decision? A decision made with resolve because of sufficient motivations? A war against one’s impulse to ambivalence, a fight between two halves? Having fought the battle myself a few times, I know it’s not easy, but perhaps it does come down to which side has the bigger army.
Another more modern line of thought is, and it’s been around a long time – that drug abuse is a form of maladaptive learning. This goes back to behavioural psychologists. But neuroscience is quickly finding this to be true. And our understanding deepens the more time passes. Patterns form quickly when our reward centres are being tickled. There’s no mystery in that at least – people do drugs because they feel good; at least for awhile.
But learning may be occurring both ways as the first study shows. If the moderating region of the brain is under activating in the addicted, perhaps we could view this as a muscle. That might explain why the first days are the hardest when moderating or quitting, and why things slowly seem to get easier as time goes on. Why some people find is easier to quit than others.
And it might offer consolation – if one does slip up, it is indeed practice makes perfect – and things should get easier. The more you try, the better you should get at it.
Addiction was once seen as a collection of withdrawal symptoms. Now it is understood as a series of neurological conditions brought about by use of the drug – conditioning; behaviours produced by reward or suffering, and down-regulation of certain systems; parts of the brain becoming ‘worn out’ temporarily, affecting mood, energy and cognition.
While human beings, and certain other higher animals have some chance of avoiding habituated drug use once started – lower animals lack the higher functions produced by the cerebral cortex. We understand that indeed it is something in the reptile or mammalian brain, the mid or lower brain that produces addiction, and something in the cerebral cortex that can abort, or prevent it. Likely the nucleus accumbens and beta endorphins have a role, as well as certain regions in the cortex. It is a higher function override, of lower function that enables us to rise above our less intelligent base desires. And as we advance our understanding, we will get to know how this all works better.
So many factors
But as a friend of mine would quickly point out, understanding this doesn’t resolve the social, human and other environmental issues surrounding addiction. The field of recovery itself has a long way to go.
Progressing from abstinence, and other older approaches to peer based, moderation and holistic models – that factor in upbringing, trauma, social and lifestyle circumstances. People tend to use drugs to balance stress, loneliness, trauma and other factors in their lives. And that makes sense. Natural pleasures will compete with drug pleasures. If you don’t have much of one, you might seek the other more.
Because for a brain that struggles between two halves, two choices, two voices – anything that raises the one you want, or lowers the one you don’t – anything that helps gain control, can be useful. The whole person needs something to be held in that higher function somehow – a sense of hope, purpose, striving, love or goals.
Essentially one wants to ‘arm’ oneself mentally for the fight. And because I am about to embark on the whole journey myself with smoking – I trust I brought along enough mental bullets!
Hammers only see nails
Addiction therapy reminds me of mental health – the old school approach of psychiatric drugs, versus the newer recovery models and peer based therapy. And this is where I worry about neuroscience studying addiction – every time such a study is produced, you can bet there is a big pharma company with a patent pending. They probably funded it. People studying the effects of chemicals on the brain, are going to want to push chemical solutions like salesmen selling vacuum cleaners in the 1960s.
At the same time, if this research could produce essentially a ‘willpower’ enhancing implant or drug, that would have pretty profound implications for society, and for addiction. A temporary boost might be as useful a short term therapy as benzo’s are for anxiety.
We have made some strides in understanding how addiction takes place, and some of the factors involved. But it’s worth remembering how little we know in general – we are still very much puzzling at the complexity of how things make people happy for example, and without understanding that neurologically, it’s hard to understand other things like addiction fully.
But for the addict, I see hope. Harm minimization interventions are sometimes available, such as methadone etc., e-cigs for smokers. We could see a lot more for other drugs, but it’s a start. There are growth areas in peer support, moderation methods, the use of mindfulness and more expansive approaches to addiction therapy. Maybe even a willpower enhancing therapy. We are moving beyond the disease model, and starting to listen to the neuroscientists and researchers in other areas. We have a lot of peoples hard work to thank for that. And hopefully that means better help for people struggling with addiction.