How does addiction develop? Contrary to common perspective, addiction is not the result of insuficient moral character and education. A different way to look at it is that we are all striving for a reliable way to get comfortable inside our own heads by the most efective means available. This is basically how appealing external rewards like alcohol, drugs, sugar, food, phones/internet, sex, gambling, etc. all become compulsive addictions.
Behaviorly, it’s pretty easy to observe addition develop with animal models. Rats with free access to cocaine and opitates quickly get addicted and use them. The animals then fanatically use the drugs–often to the exception of food, water and sleep until death. What wasn’t noted in these early animal studies was that these animals were isolated, with nothing to do, in stark wire cages.
We know now that environment matters. The “Rat Park” experiemnt from Dr. Bruce Alexander replicated the animal addiction studies by giving rats free access to addictive drugs. Alexander also gave them a GREAT social setting and environment. The rat park animals also had large clean enclosures, oportunities to play with toys and puzzles, and exercise. They also had room to roam, privacy and other rats to socialize and have sex with.
Guess what? Even with free access to cocaine and optiates, the animals in rat park largely avoided drug use and addiction. Why? Because they were already comfortable in thier own brains. Humans arent too different. In this light, as society “progresses”, modern humans are increasingly living in our own versions of isolated cages. THIS is the a prime environment for addiction to take hold, adn so it is no surprise to see addiction on the rise.
Here are three factors that need addiction in the cause or perpetuation of addiction:
- Genetics: Do you have a family history of addiction?
- Psychological: Are you still troubled by feeling unsafe as a child? (Were you traumatized or abused or neglected?)
- Social/environmental: Is your current social environment isolated, stressful, or abusive and is there easy access to drugs?
If you answered yes to one or more of these questions, you likely have an increased risk of developing some kind of addiction–AND relapse of that addiction.
Below are some of the more common addictions that develop in susceptable individuals.
Lets get into the nero anatomy side of addiction.
- The limbic system is our “GO” reward system: mediates our will to live and our pleasure centers (via. dopamine) that lead us to eat, drink, and have sex and–other less helpful addictive behaviors.
- The Frontal lobe is our “STOP” reasoning system that (when functioning) mediates our limbic/reward system: insight, judgement, and empathy.
Adiction develops when activity in the dopamine-driven limbic/reward system overwhelms the rational governance of the frontal lobe. Once addicted, frontal brain function continues to decline relative to limbic function. People with addiction literally do not have the frontal brain function needed to make rational decisions. Once abstaining it takes around 2 full years of abstinance and treatment care to expect to recover a normal ammount of frontal brain funtion.
Dopamine is a chemical signal sent between brain cells, and it is especially important to the limbic system reward system. Dopamine does not act alone. It’s like a thrown ball that only completes it’s journey when it lands in a mitt. The mitt is the dopamine receptor and the abundance or defecit of dopamine receptors effects how prone to addiction you are.
Like us, monkeys like to socialize. They also like cocaine. We now know that monkies in troups with higher social standing and freeer access to resources grow more dopamine (D2) receptors in their brains. Extra D2 receptors translates to a stronger dopamine response in our limbic systems and resistance to addiction. Conversely, monkies with lower social standing and access to resources have brains that are less comfortable, crave more dopamine, and are more susceptible to addiction.
Addiction to drugs is truly a health crisis.
Deaths due to drug use, are a Major cause of death:
- U.S. lifespan estimates have declined for the second year in a row. (Dowell, D. JAMA 2017) This is primarily due to deaths from drug overdose.
- From 1999 to 2016, more Americans had died from opioid overdose than American soldiers who died in battle in World War II. (351,602 vs. 291,000) according to the National Center for Health Statistics, 2016 and U.S. Department of Veterans Affairs, 2017.
- In 2017, there were 70,237 deaths due to opiods vs. 47,000 American soldiers who died the Vietnam War 1964–1975.
Back to the notion that addiction develops because we are just trying to get comfortable in within our own brains. Attempts at abstinence alone is not terribly effective with addiction. Detox and withdrawl may take a couple of weeks to get through, but we need to remember that it typically takes years for people dealing with addiction to recover fully functioning frontal cortex reasoning capasity around thier addicion. People with addiciton need long-term support, feeling connected, higher self esteem, and new coping mechanisms to deal with stress.
While we can’t do much about your genetics, we can and should address the psychological and social factors for people with addiction. To treat and prevent addiciton and relapse, we need to address past trauma, stress in current living and work environments and social connections. Addiction also cries for attention given to the fundamentals of health: movent, sleep, nutrition, stress, and healthy relationships. It takes a whole person support process.