From Reward to Slavery, the Stages of Addiction
The word “addiction” is derived from a Latin term for “enslaved by” or “bound to.” Anyone who has struggled to overcome an addiction — or has tried to help someone else to do so — understands why. In the first chapter, addiction was presented as a continuum, as there are degrees of severity, it’s not an on-or-off condition. In chapter 2, we saw that the criteria become more severe as the disorder progresses. In this section, we are going to look at addiction from a new direction — from the standpoint of neuroplasticity. If a substantial part of addiction is learned behavior, how and why does it happen, and most importantly, how can we go about reversing or countermanding the learned part of the process.
Earlier, we learned that there are three phases, or stages of normal learning. the acquisition phase, where we gather sensory data and decide what to do with it; the declarative phase, or memory we use in conscious decision-making; and finally, working or habit memory, which governs actions we take without the intervention or collaboration of our conscious mind. Although behavioral characteristics vary with the particular drug, the process of addiction can also be divided into three distinct stages, which correspond to the three memory phases.[i]
All drugs of abuse trigger the limbic system by stimulating the release of dopamine in the neurons.[ii],[iii] This stimulation focuses our attention, gives us pleasure, and causes our brain circuitry to record the entire experience, so it can be repeated in the future. Because it’s the limbic system that’s involved, the message is powerful, and even the early experiences are encoded quite strongly.[iv] The dopamine release triggered by drug use is two to ten times stronger and of much longer duration than that of any normal biological rewards.[v] For such rewards, (eating, sex, etc.) once the person has learned the most efficient behavior to obtain a reward, dopamine release to facilitate further learning is not necessary and does not occur.[vi] Drug use, on the other hand, always produces a dopamine release if a sufficient amount is taken, even in chronic users.[vii]Continue reading
This is the first post I’ve made here in a while, but that doesn’t mean nothing has been happening with this effort. I have re-structured the contents of Powerless No Longer to reflect a more accurate model of how we actually recover, and the new Table of Contents can be found on the tab above. I’ve written a lot of new material, and edited much of the older stuff. I will be introducing the new material slowly, and replacing some of the older stuff with the current versions. Please check-out the new contents, and let me know what you think. The excerpt below is from the revised Chapter One.
Why we deny
We addicts are no different from anyone else; we’ve just learned to see the world from a distorted perspective. In a very real sense, we have learned to be addicts. Although genetics do play a role, we weren’t born with our addictions, nor did we acquire them due to some moral flaw or shortcoming. Addiction is a complex bio/psycho/social disorder with many different causes. There are degrees of addiction; it’s not an on-or-off condition. Many of the chemical changes the process of addiction makes to the brain are irreversible, and it can become so severe that the only help available to the addict are programs that feature harm reduction, such as methadone or needle exchange.
The good news is that the overwhelming majority of us overcome our addictions on our own without treatment centers, formal programs, pills, or patches. Most of us are capable of learning new skills to cope with the stresses in life that helped drive many of us to dependency in the first place.Continue reading
Survey after survey has shown that the general public overwhelmingly believes that addiction is a disease, addicts are powerless over it, it’s a result of some sort of spiritual or moral issue, it’s hereditary, and the only hope the addict has of ever being free of it is for he or she to commit themselves to treatment, and resign themselves to life-long participation in some sort of 12-step or other semi-religious organization. None of this is true, of course, which I will address in chapter three, but for now, let’s look at these false beliefs from the standpoint of what we know today about the nature of addiction and how we become addicted.
Firstly, consider that those false beliefs stem mainly from a book that was published in 1939, called “Alcoholics Anonymous,” which became the foundation of the drug and alcohol treatment industry, and the source of most of the public’s knowledge about addiction. Not a single word or phrase in the operative portion of this book has been modified or updated in the slightest since its initial publication, seventy-plus-years-ago, in spite of all we have learned about addiction, especially in the last half-century. For its part, the addiction research community has hardly gone out-of-its-way to change public opinion either, partially because of a reluctance to challenge the established treatment industry, and partially, I suspect, due to their lack of access to the public-at-large. That last is truly unfortunate, because the truth of the nature of addiction, revealed by the available studies and research paint an entirely different picture than the one the public, and even most addicts, currently believe.
Addiction is an extremely complicated Biological, Psychological, Neurological, and social disorder, with no single cause. We are not addicts because we are weak, immoral, or fated to be so. We are addicts mostly because we learned to be, not because of any spiritual shortcoming. We became addicted because of a combination of genetics, experience, personality, opportunity, and outlook.Continue reading
From time-to-time, I will post articles such as this that highlight promising new research that supports recovery ideas and principles that appear in “Powerless No Longer.” This article, from “Medical News Today,“ addresses research into the disability of addicts to delay short-term gratification, even when they know that the long-term consequences of using are dire.
“The growing numbers of new cases of substance abuse disorders are perplexing. After all, the course of drug addiction so often ends badly. The negative consequences of drug abuse appear regularly on TV, from stories of celebrities behaving in socially inappropriate and self-destructive ways while intoxicated to dramatization of the rigors of drug withdrawal on “Intervention” and other reality shows.
Schools now educate students about the risks of addiction. While having a keen awareness of the negative long-term repercussions of substance use protects some people from developing addictions, others remain vulnerable.
One reason that education alone cannot prevent substance abuse is that people who are vulnerable to developing substance abuse disorders tend to exhibit a trait called “delay discounting”, which is the tendency to devalue rewards and punishments that occur in the future. Delay discounting may be paralleled by “reward myopia”, a tendency to opt for immediately rewarding stimuli, like drugs. Continue reading