There is a point we will hit where by following the logic of the brain disease model of addiction, it will begin to appear that literally everything we do is a brain disease – and thus it will become painfully obvious to most people that none of it should be considered a disease. The reason for this is that it will be seen that both “brain changes” are an everyday part of human life, and dopamine is involved in so many things, that to point at either one of them and say “see, addiction is a disease because the brain changes”, or “addiction is a disease because it involves the neurotransmitter dopamine”, will instantly register as irrelevant. [I tackle that point with “brain changes” here] I’ve stumbled across some info recently that makes me think we’re getting close to that point where we can stop being swept away by the normal processes of the brain, and get back to being focused on real world solutions to “addiction.” But before we get into that, let’s just lay the groundwork about dopamine and addiction.
In a piece called The Addicted Brain: Beyond Willpower, Nora Volkow of the NIDA writes (1):
Often, a drug is taken the first time by choice – to feel pleasure or to relieve depression or stress. But this notion of choice is short-lived. Why? Because repeated drug use disrupts well balanced systems in the brain in ways that persist, eventually replacing a person’s normal needs and desires with a one-track mission to seek and use drugs. At this point, normal desires and motives will have a hard time competing with the desire for the drug.
She goes on to answer the question “How does the brain become addicted?” (which is a philosophically asinine question to begin with) by stating:
The drug causes a surge in levels of a brain chemical called dopamine, which results in feelings of pleasure. The brain remembers this pleasure, and wants it repeated.
Drugs of abuse produce very large and rapid dopamine surges and the brain responds by reducing normal dopamine activity.
So that’s it – dopamine is the key, right? Except for the fact that it’s involved in so many things. Food, sex, gambling, and as a reader recently pointed out to me – hugs – all trigger the release of dopamine. It is claimed that the chemical properties of drugs are what makes them so powerful, yet even those activities (listed above) that don’t introduce any chemicals into your body are considered to be equally addictive (except hugs!). That is, people get just as carried away with pursuing sex or gambling as they do with drugs and alcohol. So really, there’s nothing too special about drugs, or their activity on the brain.
Plenty of other things are apparently capable of producing the same releases of dopamine as drugs – and do I mean plenty! Here’s where things get loony, and I think we start approaching the point where this dopamine talk becomes transparent. A website called “The Dopamine Project” is full of articles pushing the idea of a general “dopamine addiction” that affects 99% of the world! I have to say, I almost can’t argue with their logic. Take a look at some excerpts from their primer on dopamine:
Want to know what a dopamine rush feels like? Close your eyes, take a few deep breaths, relax. Now think about someone you love, a tasty food, your celebrity crush, the day you won that prize, or anything else that leaves you feeling warm and fuzzy. Get lost in the details. If you started smiling, it’s because your recollection triggered a dopamine rush in your brain!
…
Dopamine gives us a feeling of euphoria, like a high, when released.
….
We want fresh breath, sexier underwear, wrinkle-free pants, and so on because those things make us feel better. We feel better because dopamine is released in our brains when we think about how these things will boost our self-image, attract a playmate, etc. In fact, when we say that we like a certain food, song, book, idea, fantasy, video game, movie, hobby, or person, what we really like are the dopamine hits they provide.
On their page explicitly outlining dopamine addiction, the authors state that:
Street drugs are physical dopamine triggers that are hard to deny because they require the ingesting, inhaling, or injecting of addictive substances. Physical dopamine addictions destroy lives and wreak societal damage, but the most dangerous dopamine triggers include a short list of easy to deny psychological addictions.
Psychological dopamine addictions are more insidious because the dopamine is triggered by addictive emotions, memories, thoughts, fantasies, ideologies, rhetoric, and deceptions. Researchers have recently added video games and texting to the list while continuing to ignore the most dangerous triggers that have come to be considered “normal” behaviors.
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To keep the dopamine flowing, heroin addicts use needles, safety addicts swallow lies, peer-approval addicts join groups, and esteem addicts chase status. One important distinction between addictions is that heroin addicts have to hide their needles whereas safety addicts get to wear their weapons, peer-approval addicts are free to flock to groups, and esteem addicts get away with flaunting their status symbols every chance they get.
Yes, you read correctly – esteem, peer approval, safety, memories, rhetoric, movies, hobbies, etc, are all potential providers of dopamine rushes and thus “addictive”. Although I have a hard time figuring out whether the main author of that site is serious or not (the idea is just too absurd), I’m sure he’ll be proven correct (in a sense). I see the news about different behaviors being linked to dopamine all the time – for example, a study out of Vanderbilt University says aggression involves dopamine, and then manages to conclude that our love of violent sports must be driven by dopamine releases as well. I have a hard time arguing with the claims of The Dopamine Project, except for the fact that it ultimately means EVERYTHING IS ADDICTIVE – and thus, nothing really is addictive – it’s just a normal part of life, we choose what to pursue, and when we get it, we get pleasure which is facilitated by the release of dopamine. It may be seen that whatever we attach meaning to will become pleasurable and thus a provider of dopamine. For example, I don’t care about comic books. I won’t feel any surge of pleasure when in the presence of a mint condition Batman #1 – but the guy who’s attached meaning and value to it will get drunk off that comic book!The idea that a neurological explanation could exhaust the meaning of experience was already being mocked as “medical materialism” by the psychologist William James a century ago. And today’s ubiquitous rhetorical confidence about how the brain works papers over a still-enormous scientific uncertainty. Paul Fletcher, professor of health neuroscience at the University of Cambridge, says that he gets “exasperated” by much popular coverage of neuroimaging research, which assumes that “activity in a brain region is the answer to some profound question about psychological processes. This is very hard to justify given how little we currently know about what different regions of the brain actually do.”
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The human brain, it is said, is the most complex object in the known universe. That a part of it “lights up” on an fMRI scan does not mean the rest is inactive; nor is it obvious what any such lighting-up indicates; nor is it straightforward to infer general lessons about life from experiments conducted under highly artificial conditions.
Poole then gives a scathing breakdown of the formulaic approach of pop psychology authors, and specifically refers to dopamine as an example of the madness:
But these writers tend to reach for just one functional story about a brain subsystem – the story that fits with their Big Idea – while ignoring other roles the same system might play. This can lead to a comical inconsistency across different books, and even within the oeuvre of a single author.
Is dopamine “the molecule of intuition”, as Jonah Lehrer risibly suggested inThe Decisive Moment (2009), or is it the basis of “the neural highway that’s responsible for generating the pleasurable emotions”, as he wrote inImagine? (Meanwhile, Susan Cain’s Quiet: the Power of Introverts in a World That Can’t Stop Talking calls dopamine the “reward chemical” and postulates that extroverts are more responsive to it.)
…
Distortion of what and how much we know is bound to occur, Paul Fletcher points out, if the literature is cherry-picked.
“Having outlined your theory,” he says, “you can then cite a finding from a neuroimaging study identifying, for example, activity in a brain region such as the insula . . . You then select from among the many theories of insula function, choosing the one that best fits with your overall hypothesis, but neglecting to mention that nobody really knows what the insula does or that there are many ideas about its possible function.”
I think we’re almost at the point where people will see through all of this nonsense, and the harmful self-limiting idea of a brain “highjacked” by addiction will finally crumble.
The dopamine thing seems so simplified. To me, there is a huge difference between getting drunk or having several drinks every night. It’s the scale of the problem. Addiction is on a scale from IV junkie at one extreme to a person working too hard on the other. It’s the type of activity and the extent of abuse.
If we are talking about full scale abuse, there is a huge difference between abusing alcohol, vicodin, or computers. Alcohol can cause blackouts and dulls mental functioning. Try giving a speech while drunk. But I could give speeches on pills and nobody knew I was taking them! Yet I spent a lot of money, which a computer abuser never would.
This might be mean of me,but I look down on abusing alcohol. It violates my values of being mentally functional. Someone might look down on me for spending too much money, and that’s fine too. I just can’t lump myself in with the alcoholics or computer abusers. Whatever dopamine you get from that, yuck! If all dopamine is the same, why didn’t I like alcohol or computer games or porn? This makes ZERO SENSE!!
Hello,
Your comments about me in your blog post weren’t very nice, but that’s OK.
Just want to let you know that I’m totally serious and that I fully understand why you consider my ideas are “just too absurd.” Especially since you’re trying to prove the opposite of what I believe to be true.
No offense, but the addiction myth isn’t going to crumble because it isn’t a myth. Instead, the definition of addiction is going to continue being extended (the way it just was by the D.S.M.) until researchers finally accept the fact that it is possible to get addicted to anything that triggers dopamine. That includes all of the dopamine-induced survival needs we share with chimpanzees (safety/power, acceptance/approval/attention, esteem/status) plus money and especially religion.
You can delude yourself all you want, but “people” aren’t starting to catch on to your way of thinking. Steven Poole is a jealous charlatan who isn’t aware enough to understand that he’s desperately trying to hype himself and his new book by complaining about more famous writers hyping their books by using neuroscience. Like Mr. Poole, you don’t understand that you’re actually proving what you think you’re disproving.
Every once in a while I come across an individual who’s hell bent on denying the existence of addictions and I’m never sure why. The one science writer who actually discussed my theory with me (after dismissing me as a crank on a soapbox) went on to write an excellent article about dopamine that backed up what he initially ridiculed.
My best guess is that addiction deniers (e.g. you and Poole) are doing what all addicts do, i.e. denying their own addictions. (It’s what addicts do.)
A second explanation is a dopamine game I call, “Mary Contrary” played by arrogant/insecure individuals who are desperate to boost their esteem (i.e. trigger dopamine in their own minds) by deceiving themselves into believing they’re somehow too smart to be deceived by others.
Galileo’s peers refused to look through his telescope. Instead of risking a dopamine loss by admitting they were cowards, they rewarded their cowardice with gratuitous dopamine hits by convincing one another that Galileo was a charlatan, that his telescope was a gimmick he used to trick gullible fools, and that heliocentrism was a myth that would eventually crumble.
The parallels between geocentrism and heliocentrism backers apply today. On one side were very few individuals who, understandably, initially got many of the details and facts wrong, but who were willing to honestly evaluate the available information and who were correct about the essential premise right. On the other side were the many who turned out to be totally wrong about everything because they were afraid to look through the telescope (and see what was going on right in front of their eyes) because their only concern was protecting their safety, peer-approval, and esteem = dopamine flow.
And then there are the delusional types who desperately try to blow dopamine up their own butts by claiming that addiction is a choice. As bigots and racists demonstrate, small-minded people are always trying to build themselves up by looking down on anyone they can pretend they’re superior to. It’s a cheap trick, but it works.
I find it especially ironic to see how many esteem addicts take advantage of their ignorance (to their esteem addiction) to elevate their esteem by looking down on addicts who need drugs to trigger the same dopamine the esteem addicts trigger with their self-deceptions.
Help me out here.
What dopamine-induced craving is driving you to waste so much time and energy proving that you don’t know what you’re talking about?
You’re afraid of something. Do you have any idea what it is?
I can’t tell without out meeting in person. But give me a half hour face-to-face and I guarantee I’ll help you figure out what your problem is.
BTW, thanks for providing an idea for a future post…
Charles, is this the best you got? Kinda lame –
Kelly,
Sorry to disappoint you.
Charles
Hi Charles,
I wonder – what is your endgame? Suppose I realize that my arguments are just the result of a dopamine addiction – then what? How would that be helpful to me? Do I have to quit seeking truth (feeding my “esteem addiction”)? Would I then become a humility addict?
-Steven
Hi Steven,
My endgame is to get the word out that our species is suffering from a brain disease that’s destroying our chances of making it into the next century and possible the next decade.
If you realize that your arguments are just the result of dopamine addiction you’ll become more aware and, hopefully, trigger healthy dopamine from the insights and pride.
Did you read my post about Steve Poole’s article?
http://dopamineproject.org/2012/09/dear-mr-poole-dont-throw-your-back-out-trying-to-blow-dopamine-up-your-butt/
I tweeted a link to Steve and he retweeted it to his followers with the comment, “Priceless!”
Since he was such a good sport I agreed to buy a copy of his new book.
You might want to offer him the chance to rebut my blog on your blog.
I’ve been thinking about you and wish I had the time to send a more involved response, but based on what I think I know about you, I’m going to make time to squeeze in this half-baked comment.
You deserve a lot of credit for beating your own addictions. And you might (or might not) have come across (one of) the more effective cures for addictions with CBE.
But what if it isn’t a cure for everyone?
And what if your attempts to elevate your esteem by being proud of your beating your addictions (which you’re definitely entitled to and should be proud of) reduces the esteem of other less fortunate addicts, which shuts their dopamine flow off and sends them scrambling for drugs to put out the pain of withdrawal?
Addicts are addicts because (with extremely rare exception) they’re struggling with the dopamine deprivation that can almost always be traced back to childhood neglect, traumas, bullying, and/or other forms of abuse. Making them feel badly about themselves (because they’re too weak to simply make healthy choices) pushes them in the wrong direction.
What if it isn’t a choice for everyone because dopamine usurps free will and replaces it with dopamine will that makes it close to impossible to even want to stop destroying their lives?
Denying the existence of addictions isn’t the answer.
Addiction isn’t an excuse. It’s a word and an explanation.
To be honest, you seem to have a problem with seeing things clearly.
Some of you logic reminds me of the mistaken syllogism, “All grass is green, this is green, therefor it’s grass.”
For example, you wrote, “I have a hard time arguing with the claims of The Dopamine Project, except for the fact that it ultimately means EVERYTHING IS ADDICTIVE – and thus, nothing really is addictive…”
No, that doesn’t mean nothing is addictive anymore than saying “Everyone died in the plane crash, which ultimately means NOBODY DIED IN THE CRASH.”
What it means is just about everyone is addicted to one or more dopamine-triggering substances, beliefs, or behaviors (and especially the dopamine-induced survival needs we all share with chimpanzees for safety/power, acceptance/approval/attention, esteem/status) which explains every problem plaguing mankind, including greed, pollution, stealing, inhumanity, obesity, killing, lying, deception, bigotry, racism, and the tens of millions of substance abusers all over the planet.
One of the raps against AA is that members substitute substance addictions for addictions to AA meetings (mixed with lots of coffee and nicotine).
I might be wrong, but it seems that you’ve substituted a substance addiction for proselytizing about denying the existence of addictions, the importance of choices, and the dopamine triggered by boosting your esteem.
You replied to Joe, “It’s not dopamine that’s significant, it’s choices.”
I believe (and I’m open to being proven wrong) that it’s not about choices, it is about dopamine, because dopamine makes the choices for 99.999% of us because dopamine usurps free will.
And while I agree with you that, “Understanding the true nature of the problem is imperative to solving it.” I see the one and only problem as dopamine because it’s a powerful neurotransmitter that started out helping dumb animals survive until our sapient ancestors turned it into a life-threatening way to get high (by using drugs, gambling, food, religion, and safety, approval, esteem, money, etc.).
True, there is healthy dopamine (that reminds us to eat, i.e. refuel, and ingest enough salt to provide life-sustaining electrolytes) but there’s also unhealthy dopamine (that’s responsible for food and salt addictions, overeating, obesity, and a myriad of health problems).
Sorry if the above sounds incoherent, but I’m juggling a lot of balls right now and thought a rambling, mediocre response is better than a delayed (and possibly never written) one.
Why? Because you seem like a genuinely sincere and dedicated guy who’s a little mixed up.
And while I don’t think we’re on the same page, we’re in the same book and might be able to help one another reach our goals.
My offer to meet (in NYC) is sincere. I promise to be civil.
Let me know if you’re interested.
Charles
Charles,
What happens when we switch out dopamine for some other ubiquitous substance in your theory – perhaps oxygen.
Everything can be reduced to oxygen addiction. 99.999% of the world doesn’t realize that they live on land rather than under water because they’re addicted to oxygen. The reason I’ve chosen to be in my office right now rather than wrapped up in a plastic bag is because of oxygen. Astronauts are addicted to their spacesuits because they provide oxygen. Scuba divers are addicted to their oxygen tanks because – you guessed it – they provide oxygen! The oxygen addiction deniers won’t bury themselves alive because then they’d have to stop the flow of the oxygen that they’re addicted to.
It’s not a perfect analogy, but do you see my point? If all rewards involve dopamine, then so be it – they do. But why would I be more obsessed with drugs than gambling, or esteem, or approval, or safety, or whatever? Or to keep the analogy going, why would I be in my kitchen, office, bathroom, or bedroom? When all of these places contain oxygen, then the presence of oxygen in any one of those rooms ceases to be a meaningful explanation of why I have chosen to be there. For example, there are significant reasons why I would choose to be in my kitchen rather than my bedroom, and they have nothing to do with oxygen.
We choose our behaviors because of the perceived reward they offer, and yes, dopamine is involved in the process of feeling that reward, but I think it’s too reductionist, and not useful at all, to focus on dopamine as the motivator.
-Steven
Steven,
The only thing I agree with you about is that using oxygen is not a perfect analogy. Actually, it’s a useless analogy that doesn’t prove a thing, except that you’re grasping for straws.
You wrote (to Joe), “Understanding the true nature of the problem is imperative to solving it.”
Then, when you’re handed the true nature of the problem, you call it “too reductionist.”
Salt provides a much better analogy than oxygen (although it’s dopamine that either sends us ingesting enough salt to provide life-sustaining electrolytes or consuming enough to kill us).
We all share a healthy need for regular minute doses of salt which healthy people find easy to satisfy.
For salt addicts, the healthy need turns into an addiction to salt which leads to severe medical problems, including high blood pressure, stomach cancer, and heart problems.
Oxygen is a healthy need that never turns into an addiction. Nobody tries to increase their oxygen intake in a desperate attempt to feed insatiable oxygen needs.
Some people are more obsessed with drugs than gambling, or esteem, or approval, or safety, or whatever because different personality types seek out different dopamine triggers.
Donald Trump’s older brother, Fred Jr., drank himself to death. Donald doesn’t drink, but he can not stop desperately reaching for every opportunity to trigger dopamine by calling attention to himself.
The two boys had the same dysfunctional upbringing, but found different ways to feed the resulting, insatiable cravings.
Did the Trump boys choose their different dopamine triggers? No, they unconsciously gravitated to dopamine triggers that suited their personalities.
The difference is that one gave up trying to win his father’s attention and approval and was ashamed of his addiction and the other can’t stop trying to earn his father’s (and everyone else’s) attention and approval and couldn’t be prouder about being an attention/esteem addict.
Things are bad enough with the most common and destructive (money, power, and esteem) addicts getting away with pretending they aren’t addicts because they don’t use drugs or gamble. My goal is to expose unacknowledged addictions. Addiction deniers only make it easier for addicts to deny their addictions.
You write, “We choose our behaviors because of the perceived reward they offer, and yes, dopamine is involved in the process of feeling that reward, but I think it’s too reductionist, and not useful at all, to focus on dopamine as the motivator.”
Dopamine turns potentially conscious people into dopamine puppets and leaving dopamine out of the equation is like trying to discuss marionettes without discussing the strings working their arms and legs and denying that there are puppet masters working the strings.
A guy recently jumped into a tiger cage at the Bronx zoo and told the police, “that he made a conscious decision to jump – ‘Everyone has a reason for what they do in life,’ he was quoted as saying.
I think that even though the guy is insane he still wants to believe he’s making choices because admitting that he’s out of control diminishes esteem and dopamine doesn’t always allow that.
I’ll try to get to your other question over the weekend.
Charles
I’m with Charles, Slate lacks the capacity to be objective, acknowledges the sound logic of the dopamine argument then dismisses it when it doesn’t lead him to his preferred destination. The Slate is shallow, kudos to the dopamine project; (ps: the difference with drugs and alcohol is their ability to produce dopamine levels ten or more times higher than “natural” conduct . resulting in more intense and prolonged withdrawal). The explanation is simple, which enhances it utility as a tool for the cognitively impaired, which will be just as coherent and consistent when they are 5 years clean. KGB
You must also realize both the convenience and irony of your theory Charles.
First, it allows you to write off any challenge as the result of a dopamine addiction. All of your detractors’ arguments are dismissed as invalid because they must be contrived to keep the messenger’s dopamine flowing.
Second – your own mission must also be the result of a dopamine addiction, and thus not be trusted.
Steven,
This will probably be my last response to you, so feel free to get the last word in.
Though enjoyable (at least for me) our little debate seems pointless. That’s not to say that I didn’t learn anything.
If you’ve convinced me of one thing, it’s that neither of us are about to change our minds. Which is fine.
Despite what you might want to believe, I didn’t simply craft a clever theory with a built in gimmick that makes it easy to dismiss people who disagree with me.
(BTW, maybe you see people who disagree with you as “detractors.” I view them as people who think differently.)
I invested 40 years of my life and tens of thousands of dollars accumulating an eclectic array of seemingly disparate but interconnected information. The conviction that there had to be a rational explanation for all of mankind’s irrational behavior kept me looking.
Instead of jumping from pop theory to pop theory I looked for (and found) shortcomings and flaws in theory after theory.
My quest turned into an expensive hobby that started making sense in 2010 when I read an update on a study I’d been following.
Researchers at the Scripps Research Institute found that laboratory rats given the opportunity to consume foods that are normally considered highly palatable yet extremely unhealthy (i.e., high-calorie, high-fat junk foods) will overeat. This overeating forces a neuroadaptive change in their dopamine circuits that is similar to the changes in brains of people suffering from drug addiction. As the brain’s pathways grow accustomed to being overstimulated a pathological cycle begins where addicts require a constant flow of dopamine to avoid entering a state of withdrawal.
Since then, researchers have confirmed that there is only one addiction and it’s to dopamine. Heroin, booze, nicotine, sex, gambling, and junk foods turned out to be different dopamine triggers.
The realization that addictions held the answer to my questions raised new questions. What is everyone addicted to? What was I missing?
Knowing that food and sex were two of Abraham Maslow’s level one deficiency need (D-need) I started looking into Maslow’s other D-needs for safety (power/fear), peer approval (attention), and esteem (status).
Frans de Waal’s books helped me connect Maslow’s D-needs to the survival needs our species share with chimpanzees.
After confirming that the survival needs we share with chimpanzees are dopamine-induced, I realized that dopamine-induced addictions explain everything. Including the self-deceptions and denials that make it so easy for even dopamine experts to understand how dopamine is manipulating them.
Instead of conflicting with all the insights and information I’d picked up along the way, dopamine addiction proved to be the missing piece of the puzzle that connected all the dots.
My theory’s built-in explanation that makes it easy to rebuff people who disagree with me doesn’t make the theory wrong. Some might say that it proves how right on the theory is.
To keep the theory simple, I reduced everything down to dopamine flow. Though including other neurotransmitters makes the explanations more accurate they also make everything significantly more complicated. I believe that it doesn’t matter if it’s one or a dozen neurotransmitters manipulating behavior. The bottom line is that brain chemicals are destroying free will, making our decisions for us, and rewarding us for deceiving ourselves and one another.
Understanding how dopamine flow works threatens safety addicts who can’t admit they aren’t in control. It petrifies acceptance and approval addicts who can’t consider any information that might get them rejected. And it discombobulates esteem addicts because the facts shoot an enormous hole in the deceptions that protect fragile esteem.
While thinking about your intransigence, I was reminded of something Upton Sinclair wrote, “It is difficult to get a man to understand something when his job depends on not understanding it.”
(That gave me an idea for a post by paraphrasing insightful quotes, starting with, “It is difficult to get anyone to understand anything when scoring dopamine depends on not understanding it.” Thank you!)
In your case, you’re selling a product. According to your site,
“CBE is the most effective professional help available for addiction. find
out how you can use CBE to permanently overcome addiction“
I’m not qualified to say if CBE does or doesn’t work. But your business does give you a huge vested interest in not wanting to understand anything that challenges your theory about everything coming down to choices and beliefs. (To my way of thinking you might be able to make CBE more effective by helping your clients understand how dopamine impacts on their ability to make choices and decisions.)
As far as my mission, of course it’s the result of dopamine addiction. I get off on learning, growing, figuring things out, and sharing information. And knowing that I’m years ahead of the scientific community comes with a nice esteem inflating dopamine bonus.
But that doesn’t even almost mean my mission can’t be trusted. Except to someone who’s desperately looking for a specious argument to dismiss threatening information that he can’t disprove.
If you do decide to write back and any of your arguments turn out to be convincing, you will be the first to know. I don’t have a problem being wrong or admitting to being wrong. Which explains why I managed to use readily available research and information to reach conclusions that others aren’t interested in reaching.
If you write and don’t hear back from me you can be sure that it’s because I don’t agree.
Thanks again for helping me understand how you think. It’s been a big help.
And, for what it’s worth, I admire and respect you for adding opposing opinions and comments to your site.
Wishing you all the best,
Charles
If drug-dopamine usurps free will, how in your theory did I choose to stop using drugs? If I needed that dopamine rush at one time in my life, why don’t I need it now and why am I in fact happy? (I don’t take any meds. And one of the things I didn’t like about the 12 step rooms is so many people have mental disorders like depression, anxiety, ADD, bipolar and I like to hang out with people who have it together, sorry to be intolerant).
You say addicts are addicts because they suffer from childhood dopamine deprivation. But I am not an addict, because I don’t take drugs. So did I overcome my dopamine deprivation, or am I engaging it by writing to you? And how could writing to you give me the same dopamine rush that I got from freebasing or shooting up cocaine? Do I just need less dopamine now?
My own theory is that addiction exists on a continuum. At one extreme is the IV junkie and at the other extreme is the CEO or surgeon at the top of his field who works too much and ignores his family and is well respected. Gabor has a book where he shares his addiction to buying classical music CDs, his compulsion to it. Most people who are addicted lie somewhere in between. Then you have those people who just live a healthy life because they keep a check on their habits and do everything in moderation. I am fortunate to be one of those people today.
There seems to be an incredible amount of research implicating the dopamine reward system of the brain in addiction and pleasure. Doesn’t this point to a therapy for drug/alcohol abuse? Replace the drugs with a more benign addiction. Eat your favorite foods, enjoy sex, hug your kids… whatever floats your dopamine boat. Now, I suspect we’re only scratching the surface of understanding the neurological processes here but it seems silly to deny that addiction is neurologically based. Remember, also, that opiates and alcohol involve physical withdrawal which reinforce use for relief of pain. The user gets trapped. Again, benign dopamine stimulating activities could help relieve the pain. Maybe one day they will develop a benign dopamine regulating drug. We shouldn’t discourage their attempts. Cognitive therapy can only help some people. AA seems to help some others. We should welcome and recognize any attempts to treat addictions. It seems too many experts are wasting time trying to label the problem and not enough time trying to solve it.
Don’t you see what you’re saying though, Joe? You’re suggesting that people look for alternatives to their present choices – that they should find other things that bring happiness. You’re sorta proving my point about what’s significant. It’s not dopamine that’s significant, it’s choices.
Also, whether you realize it or not, when you say “We should welcome and recognize any attempts to treat addictions” you are labeling behaviors first as addictions, and second as things that can be “treated”.
Understanding the true nature of the problem is imperative to solving it.
Going back to my example about words and letters in the post – it’s not that words aren’t composed of letters, but the use of words, and their meanings, are not driven or determined by letters. Likewise, it’s not that dopamine and neural events aren’t involved in substance use, but they aren’t necessarily the things that drive and determine an act of substance use or greater pattern of substance use.
-Steven Slate
The dopamine reward system drives reactive behavior. Addiction is maladaptive reactive behavior. Choice assumes cognition which is active behavior. In everyday life, reaction trumps action. I say let the researchers try to find the key to the dopamine reward system and maybe treatment will improve. It can’t get any worse. We become addicted and seek help. The US treatment system tells us we are victims of a disease and offers faith healing. We are not victims but we are trapped. I’m for anything that may help because too many never find a path to recovery and many those who do destroy their live (and many other lives) before they find a way out. Many choose to quit and fail.
All excellent points.
But how do you explain what you said to people who honestly believe that their reactions are actions? And then, when they react defensively to your explanation (because they think they’re being insulted) is it possible to help them understand that their defensive reactions actually prove your point?
Kelly,
Without knowing you it’s impossible to answer most of your questions.
It’s possible that you didn’t have an addictive personality to begin with. Lots of well-adjusted, happy, secure people dabble with drugs and eventually realize that the short-lived drug high that’s quickly replaced with withdrawal simply doesn’t make sense and isn’t worth the price and trouble.
In the 80s I dabbled with cocaine with a good friend. A few months later I realized that I “wanted” coke a lot more than I was enjoying it and decided I was wasting my time and money. So I stopped.
It was only recently that my friend (who’s normally an extremely honest and levelheaded individual) admitted that he hid his coke use from me (and his wife) for more than a year after I quit, that cocaine was destroying his life, and that giving up cocaine proved to be a huge struggle.
I feel extremely grateful (as opposed to proud) that giving up cocaine was as easy as giving up cigarettes was decades ago. With both drugs I simply quit because I didn’t like the idea of being under the control of substances. But it wasn’t because I’m strong willed, it was because I was LUCKY to have a supportive, abuse-free childhood that didn’t predispose me to turning addictive behaviors into addictions.
For me, taking credit for giving up coke and tobacco would be as ridiculous as taking credit for having healthy parents.
In your case you might not have ever “needed” that dopamine rush, you just enjoyed it. If you’ve always been essentially happy, you might have simply realized you didn’t need drugs to be happy and that drugs were leaving you unhappy.
Most addicts are individuals who suffered from childhood traumas that leave them extremely unhappy (dopamine deprived). Their misery sends them trying to use drugs, money, gambling, overeating, indiscriminate sex, and doing what chimpanzees do to trigger dopamine = seeking safety, power, peer-approval, and status.
The problem is that there’s no long term happiness in any of those dopamine triggers because triggering excessive dopamine flow destroys dopamine receptors, so addictive behaviors stop being about pleasure and turn into cravings to put out the withdrawal which makes miserable people even more miserable.
As far as your complaints about AA, I’m not defending or putting down AA but I understand your reservations.
And I agree with you about “addiction exists on a continuum.”
In general, the healthier and less stressful a person’s formative years, the more likely that person will have healthy dopamine-induced needs and to practice moderation. The more unhealthy and stressful a person’s formative years, the more likely he/she is to turn addictive behaviors into out-of-control addictions.
Question. My debate has been with Steven. Why do you think I’m suggesting that you‘re an addict? I don’t even know who you are.
Charles
Charles, I was addicted to drugs for many years. I find this discussion intellectually stimulating, and interesting personally as I strive to learn more about myself and addiction in general.
I think many who are addicted are self medicating. The alcohol and drugs medicate them from anxiety, depression, bi-polar disorder, ADD, or of course physical pain. Maybe for them it is harder to stop. I personally don’t blame childhood because I have seen people with good childhoods turn to drugs and people with bad childhoods not go down that road of addiction.
Chemically though addiction is about more than dopamine. Suboxone works by partially activing the mu opioid receptors. What about the role of opioid receptors, or the role of other hormones like oxytocin (also called the cuddle hormone)? People lose their craving for opiates by taking suboxone. So I have a question. If it really is all chemical based, then everyone taking suboxone would not take any illicit opiate, because their brain receptors are satisfied. My doctor explained to me that taking suboxone would take away the craving and chasing the up and down roller coaster, giving me time to fill my life with new activities. That is exactly what happened. Weaning off the suboxone sucked, but when I was done with the 6 months of suboxone, my life was filled with all those new activities and I had not even set foot in a rehab, outpatient treatment or AA facility! So suboxone worked for me and it should be more widely available and advertised. Without suboxone I would still be taking drugs today.
Kelly,
I too find this discussion intellectually (and dopamine) stimulating and educational.
I spent 40 years trying to figure out how a potentially sapient species managed to fall so incredibly short of our potential, what could possibly cause our species to flirt with its our own extinction, and why do so many people behave so irrationally and inhumanely. Answering my questions turned into an expensive hobby/obsession that introduced me to a wide range of subjects and sent me hunting down scores of false leads.
A few years ago I hired an assistant to help check out a hunch — that a congenital brain disease was somehow responsible for our species’ problems. It took more than a year to realize that looking for an exotic brain disease was a waste of time and money because a common disease was staring me in the face the whole time — addiction. Addiction explained the irrational behavior, as well as the self-deception and denial required to ignore and deny irrational behavior.
At that point I thought it would be relative easy to get the word out. It took me another two years to realize that the puzzle was there for the solving because even the experts don’t want to know. But that’s ok. I’ve got time and I’m extremely tenacious.
I agree with you about “many who are addicted are self medicating.” The problem is that most are using food, sex, safety, power, acceptance, status, money, and/or religion to self medicate. Which is why we have (in addition to drug, gambling, and obesity addictions) STD epidemics, unwanted babies, an international sex trade crisis, pollution, bigotry, racism, economic collapses, religious and economically motivated “wars.” To make matters worse, we have money addicts doing everything they can to get rich by coming up with addictive foods and products.
There’s very little profit potential in helping people reduce stress and find genuine happiness. (I’ve been promoting hugging for more than three decades, which turned out to be another expensive hobby). The big bucks are in highly addictive products because customers keep coming back for more.
I’m not sure about not blaming childhood problems because few people are in touch with what really went on during their childhoods. I’m reading a book that explains how infants neglected (or even raised by resentful or addicted parents) during the first twelve months of life fare significantly poorer than children who receive proper nurturing. Few parents are equipped to raise well-adjusted children. And then there are abused children who suppress the abuse and/or don’t want to admit they were abused (even to themselves) because the truth reduces their esteem / dopamine flow.
You’re right, “Chemically addiction is about more than dopamine.” I decided to focus on dopamine to simplify the explanations.
It turns out dopamine has a lot more to do with expectation and “wanting” as opposed to “pleasure.” Which helps explain why suboxone helped you. The expectation of the opiate high triggers the dopamine that kept you “wanting” to get high and the opiates reinforced the expectation. Take away the pleasure and it reduces the dopamine-induced expectation.
In your case the suboxone gave you “time to fill my life with new activities.”
Slot machines are highly addictive because intermittent reinforcement triggers more dopamine than consistent reinforcement. So addicts who can’t resist for more than a few weeks have to struggle against much stronger dopamine cravings than those who are able to resist temptation for months.
Question. Why isn’t suboxone used more? Side effects? Is it expensive? Inexpensive?
Thanks for the information.
Much appreciated,
Charles
Charles,
Suboxone is expensive. Now a generic version is available, subutex (suboxone minus an ingredient which prevents abuse), which is much cheaper, but only prescribed to people who won’t abuse it. This medication can only be prescribed by a psychiatrist, and you have to be in withdrawal before you can get it. It is not widely known about, perhaps.
There are a couple posts above where Steven asks you some thought provoking questions and I didn’t see your reply.
Are you saying your theory only holds for people with deprived childhoods? I was addicted to opiates for 10 years, and I quit 2 years ago and I am happy today. I still don’t see how your theory explains that. In fact, maybe it’s time to admit that addiction is fun for the person doing it, but bad for everyone else. My only problem with it is the guilt I have over hurting other people. I had fun while I did it, no regrets on my behalf! How about that as a theory?
Kelly,
I started replies to Steven’s questions/responses and hope to add them this weekend.
Responding to Steven is a bit more complicated and challenging because we’re soooo far apart that it’s difficult to address all of the potential angles to what’s being discussed. Especially (even though it might not seem like it) since I’m trying to avoid being dismissive and sarcastic.
Actually, I think Steven and I are wasting one another’s time. Especially since the way current research is going, one of us will be proven much more correct than the other within a year or two. At this point I think I’m benefiting more from our discussions than Steven is because he’s helping me better understand both what I’m up against and how some addiction deniers think. (Sorry Steven, I’m not trying to surreptitiously fault you. It’s just that Kelly asked.)
Your honesty about “having fun” with your addiction is interesting. I’m not sure if all addicts are happy or having fun, though I can see that as a possibility for certain types. Then again, I think that a lot of people confused being diverted with enjoyment.
No, I’m not saying that my theory only holds for people with deprived childhoods. And I’m sure nurtured children can end up as addicts. I’m saying that abused children are far more likely (though not always) to be predisposed to addictions because they start with an emptiness and overpowering needs (to feel loved, appreciated, safe, nurtured, special, important, desired etc) which leaves them “wanting / craving.” That makes them especially susceptible to addictive substances and behaviors that leave them feeling temporarily / artificially happy or less miserable.
Gotta go. Thanks for the honesty and insights.
Charles
Charles, this dopamine theory sounds like a version of the powerless theory, and a twist on the seeking enlightenment theory because everything we do is to make ourselves happy.
Hi Kelly,
I’m not familiar with either the powerless theory or the seeking enlightenment theory, but I wouldn’t be surprised if there were hundreds of similar theories.
Centuries ago Aristotle wrote, “The aim of the wise is not to secure pleasure, but to avoid pain.”
Decades ago, Tony Robbins built a multi-million dollar empire helping people understand that everything we do comes down to seeking pleasure or avoiding pain.
For the first time in history, it’s possible to work past the descriptions (that are often not much more insightful than saying we eat donuts because they taste good and avoid eating crabgrass because it tastes bad) and cut to neurotransmitters = ultimate causation.
My best guess is that the mainstream scientific community are slowly catching on to just how powerful neurotransmitters are but it will take them years before a few open-minded researchers start figuring out that brain chemicals are capable of keeping them from understanding how brain chemicals are making their decisions for them. Why? Because, as Aristotle explained so long ago, the only thing they’re interested in is avoiding pain.“
And that’s where my theory explains what most people continue to believe is inexplicable. Our addiction to Maslow’s deficiency needs has, so far, ensured that safety, peer-approval, and esteem addictions have prevented “geniuses” from even contemplating the possibility of safety, peer-approval, and esteem addictions. Again, because admitting to d-needs addictions is simply too painful because threatening and esteem deflating thoughts curtail dopamine flow = the same withdrawal that keeps junkies scrambling for the heroin they use to trigger dopamine.
When the mainstream scientific community finally catches on about d-needs addictions the researchers will still require years to accept the possibility that our species has been bred by unconscious uber-addicts to favor unconscious addictive types over healthy, aware, conscious types. Which explains why Maslow estimated that significantly less than 1% of the population self actualize.
Thanks again for your feedback.
Charles@DopamineProject.org
Steven,
As always, I really enjoyed reading this information from you. I had a conversation with a colleague the other day about the theories of addiction, and attempted to explain the simplist of concents which as per usual weren’t sinking in due to heavily ingrained societal influence. She then went on to talk about how the brain has been “hijacked”, and despite my attempts she continued to look at me like I was retarded. I’m going to print this out and leave it on her desk.
SFP
Did you know that in uppity addiction rehabs and recovery circles they have a person called a dopamine specialist. people will shell out tens of thousands for someone to tell them they are dopamine deficient and that is why they can’t stop drinking..drugging whatever it may be…The will load the patient up with dopamine therapy supplemetns and put them on ridiculous diets. I have known such a man and boy was he happy to be the special person to be in on this therapy only the rich and brilliant contain….these specialists will actually tell these people that there dopamine deficiency was caused by childhood trauma….and they had no choice but to become an addict