Pleasure Center Lobotomy: The Logical Extreme of The Brain Disease Model of Addiction

You’ve heard that the brain is hijacked by the disease of addiction, right?

Then you’ve also heard that it’s because of the great surges of dopamine that drugs and alcohol provide to the “pleasure center” of the brain, right?

Ok. So let’s just remove that dopamine-craving pleasure center of the brain, and voila! – no more addiction!

Right?

Wrong.

Maia Szalavitz reported in Time on a controversial surgical procedure being done in China, known as “ablation of the nucleus accumbens”, in which parts of this so-called “pleasure center of the brain” are actually burned away in order to “cure” addiction.

I’m surprised I hadn’t heard of this sooner, but I’m not shocked, and I’ll tell you why: it makes sense. But let me be clear that it makes sense only if you buy into the brain disease theory of addiction. From this materialist deterministic view of humanity, this procedure makes complete and total sense.

You must understand that the idea of addiction, as currently conceived, holds that people use drugs because of the structure and functioning of their brain. In this view, addiction has nothing to do with thoughts, beliefs, or values. It has nothing to do with personal awareness and judgment of various life options and the pursuit of happiness – it has everything to do with the makeup of one’s brain – nothing more, nothing less. And if that is true – that you use drugs because your nucleus accumbens “wants” the dopamine triggering powers of drugs, and will push you to do anything to get more drugs, then removing it must be the simplest and most surefire solution to ending addiction.

So all of you counselors and addiction theorists who have a history with addiction and identify as lifelong recovering addicts and alcoholics, and spread this tragic view to vulnerable troubled people, here’s your solution: put your brain and life where your mouth is, and move to China to get this procedure done. You will be cured of your disease. This is the end product of all your propaganda. Just beware of the full implications of this, as Maia lays out in her article:

Even the most successful brain surgeries carry risk of infection, disability and death since opening the skull and cutting brain tissue for any reason is both dangerous and unpredictable. And the Chinese researchers report that 21% of the patients they studied experienced memory deficits after the surgery and 18% had “weakened motivation,” including at least one report of lack of sexual desire. The authors claim, however, that “all of these patients reported that their [adverse results] were tolerable.” In addition, 53% of patients had a change in personality, but the authors describe the majority of these changes as “mildness oriented,” presumably meaning that they became more compliant. Around 7%, however, became more impulsive.

The surgery is actually performed while patients are awake in order to minimize the chances of destroying regions necessary for sensation, consciousness or movement.  Surgeons use heat to kill cells in small sections of both sides of the brain’s nucleus accumbens.  That region is saturated with neurons containing dopamine and endogenous opioids, which are involved in pleasure and desire related both to drugs and to ordinary experiences like eating, love and sex.

I will not be getting the procedure done myself, because I don’t believe that my former problems were the results of a disease or brain abnormality. To me, this is completely and utterly horrifying, and tragically misguided. But if I did believe in the brain disease model, and I had any intellectual integrity whatsoever, I would be all for this, because it does make sense after all, if you come from a place of believing that addiction is caused by the brain.

This is the equivalent of a modern day lobotomy. And how well does it work? 5 years later, 53% of the test subjects are still using opiates! What does that say about the brain disease theory? These people have literally had their pleasure centers that supposedly cause addiction destroyed – and yet they still use drugs! Maia’s article focuses on the ethics of the procedure and the publishing of the research, but to me, the implications of this research – the potential death blow they deliver to the brain disease model of addiction – are far more interesting.

One would assume that if addiction is all about getting that dopamine surge, then the success rate in people who have been surgically disabled from experiencing that dopamine surge, should be 100%. But it’s not. It’s 47%. For some counterpoint on that number, you should know that about 75% of people will be rid of their substance use problem at any given time. 75% vs 47%. And the vast majority of them will not have undergone “treatment” for addiction. They will simply move on with their lives.

You better think long and hard about what you’re investing in when you buy into the brain disease theory of addiction. Yes, it’s so very nice that it absolves people of “guilt”, and allows us to avoid the tough answer (the tough answer being that people use substances because they want the short term pleasure provided by them), but if it’s wrong it’s wrong, and will lead us to dangerous conclusions like the idea that we should actually surgically remove the pleasure center – and for what benefit?

Note To Readers: Hi Readers – sorry I haven’t written any new posts since October. I’ve been hard at work developing new lessons and revisions of course materials for the St Jude CBE Program. Unfortunately, as I focus on this work, it leaves me burned out for the task of writing new blog posts here. However, it is my dream job to be doing this, and as I finish up with revisions, I will have more time to dedicate to the blog and keep a steady flow of articles coming out.