Is Addiction Really a Disease? Or Am I Just a Dirtbag?
(Reprinted from my blog post July 31, 2018)
The debate rages: Is alcoholism a matter of choice or is it a disease? Well, maybe not "rages." But the question does go "blip" in some circles.
My cousin, in a phone text, referenced a blog post I wrote on May 20 about the disease question and she pointed me in the direction of a YouTube address by Dr. Kevin McCauley (https://www.youtube.com/watch?v=b2emgrRoT2c). It's well worth the investment of an hour, 12 minutes, and 13 seconds for an easy-to-follow analysis of addiction and our brains.
The prefrontal cortex is the part of the brain that controls conscious thought, behavior, decision making, and the like. Experiments with mice prove that's not where addiction attacks. The midbrain is the survival brain. It handles eating, killing (self protection), and sex. This is the part of the brain where alcohol and other drugs work, which means we are tricked into believing we need more and more for survival. Nothing else then matters. We drink to live and live to drink.
Some fortunates can drink or drug and it's just fun. Then they stop, get over the hangover, and move on. For them, a beer is a beer. But for addicts, a beer becomes life or death.
The cause of addiction, according to McCauley, is stress! 😖😖😖 We all face stress, but we don't all face the same severity of stress (rape, abuse, natural disasters), the same pattern of stress (stress in early life is more damaging, stress to a fetus in the first trimester of pregnancy is toxic), the same coping mechanisms, or the same brains.
"Addiction is a stress-induced defect in the brain's ability to properly perceive pleasure," McCauley says. If people can't properly perceive light, they are blind. No one judges them or takes away their children. If people can't perceive sound, they are deaf and no one passes judgement against them for that. But those who can't perceive pleasure properly and seek it in different ways, (alcohol, drugs, sex, food) often are perceived as immoral or lacking control over themselves or having terrible parents or friends. That's certainly true for some alcoholics, but if so it's for reasons not tied to their drinking and drugging. Instead:
"Addiction is a dysregulation of the midbrain dopamine (pleasure) system due to unmanaged stress resulting in symptoms of decreased functioning, specifically:
So when folks face jail time or loss of their kids or threats from a spouse if they don't stop drinking, we would expect them to want to stop to avoid the consequences. Makes sense. But threats have no effect on use. They add stress, which increases the likelihood of more substance abuse and relapse.
But don't take it from me. Listen to what Dr. McCauley has to say about the disease of addiction. It's good stuff. In addition, a copy of the visuals he uses in the presentation cited above can be found at http://www.ncadd.org/images/stories/2011_conference_pics/ppt/KevinMcCaulry.pdf.
The debate rages: Is alcoholism a matter of choice or is it a disease? Well, maybe not "rages." But the question does go "blip" in some circles.
My cousin, in a phone text, referenced a blog post I wrote on May 20 about the disease question and she pointed me in the direction of a YouTube address by Dr. Kevin McCauley (https://www.youtube.com/watch?v=b2emgrRoT2c). It's well worth the investment of an hour, 12 minutes, and 13 seconds for an easy-to-follow analysis of addiction and our brains.
The prefrontal cortex is the part of the brain that controls conscious thought, behavior, decision making, and the like. Experiments with mice prove that's not where addiction attacks. The midbrain is the survival brain. It handles eating, killing (self protection), and sex. This is the part of the brain where alcohol and other drugs work, which means we are tricked into believing we need more and more for survival. Nothing else then matters. We drink to live and live to drink.
The cause of addiction, according to McCauley, is stress! 😖😖😖 We all face stress, but we don't all face the same severity of stress (rape, abuse, natural disasters), the same pattern of stress (stress in early life is more damaging, stress to a fetus in the first trimester of pregnancy is toxic), the same coping mechanisms, or the same brains.
"Addiction is a stress-induced defect in the brain's ability to properly perceive pleasure," McCauley says. If people can't properly perceive light, they are blind. No one judges them or takes away their children. If people can't perceive sound, they are deaf and no one passes judgement against them for that. But those who can't perceive pleasure properly and seek it in different ways, (alcohol, drugs, sex, food) often are perceived as immoral or lacking control over themselves or having terrible parents or friends. That's certainly true for some alcoholics, but if so it's for reasons not tied to their drinking and drugging. Instead:
"Addiction is a dysregulation of the midbrain dopamine (pleasure) system due to unmanaged stress resulting in symptoms of decreased functioning, specifically:
- Loss of Control
- Craving
- Persistent drug use despite negative consequences."
So when folks face jail time or loss of their kids or threats from a spouse if they don't stop drinking, we would expect them to want to stop to avoid the consequences. Makes sense. But threats have no effect on use. They add stress, which increases the likelihood of more substance abuse and relapse.
But don't take it from me. Listen to what Dr. McCauley has to say about the disease of addiction. It's good stuff. In addition, a copy of the visuals he uses in the presentation cited above can be found at http://www.ncadd.org/images/stories/2011_conference_pics/ppt/KevinMcCaulry.pdf.
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