June 06, 2020   12:37am

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Is Addiction a disease … or is it a weakness?

Is addiction a “moral failing or a “legitimate disease” or a little of both? Jeneen Interlandi reports for a Newsweek cover “The Hunt for an Addiction Vaccine” with the story “What Addicts Need.” This story is followed by: “Sadly, There Is No Magic Bullet” by Mitchell S. Rosenthal, M.D.If you commit to reading one then you only get the full picture by reading the other as well. Here’s an overview of both.

“What Addicts Need”
“Addiction isn’t a weakness; it’s an illness. Now vaccines and other new drugs may change the way we treat it.”

Since 1956 The American Medical Association recognized that addiction is a disease – but we’re only now beginning to see treatments that target the underlying biochemistry…

“Geneticists have found the first few (of what is likely to be many) gene variants that predispose people to addiction,” which helps explain why everyone doesn’t get hooked…” The five drugs considered to be the hardest to give up: nicotine, alcohol, amphetamines, cocaine, and heroin. Some 22 million Americans are hooked on at least one of these substances.

These “flood the brain with the neurotransmitter dopamine, a chemical that induces a sensation of pleasure and trains the subconscious to remember everything that preceded that sensation…all five hijack the same pathway, deep within the brain. It’s the pathway that conditions us to eat, have sex, form emotional attachments and carry out the other activities essential to our species survival…Take a drug like [cocaine] consistently enough, and your brain and body will come to depend on it – first for euphoria, then for normalcy.”

“Researchers are now working with various dopamine receptors, as people with fewer may receive less stimulation from their naturally occurring dopamine, and, therefore be more inclined to seek an artificial high from drugs.” However, for many reasons outlined in this article, that hasn’t been easy, and there are numerous neurotransmitters now being tackled with some very positive results and “enormous promise.”

“One reason addictions become so hard to break is that the pleasure of taking the drug becomes associated with all the situations and activities around it, which then become cues for a relapse…so researchers are working on ways to break the association…”

Neuroscientists don’t talk about “willpower,”…but they are starting to get a handle on the parts of the brain involved in self-control … “They distinguish three kinds, and unsurprisingly, addicts score poorly on all of them…” These are:

  • Delayed discounting, the willingness to put off present gratification in the interest of a bigger long-term reward…
  • Reflection impulsivity, a measure of how much information is required to make a decision. Addicts typically act without processing all the available information.
  • Intentional action, the ability to consciously stop a behavior that has become automatic.

“The idea that we can restore “self-control” or “free will” with medication is a very, very exciting one…it could be paradigm shifting. But we need more studies to see how consistently that impacts recovery…”

“These drugs are new and their mechanisms are still only partially understood. the brain has a way of resisting attempts to tinker with its chemistry…”

“Sadly, There is no Magic Bullet.”
“Addiction is not solely a disease of the brain. The case for holistic treatment.”

“We’ve come to believe in a prescription for every condition and a pill for every ill…And this pharmacological boom has proven particularly creative and bountiful in the treatment of addiction…Advances in brain science have given us a new understanding of addiction and its neurological basis…the latest, now in development, are vaccines that may be able not just to treat addiction but to prevent it as well.”

“It sounds great…[but] drugs alone are not the answer to addiction…the law of unintended consequences warns us that there’s a downside to just about every advance…[there’s] a widespread assumption that addicts are powerless over their condition — that drugs have hijacked their brains. This, in essences, rules out free will and the possibility that some addictive behavior may be voluntary.”

“The adolescent brain is a work in progress. While the brain’s pleasure- and sensation-seeking center is up and running strong at puberty, that portion of the brain exercising cotrol over impulsive and irrational behavior isn’t yet fully hooked into the mental communication system until the mid-20’s…”

“Biology is not necessarily destiny. To accept the proposition of an addict’s powerlessness is to eliminate volition from the equation, for we know from hard evidence that addicts can and do kick the habit…There is always a period at the outset when choice is not only possible but relatively easy.”

“It is through talk therapy that most drug abusers come to understand themselves well enough to take control of their lives…The combination of drugs and psychotherapy can work as well for addiction as it does for depression.”

“Addiction is a lifelong condition and can recur at any time…but need not…[it] can be treated, monitored and controlled.

NOTE from Snoety:
The first article, “What Addicts Need,” is chocked full of information, research and case studies. If addiction is an interest, a concern or runs in your family, it’s definitely worth the read. It’s followed by: “Sadly, There Is No Magic Bullet” by Mitchell S. Rosenthal, M.D. He reminds us that “Addition is not solely a disease of the brain” and makes the case for holistic treatment. Don’t read one of these articles without reading the other.

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