Explanations of Addiction Make No Sense To Me

How come the scientific explanations of addiction I receive in drug court and treatment make no sense to me?

Dr. Peele,

I am currently halfway through a one-year drug court program, having been arrested with .2 g of heroin. As you know, drug courts and the associated treatment programs are often the only alternative to a felony drug trial, no matter what the amount may have been.

The law is the law and I knew that, but having to admit to an addiction (and later in treatment, a disease) that I no longer have was humiliating and damaging.

My questions pertain to nagging feelings that the treatment program is not only a bad fit for my pattern of drug use (over 10 years, had quit many times; some with withdrawal other with no discomfort at all AND had not used for over two months when arrested) but a flood of plain bad science. (Let’s ignore the problem of forced NA attendance for an atheist.)

Your site confirms many of my suspicions. Since I haven’t the necessary scientific training to interpret data, I have to rely on informed and qualified commentators such as yourself.

So, then, a question about scientific data that I have not seen mentioned on your site. In the treatment classes we are often presented with the now-familiar MRI scans of ‘normal’ brains and ‘craving’ or ‘addicted’ brains, as well as the mantra that “drug use changes your brain.” In an excruciating Hazelden-produced video on the subject, a psychologist shows recovering addicts a lemon, then asks them to imagine biting into it, producing the expected physiological response. This in itself suggests such a large cognitive input that it seems to dispel the very biological, disease model that the video expounds!

I don’t think it takes a radically adventurous mind to realize that every behavior changes the brain, does it?  I’ve since referenced in your writings to the idea of drug use as part of a continuum of human behavior, something to which I intuitively subscribed, I wonder if there aren’t refutations of this simplistic and mechanistic explanation of addiction, craving, and the effects of drugs on the body.

Surely there are (though I can’t find them) studies showing that other pleasurable experiences, or even simply other cognitive or autonomous brain functions can change the brain in similar fashion?

This is for my own edification: dissent of any kind in the treatment classes would almost certainly find my case ‘staffed’ and time added to the treatment of my ‘disease.’

Sincerely,
David

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Dear David:

Not only are there available refutations to these videos typically shown by treatment programs, but you yourself have identified what they are! In the first place, if the imagination can create the brain scans associated with substance use, then the mind is obviously a critical ingredient in drug reactions. Moreover, as you correctly conjecture, all activities create brain activity. You don’t have to look for studies indicating that all pleasurable experiences impact the brain in related ways — the director of the National Institute on Drug Abuse (Alan Leshner) lectures around the country about this, which seemingly undercuts the need for a special branch of the government to deal strictly with drug abuse!

All of these things lead exactly to the point you make — that supposedly pleasurable stimulation of the brain (and everyone does not find the same things pleasurable) cannot account for why people become addicted to drugs. I hereby award you, Oz-like, the medal of “Deep Thinking About Addiction,” so that you can now declare yourself an addiction expert, one who surely makes more sense than the head of the NIDA.

Best regards,
Stanton