Addiction

Every form of addiction is bad, no matter whether the narcotic be alcohol or morphine or idealism. Carl Gustav Jung 

 

I didn’t decide to drink myself to death. It is a result of alcoholism. George Best

 

____________________

 

In a previous post, Welcome to the Psychosphere, I referred to the increasing use of the term addict so that it could apply to almost any human activity.  I thought that it would be a good idea to examine this question in greater depth.

Science has provided a lot of insights into the causes and effects of addiction. One important area of investigation is whether some people have a genetic predisposition towards addiction. There is most definitely not a single addiction gene; susceptibility to addiction is the result of many interacting genes. Addictionologists have theorized that some people may have deficiencies in their brain reward systems. I have been on the web looking up some of the experiments carried out by scientists, a lot of which involve mice (their reward pathways functions in much the same way I as humans). I found a really informative page produced by the Genetic Science Learning Center at the University of Utah. Here are some of the things I learned:

  • Increased expression of the Mpdz gene results in mice experiencing less severe withdrawal symptoms from sedative-hypnotic drugs such as barbiturates.
  • Mice with low levels of neuropeptide Y drink more alcohol, whereas those with higher levels tend to abstain.
  • Non-smokers are more likely than smokers to carry a protective gene, CYP2A6, which causes them to feel more nausea and dizziness from smoking.
  • Alcoholism is rare in people with two copies of the ALDH*2 gene variation.

But genetics does not equal destiny and environment also plays a vital role.

Science has also advanced rapidly in what happens in addicts’ brains. Drugs change brain chemistry, which causes behaviour to change. fMRIs and PET scans have enabled investigators to pinpoint what goes wrong in the brain of an addict. They are developing a more detailed understanding of how deeply and completely addiction can affect the brain, hijacking memory-making processes and exploiting emotions. Maybe with this knowledge, scientists will be able to design new drugs that will prevent addicts relapsing. But until that happens we need to look at other solutions

Alcoholics Anonymous, which celebrates its 75th anniversary this year, is undoubtedly the most famous organisation that deals with addiction. The man responsible was a drunken stockbroker named Bill Wilson. He was undergoing treatment at the Towns Hospital, an upmarket detox centre, where he had already stayed unsuccessfully on a number of occasions. His Wall Street career had been destroyed and he was deep in debt. Lying in a hospital bed, still heavily under the influence of belladonna, in desperation Wilson, called out:

“If there is a God, let Him show Himself!  I am ready to do anything. Anything!”

Then according to AA lore, white light filled the hospital room, as God revealed himself. Wilson, who until this experience had been an agnostic, would never drink again.

He went on to write a book Alcoholics Anonymous, now better known as the Big Book. At the heart of the book were the famous 12 steps:

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed, and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

The rest as they say is history. The organisation, which was non-profit had an ethos that would be described as open-source, anyone could start a meeting based on the 12 steps. There was no centralised quality control. Nobody was told you have to do it this way. This has been one of its great strengths.

They have been highly successful; they claim a membership of more than two million. AA have popularised the disease theory of alcoholism, which also seems to be the current mainstream scientific and medical consensus, although this is still the subject of debate. A more difficult question is its effectiveness, where I have seen estimates, which range from 5% to 75%. It is an area which is notoriously difficult to measure. In general it is very difficult to go dry no matter what method you use.

Alcoholics Anonymous has spawned a whole series of spin-offs. A quick glance at Wikipedia and you will see Gamblers Anonymous, Debtors Anonymous, Food Addicts Anonymous, Workaholics Anonymous Clutterers Anonymous, Sex Addicts Anonymous and even Pagans in Recovery. I’m rather sceptical about the transfer of the model of addiction to behaviour.

For example I remember seeing a story about tanning addiction. This is one those typical newspaper scare stories which come with those typical questions looking for signs that you may be addicted: Do you feel guilty about how much you tan? Have you tried to cut back but failed? Have you missed important activities because you chose to tan instead? The conclusion is that up to 39% of tanners are tanning addicts.

The massive growth of addiction is a very worrying phenomenon. We are told of the progressive nature of these diseases. The message is if you think you have a problem, then indeed you do. If you say you are not an addict, then you are in denial. 

But ultimately there must be personal responsibility. We have to know our limits. I use the internet a lot, maybe too much but I do not consider myself an addict. When I go on holiday I normally have a break for a month and I feel fine. I have often wondered if I could stop drinking tea and coffee. I have never tried. I have always been wary of getting hooked on drugs or alcohol because I think I would find it very hard to get off. I have a curious relationship with alcohol – I love the effects but I hate the taste. Maybe it’s genetic. I really do admire those people who are able to get off drugs or alcohol but I’m not sure I would be able to do it. So I prefer to be cautious. I think the overuse of the term addiction is very dangerous – it makes us feel like passive victims. Almost every human activity is being pathologised. In the face of this barrage a healthy dose of scepticism is surely the best antidote.

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One Response to Addiction

  1. Robert says:

    VERY well written Martin. And to quote somebody else’s words in the context of a review of a new opera “I more or less agree with about half of of it.” Just kidding….good stuff.

    Robert

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