Can You Get Over an Addiction? | New York Times | Jun 2016 | by Maia Szalavitz
I SHOT heroin and cocaine while attending Columbia in the 1980s, sometimes injecting many times a day and leaving scars that are still visible. I kept using, even after I was suspended from school, after I overdosed and even after I was arrested for dealing, despite knowing that this could reduce my chances of staying out of prison.
They kept hoping I would just somehow stop, even though every time I tried to quit, I relapsed within months.
There are, speaking broadly, two schools of thought on addiction:
The first was that my brain had been chemically “hijacked” by drugs, leaving me no control over a chronic, progressive disease.
The second was simply that I was a selfish criminal, with little regard for others, as much of the public still seems to believe
We are long overdue for a new perspective — both because our understanding of the neuroscience underlying addiction has changed and because so many existing treatments simply don’t work.
Addiction is indeed a brain problem, but it’s not a degenerative pathology like Alzheimer’s disease or , nor is it evidence of a criminal mind.
Instead, it’s a learning disorder, a difference in the wiring of the brain that affects the way we process information about motivation, reward and punishment. And, as with many learning disorders, addictive behavior is shaped by genetic and environmental influences over the course of development.
Scientists have documented the connection between learning processes and addiction for decades.
The studies show that addiction alters the interactions between midbrain regions like the ventral tegmentum and the nucleus accumbens, which are involved with motivation and pleasure, and parts of the prefrontal cortex that mediate decisions and help set priorities.
In essence, addiction occurs when these brain systems are focused on the wrong objects:
a drug or self-destructive behavior like excessive instead of a new sexual partner or a baby
If, like me, you grew up with a hyper-reactive nervous system that constantly made you feel overwhelmed, alienated and unlovable, finding a substance that eases social stress becomes a blessed escape. For me, heroin provided a sense of comfort, safety and love that I couldn’t get from other people
This means that addicts can learn to take actions to improve our health, like using clean syringes, as I did. Research overwhelmingly shows such programs not only reduce , but also aid recovery.
The learning perspective also explains why the compulsion for alcohol or drugs can be so strong and why people with addiction continue even when the damage far outweighs the pleasure they receive and why they can appear to be acting irrationally:
If you believe that something is essential to your survival, your priorities won’t make sense to others.
Moreover, if addiction resides in the parts of the brain involved in love, then recovery is more like getting over a breakup than it is like facing a lifelong illness.
Healing a broken heart is difficult and often involves relapses into obsessive behavior, but it’s not brain damage.
To return our brains to normal then, we need more love, not more pain.
studies have not found evidence in favor of harsh, punitive approaches, like jail terms, humiliating forms of treatment and traditional “interventions” where families threaten to abandon addicted members.
In line with the idea that development matters, research also shows that half of all addictions — with the exception of tobacco — end by age 30, and the majority of people with alcohol and drug addictions overcome it, mostly without treatment. I stopped taking drugs when I was 23. I always thought that I had quit because I finally realized that my addiction was harming me.
But it’s equally possible that I kicked then because I had become biologically capable of doing so. During , the engine that drives desire and motivation grows stronger. But unfortunately, only in the mid-to-late 20s are we able to exert more control.
This is why adolescence is the highest risk period for developing addiction — and simple maturation may be what helped me get better.
Indeed, if the compulsive drive that sustains addiction is directed into healthier channels, this type of wiring can be a benefit, not just a disability.
After all, persisting despite rejection didn’t only lead to addiction for me — it has also been indispensable to my survival as a writer. The ability to persevere is an asset: People with addiction just need to learn how to redirect it.
Author: Maia Szalavitz is the author of “Unbroken Brain: A Revolutionary New Way of Understanding Addiction.”