Addiction Is Not A Disease Of The Brain

By on September 13, 2011 in News 43

OCDAlva Noe explains at NPR:

Addiction has been moralized, medicalized, politicized, and criminalized. And, of course, many of us are addicts, have been addicts or have been close to addicts. Addiction runs very hot as a theme.

Part of what makes addiction so compelling is that it forms a kind of conceptual/political crossroads for thinking about human nature. After all, to make sense of addiction we need to make sense of what it is to be an agent who acts, with values, in the face of consequences, under pressure, with compulsion, out of need and desire. One needs a whole philosophy to understand addiction.

Today I want to respond to readers who were outraged by my willingness even to question whether addiction is a disease of the brain.

Let us first ask: what makes something — a substance or an activity — addictive? Is there a property shared by all the things to which we can get addicted?

Unlikely. Addictive substances such as alcohol, heroin and nicotine are chemically distinct. Moreover, activities such as gambling, eating, sex — activities that are widely believed to be addictive — have no ingredients.

And yet it is remarkable — as Gene Heyman notes in his excellent book on addiction — that there are only 20 or so distinct activities and substances that produce addiction. There must be something in virtue of which these things, and these things alone, give rise to the distinctive pattern of use and abuse in the face of the medical, personal and legal perils that we know can stem from addiction…

[continues at NPR]

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  • Guest

    Clueless.

  • http://www.facebook.com/people/Brent-Andrew-DeBoard/661165331 Brent Andrew DeBoard

    lolwut

  • http://www.facebook.com/people/Brent-Andrew-DeBoard/661165331 Brent Andrew DeBoard

    lolwut

  • Fshfjkshk

    Seriously? It’s not necessarily an addiction to an external substance, it can be an addiction to a substance that, when doing certain activities, increases the production of certain natural chemicals in the brain associated with pleasure. People want to keep doing whatever makes them feel good.

  • iPINCH

    dopamine 

  • Dunzain

    A Swedish (adult) cartoon character named ‘Arne Anka’ had a great comment (regarding alcoholism). 

    “I don’t have any problems with alcohol, I have problems with the reality.”

  • Dunzain

    A Swedish (adult) cartoon character named ‘Arne Anka’ had a great comment (regarding alcoholism). 

    “I don’t have any problems with alcohol, I have problems with the reality.”

  • Thoughts

    I would have love to hear how Freud would have read the addiction hysteria in the US that has been through so many phases since the crack 80′s. I cannot help but think that he would point out the repetitive loop of compulsive consumption that defines addiction is nothing but a pared down, reduced version of what characterizes all life: todestrieb. What are most normative human activities in many respects but more complex and circuitous forms of addiction constitutive of cultural norms? I could go on about this for pages … but what stands out in my mind is simply that Freud did something intellectually that I think more people, particularly people today, should all do more often: consider that what appears to be exceptional and aberrant in human behavior is just part of typical and familiar human behavior appearing obscured by the mask of overt visibility. We do not recognize ourselves under a microscope.

  • Thoughts

    I would have love to hear how Freud would have read the addiction hysteria in the US that has been through so many phases since the crack 80′s. I cannot help but think that he would point out the repetitive loop of compulsive consumption that defines addiction is nothing but a pared down, reduced version of what characterizes all life: todestrieb. What are most normative human activities in many respects but more complex and circuitous forms of addiction constitutive of cultural norms? I could go on about this for pages … but what stands out in my mind is simply that Freud did something intellectually that I think more people, particularly people today, should all do more often: consider that what appears to be exceptional and aberrant in human behavior is just part of typical and familiar human behavior appearing obscured by the mask of overt visibility. We do not recognize ourselves under a microscope.

  • Anonymous

    “…there are only 20 or so distinct activities and substances that produce addiction.”

    Not true. You can be addicted to anything.

  • Micho_rizo

    I’ve been an addictions counselor for two years now. Those with addictions deserve nothing short of the utmost empathy, compassion and care. However, it’s not a disease of the brain. It’s not the same thing as Parkinson’s or Tourrettes. Behaviors are not diseases. If they were, playing the piano exceptionally well would be a disease. Yes, things happen in the brain of an addict–things also happen in the brain of someone playing piano, or watching a good TV show or a funny comedian or having sex or eating a tasty meal. It’s just that within the addicted brain, these processes are more intense–but not even all that much (a crack addict’s brain activity is almost identical to someone who hasn’t eaten all day–which is bad, but plenty of people go all day without eating, so it can be done).

    Even if it were a disease of the brain, those with addictions would seek treatment from a Neurologist, as opposed to a counselor or a psychiatrist.  Someone with a genuine brain disease such as Parkinson’s doesn’t go to a counselor or a psychiatrist to deal with their primary symptoms, why should someone with an addiction? There is a lot of money to be made by labeling an addiction a disease, and so that is why there is this big push to qualify it as such.

    I do not exaggerate when I say every single human being with an addiction that I have worked with has deep and profound psychological scars…usually stemming from incidents that occurred during childhood and their teen years (occasionally a harsh divorce or a tragedy later in life can lead to addiction in an otherwise psychologically healthy individual). This might just be a correlation, but I think it’s a pretty strong one, and one that probably suggests that addiction is more psychological than neurological (although, yes, some genes make one more susceptible to addiction. Just as some genes make one more susceptible to running fast or being musically inclined–but again, we don’t label any of those behaviors as “diseases”)

  • Anonymous

    Where does the ‘agency’ of the ‘self’ end, and the ‘external environment’ begin? You can make the cut anywhere you like, but the distinction will always be arbitrary.

  • Shinken62169

    I claim BULLSHIT!! having done all these…I can say it is basically anything that fires Endorphins, and stimulates the release and/or production of Serotonin and/or Dopemine.
       Thats why I gave up food and breathing…..they are addictive.

  • Anonymous

    Freud, not only was an “addict” himself, he has been widely denounced by the academic mainstream ESPECIALLY in regards to social psychology and the use of freudian sociology. What you are positing as normative – i see as a direct result of contemporary society’s system(s) of organisation and hierarchy.

  • Anonymous

    http://www.democracynow.org/2010/2/3/addiction

    Dr. Gabor Mate on addiction and childhood trauma.

  • Samaritan

    Addiction is not a disease, it’s a decision. Stop using “disease” as a crutch to hide behind. If you used the will power to drink, and drink, and drink and drink and drink again. (exchange drink with anything you’d like) then you have the willpower to stop. It’s not a disease, it’s a decision.

  • Samaritan

    Addiction is not a disease, it’s a decision. Stop using “disease” as a crutch to hide behind. If you used the will power to drink, and drink, and drink and drink and drink again. (exchange drink with anything you’d like) then you have the willpower to stop. It’s not a disease, it’s a decision.

  • Thoughts

    Freud was indeed a cocaine addict. However, that is moot. Freud has been widely denounced by the academic mainstream because the academic mainstream is normative, not because Freud was. To the contrary, Freud was the most non-normative psychologist of the 20th century. Read his essays on sexuality, Civilization and its Discontents, Totem and Taboo, etc… Freud challenged the idea of normativity more than almost any other thinker in written history. That what is seen as normal is really a consequence of social organization and hierarchy was my point about Freud, and was Freud’s point over and over again about social norms (this is why I used the term “normative” and not normal). It was in contrast, mainstream psychology that reasoned in terms of normalcy and how to punitively beat it into people using operant conditioning and Behaviorism. That Freud’s views were normative is total conservative propaganda perpetuated by normative American sociology. Mainstream academic psychology did not understand Freud at all, and manipulatively constructed a straw man of his ideas.

  • DeepCough

    Here’s a little word history. The word “addiction” comes from the Latin “dicere” which means “to speak” with the prefix “ad” meaning “to” or in this case “for.” And while the etymology of the word “drug” is rather obscure, it apparently also means “demon” in Vedic mythology, so “drug addiction” actually means “to speak for a demon,” and in religious connotations, this is just a way of defining bad behavior.

    Now as far as this study is concerned, I’m inclined to agree that gambling and sex aren’t as habituating as cocaine and opium are, but I strongly question this focus on dopamine as a tad fallacious, because it should be known by now–what with the decoding of the humane genome and all–that while a single chemical can have a profound effect on the body and brain, it is NOT the only one In the body. That’s why I’m now concerned about how this study will just lead to another pharmaceutical solution called “Doperall” to help fill the overflowing coffers of the mental health industry.

  • http://hormeticminds.blogspot.com/ Chaorder Gradient

    The world needs more people like you: those that understand people can have problems in the mind but not the brain, and what that really means.

  • http://hormeticminds.blogspot.com/ Chaorder Gradient

    you’ve never really been addicted to anything have you?

  • Okarin

    addiction is marketing’s holy grail as many addictions are to products that have a brand behind it rather then addictions to priceless and beneficial habits

  • AliRulz

    i agree 110%. The father of my child is an addict, and he uses any excuse he can to use. (usually being me.) It’s a conscious decision to decide “am i going to use, or am i not going to use?” addicts don’t have a disease, it’s not an illness… it is a pure lack of self control. they want what they want, when they want it. not just with their addiction but in every aspect of their lives. I’ve grown up around drug and alcohol counseling. both my grandmother and great grandmother have being doing it for years. Seeing the people that come in and out all have the same pattern. it’s about conforming to your friends’ idea of fun, and self gratification. if that’s categorized as a disease…please, sign me up. drug addiction is a simple enough fix… leave where you use. move to a new town where you have no connections, and no friends. if you continue to look for it… bet money on you getting arrested. with alcohol, again…it’s a conscious decision.no one other than yourself makes you walk into the liquor store. no one makes you drink or use drugs because of your past. Drug/ Alcohol use to suppress your past is a joke. anyone can name something bad that happened in their childhood… i can think of plenty… but i’m not a user. to sum this up… addiction is not an addiction… it’s a self gratifying choice to slowly cause your life to deteriorate in front of your eyes just to “feel good”.

  • Izkata

     Very basic addiction cycle, with the 1st step including more information than a lot of people consider:

    1.  You start using a substance or doing an activity that produces unusually high amounts of certain chemicals in the brain (such as dopamine)
    2.  Your brain gets used to those high levels
    3.  Loss of those levels (when the activity/substance use is over) creates an urge to return to them
    4.  The substance or activity is something that you can build a tolerance to, and so require more of when you return to it
    5.  You get used to those higher levels and the cycle repeats

    Oversaturation of the brain with certain chemicals that are normally naturally produced, is the one thing that all types of addiction have in common.  However, I wouldn’t cause it a disease, as the initiator is still by choice.

  • E.B. Wolf

    RE “Stop using ‘disease’ as a crutch to hide behind.” It’s not the addicts themselves pushing the disease concept; it’s the treatment industry drilling the idea into addicts heads that they have a disease.

  • E.B. Wolf

    RE “Stop using ‘disease’ as a crutch to hide behind.” It’s not the addicts themselves pushing the disease concept; it’s the treatment industry drilling the idea into addicts heads that they have a disease.

  • E.B. Wolf

    Excellent points. The addiction counseling industry definitely needs more people like you who don’t parrot the 12 Step Cult’s talking points and slogans.

  • E.B. Wolf

    Excellent points. The addiction counseling industry definitely needs more people like you who don’t parrot the 12 Step Cult’s talking points and slogans.

  • Ronniedobbs

    Your compassion is truly overwhelming….

  • WakeUP

    YOUR LOGIC IS FLAWED

  • Dapotpie

    You didn’t actually read the article did you? 

    ” Addictive substances such as alcohol, heroin and nicotine are
    chemically distinct. Moreover, activities such as gambling, eating, sex —
    activities that are widely believed to be addictive — have no
    ingredients.”

    So what they are saying is that there are only 20 substances that are physically addictive meaning your body will not function properly without it.  Technically it is true that anything you do in excess is defined as an addiction but the point I believe the author is making is that there is a clear difference between an addiction to sex and an addiction to crack.  The only withdrawal symptoms the sex addict will experience are no more intense than the withdrawal symptoms you would get if someone took away your favorite activity.  The crack addict on the other hand will experience the following symptoms:

    -agitation
    -intense craving for
    the drug -extreme fatigue-anxiety-angry outbursts-lack of motivation-nausea/vomiting-shaking-irritability-muscle pain-disturbed sleep

    I smoke lots and lots and lots of weed and so by definition I am an “addict”.  However when I go on vacation for several weeks (and have no access to dank) I do not experience any withdrawal symptoms other than a slight urge to smoke the first day or two and after that I forget all about it.  People who claim to be “addicted” to substances that are not physically addictive, nine times out of ten just lack the motivation or will power to stop doing whatever they’re doing.

  • Sirius Fnord

    Well said,

      I myself have been addicted to many different things over the years  and yes i was a victim of severe childhood abuse and bullying. I also agree that addiction isn’t a disease rather a state of mind or rather an overworked pattern or program.Ask yourselves what is the biggest most common addiction to date shared by almost everyone.Answer: Economic and monetary systems.As an overall species we will condone poverty and war and condemn generations to slavery, backward evolution, misery and idiocy.Now how quick we all are to be disgusted at the addict stealing or worse to feed their habit when we all are guilty of the same.Problems are not solved because that enables money to be made and i assume this means as a species we desire money and items more than solving our species problems. Well that sounds like addiction to me.  How about you?  

  • Inspectorlestrade2

    The one thing that all addictions have in common is their feeding into the reward mechanisms of the brain. When things are done in a certain way, the reward centers get out of wack and an addiction can develop. The scientific criteria for an addiction are as outlined below. Addictions are consequences of abnormal functioning of the reward centers of the brain. Addiction is most definitely a disorder, like insomnia. It is not, however a disease, like cancer. Disorders result directly from human action ( drinking alcohol, taking drugs, having sex) and mean a normal function is out of order. Diseases also result from disorder but do not result directly from human action. What caused the alcoholism? Drinking alcohol. What caused the cancer? Who knows?

    Answer yes or no to the following seven questions. Most questions have more than one part, because everyone behaves slightly differently in addiction. You only need to answer yes to one part for that question to count as a positive response.Tolerance. Has your use of drugs or alcohol increased over time?
    Withdrawal. When you stop using, have you ever experienced physical or emotional withdrawal? Have you had any of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting?
    Difficulty controlling your use. Do you sometimes use more or for a longer time than you would like? Do you sometimes drink to get drunk? Do you stop after a few drink usually, or does one drink lead to more drinks?
    Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?
    Neglecting or postponing activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?
    Spending significant time or emotional energy. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?
    Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?If you answered yes to at least 3 of these questions, then you meet the medical definition of addiction. This definition is based on the of American Psychiatric Association (DSM-IV) and the World Health Organization (ICD-10) criteria.(1)

  • Monkey See Monkey Do

    I believe addiction is a mental illness related to obsessive-compulsive behaviour. ‘An individual will be inclined to compulsively act in order to increase good emotions and decrease bad emotions’.  They’ll sustain their addiction to decrease irregular feelings of depression, anxiety etc even at the detriment of their lives.

    If addictions are understood in terms of mental illness instead of physical diseases then the picture gets less blurry and there is good reason to show compassion.
    Instead of a simple ‘write off’ that its a “decision” you should know that the decisions get much harder and blurrier for addicts.

  • Monkey See Monkey Do

    I believe addiction is a mental illness related to obsessive-compulsive behaviour. ‘An individual will be inclined to compulsively act in order to increase good emotions and decrease bad emotions’.  They’ll sustain their addiction to decrease irregular feelings of depression, anxiety etc even at the detriment of their lives.

    If addictions are understood in terms of mental illness instead of physical diseases then the picture gets less blurry and there is good reason to show compassion.
    Instead of a simple ‘write off’ that its a “decision” you should know that the decisions get much harder and blurrier for addicts.

  • Aninlala

    Eating, sex and gambling can all result in higher levels of hormones in the brain, and while all of the chemicals in the substances you mentioned are different, the way the addiction occurs is the same – the brain becomes dependant on that chemical, regardless of what it is. This is why someone who is addicted to gambling isn’t necessarily addicted to alcohol. It is chemical specific. Not to say that person isn’t more likely to be addicted to alcohol. I don’t disagree with what you are saying in general – just wanted to comment that.

  • Guest

    Umm…reward pathways? In the brain, funnily enough. Also, ‘distinct pathways’ does not mean you can say ‘these things alone’ are special, yes, addictions to these are more prevalent, but people become addicted to a variety of behaviours. Habits are low level addictions, it is all down to reward pathways. 

  • http://www.facebook.com/agent139 Jamie Lee

    You’ve missed the point in quite a few ways, “Samaritan.” (But not a Good one, I’ll wager.) 

  • http://www.facebook.com/agent139 Jamie Lee

    Some people are weaker willed than others, though I don’t know how you’d measure it. But that’s not what addiction is. By definition if someone is truly addicted to something, they can’t simply will themselves to stop. So maybe the person in your case study of one is just weak willed, who am I to say. That doesn’t, however, encompass the spectrum of addiction. Not even close. 

  • AliRulz

    I’m sorry, but i have zero compassion for addicts. They all have selfish tendencies it’s part of having an addictive personality. I’ve grown up around it my entire life and everyone’s story is the same. There was never any reason to start using or gambling…it was just fun. By the time they realize they have a problem it’s already too late because they’re sucked into the ” it makes me feel good” aspect of it and that’s all any addict cares about. i maybe blunt and it may sound heartless… but it’s the truth. I don’t try to sugar coat things when there’s no good to come out of it.

  • AliRulz

    also, i noticed that someone commented on Samaritan’s post saying “you’ve never been addicted to anything have you?” Samaritan and I have the same kind of idea… and with that being said I was addicted to alcohol for about 3 years. Drinking an entire bottle alone every night. I used my addiction as a crutch and hurt my family, and lost most of my friends. I didn’t stop by going to rehab or counseling, i took a step back an realized that i was wasting my life on something that was pointless. it didnt make me feel better, or fix my problems. If anything it ended up causing more problems. I made the conscious decision, by myself that i needed to stop worrying about feeling good. It was time to take responsibility for my actions and make a change. so, just because i have the views on addiction that i do… doesn’t mean i haven’t been there myself or because i dont know what it’s like. Infact it’s just the opposite, I have these opinions because i HAVE been there I DO know what it’s like and I DO know you have the ablilty to stop…. most just lack the will power.   

  • Earaches

    “Behaviors are not diseases.”

    Thank You Mr. Rizo!

  • Alternity

    Maybe Logic is the Flaw.