I love tea. Love. I only drink the stuff at certain times of the day, but when those times approach, I feel the urge, the pre-hit downer, the first-sip high, and I guzzle it down in excess. I recently listened to a Stuff You Should Know podcast on the pros and cons of caffeine consumption (tl;dr it's a mixed bag), and it got me thinking about the nature of addiction. Then I remembered a 1970s experiment that was carried out with rats which should have, by all rights, shaken our understanding of addiction to its foundations. Society pretty much ignored it. Let's bring it back up.
First, let's try to answer the simplest question: what is addiction? When we engage in an activity that is beneficial in some way - maybe it was eating something that tasted good (brains love calories), or maybe that crush of yours gave you a sneaky kiss (brains love implied future relations), or maybe you finally beat your friend at Pokémon (brains love OHKOs) - your limbic system, the brain's reward centre, kicks in and releases dopamine. Dopamine is the feel good chemical, a little treat for your good behaviour, because we're all overgrown children it seems. Dopamine binds to just the right receptors in the nervous system in just the right way to make you feel fantastic. Evolutionarily, it's a survival tool. Catching prey, escaping a predator, mating, etc., all would have been hard wired to release this feel good drug, because they all continue both your individual and species survival. Stay alive, make kids, thumbs up.
Our brains are wired to try and repeat these feel-good tasks. It's not just a psychological "I want to feel good again", the brain demands more dopamine releasing activities. We can't have a person forgetting to eat or mate! It would be a pretty short-lived species if we did the feel-good thing and said "right, box ticked, what's next?". No. We must do more of those things, and often! A question then arises: what if we trick our brains into releasing dopamine when we've done absolutely nothing beneficial? Are our brains really so stupid to demand we repeat the task? What if we trick it into releasing all the dopamine it has? Will it demand doing more of that thing at the expense of everything else?
One way to trick your brain is to fill it with various concoctions of chemicals. Heroin, for example, an opiod derived from the poppy plant, is a pretty good brain-tricker. Take it and your brain will release lots of that tasty tasty dopamine. At what point though does your brain start to demand we do that one thing more than all the other good things? Heroin addicts are known to stop eating, cut off all human relationships, and basically do nothing but heroin. Is it really as simple as they just took too much, their brains got used to it, and that was that? They were just hooked?
Well, the amount of dopamine released this way is so unusually high that after the dopamine has been broken down, the brain struggles to find its equilibrium again. It has a hangover, so-to-speak. Further, continued abuse interferes with the way the brain releases dopamine in the first place. All those hangovers are likely telling your brain that something is wrong, we must stop releasing so much dopamine all the damn time! A change takes place, and now only the most rewarding of activities - heroin - will release dopamine at all, and in ever smaller quantities. Small feel-good activities like eating or Pokémon will now no longer have any effect, and this is when the addiction is a physical disease of the brain, with physical changes visible under MRI scanners. If you're at this point, any attempts to recover will result in debilitating physical symptoms as your brain finds itself back to normal dopamine levels. Symptoms include, but are not limited to: convulsions, vomiting, being a complete asshole.
But what about sex addicts? Their addictions can be just as life crippling, yet there isn't this huge influx of dopamine going on. Sex does release dopamine, but at nowhere near the same levels. It does also release oxytocin, a calming chemical, but reserach has shown this to be completely non-addictive. What about food addicts? Or gambling addicts? Clearly we've only got part of the story of addiction here. What are we missing?
Experiments have been done on rats to show that drug addiction isn't human specific. These results showed that, if you give a lab rat a choice between pure water and morphine infused water it will keep going back for the morphine. Rats become addicts very quickly. There's a huge caveat to this observation though - these rats were caged. They weren't carefree rats about town, they were caged animals. So in the 70s, a group of scientists did something unusual - they repeated the morphine experiment, but this time not just in a cage, this time in rat heaven. Anything you could imagine a rat enjoying, like climbing frames, things to chew on, tasty food, and sexy other rats to go have private time with, were all in abundance. The results? In rat heaven, the rats didn't become addicts, they preferred regular water. They had no concept of what an addiction was, they just knew that one was water, and one was water with something in it that made them feel good. Caged rats had the feel good water every single time, but heaven rats only dabbled. They took the drugs, the free drugs with no known consequences, roughly 18 times less frequently.
What's even more amazing is that, if the caged rats that had spent 57 days on nothing but the drug concoction were then moved to heaven, they stopped taking drugs. They started drinking regular water, showing some temporary physical symptoms of withdrawal (twitching, ass-holery), but they cleaned themselves up without being prompted to. I can't stress this point enough - without any concept of the downsides of addiction, these rats cleaned themselves up! They must have just been so happy with their change of situation, that they no longer felt they needed a chemical hit to feel good. This runs a little counter to the idea that we're hard-wired to always chase the dopamine high, particularly when we've ridden the dragon for a while.
When America was at war with Vietnam, the horrors of the war drove many American soldiers to heroin abuse. Completely understandable. Back home, family, friends and strangers alike were getting a bit concerned about an influx of heroin addicts once the war ended. Despite the worry, when the war was over, only 5% of heroin users remained addicts, and 95% just got back on with their lives. Heaven, it seems, is sobering (though I bet many of the sober 95% dabbled). Answering our earlier question of whether our brains can really be stupid enough to chase a pointless dopamine rush... The answer is that it depends on how miserable the human is!
Like humans, rats are social creatures - if you've ever heard of a King-rat then you'll know that rats' social nature can be pretty disgusting - and it seems that the best way to de-drug a rat is to put it in a comfortable social situation. There is, without a doubt, an unavoidable chemical element to addiction, it can't just be ignored that certain drugs will rewire our brains to desire more of the feel-good-thing. But it also seems that the best path to both recovery and avoiding drug addiction in the first place is to put the user in a stable environment, surrounded by supportive friends and family, with opportunity to live the lives they want to live. It's not always drugs either, any activity that releases dopamine could be what fills the unique void in their life. Gambling, for some odd reason, releases as much dopamine when you almost win, as it does when you actually win, so you can see how people get hooked even when they're losing! It's likely though that it's only the people who aren't happy with their lives that would chase this gambling high with the knowledge that they just lost!
We should also note that humans are not rats. One of the key differences is the role of psychology. For example, smokers are far less likely to quit smoking if they don't think that they're capable, even if they're forced to go cold Turkey until their dopamine production returns to normal. In fact, several studies have shown that habitual addiction can last far longer than the physical addiction that's visible on brain scans. By telling ourselves that we're addicted, that we need that 10 am crutch just to get the day going, we set up psychological barriers that a rat won't have to deal with. Then there's the rose-tinted glasses we wear when remembering the past. "Remember the good old days, when people were nice to each other, we weren't all on facebook all the time, and the cocaine flowed freely?". Being sober long enough isn't sufficient when we can convince ourselves that past-me had it good! Our big brains, it seems, could be a hinderance.
There's no one answer to addiction. Everyone is an individual with individual problems. Being surrounded by your family might be a blessing for some, but for others it might be what's caused the depression that led them to feel the need to turn to substance abuse in the first place, and depression is a very complex disease worthy of its own blog post. What's absolutely not the answer though is ostracising the addicted, or worse, sending them to prison.
Remember what happened to that rat in the cage?
I must thank Kurzgesagt - In a Nutshell, a fantastic YouTube channel, who some months back did a video on addiction from which the heart of this post is derived. I feel like a bit of a fraud for passing some of these thoughts off as my own, but when they did such a bang-up job, what's a blogger to do? Now... Is anyone going to put the kettle on?!