Very interesting POV, helped me understand the addict brain better
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Join Date: Oct 2014
Posts: 412
David Scheff addresses this in his book 'Clean'. He's done a heck of a lot of research including some of the most modern science we currently have on addiction.
His opinion is that addiction is most definitely a disease, and I believe he explains it as a brain disease, or at least he show how addicts brains are affected which makes it very hard to stop.
As for me, I think it's a disease. However it seems a very complex condition, and I can safely say 'I don't really know!'.
His opinion is that addiction is most definitely a disease, and I believe he explains it as a brain disease, or at least he show how addicts brains are affected which makes it very hard to stop.
As for me, I think it's a disease. However it seems a very complex condition, and I can safely say 'I don't really know!'.
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Join Date: Feb 2012
Location: Stoughton, MA
Posts: 44
I don't understand some of the replies in this thread. Are some people upset because they think the author is saying that it is not a disease? From what I've read he said "some people" don't know or don't believe that it is a real physical disease, not that he himself didn't or that it is not.
This article as far as I can tell, wasn't necessarily a medical journal publication but an article in more laymens terms for regular people to get a grip on understanding it. I have read plenty of stuff on it and how it changes the brain, whether the brain ever gets back to normal etc. even doctors do not fully understand addiction so how can we expect the everyday person to?
As for the tolerance. My understanding is that while they may not be able to go back to their full dose the first time they use, that they can within the first few days. My A is certainly proof of that. He was doing 80 mg oxy's pretty quickly.
I'm not here to debate or argue with anyone. If this helps a few people feel less anguished then great. I think we could all use a little less stress right now.
This article as far as I can tell, wasn't necessarily a medical journal publication but an article in more laymens terms for regular people to get a grip on understanding it. I have read plenty of stuff on it and how it changes the brain, whether the brain ever gets back to normal etc. even doctors do not fully understand addiction so how can we expect the everyday person to?
As for the tolerance. My understanding is that while they may not be able to go back to their full dose the first time they use, that they can within the first few days. My A is certainly proof of that. He was doing 80 mg oxy's pretty quickly.
I'm not here to debate or argue with anyone. If this helps a few people feel less anguished then great. I think we could all use a little less stress right now.
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Join Date: Dec 2013
Posts: 213
"Disease" is not actually the "very definition" of "addiction." Look it up in any dictionary, and while you're there, look at the etymology of the word "addiction."
I am not arguing against the theory that it is a disease, just that "disease" is not its definition.
One thing about Melissa's post I do question: you say the brain is such a marvelous organ that it can make new receptors. IMO it follows logically that if it can make new receptors it can also unmake old ones.
Do you know if this is the case? I mean, the brain is truly a miraculous organ, and God who made it also heals us, so seems to me the receptors, when no longer being fed, could be unmade or desensitized, or something?
From what I have read, even medical "experts" do not agree as to whether addiction is a disease or not. I don't think anybody knows for sure, and I think that that is one reason it is so hard to "cure."
Similarly, the 12-step programs work for a lot of people, but not for a lot of others, and some people with more knowledge and experience than I have believe that the 12-step program is outdate and not effective, while others know it is great because it has worked for them.
No two people are alike.
I am not arguing against the theory that it is a disease, just that "disease" is not its definition.
One thing about Melissa's post I do question: you say the brain is such a marvelous organ that it can make new receptors. IMO it follows logically that if it can make new receptors it can also unmake old ones.
Do you know if this is the case? I mean, the brain is truly a miraculous organ, and God who made it also heals us, so seems to me the receptors, when no longer being fed, could be unmade or desensitized, or something?
From what I have read, even medical "experts" do not agree as to whether addiction is a disease or not. I don't think anybody knows for sure, and I think that that is one reason it is so hard to "cure."
Similarly, the 12-step programs work for a lot of people, but not for a lot of others, and some people with more knowledge and experience than I have believe that the 12-step program is outdate and not effective, while others know it is great because it has worked for them.
No two people are alike.
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Join Date: Feb 2012
Location: Stoughton, MA
Posts: 44
Firesong... One of the things I thought of when this post talked about growing new receptors but not getting rid of old ones was fat cells. When you gain weight, your body makes more fat cells. When you lose weight, they shrink and become deflated but they do not go away. Hence part of the reason overweight people have a hard time. Gaining a lot of weight at a young age can alter your metabolism. I remember a young girl, 22, on the biggest loser, the dr told her because of her body fat percentage at her age the rest of her life would be a battle. Sounds familiar huh?
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from the book Beyond Addiction
Here is another POV, along similar lines:
From another corner of neuroscience, we’re learning about a neurotransmitter called dopamine. Though there are more than fifty neurotransmitters (that we know of), scientists studying substance problems have given dopamine much of their attention. The brain’s reward system and pleasure centers—the areas most impacted by substance use and compulsive behaviors—have a high concentration of dopamine. Some brains have more of it than others, and some people have a capacity to enjoy a range of experiences more than others, owing to a combination of genetics and environment. The thing about dopamine is that it makes us feel really good. We tend to want more of it. It is naturally generated through ordinary, pleasurable activities like eating and sex, and it is the brain’s way of rewarding us—or nature’s way of rewarding the brain—for activities necessary to our survival, individually or as a species. It is the “mechanism by which ‘instinct’ is manifest.” Our brains arrange for dopamine levels to rise in anticipation and spike during a pleasurable activity to make sure we do it again. It helps focus our attention on all the cues that contributed to our exposure to whatever felt good (these eventually become triggers to use, as we explain later). Drugs and alcohol (and certain behaviors) turn on a gushing fire hose of dopamine in the brain, and we feel good, even euphoric. Dopamine produced by these artificial means, however, throws our pleasure and reward systems out of whack immediately. Flooding the brain repeatedly with dopamine has long-term effects and creates what’s known as tolerance—when we lose our ability to produce or absorb our own dopamine and need more and more of it artificially just to feel okay. Specifically, the brain compensates for the flood of dopamine by decreasing its own production of it or by desensitizing itself to the neurotransmitter by reducing the number of dopamine receptors, or both. The brain is just trying to keep a balance. The problem with the brain’s reduction in natural dopamine production is that when you take the substance or behavior out of the picture, there’s not enough dopamine in the brain to make you feel good. Without enough dopamine, there is no interest or pleasure. Then not only does the brain lose the pleasure associated with using, it might not be able to enjoy a sunset or a back rub, either. A lowered level of dopamine, combined with people’s longing for the rush of dopamine they got from using substances, contributes to “craving” states. Cravings are a physiological process associated with the brain’s struggle to regain its normal dopamine balance, and they can influence a decision to keep using a substance even when a person is experiencing negative consequences that matter to him and a strong desire to change. Depending on the length of time and quantities a person has been using, these craving states can be quite uncomfortable and compelling. The dopamine system can and does recover, starting as soon as we stop flooding it. But it takes time, and in the time between shutting off the artificial supply of dopamine and the brain’s rebuilding its natural resources, people tend to feel worse (before they feel better). On a deep, instinctual level, their brains are telling them that by stopping using, something is missing; something is wrong. This is a huge factor in relapse, despite good intentions and effort to change. Knowing this can help you and your loved one make it across this gap in brain reward systems.
From another corner of neuroscience, we’re learning about a neurotransmitter called dopamine. Though there are more than fifty neurotransmitters (that we know of), scientists studying substance problems have given dopamine much of their attention. The brain’s reward system and pleasure centers—the areas most impacted by substance use and compulsive behaviors—have a high concentration of dopamine. Some brains have more of it than others, and some people have a capacity to enjoy a range of experiences more than others, owing to a combination of genetics and environment. The thing about dopamine is that it makes us feel really good. We tend to want more of it. It is naturally generated through ordinary, pleasurable activities like eating and sex, and it is the brain’s way of rewarding us—or nature’s way of rewarding the brain—for activities necessary to our survival, individually or as a species. It is the “mechanism by which ‘instinct’ is manifest.” Our brains arrange for dopamine levels to rise in anticipation and spike during a pleasurable activity to make sure we do it again. It helps focus our attention on all the cues that contributed to our exposure to whatever felt good (these eventually become triggers to use, as we explain later). Drugs and alcohol (and certain behaviors) turn on a gushing fire hose of dopamine in the brain, and we feel good, even euphoric. Dopamine produced by these artificial means, however, throws our pleasure and reward systems out of whack immediately. Flooding the brain repeatedly with dopamine has long-term effects and creates what’s known as tolerance—when we lose our ability to produce or absorb our own dopamine and need more and more of it artificially just to feel okay. Specifically, the brain compensates for the flood of dopamine by decreasing its own production of it or by desensitizing itself to the neurotransmitter by reducing the number of dopamine receptors, or both. The brain is just trying to keep a balance. The problem with the brain’s reduction in natural dopamine production is that when you take the substance or behavior out of the picture, there’s not enough dopamine in the brain to make you feel good. Without enough dopamine, there is no interest or pleasure. Then not only does the brain lose the pleasure associated with using, it might not be able to enjoy a sunset or a back rub, either. A lowered level of dopamine, combined with people’s longing for the rush of dopamine they got from using substances, contributes to “craving” states. Cravings are a physiological process associated with the brain’s struggle to regain its normal dopamine balance, and they can influence a decision to keep using a substance even when a person is experiencing negative consequences that matter to him and a strong desire to change. Depending on the length of time and quantities a person has been using, these craving states can be quite uncomfortable and compelling. The dopamine system can and does recover, starting as soon as we stop flooding it. But it takes time, and in the time between shutting off the artificial supply of dopamine and the brain’s rebuilding its natural resources, people tend to feel worse (before they feel better). On a deep, instinctual level, their brains are telling them that by stopping using, something is missing; something is wrong. This is a huge factor in relapse, despite good intentions and effort to change. Knowing this can help you and your loved one make it across this gap in brain reward systems.
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Join Date: Jul 2015
Location: Wilmington, DE
Posts: 393
Melissa - thanks for the post.
I was at a recovery lecture on Tuesday and this was the exact topic - specifically heroin / opiate addiction - how the brain changes with addiction. The lecture was given by a person with a medical background and he attempted to put the whole scenario into layman's terms.
He did very well, but this version is even easier to understand!
Thanks again,
Jim
I was at a recovery lecture on Tuesday and this was the exact topic - specifically heroin / opiate addiction - how the brain changes with addiction. The lecture was given by a person with a medical background and he attempted to put the whole scenario into layman's terms.
He did very well, but this version is even easier to understand!
Thanks again,
Jim
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