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Addiction: Pay Attention

Old 03-21-2007, 02:07 PM
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Lightbulb Addiction: Pay Attention

Addiction: Pay Attention

Heroin and chocolate cake have a nasty way of crowding out the rest of the universe. The country's chief addiction expert argues that the propensity to drink, overeat and take drugs is a matter of attention gone awry.

By:Kathleen McGowan
Meeting her now, it is hard to believe that the Mexican-Russian great-granddaughter of the revolutionary Leon Trotsky ever felt the need to impress her friends. But the universal teenage urge to look more glamorous drove a young Nora Volkow, then in high school, to smoke her first cigarette. It could have been the first step toward a nasty habit, but something in her neurochemistry rebelled. She hated it.

Volkow, now one of the country's most prominent drug addiction researchers and the director of the National Institute on Drug Abuse (NIDA), doesn't think that her disgust for cigarettes had anything to do with morals or self-control. She says she's just naturally intense; the additional stimulation provided by the nicotine was simply too much for her. "I like coffee, but I cannot even drink it because I get so wired," she says. "I was probably born like that. I'm very protected against drugs. It's my neurobiology, and I'm lucky."

Listening to her explain her theories about addiction and the brain, her self-diagnosis sounds right on target. Even though she's petite, with a jogger's lean physique, she dominates the room. She speaks very fast, with a Spanish accent that rounds her vowels, and ideas tumble out one after the other so quickly that it's almost impossible to keep up.

She's a fast-moving example of one of her most interesting theories: that addiction may be a malfunction of the normal human craving for stimulation. Volkow thinks that drugs and other addictive habits tap into some of the deepest forces within us—our lust for newness, our yearning for vitality and the deep-down thrill of being alive. "We all seek that intensity," she says. "There's something very powerful about that."

This idea is based on a new understanding of dopamine, the brain chemical involved in motivation, pleasure and learning. Because addictive drugs like cocaine and nicotine cause a flood of dopamine in the brain, researchers once thought that the neurochemical was a simple pleasure switch, the body's own "reward" button. Yet something didn't add up. If dopamine delivers the pleasure message, addicts should be in a continual state of bliss—but most of them get very little pleasure from the drug, despite the surge of neurochemicals. "I've seen hundreds of addicted people, and never have I come across one who wanted to be addicted," says Volkow. As she began doing brain-imaging studies with drug addicts, that contradiction haunted her.

In response, Volkow and other researchers are developing a new understanding of addiction. Rather than just telling us to feel good, dopamine tells us what's salient—the unexpected bits of new information we need to pay attention to in order to survive, like alerts about sex, food and pleasure, as well as danger and pain. If you are hungry and you get a whiff of a bacon cheeseburger, Volkow's research team has shown, your dopamine skyrockets. But the chemical will also surge if a lion leaps into your cubicle. Dopamine's role is to shout: "Hey! Pay attention to this!" Only as an afterthought might it whisper "Wow, this feels great." So maybe addicts aren't just chasing a good time. Perhaps their brains have somehow mistakenly learned that drugs are the most important thing to pay attention to, as crucial to survival as food or sex.

The salience theory of dopamine also provides new explanations for other self-destructive human tendencies, from binge eating to gambling. It may explain why we crave the stimulation of new information. The experiments that Volkow and her team are conducting may also reveal some of the most powerful behavioral machinery in our brains, the equipment that motivates and inspires us. If they are right, dopamine is more than a joyride. It's more like the drug of life. Its mission is more profound and philosophical: to connect us to the world and supply us with the will to stay alive.

Nora Volkow has science in her blood. Her father is a chemist, her grandfather and her great-grandfather were physicists. But her family, which emigrated from Russia to Mexico in the 1930s, has another intellectual legacy. One of her great-grandfathers was the brilliant Bolshevik leader Leon Trotsky, and Volkow grew up in the Mexico City home where he spent the last days of his life—and where he was killed on Stalin's orders in 1940. Parts of the house became a museum of Trotsky's life, and when Volkow was a child, people like the Nobel Prize-winning novelist Gabriel Garcia Marquez would stop by.

Volkow, though, was more interested in psychiatry than in politics. She graduated at the top of her medical school class at the National University of Mexico, then came to the United States to pursue the new science of brain imaging. During the 1980s, at New York University and then at University of Texas, Austin, she used brain imaging techniques to study schizophrenia and cocaine addiction—and established herself as a leader in the field. She then moved to Brookhaven National Laboratory in Upton, New York, where she won a reputation as an intellectual powerhouse, respected for her creativity as well as for her productivity. "Nora has that enthusiasm, that spark," says NYU Medical Center psychiatry chair Robert Cancro, who worked with her early in her career. "She'd get excited about things, talk 160 words a minute—and that was in English!"

Her colleagues say she is a bold and unconventional thinker. Early on, she demonstrated that cocaine physically damaged the brain. It took years before this controversial finding was accepted, but other research eventually proved her right. She was also an early champion of the idea that drug addiction is a medical problem, rather than a lack of willpower or moral fiber. That formerly radical view is now considered mainstream.

Since she was chosen to direct NIDA, Volkow has brought new visibility to the controversial theory about dopamine that has percolated in the scientific community for approximately the past decade. According to the salience theory of dopamine, the neurochemical is released when something surprisingly important happens, whether that's an unexpected reward or accidentally stepping on a nail. Since dopamine is also involved in learning, memory and motivation, the chemical helps us pay attention to the information we need to survive, act upon it, and remember it for the future. But drugs hijack that machinery, sending 5 to ten times as much dopamine surging through the nucleus accumbens and forcing the brain's motivational and attentional mechanisms to focus purely on the drug. It becomes the most interesting and important thing in the world. "In any addicted person, what's salient is the drug," says Volkow. "There's no competition."

Over time, the addict's brain adapts to the torrent of dopamine by dampening the system down. Imaging experiments show that cocaine addicts' brains don't react to the things that turn on the rest of us, whether that's romantic passion, food or cold, hard cash. Volkow's research has also shown that addicts have fewer dopamine D2 receptors, which are found in parts of the brain involved in motivation and reward behavior. With fewer receptors, the dopamine system is desensitized, and the now-understimulated addict needs more and more of the drug to feel anything at all. Meanwhile, pathways associated with other interesting stimuli are left idle and lose strength. The prefrontal cortex—the part of the brain associated with judgment and inhibitory control—also stops functioning normally. It's a neurological recipe for disaster. "You have enhanced motivation for the drug, and you have impaired prefrontal cortical systems. So you want the drugs pathologically, and you have reduced control of behavior, and what you've got is an addict," says University of Michigan, Ann Arbor psychology professor Terry Robinson, who pioneered this new way of thinking about dopamine with his University of Michigan colleague Kent Berridge.

Some people are apparently born with fewer dopamine receptors, and they are more likely to enjoy the rush of addictive drugs. In one imaging experiment, Volkow gave Ritalin, which gently lifts dopamine levels, to a group of ordinary volunteers. Some loved the feeling of the drug, but others hated it so much that they threatened to drop out of the study. Volkow was puzzled until she imaged their brains. She found that those who liked the rush from the drug had fewer dopamine D2 receptors than those who hated it. Volkow thinks that some people have a sensitive dopamine circuitry; they can't take the additional stimulation of drugs.

Obesity may involve similar malfunctions in the dopamine system. Volkow's longtime Brookhaven collaborator Gene-Jack Wang has discovered that the brains of seriously obese people seem to be tuned toward food. Even when they are lying quietly in the scanning machine, the sensory cortex of their mouth, tongue and lips is more active than it is in normal-weight people, he says: "They are putting out their antennae." Yet he also found that the dopamine circuitry of heavy people is less responsive, with fewer dopamine D2 receptors. Even among the obese, there are dopamine differences. The heaviest people in his study had fewer dopamine receptors than the lightest. Like addicts, overeaters may be compensating for a sluggish dopamine system by turning to the one thing that gets their neurons pumping.

It's a mark of changing times—and more sophisticated science—that the head of the National Institute on Drug Abuse is thinking about doughnuts as well as heroin. Just as blaming drug addiction on moral weakness was a shortsighted and unscientific way of framing a social problem, Volkow believes that focusing solely on metabolism, or blaming fat people for overindulgence and gluttony, are intellectual dead ends. "What motivates us to eat is clearly much more than hunger," she says. "We need to expand the way we think about eating." Wang and Volkow suggest that dopamine may provide a new window into weight loss: Animal studies have shown, for example, that exercise elevates dopamine release and increases dopamine D2 receptors.

Volkow and the other champions of the new view of dopamine don't deny that the chemical helps us register pleasure. But they think that pleasure is just part of a set of interconnected dopamine-related behaviors. Volkow recently found that adults with attention deficit disorder who took dopamine-boosting Ritalin before taking a math test found it easier to concentrate, in part, because the task seemed more interesting, so they felt more motivated to do the problem.

From this angle, it makes sense that the cognitive process of absorbing new information is closely tied to the brain's pleasure mechanisms. You might say that what the brain really "wants" is new information, suggests Gregory Berns, associate professor of psychiatry and behavioral sciences at Emory University in Atlanta. "Neurons really exist to process information. That's what neurons do. If you want to anthropomorphize neurons, you can say that they are happiest when they are processing information."

This urge to connect to the world and learn from it is more important than mere pleasure, says Volkow. It's part of the most basic force in behavior: the will to live. It's not automatic, she points out. Seriously ill or very depressed people can lose the will to survive. "What is the motivation we all have to be alive, to do things?" she asks. "It's not pleasure. Our lives would be so much simpler if we were motivated just for the sake of pleasure."

But dopamine sensitivity and addiction aren't genetically determined or inevitable. One experiment with monkeys showed that the dopamine system may be influenced by social interactions: Animals that lost social status also lost D2 receptors. Context is also crucial. Obviously, it's easier to get hooked if drugs are easy to get in your neighborhood, but it's not just a question of supply and demand. People who grow up in stimulating, engaging surroundings are protected against addiction, Volkow believes, even if they don't have a naturally responsive dopamine system. If you connect to the world in a meaningful way, and have more chances to get excited about natural stimuli, you're less likely to need an artificial boost.

"If you don't get excited by everyday things in life, if things look gray, and the drug makes things look extraordinary, that puts you at risk," she says. "But if you get great excitement out of a great multiplicity of things, and intensely enjoy these things—seeing a movie, or climbing a mountain—and then you try a drug, you'll think: What's the big deal?" For those lucky enough to grow up as Volkow did, surrounded by sharp minds and fascinating history, drugs are just nowhere near as interesting as everyday life.


I found this information very interesting.
Hope you do too!
Any thoughts to share?

Shalom!
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Old 03-21-2007, 02:25 PM
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Interesting article; I believe it. I was just expressing to someone yesterday my opinion that people get addicted to things because they don't know how to deal with boredom.

The cures for the anxiety issues that are often a part of addiction recovery are practices like breathing techniques, meditation and what not that could very accurately be described as boring. There's a deep connection there, I think, but I'm too foggy-brained today to try to be eloquent about it.
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Old 03-21-2007, 02:28 PM
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I don't know if the secular forum is the place for this, but this article I read yesterday seems quite relevant and connected to the topic here:

ZEN IS BORING

Let's face it. Zen is boring. You couldn't find a duller, more tedious practice than Zazen. The philosophy is dry and unexciting. It's amazing to me anyone reads this page at all. Don't you people know you could be playing Tetris, right now? That there are a million free porno sites out there? Get a life, why don't you?!



Joshu Sasaki, a Zen teacher from the Rinzai Sect, once said that Buddhist teachers always try to make students long for the Buddha World, but that if the students knew how really dry and tasteless the Buddha World actually was, they'd never want to go. He's right. Look at Zen teachers. Not a one of them has any sense of fashion. They sit around staring at blank walls. Ask them about levitation, they won't tell you. Ask them about life after death, they change the subject. Ask them about miracles and they start spouting nonsense about carrying buckets of water and chopping up fire wood. They go to bed early and wake up early. Zen is a philosophy for nerds.



Boredom is important. Most of your life is dull, tasteless and boring. If you practice Zazen, you learn a lot about boredom. I remember the first time I sat Zazen, I was real excited. I figured I'd be seeing visions of four armed Krishnas descending from the Heavens, or I'd be fading into The Void just like the old Beatles song, or reach Nirvana (whatever that was) or some great wonderful thing. But the clock just ticked away, my legs started aching, and stupid thoughts kept drifting by. Maybe I wasn't doing it right, I thought. But no, year after year it was the same. Boring, boring, boring. After almost 20 years it's still boring as Hell.



People hate their ordinary lives. We want something better. This, our day to day life of drudgery and work, is boring, dull and ordinary, we think. But someday, someday... There's an episode of The Monkees* where Mike Nesmith says that when he was in high school he used to walk out on the school's empty stage with a guitar in his hands thinking "Someday, someday." Then he said that now (now being 1967, at the height of the Monkees fame) he walks out on stage in front of thousands of fans and thinks "Someday, someday." That's the way life is. It's never going to be perfect. Whatever "someday" you imagine, it will ever come. Never. No matter what it is. No matter how well you build your fantasy or how carefully you follow all the steps necessary to achieve it. Even if it comes true exactly the way you planned, you'll end up just like Mike Nesmith. Someday, someday... I guarantee you.



Your life will change. That's for sure. But it won't get any better and it won't get any worse. How can you compare now to the past? What do you know about the past? You don't have a clue! You have no idea at all what yesterday was really like, let alone last week or ten years ago. The future? Forget about it...



People long for big thrills. Peak experiences. Some people come to Zen expecting that Enlightenment will be the Ultimate Peak Experience. The Mother of All Peak Experiences. But real enlightenment is the most ordinary of the ordinary. Once I had an amazing vision. I saw myself transported through time and space. Millions, no, billions, trillions, Godzillions of years passed. Not figuratively, but literally. Whizzed by. I found myself at the very rim of time and space, a vast giant being composed of the living minds and bodies of every thing that ever was. It was an incredibly moving experience. Exhilarating. I was high for weeks. Finally I told Nishijima Sensei about it . He said it was nonsense. Just my imagination. I can't tell you how that made me feel. Imagination? This was as real an experience as any I've ever had. I just about cried. Later on that day I was eating a tangerine. I noticed how incredibly lovely a thing it was. So delicate. So amazingly orange. So very tasty. So I told Nishijima about that. That experience, he said, was enlightenment.



You need a teacher like that. The world needs lots more teachers like that. Countless teachers would have interpreted my experience as a merging of my Atman with God, as a portent of great and wonderful things, would have praised my spiritual growth and given me pointers on how to go even further. And I would have been suckered right in to that, let me tell you! Woulda fallen for it hook line and sinker, boy howdy. If a teacher doesn't shatter your illusions he's doing you no favors at all.



Boredom is what you need. Merging with the Mind of God at the Edge of the Universe, that's excitement. That's what we're all into this Zen thing for, right? Eating tangerines? Come on, dude! What could be more boring than eating a tangerine?



Some years ago some psychologists did a study in which they sat some Buddhists monks and some regular folks in a room and wired them up to EEG machines to record their brain activity. They told everyone to relax, then introduced a repetitive stimulus, a loudly ticking clock, into the room. The normal folks' EEG showed that their brains stopped reacting the stimulus after a few seconds. But the Buddhists just kept on mentally registering the tick every time it happened. Psychologists and journalists never quite know how to interpret that finding, though it's often cited. It's a simple matter. Buddhists pay attention to their lives. Ordinary folks figure they have better things to think about.



If you really take a look at your ordinary boring life, you'll discover something truly wonderful. Our regular old pointless lives are incredibly joyful -- amazingly, astoundingly, relentlessly, mercilessly joyful. You don't need to do a damned thing to experience such joy either. People think they need big experiences, interesting experiences. And it's true that gigantic, traumatic experiences sometimes bring people, for a fleeting moment, into a kind of enlightened state. That's why such experiences are so desired. But it wears off fast and you're right back out there looking for the next thrill. You don't need to take drugs, blow up buildings, win the Indy 500 or walk on the moon. You don't need to go hang-gliding over the Himalayas, you don't need to screw your luscious and oh-so-willing secretary or party all night with the beautiful people. You don't need visions of merging with the totality of the Universe. Just be what you are, where you are. Clean the toilet. Walk the dog. Do your work. That's the most magical thing there is. If you really want to merge with God, that's the way to do it. This moment. You sitting there with your hand in your underwear and potato chip crumbs on your chin, scrolling down your computer screen thinking "This guy's out of his mind." This very moment is Enlightenment. This moment has never come before and once it's gone, it's gone forever. You are this moment. This moment is you. This very moment is you merging with the total Universe, with God Himself.



The life you're living right now has joys even God will never know.

http://homepage.mac.com/doubtboy/boring.html
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Old 03-21-2007, 03:03 PM
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I'm trying to break a cycle of being long winded so I'll try to keep this short. I enjoyed reading this. It goes along with quite a few personal beliefs. The medical studies, I tend to let them be what they'll be. The mindset I take seriously. I believe it's possible, we've lost quite a bit of what our minds are capable of doing because of a vast amount of constantly changing circumstances. Not to say were less intelligent then the Mayans, Aztecs or any other from that time, but it's been my personal experience that I'm better off if I slow down to smell the roses.

I watch very little television and try to limit negative or meaningless stimulation. I try to fill the void (if you can call it that) with positive, knowledgeable things. In turn new things I'd never imagined come rushing in, but even these I limit to avoid an overload. From the tiniest of matter to the ends of the universe, I find myself yearning for more and my findings are nothing short of fascinating. Of it all, the art of practicing knowledge can become lost if not applied where its best suited.

I guess to sum it all up. There are exceptions, but I believe most of us are exactly what we chose to believe we are. We're what we eat, drink, think and everything else we allow ourselves to absorb. I doubt we know how many of our outside stimulations effect us totally, but limiting the negative ones is a good place to start.

The dream was never over, the dream has just begun.
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Old 03-21-2007, 08:50 PM
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But dopamine sensitivity and addiction aren't genetically determined or inevitable. One experiment with monkeys showed that the dopamine system may be influenced by social interactions: Animals that lost social status also lost D2 receptors. Context is also crucial. Obviously, it's easier to get hooked if drugs are easy to get in your neighborhood, but it's not just a question of supply and demand. People who grow up in stimulating, engaging surroundings are protected against addiction, Volkow believes, even if they don't have a naturally responsive dopamine system. If you connect to the world in a meaningful way, and have more chances to get excited about natural stimuli, you're less likely to need an artificial boost.

"If you don't get excited by everyday things in life, if things look gray, and the drug makes things look extraordinary, that puts you at risk," she says. "But if you get great excitement out of a great multiplicity of things, and intensely enjoy these things—seeing a movie, or climbing a mountain—and then you try a drug, you'll think: What's the big deal?" For those lucky enough to grow up as Volkow did, surrounded by sharp minds and fascinating history, drugs are just nowhere near as interesting as everyday life.
Well, I think you had me until this part, Teach. I can well imagine the reduction in dopamine receptors... in fact, with my daughter, her meth use may have exacerbated that. She flooded the brain with the "feel good" chemicals (dopamine, serotonin, etc)... so much that the brain couldn't process all the chemicals with the existing receptors.... so it grew MORE receptors. Then she came down, and had the same "normal" amount of brain chemicals, but MORE receptors. She felt bad... worse than before, and took more drugs to feel good... but never as good as the first time.

But the idea that a lack of stimulation in childhood leads to drug use? I think the woman is off her ever loving tree... I've met TONS of addicts and alcoholics. Many of them had perfectly normal, perfectly stimulating childhoods. Even if they were born with a paucity of receptors... SOME lead full lives as kids.

Mine did.

I've never doubted that they had full childhoods... perhaps too full. I read to them, sang with them, they were in church, scouts, music, dance, sports. Nope, on the "how to prevent it" part, I think she strikes out.

Thanks for the article. It was definitely interesting... and she is one smart cookie - so I hope she keeps searching. Perhaps there will be a way to PREVENT this crap one day.
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