The complexity of addiction

I did a brief post back in April on Maia Szalavitz’s new book that argues that addiction is essentially a learning disorder.  New York magazine’s Jesse Singal has a recent take focusing mainly on the completely un-scientific ideology of “hitting rock bottom” before seeking treatment.  Short version: there’s no research at all supporting this and it is probably counter-productive (don’t get me started on Alcoholics Anonymous.  Sure, it helps people, but… science!).  Singal also nicely summarizes Szalavitz’s take on how addiction is learned:

It should be seen not as a disease or a moral or personality shortcoming, but rather a learning disorder. “Addiction doesn’t just happen to people because they come across a particular chemical and begin taking it regularly,” she writes early on. Rather, “[i]t is learned and has a history rooted in their individual, social, and cultural developments.”

Or, as Szalavitz put it to the Daily Beast: “If you don’t learn that a drug helps you cope or make you feel good, you wouldn’t know what to crave. People fall in love with a substance or an activity, like gambling. Falling in love doesn’t harm your brain, but it does produce a unique type of learning that causes craving, alters choices and is really hard to forget.”

This can help explain many little-known facts about drug addiction: for example, that the vast majority of people who try even drugs like heroin will not become addicted to them; or that early-life trauma hugely increases the odds of becoming addicted to a substance. To take an oversimplified hypothetical: If someone first offers you alcohol at a time when you’re dealing with serious family issues, unresolved trauma, and other addiction risk factors, you’re more likely to develop an unhealthy relationship with the substance than if your first sip comes at a time when stuff is going okay for you. Many, many factors intermingle in complicated ways to determine whether a given individual will develop an addiction. [emphasis mine]

Fortunately for me, my only addictions are over-researching cameras and automobiles on-line.  What’s really frustrating, though, is how wrong our society seems to have gotten it on addiction and how much this has set us back in addressing a very real problem.


About Steve Greene
Professor of Political Science at NC State

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