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Addiction: a Fault of Chemistry

The views expressed are those of the author and are not necessarily those of Scientific American.

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Chemistry is at the brunt of it all, isn’t it? Addiction, the sinuous, stealthy disease is controlled by neurochemicals. Simple as that. You’re an addict or you’re not. Sounds easy and breezy, doesn’t it? The trouble and truth is, it could take years to figure out if you’re an addict. The truth is, you may never find out.

You can become addicted to drugs, alcohol, nicotine, exercise, love or just about anything. However, some substances are much more freely craved, more pleasurable to the masses than others. What’s pleasure? Food, sex, cocaine. At least, so indicate animals that press a lever for a drug, or pleasure, release in labs. Yes, they want cocaine. Yes, they want sex. Neurotransmitter levels in the brain skyrocket with certain drugs, flooding the neural wiring and stimulating dopamine circuit activity. In short: it feels good, at least in the beginning. So, what’s the difference between really liking and obtaining that glass of wine vs. having to have it?

Addiction arises out of the compulsion, the need, the craving to take a drug despite the negative consequences that become apparent: the loss of a job or a family, the alienation of friends or loved ones. Addicts have skewed brain chemistry. Most people try drugs or alcohol in their lifetime and for the small portion of this crowd suffering neurochemical imbalances, drugs fix their deficiency. They feel “normal” for the first time in their lives.

To reach this normalcy, different addicts have different drugs of choice. This isn’t always a matter of taste or preference — shooting vs. snorting — it’s because cocaine addicts may be short one sort of neurotransmitter, while heroin addicts are short another. This shortage of correct combinations of neurotransmitters in the brain is known as Reward Deficiency Syndrome, or RDS. Without the proper neurochemical cocktail, addicts can suffer anxiety, a sense of unease or a feeling of incompleteness.

And actually, different drugs act as keys for those lacking various neurotransmitters. For those lacking dopamine, cocaine or amphetamines will be a fine neural cocktail. For those lacking GABA, benzodiazepines, such as Xanax, Valium or Ativan, will provide the kick. Natural alcoholics lack several types of neurochemicals and luckily (or unluckily), alcohol floods all receptors. For these people, finding the drug that equalizes their neurotransmitter shortage makes them feel better, at least at first.

Really, after an addict’s repeated use, the brain starts to expect higher amounts of dopamine or another neurotransmitter, artificial though those drug methods may be in replacing a neurotransmitter that’s naturally lacking. The brain doesn’t know any better: high dopamine levels inherent with drug use become normal. When a person goes cold turkey, or stops using, the reward pathways in the brain shut down. The brain gets used to having a certain amount of drugs, and thus, becomes used to having certain amounts of neurotransmitters in its circuits, and when taken away it’s worse off than before. It craves the drugs to function.

Once the body normalizes to having a drug, or a certain level of dopamine in the system, a physical dependence develops. Say an addict becomes used to having cocaine daily. When a drug bleeds from her system, effects waning, illness manifests. For some, whole-body tremors develop, similar to early flu onset, while others like alcoholics become restless and stir-crazy. Because of this, users have to take more of the drug to avoid the pain and discomfort its absence creates. They have to take their drug of choice to feel normal, to equilibrate their neural circuitry, to simply exist without it.

If you never find your drug of choice, a dirty band-aid to the gaping wound of neurochemical imbalance, then perhaps you’ll never find addiction. For most of us, it isn’t worth the experiment to know. For others, it starts out innocently, by becoming too reliant on pain pills prescribed by a doctor after an accident. Would you be “better” with a neurochemical enhancement? I’ve been to rehab facilities and have seen good people lose their livelihoods, children and everything they hold dear. And thus, I ask: how could you say it’s not chemistry? How could you say it’s choice? Choice to feel robbed of free will? Choice to be dependent?

For addicts, it’s never over. A structure in the reptilian or old brain, the amygdala, causes the addict to crave a drug when she recognizes people, places, situations or patterns with which she’s previously used. It’s instinct, without conscious thought. Consider this: if you’re drowning, you’ll push up for air. So will an addict, only her air is a drug.

For chemistry day, I say addiction is merely a disease of improperly-balanced neurons. Perhaps you already know that and perhaps it’s already obvious. If so: this is I celebrate. For more of a look, here are a few good reads:

For a dose of science: The Addiction Solution: Unraveling the Mysteries of Addiction through Cutting-Edge Brain Science

Drugs and the Brain

Molecules of Emotion: The Science Behind Mind-Body Medicine

For family members and friends coping: Addict in the Family: Stories of Loss, Hope and Recovery

Cassie Rodenberg About the Author: I write on culture, poverty, addiction, and mental illness: I explore things we like to ignore. I also teach public school in New York City's South Bronx. Follow on Twitter @cassierodenberg.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. JeanneGarb 9:03 am 08/2/2011

    Hi Cassie:
    Great post (again!). Not that I know that much about the physical processes involved with addiction, I never really considered that individuals are predisposed to be addicted to specific drugs – like you said “cocaine addicts may be short one sort of neurotransmitter, while heroin addicts are short another.”

    Given this, I wonder if there are any genetic polymorphisms that could help explain why addicts have a “drug of choice” and if this information can be used to develop more personalized treatments – sort of another branch of personalized medicine. Also, these new vaccine treatments could also be tailored to meet the genetic needs of the patients.

    I’m not sure how feasible this is (at least at this time), but I truly hope that there is more on the horizon as we fight the terrible plight that is drug addiction.

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  2. 2. GAry 7 1:12 pm 08/4/2011

    ,,,and I wonder why psychedelics show no dependency effect. They stimulate the release of many neurotransmitters so one might expect significant rates of addiction.

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  3. 3. sunnystrobe 7:29 am 08/13/2011

    Any addiction is fed by a ‘too-muchness’ of some sort:
    The fact that 1 billion of us humans on this planet suffer from obesity tells a sorry tale;
    in their case, it’s the ingesting of high concentrates of (hidden) sugar,(too much for our original pancreas design, geared to a hundred times less intake),
    and , in combination with man-made high concentrates of fat, in concoctions like sausages and meat balls,
    plus so-called ‘table’ salt- (without which we would never have swallowed minced-up cadavers in the first place!)
    This unholy trifecta of concentrates , ingested over a lifetime,makes for most of our medical troubles in later life.
    Any food intake ( bottled or not) , if taken in too high concentration, acts as a biochemical booster drug.
    Our body is originally designed to derive pleasure from fibre-rich, raw plant food,with sweet fruits providing the natural little sugar kick.
    If we do not follow our normal, species-specific , primatic food regime, our body ,in its automatic search for ‘the real thing’, biochemically speaking, will have to keep searching for more- like the rats pressing the button for ‘more of the same’.
    That’s addiction in a nutshell for me.

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  4. 4. 12345 11:00 am 08/20/2011

    You’ve interpreted all of the facts incorrectly. To understand addiction see and understand how addiction really works.

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  5. 5. DialecticDiaries 10:11 pm 10/12/2011

    This is a very useful blog as a resource for my own blog about Borderline Personality Disorder. This article in particular is a great one as it reviews that dependencies no matter how different they can seem are all parts of the bad wiring that is Addiction. I’ve been delving into the side of Borderline Personality Disorder that manifests in urges and dependencies, for example, many Borderline sufferers self harm and it releases similar rushes in the brain that then lead to an addiction to the act itself to feel “normal” or to relieve stress.

    Thank you and I’ll continue reading and citing your articles as I continue writing my own.

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