Going to post some of this up again - it's here, read it, listen to it, learn it.

To start with, a bevvy of resources on addiction, recovery, etc;


Under April 25th, 2011 there is a link for "The Physiology of Addiction," as presented by Dr. Carl Christensen MD, PHD, MRO:


What originally got me searching for more information on addiction, is twofold;

1) The propensity of some to toss around the word "addiction" when it comes to sex or pornography.

2) The number of people who are actually dealing with real and actual addicts and/or recovering addicts.

I put my own time into watching this presentation and taking some notes, and was going to do some further research and formulate something of a further post - that was derailed by simple economics; there is quite simply no gain for my selfish behind to put that much time in for something that is going to float by. So, what I put out here is a skeleton of my original plan.

The catalyst was this:


Why is that? How can a BEHAVIOR be the same? WHAT IS ADDICTION?

Now, there is crap that jerkwads who think they know something will toss around; psychological dependence, lack of will power, lack of integrity or amorality... even though some people are part of various programs that recognize particular substance abuse problems as a disease, they most often see the substance as a disease, and not that the addict is a person with a chronic, treatable, incurable disease.

Let me repeat that; addiction is a chronic, treatable, incurable disease. It is in a class with; obesity, hypertension (high blood pressure), and asthma. The alcohol didn't do it, sugar... your body did.

So, exactly how is it a disease?


Specifically - in a chemical manner, the brain of an addict has a decreased response to pleasurable things; food, sex, drugs, etc.

Anyway;

The Addicted Brain

The Addicted Human Brain: Insights from Imaging Studies

And the presentation itself;

The Physiology of Addiction

While this presentation is focused on Grief and Loss as it relates to addiction, grief and loss operate the same across the entire spectrum.

The first presenter states that she originally dealt with end of life grieving - which is something a lot of people in health care receive education and training in - when it comes down to it loss is like pain; it is exactly what the person experiencing it says it is, occurring whenever they say it does.

http://www.slideshare.net/jschwartz/grief-and-loss-in-addiction

Notes and/or observations;


All of these losses are pretty broad-swath, and everyone will experience them at one time or another.


Attachment--->Loss--->Grief

When the attachment and loss is connected to something that is not accepted by your peer group, complicated grief occurs.


I got nothing on the addiction front here...

Beyond that, I leave it to the reader to watch/listen to the presentation. If you feel you are "getting it" you can skip slides and the audio will go along with the skip.

Bump?

HHH, I think addiction is actually a relatively simple thing and sure explains a lot when it comes to self-destructive behaviour.

We are all wired to want more of any substance or behaviour that makes us feel good - more of anything that hits the pleasure/reward centers in the brain and gives us a hit of the brain chemicals that leave a good feeling.

Alcohol can do that. Heroin can do that. Cocaine, meth, nicotine, morphine, gambling, sex, food and shopping/hoarding all travel the exact same pathways in the brain - the pathways to the pleasure/reward center. If the user starts seeking these things out not for "normal" use, but solely to get another hit and another hit and another hit and another hit, that's when these behaviours and substances become Addictive.

It's really not so complicated. All addicts basically follow the same pattern with the lies, the escalation and the supreme selfishnesses. And it sure does explain a lot.

No, it's not. But what comes first, chicken or egg? Addiction or addict?

"Alcoholism is a disease, but it's like the only disease you can get yelled at for having.

'Damnit, Otto! You're an alcoholic!'

'Damnit, Otto! You have Lupus!'

One of those two just doesn't sound right..." - Mitch Hedberg

Addiction is a chronic, incurable, treatable disease.

The behavior is a result of the disease, the disease is not a result of the behavior.

There is a measurable, medically observable difference in the brain physiology of an addict.

Yes, we are all wired to want "more" of a behavior or substance that makes us feel good, but an addict needs "more" of that substance from the outset, as even their primary chemical reward response is muted when compared to that of a "normal" person.

Nesre had made a comment about alcoholics having an unfulfillable "hole" right through the center of themselves - that "hole" is the decreased pleasure response.

A behavior or substance in an amount that would make those of us without the physiological defects of addiction "happy" may only succeed in making the addict feel "normal."

This is not my opinion, this is the information presented by a trained and educated professional gathered through years of scientific and medical study.

I am simply providing the information again.

People can have a genetic predisposition to be vulnerable to addiction - but a person who never takes a drink will not become an alcoholic. They may have the predisposition for it, but they will not become an addict of any kind if they do not ever use an addictive substance or practice an addictive behaviour.


Not necessarily. I cannot control getting cancer (much), but I can control being an alcoholic even though it runs in my family and I would probably make a very good alcoholic. I control the behaviour, which is "not drinking".


All addicts can be described this way. They are the ones who destroy the pleasure response by using their addictive substance or practicing the addictive behaviour, and simply burning out the response center through overload. That's why Escalation is one of the hallmarks of addiction.

You are saying that some people are born with this condition of "decreased pleasure center response" - but this seems to be much more a component of psychopathy. They are often described as having a very high threshold for stimulation (as in, it takes a lot to make them feel anything) and are often fearless when a normal response *would* be fear. It's been noted that little kids who aren't afraid of anything may be on the road to psychopathy. (Ever see the movie *The Bad Seed*?)

You seem to be saying that addicts are born that way and can't help being addicts. I don't agree. Nobody is born an addict - not unless their mother was using while pregnant. And even then, the addiction can be broken. It's not inevitable that someone will be an addict. Even with a predispostion, people do have a choice. If they had no choice, then no one would ever be in recovery - and I'd be a raging alcoholic right now.

Exactly. As with your family, alcoholism runs heavily in my family. I choose not to drink, and therefore to not become addicted to it.

So, let's examine some behaviors that can be addictive; eating, sex, shopping, gambling, pornography, computers, video games, the internet, work, exercise, spiritual obsession, pain, risk, cutting...

A few of those fall into the "not ever" category for avoidance of use. Food, work, sex, exercise, or shopping? All of those have their addicts, as well. 3/4 have groups and programs established for treatment of that particular addiction.

Again, it's chicken or egg. Again, not my opinion, simply what the studies show.

The particularly cited study took individuals who were NOT addicts, and did brain scans. The subjects were then given an IV dose of Ritalin. In the subjects with "normal" brain function, the drug was found "unpleasant." In those with brain patterns consistent with addicts, the drug was found "pleasurable."

Another example was prescription pain relievers; you give 100 people morphine for 2 weeks, and then end the prescription. 95 of those people will have medication withdrawal, and then go on with their lives. 5 will "begin robbing party stores" to get more.

Clinical addiction is attributed to something like 3% of the population. Three. Percent.


This is not the behavior you were mentioning.

Consider the converse; what about those who drink, and never become addicted, or those who drink, but never abuse alcohol? Directly, in your opinion, what makes those people different from those who do develop a problem?

How do you know this?

Because, the trained, educated, licensed professionals who study addiction and treat addicts every day say that it is NOT their behavior, will power, or moral fiber. The evidence supports that it is a brain disease, which is present BEFORE introduction to the substance or behavior.


This is chicken and egg again. Again, the defect is present in people BEFORE the substance is introduced. Escalation is present from the beginning, before abuse begins.


Eh? I'm confused at where the correlation between addiction and either psychopathy or fearlessness come from (side note; fearlessness is also commonly coupled with remorselessness)? That's more what's referred to as a "Type A" personality, and is consistent with gang members, murderers, and other violent criminals... as well as policemen, firefighters, coast guard rescue divers, and other "heroic" professions.

Can you cite any sources for this supposition?


You seem to be making assumptions because you don't like the information presented.

Stating that addiction is a physiological disease does not magically free the sufferer from management of that disease.

A diabetic does not get to keep a poor diet, not check their blood sugars, and skip out of their medications because they have a disease.

Someone with COPD doesn't get to continue to smoke because they have a disease.

However, I AM saying that addicts cannot help being addicts. Absolutely. That does not free them from managing their disease.

If the diabetic does not manage their disease, they die. If the COPD sufferer does not manage their disease, they die. If an addict does not manage their disease, THEY WILL DIE.

And no, family history does not guarantee a predisposition, or I would be a raging alcoholic, and I do drink.

HHH, I have no idea what your point is. It sounds like you want to believe that addicts have no choice about being addicts. I don't think that's true at all, but okay.


As I said above, when the pleasure centers of the brain are not functioning properly - either because the person was born with malfunctioning centers or because they've burned out the receptors with addictive behaviours or substances - it takes a lot to get them to feel anything. That's why psychopaths will do horrific, unthinkable things - because "normal" things have no effect on them and it takes something extreme to provoke a response.

But, anyway, if you want to believe addicts have no choice then please feel free. That's a terribly hopeless way to approach a problem as life-destroying as addiction, but okay.

I, myself, this person, did not have a "point." I simply presented a presentation by medical professionals - people who are trained and educated in addiction, it's causes, and the treatment of addiction. The information provided in the linked presentation is in direct conflict with your assertions. All I have done is to restate what the research says. Having a "point" is not the point.


So all addicts are psychopaths? All of them.. what? Commit violent crimes? I'd like to see the data on that, but I would guess a more fitting descriptor would be some, or few. Not most, not all.


It sure is hopeless when you repaint it as such. Yet, when you recognize that something has a physiological cause, and isn't just because of some kind of behavioral flaw, then you can lay out ALL of the options for treatment including behavioral treatment, medication, or surgical intervention (which is rather radical, and not done in the US).

Of course, all of this is laid out in the presentation...

HHH, there is a defined criteria for the diagnosis of addiction. According to the Diagnostic and Statistical Manual, 4th Edition (referred to as DSM-IV) the following seven criteria are used in the diagnosis of addiction. A partial "yes" answer is considered a "yes:"

• Tolerance. Has your use of drugs or alcohol increased over time?
• Withdrawal. When you stop using, have you ever experienced physical or emotional withdrawal? Have you had any of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting?
• Difficulty controlling your use.Do you sometimes use more or for a longer time than you would like? Do you sometimes drink to get drunk? Do you stop after a few drink usually, or does one drink lead to more drinks?
• Negative consequences.Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?
• Neglecting or postponing activities.Have you ever put off or reduced social, recreational, work, or household activities because of your use?
• Spending significant time or emotional energy. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?
• Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?

A "yes" answer to three or more are sufficient to meet the medical definition of addiction.

If these can be applied to other behaviors (gambling, sex, pornography, overeating, etc.) then a medical diagnosis can be made.

This has been sufficient for the medical community for decades.

Fred, thank you for the reply, but I don't seem to remember arguing any differently.

In fact, that is all in the links I have provided. Which, again, is compiled by medical professionals who specialize in addiction.

I didn't post this info to debate or argue, I posted it to provide a resource to people who want to or would like to learn more about the mechanisms behind addiction, whatever the substance or behavior involved is.

I can only provide the information, however. It is up to the reader to access it.

HHH, I'm sorry if I came across as being argumentative. It's been my experience that trying to focus on the cause of addiction is much like trying to determine how many angels can dance on the head of a pin. Just yesterday I received an email from a friend with a link to an article suggesting that a gene called autism susceptibility candidate 2 (or AUTS2) is linked to increased alcohol consumption.

I could barely stifle a yawn. My response to the email was to say, in essence, that my interest lies more in the way OUT of addiction than the way IN. I'll leave that to the researchers.

Like cancer, there is still so much unknown about the hows and whys. But the treatment for addiction is known and has been proven over and over for nearly a century: 100% abstinence.

Bah, chain e-mails.

There is a good argument for AA included, including an argument for the spiritual aspect, or "submitting yourself to a higher power."

It's not just abstinence. Abstinence alone fails. It's abstinence and filling your life up, making yourself too busy to give in to the addiction. Those who fail to fill their lives up usually relapse (that is my opinion, though).

There is an apocryphal story one hears in the rooms of A.A. The newcomer says to his old-timer sponsor, "I really like A.A., but I'm just not real sure about the spiritual part." To which his A.A. sponsor replies, "What other part is there?"

I agree. There's another concept I've heard said in A.A.: "There is a hole in our soul that we tried filling with alcohol. Once the alcohol was removed, we found it was the perfect shape of God."

The Dr. doing the presentation compares the submission to a higher power in AA to being a US Marine, and goes on to explain how being a member of the Marine Corps is submitting to a higher power. Can't say I disagree with his argument. In fact, having been around the program long enough, it could easily be compared just as well to being part of a military squad or sports team. There is a lot of fellowship, support, and mentoring. All of that comes under the submission to the higher power, and dedication to a common cause.

Finding every possible way OUT, is the reason to try to pinpoint the way IN. If that makes sense.

Just the way I think, that if you fix the problem, you eliminate the symptom. In contrast, if you treat the symptom the problem remains despite no longer suffering the symptom.

It makes sense if you're a researcher. It doesn't make a lot of sense if you're trapped in the mire of addiction.

This is what A.A. does. But note, the problem is NOT alcohol. Alcohol (or whatever the addiction) is just the symptom.

Aaaaaaaaaaaaand, on that point... we have no disagreement.