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Dear Dr. Simon

I’d like to welcome Dr. Derek Simon, a doctor of philosophy from New York, to blogging.  Let’s see what’s bugging him, shall we?

This article makes many false claims that ignores the scientific basis of addiction. I’m a neuroscientist studying the neurobiological basis of drug addiction at the Rockefeller University (NY, NY) and many of the views presented in this article are, in my professional opinion, harmful to the decades of scientific progress made in understanding this devastating disease…

This article helps the average person understand addiction better, but it’s not supposed to be a scientific article. It’s part of a thorough investigative report, the size of a book, which gives an overall view of addiction and the drug war.  For a neuroscientist to claim that this article is harmful is very puzzling to me.

And I’ll just add that, as was pointed out in one of the comments to your post, decades of scientific progress have made little difference in the number of people who abuse drugs and become addicted.  While it’s true that an understanding of what happens in the brain helps patients to better understand their own illnesses and addictions, blog posts and scientific articles going into details about these processes are not very understandable by the general public, including me. On the other hand, Mr. Hari’s writings are both an easy and compelling read.

This article makes no mention of the vast amount of concrete basic research that has identified real molecular changes that occur to brain as result of drug use and the subsequent effects on behavior that these molecular changes have. There is no mention of neurons, or dopamine, or neurotransmitters, or neurotransmission, or receptors, or gene expression changes, or neuroplasticity, or mesolimbic reward pathway, or many other of basic concepts in the neuroscience of addiction…

In fact, everything that the brain does and everything that happens to brain ultimately has a chemical basis. And yes, that means there is of course an enormous chemical basis for addiction and the effects of drugs themselves. To say anything otherwise is blatantly not true…

Perhaps you missed these parts of the article?

Imagine if you and I and the next twenty people to pass us on the street take a really potent drug for twenty days. There are strong chemical hooks in these drugs, so if we stopped on day twenty-one, our bodies would need the chemical. We would have a ferocious craving. We would be addicted. That’s what addiction means…

If you still believe — as I used to — that addiction is caused by chemical hooks, this makes no sense. But if you believe Bruce Alexander’s theory, the picture falls into place. The street-addict is like the rats in the first cage, isolated, alone, with only one source of solace to turn to. The medical patient is like the rats in the second cage. She is going home to a life where she is surrounded by the people she loves. The drug is the same, but the environment is different…

In general, this is true, if an over-simplification.  But different chemicals can cause different levels of addiction.  And if it were 100% true in all cases (which I believe is statistically impossible), then all those middle-class white people abusing opioids are apparently living in bad environments.  

Of course, a bad environment does not only describe your home, surroundings, and economic condition, but mental conditions too, like PTSD.  Chronic pain, depression, and PTSD are bad environments inside your brain, sometimes caused by environmental and genetic factors, but sometimes caused by physical injuries…

Geez, I’m starting to confuse myself with all these connections; the possibilities appear to be endless, especially when we’re talking about what the brain can do.  Sure, I’d like to understand all the different neurons and chemicals in play inside my brain, but only up to a point — after all, I just want to manage my constant pain in the best way possible.  I’m not looking to become a scientist.

Yet there are no chemical hooks on a craps table… But what it reveals again is that the story we have been taught about The Cause of Addiction lying with chemical hooks is, in fact, real, but only a minor part of a much bigger picture…

But if drugs aren’t the driver of addiction — if, in fact, it is disconnection that drives addiction — then this makes no sense.

As someone who lost money in Atlantic City when I was young, it seems I learned my lesson on gambling very early in my life.  I think the lottery is for people who don’t understand the odds, or want to believe that they’re lucky.  Irish or not, I’ve never been lucky, so I don’t have a problem with that.  On the other hand, I know that I’m not fond of risk, so perhaps it was a combination of these two things that controlled my need to gamble.  After all, losing money isn’t fun, and even when you win, it doesn’t make up for the losses.  Obviously, those who are addicted to gambling don’t feel the same way.

Unfortunately, my beliefs did not keep me from being addicted to cigarettes, perhaps because my dad smoked.  But I also have alcoholism in my family, and I didn’t have any problem giving up alcohol after I was finished partying in my youth.  It’s all rather confusing…

The chemical hooks from gambling are found in the reactions of the brain that make us feel good, and no, a drug doesn’t need to be consumed to suffer from addiction.  But the food we eat and the entertainment we seek can offer the same effect as a drug. Of course, being addicted to junk food, video games, and cigarettes is not against the law. In fact, you cannot remove the effects of the drug war on the brain… the fear and the criminalization of “illegal” medications and those who take them, the majority of whom don’t suffer from addiction.

And last, but not least, from Dr. Simon:  However, I do agree that 12-step programs (on the whole) are successful and that addicts should be treated with compassion and love.

Who are you agreeing with about 12-step programs?  Dr. Simon, are you a recovering alcoholic?  Treating addicts with compassion and love does not sound very scientific to me, unless you want to talk about the chemicals in our brains that are created when we give or receive compassion, love, and acceptance.

If there is a gene for risk-taking, then that is where science should be looking when researching addiction.  Would you agree, Dr. Simon?  I sure hope you respond — I’m looking forward to it. 🙂

It’s Raining Purple

[Etta] James encountered a string of legal problems during the early 1970s due to her heroin addiction. She was continuously in and out of rehabilitation centers, including the Tarzana Rehabilitation Center, in Los Angeles, California. Her husband Artis Mills, whom she married in 1969, accepted responsibility when they were both arrested for heroin possession and served a 10-year prison sentence. He was released from prison in 1981 and was still married to James at her death…