Response to Huff Post Article: The Likely Cause of Addiction has Been Discovered, and It’s Not what You Think

http://www.huffingtonpost.com/johann-hari/the-real-cause-of-addicti_b_6506936.html

So my goal today was to post an introduction to the neuron but then I read the above article and felt it my duty as a neuroscientist that actually studies addiction to respond to the many glaring problems with this piece.

This is my response (also read it on the Huffington Post Blog directly):

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.

Addiction is a very complicated disease with genetic, environmental, and drug-specific causes and effects. The disease/medical model of addiction is not a “liberal” view but the scientific view (which has no left/right bias). 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.

And of course, being in a harmful/stressful environment can induce or exacerbate drug-taking behavior. This has been known for years and the drug/stress interaction is a huge area of study within the addiction field. Stress induces chemical changes within the brain, and many of these chemical changes are similar to the ones that drugs cause. 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. The synergy of drug-taking and stressful situations also has a concrete molecular basis and there is an enormous body of published, peer-reviewed scientific studies that support this.

However, I do agree that 12-step programs (on the whole) are successful and that addicts should be treated with compassion and love. Treatment of addiction is just as complicated as the disease itself and multiple approaches are likely required. But to ignore the science, and claiming a political bias of the science, and cherry-picking a handful of studies that support a false overall conclusion, is inexcusably irresponsible. My newly-minted website is attempting to counter harmful information, such as this article, regarding addiction (drsimonsaysscience.org). Thank you.

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10 thoughts on “Response to Huff Post Article: The Likely Cause of Addiction has Been Discovered, and It’s Not what You Think

  1. Carson Gardner, M.D. January 28, 2015 / 1:12 am

    Dr. Simon,

    I, too am a doctor, one working on an Indian reservation to help real people with real addictions. I concur with your assessment of the scientific correlates of addiction. However, that said and with all due respect, current scientific research has not been productive in actually solving any street-level addiction problems to date. No doubt, you will say that the solutions are coming and the research must continue to discover those solutions. That, in itself, demonstrates that you and your research colleagues are not non-biased seekers of truth–you are seekers of research monies, even if you get them from your employer as a paycheck. Granted, research is necessary in order to learn. But please don’t assume that the only place learning can be done is in a lab with f-MRI.

    Here is my very personal take on what it means to live on an Indian reservation, be an Indian–though I am merely a “nosebleed Indian” if you are familiar with that particular slur–watch my family, friends, neighbors and fellow citizens grapple with the destructive forces of abuse drugs, and wonder “What went wrong?” with all the great Western science research that promised new, biologic “cures” for addiction. Please don’t use your “newly-minted blog” as a bully pulpit to smash the spiritual hope out of addiction recovery.

    Please continue your crucial neuroscience basic and applied research–while also allowing for the added dimensions of spiritual street-level reality in all its beautiful, inexplicable variegations.

    Sincerely,

    Carson Gardner, M.D.

    COVERT BOOK REVIEW—Carson Gardner, January 2015
    I have just been stunned by a “book review” describing a simply profound “new” vantage point from which to view the battlefield of addiction treatment science. Normally it is the tragic stories of addiction’s personal, familial, cultural and societal atrocities that, again and again, shock me. I don’t recall ever being shocked by a method of addiction healing. That is all pretty ho-hum, no offense meant: take away access to drugs, treat withdrawal, deal with criminal justice, invoke higher power, teach addiction science, provide sobriety and social-service support counseling, offer responsible peer-shared aftercare, wait for the next relapse, don’t give up—and realize that the odds are substantially less than 50% for prolonged sobriety with effective, productive, responsible, positively-adaptive community reintegration. Sad, but true, eh? Well, maybe not as true as I had thought, niijiiwag.
    The stunning book review with which I was gifted points out that the whole “war on drugs” has been a profoundly-flawed misunderstanding of human-spirit healing. People don’t stay actively addicted because of chemicals, receptors, habits and cravings. They stay actively addicted because of isolation, loneliness, futility and despair. The classic old “rat-cage experiments,” in which a rat placed in an empty cage with both a water bottle and a heroin-laced water bottle will almost always settle on the heroin-laced water as the better option, is a crock of…nonsense. Redo the rat experiment by first building a healthy rat community in a huge, well-provided cage; with enjoyable activities, healthy diet and the option for meaningful relationships. Then offer the heroin-water—almost none of the rats will fall for it. Then, even more revealing, redo the original rat-cage experiment but after a couple of months of lonely isolation and futile uselessness, relocate the heroin-addict rats to the healthy rat-community cage, while continuing to offer them their heroin water—almost all of the “addicted” rats will choose to go back to plain water after having the option of healthy and meaningful, truly-peer-connected life.
    That insight is part of what stunned me—but only part. We may seem like Earth’s “connected society,” with all the internet, cell phones and social media; but, in truth we are the almost-totally disconnected society—ever more isolated from spiritual connection with each other. The rest of what stunned me about the book review is this: We First Nations Anishinaabeg people have been caged—emotionally, spiritually, culturally and intellectually—by the theft of our past traditional world views and healing communal-and-personal rituals and relationships. Rituals are not, in and of themselves, somehow magically healing—they’re just very important reminders of the underlying foundational principles of healthy, adaptable, creative, meaningfully-shared life Creator offers us. Our underlying principles, here in Anishinaabeg country, tend toward the seven grandfathers teachings and the medicine wheel way. When we had the option of voluntarily and freely choosing to live these principles in our rituals, relationships, responsibilities and recreations there was very little—if any—addiction in Native communities. But when our past, our beliefs, our world views, our purpose, our meaning and our inter-personal and family/clan connections were first stolen; and then when into our “empty cages” were placed alcohol and other destructive chemicals— guess what? We went for the symbolic, temporary illusion of “escape” those chemicals offered.
    Interdict abuse-drug supplies? Take down manufacturers/growers? Jail dealers and users? Shame and frighten addicts and their families? Desert “losers”? Keep criminalizing chemical escape-the-cage attempts? Won’t work. Give lonely, hopeless, desperate, angry, marginalized and trivialized, broken-spirited people back safety, peace, meaning and purpose—model it for them and with them, from a heart of respectful love. Will work.

    I won’t even tell you the title of the book, right now. You can either guess or start hunting! But I’m going to buy it and read it. And even if the book turns out not as good as the review I read, I guarantee that getting back to living by the traditional spiritual principles of honoring the land, the spirits, the seven grandfathers—and each other—will be heart-stopping. No, it’ll be resuscitatively heart re-starting. Think about it, while you’re waiting for my after-the-read book review. The book, apparently, has found a way to model going from the bad cage to the good cage. That’s O.K. But we Anishinaabeg aren’t lab rats—we know our traditional spiritual heritage has, all along, showed us how to stay free of all cages. Think about that, too, niijiiwag. Mii i`iw.
    ###

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    • derekpsimonphd February 3, 2015 / 9:28 am

      Dr. Gardner,

      Thank you for taking to the time to respond but I am not am MD, do not work directly with addicts (and did not suggest either of these things) and never claimed that current research had solved the problem of “street-level addiction”. Furthermore, I do not do fMRI studies either; the state of neuroscience research has advanced to level of detailed molecular analysis, the details of which I will continue to write on for the general public. Like I said, addiction is a complicated problem with sociological, economic, public policy, AND biological components. I also never claimed that a single “cure” existed so please do not put words in my mouth. However, I am a scientist and while I do not wish to dismiss your spiritual beliefs towards addiction treatment, I deal with objective facts and this is what this blog will focus on. There is a great deal of concrete, hard-evidence dealing with how the brain functions and how the drugs affect the brain and that is what I write about here.

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  2. katie February 27, 2015 / 2:07 pm

    Thank you so much for this important post. May I quote the post (cited, with a link to your blog) in a piece I am writing?

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    • derekpsimonphd February 27, 2015 / 3:40 pm

      You’re very welcome! Yes, that would be great. Also, if you have any other addiction or neuroscience questions, please don’t hesitate to ask. I don’t claim to be an expert on everything in the addiction field but can at least give you my most educated response. I would also like to point you to another one of my other posts which is a link to a Huffington Post article on the treatment of opioid addiction . The reporter who wrote the article actually visited the lab I work in and interviewed my boss. She is quoted several times in the piece. It’s probably one of the best pieces in popular media that I’ve read on the subject. Thanks for your support!

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      • katiemac February 27, 2015 / 4:06 pm

        Excellent, I will definitely check that out as well. I look forward to reading more of your articles, too.

        Like

  3. Foghorn The IKonoclast March 25, 2015 / 11:57 pm

    City and National governments have a complex system that accommodates and even uses the vast system of government as a source of revenue, so they may not be entirely without guilt in getting people the help they need. IMHO.

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