What’s the science behind addiction?
There has been recent controversy among Sackville residents regarding the installation of ENSEMBLE’s electronic dispensing service for harm reduction. The service, which is located in the United Church on the corner of Main and York, provides supplies such as sterile needles and pipes. Debby Warren, Executive Director of ENSEMBLE Moncton, says that with the installation of the dispensaries in both Moncton and Sackville, the non-profit’s goal “is working to ensure people with addiction disorders are treated in a respectful, non-judgemental manner.” But not all members of our community seem to share this view.
Part of what has created the controversy regarding the local electronic dispensary relates to stigmas surrounding addiction and how those with the disease are treated. It is often thought that substance use and addiction is a choice and that those who engage in the behaviour are morally inferior. Many believe that substance users do not want help, nor do they deserve it. These views lead to the erroneous belief that harm reduction services, such as the downtown dispensary, enable substance use.
Warren says that many believe “people choose this lifestyle.” However, she argues that addiction is usually the result of trauma in a person’s life, whether that be in childhood, generational, or life trauma. Warren says that “we all deal with trauma differently, some have support networks, coping skills–others don’t.”
However, as research about drug addiction develops , it is known that that addiction is a disease, much like cancer, lupus, and Crohn’s, for example. Dr. Joshua Gulley, a University of Illinois psychology professor researching substance abuse and addiction, recently conducted a study using laboratory rats that “can tell us a lot about how these drugs affect the brain and behaviour.”
Many common illicit substances used by addicts cause changes in the users’ brain regions that are known to be important for behaviours such as craving, impulse-control, self-control, and goal-driven thought processes. It is likely that people who begin using these drugs at a young age experience differential development in the front and mid sections of their brain regions linked to these behaviours. More specifically, these changes influence the dopamine systems, decreasing optimal decision-making processes, emotions, and thoughts.
Dr. Gulley says that while the findings on addiction in rats are transferable to humans, there are some limitations: “humans have very rich, diverse, and sometimes complicated experiences that very likely play an important role in how they respond to drugs” meaning that understanding the disease of addiction is all the more complicated.
Triggers can also produce automatic craving responses. Research led by Dr. Antoine Bechara, professor at the University of Southern California found that ‘just saying no’ can be an extremely difficult task, as our own brains can be working against us within certain scenarios. A particular place, sight, or even smell can trigger substance-use-related memories, which in turn activates subconscious cravings. When one cannot access the subconscious craving, feelings of frustration take over. The insula, a brain structure located in the front-to-middle part of the brain, then processes and translates this information from our sensory impulses.
The subconscious cravings that we have activate our impulse system, which intensifies the feelings of wanting something. Essentially, a given trigger causes the subconscious brain to say ‘Hey, I am in severe need of [insert substance of choice]… I need it right now!’ while the conscious brain is saying ‘No, that’s not really a good decision.’ However, the goal-driven or self-control systems of the conscious brain are already weakened, making it extremely difficult for the conscious brain and willpower to resist.
Think of something that you simply cannot resist or something that you have a hard time cutting out of your daily life. Maybe it’s chocolate? Social media? Or maybe it’s that morning coffee? Now, just stop thinking about it. Cut it out of your day tomorrow, the next day, and the next week. It probably requires serious self-control and willpower. Likely you will slip up one morning and check social media before rolling out of bed, or you will ‘just have a small piece’ of chocolate. Now, think about having a disease that actively weakens the neurological systems required to effectively use willpower and self-control. Imagine trying to stop a car with no brakes.
With the advances in science and society, we can learn to treat people with substance use disorders much like we treat those with any other disease or health-related issue. Or, we can learn to treat them how we would want them to treat us. Because after all, the science is telling us that addicted individuals are no longer choosing to use. Certainly, you would not judge someone for needing their daily morning coffee, nor would you judge someone for having Lou Gehrig’s disease, would you?