UNDERSTANDING and MANAGING ADDICTION

Scientists seem to have found the underlying defect that explains why some people get addicted, be it to substances (alcohol, tobacco or drugs), sex, the internet, gadgets or shopping, with the discovery that addiction drives up levels of a chemical substance called Dopamine in a part of the brain called the “Pleasure Centre”.
In an article published in the journal Nature Neuroscience in June 2014, researchers from USA looked at addiction related role of nerve-to-nerve communication in the brain, and concluded that activity in the neural circuit that provides the feeling of pleasure gets unduly strengthened in addicts, to the extent that it then starts obstructing other circuits dealing with reasoning and self-control.
Addiction is therefore proving to be a brain disease of a chronic relapsing nature that cause compulsive seeking of pleasure-providing substances or acts that the addict finds helpless in controlling by will power or logical reasoning.
Anyone who has observed an alcohol addict could not have missed noticing his helplessness – in saner mood in the morning he seems to realise and admit that what he is doing is wrong and harmful, often expressing remorse and promising to stop. But come evening and there he goes compulsively after the bottle!
In a recent national conference on alcohol addiction (ALDACON 2015) in Delhi, organised by HOPE Initiative, neuro-psychiatrists drew attention to how society often mistakenly assumes that abusers lack moral principles or willpower, believing that the solution of stopping alcohol or drugs simply lies with their choosing to change their behaviour.
In reality, addiction is a complex disease and quitting takes more than just good intentions and strong will. And because drugs or alcohol change the brain by activating and strengthening the ‘Pleasure Pathway’ with surplus amounts of Dopamine, the cognitive or reasoning pathway is rendered weak and ineffective.
No doubt the first step to addiction begins with a voluntary exploration or seeking of pleasure under temptation or peer pressure. The brain quickly recognises the feeling and perpetuates it repeatedly so that the person then feels compelled to take the drug or perform the habit to maintain the high.
This new understanding is bringing about a profound change in the way de-addiction centres are dealing with addicts. Effective therapy often needs a combination of medicines that reduce craving, substitution of the pleasure seeking substance with less harmful mimics, as well as treatment of the associated anxiety or depression that some forms of addiction such as to alcohol is often associated with. Motivation of course still remains pivotal, but with good family and social support, getting off the hook is getting easier.
In our present permissive times of easy access to pleasurable substances and habits, addictions are getting frightfully common, but a deeper understanding and availability of targeted therapies should help to bring many of them back to normalcy.