So here’s the resolution that occurred to me.
The problem was that the learning curve that describes addiction onset is often unusually steep — what I’ve called accelerated learning. But the biographies I include in the book, and other tales of addiction sent my way, sometimes show a gradual onset — a period of coasting before substance use takes off. And sometimes there are plateaus, or even remissions, when our addictions may live underground. We might hear them stirring late at night, but they don’t always rise up and send us on another cliff-hanging romp with self-imposed torture.
So I wanted to come up with a description of addictive learning that allows for accelerated learning but also gradual onsets and plateaus. The following is a (slightly edited) passage from the final draft of the second-last chapter, sent to my publisher this morning. It’s not particularly new or amazing, but I think it covers the issue. And serious thanks to you guys for the suggestions and insights you posted or emailed to me. They helped me think it through.
Brain changes naturally settle into brain habits — which lock in mental habits. And the experiences that get repeated most often, most reliably, and that actually change synapses rather than just passing through town, are those that are emotionally compelling. Most important, combining strong motivation — such as desire — with frequent repetition changes the rate of learning. It speeds up the feedback cycle between experience and brain change. This kind of accelerated learning is bound to boost the entrenchment of long-term habits, for several reasons:
- because desire focuses attention like nothing else, and attention is the springboard to learning.
- because addiction offers highly desired rewards that disappear before long, thus priming the desire pump repeatedly.
- because a feedback loop that cycles faster will generate more of whatever it generates, thus accelerating its rate further. This is the well-known snowball effect.
- because any growth process that is speeded up enough will outrun its competitors. Since synapses fade and disappear when they are no longer in use, and since addictions are pursued at the expense of other goals, addictive habits come to usurp habits incongruent with addiction — like caution, integrity, and empathy.
The onset of addiction doesn’t always looks like an accelerated learning curve. The biographies of Brian and Donna show us that people can take drugs for a long time before they become addicted. Brian’s use of stimulants and Donna’s use of opiates had little motivational thrust for that initial period. Brian was trying to remain awake and alert so he could accomplish work goals, and Donna was taking Vicodin for pain long before she took it for pleasure. Nevertheless, both Brian and Donna reached a turning point, at which the learning curve must have risen steeply. For Donna, this occurred more than once, since there were periods of calm between her drug-stealing storms. The learning spiral would have first quickened, showing a snowball effect in behavior and a cascade of neural changes, when Donna and Brian began to pursue drugs for the feelings they provided, not as a means to an end — when desire kicked in and their quest for drugs overrode their other goals, including the wish to avoid big risks. That’s when their lives started to unravel.
Because the onset of addiction must include one or more phases of accelerated learning, but can also simmer for long periods, I’ve settled on the phrase “deep learning.” This is meant to cover the overall profile of addictive learning, including periods of rapid change and periods of coasting (or even periods of abstinence — “remission” in medical parlance). Note that this profile corresponds with models that view the onset of addiction as a series of stages or steps.
That said, I want to wish you all a calm, happy, warm, peaceful holiday. May we all be free of our demons and let the holiday maelstrom of emotions pass without harm.
Informed by unparalleled neuroscientific insight and written with his usual flare, Marc Lewis’s The Biology of Desire effectively refutes the medical view of addiction as a brain disease. A bracing and informative corrective to the muddle that now characterizes public and professional discourse on this topic.” —Gabor Maté, M.D., author of In The Realm of Hungry Ghosts: Close Encounters With Addiction
Happy holidays Marc!
I have worked on a theory for addiction which I call a cumulative theory: Essentially there is a momentum towards or away from addictive behaviours. Some people are more at risk, or have a gentle slope towards, and some people have little risk, or a slope away from. Essentially factors can build to increase the momentum towards or away from addiction. The whole theory is too long to explain here, and still not finalised, but it aligns very much with your previous statement: “Repetition + desire + loss of competitors + the fundamental nature of the snowball effect in learning…. There are so many factors that come together to accelerate the learning curve.”
So really different factors accumulate until the force is great enough to overcome the inertia, and then a bifurcation point is reach with very rapid acceleration. This can happen both neurologically and in terms of “life-events”, one feeding in to the other perhaps?
Anyway, I hope you have a great festive season and look forward to more discussions in the new year!
As a manager of two sober houses for four years I would agree with this if what you are saying is that conditions can trigger the focus of desire as well as a change or decrease in that focus. I basically saw two groups of women enter the homes I managed. Most of the women fit two age groups. One age group was between17 to 23 and was a group floundering right out of high school. This group was, for the most part, signed into the sober houses by parents for flunking out of their first years of college. Very few had criminal histories. The second age group was between 40 to 60 in one stage of menopause or another, divorced or considering divorce, most with older children. I see biology and age as fitting into the category of environmental change in relation to how it can have an effect on wellbeing. This group signed into the sober house under the duress of family or the courts. Almost half of this group had criminal records of one or more DUI’s. The time spent in abstinence from alcohol/drugs was very beneficial in focusing on who they were and wanted to be in their next steps of life. Gaining this insight created more self-confidence and the ability to re-frame many experiences and look for help in areas they felt stuck. The communal atmosphere provided affirming support from piers with similar experiences. I think most all learned the value of slowing their lives and thought processes down to practice and develop the idea of acting rather than reacting to their personal life experience. During the four years I managed the sober houses I observed the comings and goings of approximately 300 women and none had a close proximity to a sense of real self-identity. All were filled with a shame of not being able to live up to the expectations others had for them. All felt traumatized and reframing their experience would take a lot of time but with the right condition it surely did happen.
Hi Cheryl. I hadn’t read your comment before replying to Shaun, in the comment that comes below this one. But maybe I read your mind. Your astute observations fit perfectly with Shaun’s and my reasoning.
In fact, I would have fit in the first age group when I started taking drugs. My addiction began at age 18 and skyrocketed through my early twenties, and it was fueled by the depression and alienation I’d carried with me from boarding school to university. Then the older age group you mention…they’re the specialists in later-life disasters, including, as you say, broken marriages and separation from kids (or kids growing up and leaving the nest). In fact, my last marriage failed when I hit 45. I was in England with my daughter, my step-sons were suddenly not “mine” anymore, and I spent many nights in the local pubs, drinking beer while my kid played in the children’s area. Luckily I stayed off drugs while riding that wave, but I guess I came close to tossing it all in.
So…these developmental windows provide an important perspective on addiction over the life cycle. And they’re not far from home. Thanks for your input.
I think it is so important to notice how condition through ones life trigger the lack of self-esteem and self-trust which, as far as I am concerned, lead to the habit of self medication. We live in a society that doesn’t do much to shore up self- reliance, self-trust, resilience, and self love so we are left with a large vulnerable population. The qualities I mentioned above are ones that require practice every day because conditions will change and it is our reaction to that change that determine how we see those changes through. I would love to see the little ones trained in taking personal responsibility for this practice. It is one they will need throughout their lives and it is difficult to change brain/thought patterns, habitual reactions later in life. Although it can be done. Just takes more diligence. Thank you for the contribution your books will have on taking an honest look at the bottom line of all of this.
HI Shaun. Happy holidays to you too! I’m never surprised and always pleased to see your comments here.
We’ve talked about this and in fact your voice has helped me gather these ideas into a versatile model. The stage-like nature of addiction, the inflection point or bifurcation point, the impact of life events…Also, you and Matt helped me to see that the rapid rise of addictive behaviour is easily triggered by the retraction of countervailing forces, like self-regard and self-regulation, when things get bad.
I think your emphasis on the word “cumulative” is right on. For me there was one major life event — being sent away to school. But then quite a few straws were placed on that camel’s back, including bullying, winter blues, the defection of a friend with whom I’d planned my escape from school… For others, it can be a packet of life events that strike like shot from a shotgun. Separation, loss of connection with children, financial disasters, often they come in clusters. So, yeah, bad shit happens, negative emotions go up, the allure of the “cure” goes up, and the rationale for resisting it goes down. And then you’re off.
Thanks for all your good ideas and have a good rest for a few days.
Hi Marc
I’m first here because I suspect most potential posters are otherwise occupied today.
I like your thinking here. The alternative you are proposing to the disease model has to have a way to acount for the roller coaster like attributes of real world addiction. The steady state assumptions (hooked once and forever) of the disease model is one of its worst deficiencies.
Somehow you made me think of Neil Young’s epitaph for a departed junkie (Tired Eyes):
“He tried to do his best, but he could not.”
Hope the book is on track. Mark me down for a copy.
Hi Jeff. It seems Shaun had you beat by 5 minutes….and then Cheryl’s and my comments were nested under his. But you still made a very respectable showing.
It’s true, the disease model would suggest a steady state or a steady rise and then plateau. It’s not very good at rolling with the punches of life events, or at conceptualizing the teeter totter of negative emotions and self-regulation that gives rise to accelerated learning.
I’m still tinkering away at revisions — this book ate up my four months in L.A. But it’s so close to done, and my editor just sounded the alarm so I have to get everything in by the beginning of January.
I’ll definitely put you down for a copy — a free one in fact.
Happy holidays!
This makes sense to me, but I think I’m still trying to wrap my head around it. Isn’t the early regulation attributable to the higher cortcial functions of “caution and integrity and empathy”? What is influencing the waxing and waning, the plateaus and the cyclical buildup of addiction? The early recognition of the attraction and seductive relief the addiction provides, as being potentially dangerous? Even Donna and Brian’s earlier “practical “use of their respective substances as “tools” gave them a functional preview of the relief they could provide as coping mechanisms. There was some motivation to use them practically at first. The heroin use by jazz musicians in the 30’s and 40’s is an example of this.
Also, I’m not sure I understand the color coding of the curves…shouldn’t the steepest one be the red one?
Good morning Matt. Don’t think too deeply about the color coding. I just “borrowed” that image from Google, as it was close enough to what I had in mind.
I’ve already put your two cents in for you….see my reply to Shaun, above. I totally agree with you. As I state above, the retraction of self-regulatory skills is a strong precipitating factor, which you have reminded me about — didn’t you call it “decelerated learning”? And you and I agree that this can take time to happen. Indeed there is a parallel between changes in cortical mechanics, life events, and the addiction learning curve. We’ve discussed this. But to summarize for others, there’s a disconnection between the most sophisticated part of the prefrontal cortex — what I call the bridge of the ship — and the striatum, where craving triggers goal pursuit — what I call the motivational engine. That disconnection is measurable with scanning methods, it takes time, it’s likely to correspond with changes in thinking that synch with life events, and it rearranges some prefrontal capabilities, at least for awhile.
Thank you, Marc. But you know that OCD/ addictive part of my brain…some pretty colors, an oblique distraction and it’s off to “Squirrel!!” mode.
I’m toally aligned with you and Shaun. Whether it’s the cumulative wear-down of the drip-drop of water torture or a debilitating shotgun blast, eventually there has to be a re-integration of self that puts Humpty together again in “recovery.” Whether it’s kicking the squatter out, or shaking hands and going back into business, you cross a threshold of acceptance that is overarching. And before I massacre any other metaphors, I’m gonna quit while I’m ahead.
Marc, thank you for this blog and for the work you’re doing. I went through the typical teen drug experimentation back in the mid to late 80’s. When I was about sixteen I was sitting in my 7th period ( is that the last one?) math class on a hot May afternoon struggling to cope with the lethargy I was feeling. I had probably toked with friends before school and at lunchtime, so I was feeling pretty burnt by then.
My friend at the desk next to me casually handed me a bullet with peanut butter crank in it. I snorted it and within 5 minutes I was feeling refreshed and uncharacteristically interested in what the teacher was saying. I thought, ‘man, if I could get a pound of this stuff I could get straight A’s for the rest of my high school days!’ Common story I’m sure.
That summer I discovered that owning a car would get me free meth. I knew people who wanted to score but had no way to get to their dealer. I ended up wasting the entire summer running around town, sitting outside scary houses in the barrio for what seemed like hours waiting for the promised crystal.
After about a year I started getting bad sinus infections from snorting who knows what chemicals. Fortunately that was before smoking meth gained popularity. At some point I realized that if I had to get on one more course of antibiotics my doctor might start asking questions. I knew my mom would be devastated if she found out I was doing meth so I decided to quit.
It was during that same year that I first took acid. I remember thinking it was a love drug. It made me more aware of my health and gave me an appreciation for healthier foods. I guess it opened my eyes to a more holistic lifestyle. I credit LSD and mushrooms for helping me stay off meth. I haven’t tripped in about twenty years and it’s been even longer since I did any meth.
Ironically, as a result of reading your book, I read Gabor Mate’s book on ADD. I recognized many features of ADD in myself and surmised that a poor connection with my mom when I was a baby had effected my dopamine making apparatus. After much deliberation and weighing pros and cons I found a doctor who ‘specializes’ in so-called ADD and got a scrip for Adderal. I’ve been experimenting with it for about six months, never taking more than the prescribed 30 mg per day. Well, a few times I took 35. Well, long story short I’ve increasingly come to the conclusion that the comedown is not worth the feeling of well being and centeredness.
A few months ago I discovered the concept of microdosing psychedelics for improved functioning. I started on a regimen of psilcybin every three days about a month and a half ago. My Adderal intact decreased considerably in that time, I’ve taken it maybe a handful of times.
I’ve been reading some exciting things about the potential of psychedelics to help people overcome drug and alcohol addiction. It’s great to know that restrictions on research are finally being lifted. I recently read that Lindsay Lohan has tried Ayahuasca and that she feels it has helped. I say good on her! That took a tremendous amount of courage and I hope she continues to get better.
Anyway, thanks again for this blog. I realize the fact that having amphetamines in the house and that I was probably addicted to meth years ago makes me vulnerable to addiction to that substance.
Morgan.
That should have been Adderal ‘intake’ there near the end.
Cheers
Hi Morgan
It’s funny how so many people’s stories sound the same— even when separated by 20 years. Yours sounded a lot like mine during the late 60’s..
It’s true that looking at psychedelics in a clinically constructive way holds promise in many areas. That’s what was supposed to happen when they first emerged, but the belligerent brouhaha of the 60’s quashed that notion. Let’s hope the research on treatment possibilities can continue now that the hysteria has abated
Amen brother! So here’s a conundrum. Having altered my psyche at a relatively young age I have no way of knowing whether the depression I’ve suffered since before then was exacerbated by psychedelics or whether psychedelics still hold the promise of relieving me of depression.
Without knowing someone and their situation, I would never presume to give anybody advice on their depression. That pit is too deep and the stakes are too high. The effect of drugs is hard to tease out— especially without knowing how much you used, for how long at what potency, etc.. I knew intuitively what worked for me, just like that day in high school when like you, I felt my lethargy and malaise dissolve within minutes after filling that hole with the right substance. “Oh, okay. So this is how people manage this.” And it was a deep hole.
What I would do is an experiment. Get clear of substances for some time, then really try the non-pharmacological methods at my disposal(for at least 3 months)— exercise, psychotherapy, meditation, diet, skydiving, whatever’s helped me in the past. Then with someone else to hold me accountable, I’d try a very measured regimen of the low dose psilocybin. If I couldn’t stick to that, it escalated, or the depression became intolerable, I’d seek help and other alternatives. We need someone else to keep us honest in these attempts, because doing it alone, we’ve been our own worst enemy. We use the stuff the way we use it. That’s why the reality check that groups provide can be so helpful.
Good luck.
I can do that. Thanks a lot for the feedback Matt!
Happy Holidays to all
The idea of ” tipping point” just popped into my head in reading all this
Matt, I just now saw and read your post on Mindfulness meditation. The concept seems to be popping up more and more for me although I have been aware of it for several years. I spent about a year near the end of the last decade involved with a Zen community. I would go to the zendo several evenings a week and really enjoyed the restful effects on my mind of sitting on the cushion. Sometimes it was TOO restful, but anyway at some point I stopped going because I just couldn’t seem to embrace the cultural and religious aspects.
You mentioned ski diving and although I can’t see myself jumping out of a perfectly good airplane I do enjoy several adrenaline sports and I believe they’ve been instrumental in helping me avoid serious drug addiction. I feel most alive when I’m experiencing the focus and sense of mastery that I get when I’m one with the board or the bike. The older I get the more I’m able to get in the ‘zone’ without going at breakneck speed on the ragged edge, thankfully!
I know that mindfulness practice is and will continue to be a helpful addition to the transpersonal therapy I’ve been doing for quite some time. How important do you feel is having a regular sitting practice? I know that ideally our everyday life would be the practice but I can’t seem to remember to sit at a certain time and for a specific duration.
As I was typing that I was reminded of a talk on Youtube that John Clease gave to some corporate group regarding the importance of meditation for spurring creativity. He thinks it’s important to create a space just for meditation and that an hour should be the minimum duration, since he feels it takes at least a half hour to just to quiet his mind and make it receptive to inspiration.
Hi Morgan
Everyone has difficulty finding the time to sit and for what they believe is the optimal duration. The short answer is the obvious one: regularity trumps frequency and duration. 5 minutes isn’t as good as 30, but it’s better than nothing, or just 2 hours on Sunday. It’s good to link your practice to already established routines like meals or waking/bedtimes. How long is best varies considerably from person to person. I asked a Tibetan lama once what the minimum time was that one could benefit from meditation and he said authoritatively: 21 breaths. So it’s relative. Find what works best for you and stick to it. Then you’ll start to notice when you don’t do it. There’s a joke: Why is meditation like going to the bathroom? Everyday it’s the same thing, but always very different; some days are better than others; and if you don’t do it for a few days you can get a little cranky. Just like our recovery practice.
Have you looked into what a method like system dynamics might do for our understanding of drug use and addiction? Your discussion of accelerating rates, bifurcation points, feedback, etc. sounds like it could have come from a system dynamics lesson plan. SD is not often used at the individual level, but it has been done. I’m considering doing so for my dissertation, but am more interested in proximate social influences on drug use, and how these might be harnessed to kick in those self-regulating “countervailing” balancing feedback loops in the system.
Hi Erin. I studied nonlinear dynamics (complexity theory) approaches to developmental psych for years.. That’s what got me into neuroscience in the first place. Wrote a few articles from that perspective, but once I got into addiction science, I could only use these ideas in their most abstract form.
Still, the notion that the brain is a self-organizing system driven by feedback with experience is, to me, a very fertile idea that informs any developmental phenomenon, including addiction. Thanks for bringing this into the discussion.
Hi Marc,
Just a quick hello here from NYS. Wanting to wish you a very Happy New Year and to let you know I loved your book, read it several times; it helped me (with much time and discipline) end my own opioid addiction. Now four years removed from what I thought I could not enjoy and interact in life without ~ cheers to that and to you sir.
Best ~
mjs
Hi Michael. I sometimes hear how my book has helped someone quit, but each time it makes my day. Especially when you highlight the newfound ability to enjoy the rest of life. I remember that, as an addict, the thought of enjoying what I then felt to be mundane and flat seemed like a stupid dream. Isn’t it amazing to cross that barrier back into life and see it with new eyes? Thanks very much for letting me know. And happy new year to you!
I liked your thoughts on brain habits turning into mental habits and how repeated emotionally compelling habits change synapses. Interesting. It certainly doesn’t take long to become an addict by giving into some emotionally compelling habits. Last week I listened to a 95 yr old woman talk about habits she is still trying to change. She made a great point when she said things are much easier to give away than habits.
What a splendid case in point! Whoever this 95 year old woman was, she must have been a wise old lady with a good sense of irony. Thanks for this image.
Interesting article about a Heroin Addiction Vaccine …
http://time.com/3654784/why-youve-never-heard-of-the-vaccine-for-heroin-addiction/
Well you know there have long been substances you take to block the substance that you really want to take, like Antabuse for alcoholism. The problem is that people take drugs because they want to feel the drug, not the vacuum that is left in its place.
If you want to keep rats from taking opiates, there’s a much easier way: put them in community cages where they’re not isolated and depressed. See the Rat Park studies: http://www.brucekalexander.com/articles-speeches/rat-park