I didn’t think I’d do another blog post for a few weeks, but I am learning so much about addiction — from gamblers! — I have to share it with you.
Gambling really is a problem in Australia, and here’s what it looks like. The night before last I was walking around Melbourne, searching for a restaurant, when someone pointed me to the casino — a magnificent building with an enormous neon crown emblazoned on its glass and concrete exterior. The Crown Casino. I entered, past smiling security guards, and strolled down a central corridor infested with slot machines, one glittering gallery after another branching off it. Different rooms sported different games: 
roulette, baccarat, poker, some blackjack tables, but the most riveting signs above each table announced minimum bets per hand: $50, $100, $200, $500. Per hand! (at one point I located a $10 blackjack table and calmly surrendered my $50 stake.)
The roulette and card tables weren’t really that interesting. Very rich, mostly Chinese people stood around throwing away tremendous amounts of money, not much moved either by winning or by losing.
But there were some roulette tables where one or two dowdy looking men stood, intently calculating. Just before each spin they would spread their chips in some intricate cabalistic pattern of numbered squares and 
intersecting lines. And when the wheel slowed down and the white ball finally settled, it mattered. You’d either see a flash of triumph or else despair. And sometimes a protest:
“Oh fuck, again?! You couldn’t do me a favour this once!” shouted one man, only slightly conspicuous by the sweat stains in his armpits.
And then he’d shovel another $50 or $100 at the dealer and get another pile of chips in return.
“Who was he angry at?” I asked the dealer, after the guy stormed away. “Is he angry at you?”
“I’m just doing my job,” the young man replied. He looked like he might be working his way through law school.
“Yeah, but they know that, right? And they know that whatever number comes up is completely random, right?”
“Sure, they know it, rationally they know it, but they still think they’ve figured out the pattern. And I don’t know why that guy was so mad. He won a thousand bucks in the last hour.”
I think his anger came from shame. Losing makes you a loser, especially when someone’s watching. But the most horrific sights in the casino were the slot machines. These high-tech electronic monsters are designed to instill a sense of triumph while you continue to lose your shirt. Men and women of all ethnicities and incomes sat there and hit one of a short row of buttons mindlessly, repeatedly, watching their net balance dwindle, roll by roll. But with occasional rebounds — accompanied by flashing lights, prancing cartoon nudes, and peppy 
jingles. Only to continue their downward journey a moment later. I watched a middle-aged Eastern-European couple shovel bills into the slim mouth of the machine every few minutes and keep on playing. Did they actually think they would win? I asked them that. The man told me to go away.
What was so spooky about this robotic ritual was the flatness of the facial expressions. The players hardly reacted to winning — or losing. Their expressions didn’t change. They just kept punching those buttons, every time the machine reset, which was every few seconds. And for them it mattered.
Losers eventually have to give up. Then they go home and lie to their loved ones, take out another loan or ratchet up their credit card maximum, and come back to press that button again in a few more days. The only time you see emotion on their faces is when they finally stop, transfigured by despair and disgust.
Nobody has to tell you that gambling is addictive. It’s obvious. But here’s what I learned that night and in my readings and discussions since then:
First off, the compulsive slot-machine players looked exactly like end-stage drug addicts. People who snort or shoot up hour after hour or minute after minute. They’d display almost no pleasure. And then, when it was all gone, they’d go out to score, because that’s just the next step. I’m reminded of a guy 
bedded in the cot next to mine in a cheap hippie hotel in Delhi, many years ago. This guy would rise up on his bed, reach down below for his carton of morphine ampoules, break the top off one of them, load it, shoot it, and then lie back down for almost exactly four hours. Until he started to twitch. Then he’d do it again.
Maia Szalavitz calls it the hedonic treadmill. And it’s got everything to do with our standard biological computations. It’s about dopamine and reward prediction error. If the reward is the same or less than what was anticipated, the dopamine surge that came with anticipation drops back down to zero. With heroin, that takes place soon after you get the rush, the buzz…once you realize “oh this is all it is? — Now what?” With coke you get it in a few minutes, once you perceive that this little bump was merely a flash in the pan. False advertising. Ice-cream melting. But with gambling?! These folks lose almost every bet, and the bets they win are tiny.
So that’s the exaltation offered by gambling.
But then there’s the longer-term loss. The loss you feel when you get up after you’ve given up and look in your wallet (as if you had to) and realize that you lost it all.
Then there’s the blunting. I won’t get into that here, but addiction neuroscience is pretty clear that dopamine receptors thin out with all that action, so all rewards — both those provided by the addiction and those provided by pizza, sex, and playing with your dog — become flattened, diminished, boring. In which case, all you can do is to take bigger hits (more coke, more smack, or bigger bets at the tables) or else — finally, once you’ve had enough — quit. (Note that disease-model advocates conflate this effect with tolerance, which often rises in parallel though it’s not the same thing.)
And then there’s the really long-term loss: the loss of self-esteem. That’s the shame and mortification and self-disgust that shrouds you the way mist clings to the branches of a dying tree. That’s what gave rise to the rage of mister sweaty-armpits roulette player — anger borne of shame. That’s what gave rise to the despair shown by the couple with the Eastern-European accents as they staggered away from the slot machine, the machine that betrayed them.
Sound familiar?
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
Interesting stuff, Marc. Would you explain why flattening of rewards is not the same as tolerance as in your second last (substantial) paragraph?
Good question, Nik. Certainly the down regulation of Da receptors produces one kind of tolerance. Marc needs to be careful not to get too close to the disease model. He also has to deny disease status to disorders like OCD for the same reason. He just misses the point that natural processes can go awry and produce disease. Of course, he’s also a “recovered” addict who’s using (alcohol), so there you are. When the fix you’re using is the problem to be fixed, you’re sick.
Wow Nicolas, that’s a very big judgement to put on Marc. The majority of people who use alcohol do so without problems, but because he had an opiate addiction a long time ago you’re saying his use of alcohol has to be problematic?
Marc can take it in the spirit it is meant. Since all addictive substances and behaviors activate the same brain circuitry, to become addicted to one sensitizes the system to the others, curse the luck.
Nah. I didn’t much like the spirit of your note, because you are saying my judgement of the mechanisms of addiction is distorted because I used to be an addict and now I’m a social drinker. Those are cheap arguments.
Normally I do like sparring with you, but let’s find some, um, tolerance.
The only person who knows if Marc has a problem with alcohol is Marc.
It feels creepy to me to talk about him like he’s not in the room
True, Matt, but there’s a deeper issue here. Whether I had a problem with alcohol, still do, used to be an addict, still am, have dandruff or unfortunate taste in sportswear has no bearing on the validity of my explanation of the physiology of addiction. Unless I truly am brain damaged.
We need to be careful about implications. The hidden assumption that addicts or people with “problems” (past or present) can’t think rationally about addiction is exactly what we need to overturn.
Agreed. I try to every day. And the most important tool we need to keep honed and at the ready is listening.
Guilt, regret, remorse are all about something we did. Shame is about who we are, or what we feel we are. My feeling that I’m a piece of shit cuz I lost at craps is not helpful to anyone.
Yes, for sure. By the way, to take the argument a step further, it seems to me that people who’ve been in addiction are often better suited to try to explain this complex phenomenon than people who’ve only looked at it from the outside. I’d bet you’ll agree with that as well.
You can’t truly understand another’s experience until you’ve walked in their shoes. I think that’s a fundamental truth we all forget from time to time.
The fix your using is not the problem, but the end result of other underlying issue. You are using that fix to fix other problems. Unless you become dependent on that fix, then you are fixing the side effects of that which you are using to fix. I am not a profession in diagnosis but even I can relate that OCD is a DISORDER not A Disease? Otherwise I would think they would have called it OCDD? I think people are SICK if they believe the problem is solely the substance of abuse and believe if simply quitting that substance is the answer.
Excellent point. Start with self medication for whatever which develops into an autonomous psychological behavior pattern which locks it in, at which point the fix for the addiction problem (not the underlying one that the substance initially relieved) is using which is the problem. It’s like the addiction is a dissociated (and very sick) state.
Thanks, James. Why so bitter, Nicolas? Please see my explanation of the difference between tolerance and DA receptor change.
Because the thinning or decreased sensitivity of dopamine receptors is about dopamine receptors. It is the cause of reduced excitement or possibly pleasure (of the high-energy kind). And it is temporary. And it’s the same thing your kids will experience after a week at Disney World. it’s also notable with porn addiction and internet (gaming) addiction.
Tolerance can take place at other receptors, for example opioid receptors (in the case of opioid addiction), which also become less sensitive or else their activation is counterbalanced by other neuromodulators, like norepinephrine, in the body’s attempt to attain homeostasis. Tolerance to meth most likely depends on the desensitization of norepinephrine receptors, so it’s sort of the opposite. Only some drugs produce physical tolerance, but any drug or other highly-rewarding experience can down-regulate dopamine receptors. These two consequences of repeated drug use often overlap, hence the confusion.
addictions are never cured – they are only replaced by better habits, hopefully. All humans operate by habit, a mix of good and bad, and some habits become addictions often due to high levels of anxiety, from various sources. in all my years of work in this field and in my own experiences there is no other possibility than replacing bad habits with other habits. whether the new habit(s) become in their own time addictions is dependent upon how much the person has changed inside themselves from one who unconsciously treats themselves badly to one who seeks to treat themselves well. that’s my view anyway for what its worth.
Well, if they’re replaced by something better, doesn’t that mean they’re gone?
Matty H,
If falling “in” and “out” of love is a way of describing addiction and recovery, a person can refer to their own personal experiences with falling “in” and “out” of love, to understand their own addiction and recovery.
Some things that seemed love-eternal, may no longer spark the feelings and desires they used too, yet others last a lifetime.
This cannot be measured or confirmed medically, only the individual knows,
Change seems to be due to realizations that can occur.. regardless of whether a person is in addiction treatment or recovery programs or not.
Not really. Because if you start chipping or spotty usage and something hasn’t filled the hole left by the addictive habit, those old pathways can light back up. It won’t be like starting over, as if the pathways were gone.
The replacement by another habit is about intention. If it’s fulfilling enough, the motivational vectors center on the new habit, and you don’t feel like going back. I could drink or use if I wanted to, but I don’t.
I have a different relationship with my life and the world. Why would I want to go back to old abusive one, even for a visit? Having unconditional positive regard for myself and my relationship with the world is key for me.
Good to hear that you’re doing well. But do you have any evidence for the claim that a clean slate is never possible again?
Hi Matty
It depends on what you’re asking. What do you mean by a “clean slate?”
Terry,
Rather than “sick” and “cured”, terms such as falling “in” and “out” of love is being considered.
Maia Szalavitz and Gabor Mate are currently referring to this area, and in hindsight, it is indeed more applicable.
maybe other addicts that no longer feel addicted , ( i.e. ex-addicts) may agree.
This new consideration may offer some major insights into the understanding of Addiction and recovery in the 21st century.
in a way its all about a word – addiction – where does a habit become an addiction and then does an addiction remain that or does a habit/addiction wax and wane depending on the life stressors present or not at any point in time – 40 years later I remain a person very prone to habitual behaviour, now a gym junkie & workaholic (note the language) and obsessive about cleaning my house – anxiety in different forms. I am not a destructive alcoholic anymore but I remain a person who has a major anxiety disorder that I seek relief from in behaviours that generate neurochemicals to help me feel safe or just plain different to how I feel “normally”.
Yes, whether it is a Disease or Love, an addiction can remain for life, wax or wane, end suddenly, etc.
But there is a unique sense of freedom that can be realized when one feels they are no longer in love.
Triggers, or no longer triggers, etc.
Research could throw light on this difference and help in the understanding of Addiction and Recovery.
my increasing sense is we are looking at a study of normality rather than a study in abnormality because one way or another habits and addiction in varying degrees rules the world. Sport, stock markets, phones, internet, gaming, shopping, gambling, work, trill seeking, prescribed medications, gym, sex. maybe even war (power) etc. – all sorts of behaviours are addictive – little is heard of this as we focus our efforts in judgement upon drug users. Addiction and recovery are in a way false trails. The search for a higher consciousness or emotional block out or thrills is human.
I completely agree!
Terry,
This essay I have been working on, for a decade now, addresses “Normal-ness” is a way.
The human traits that sustain a person’s
devotion to worthy causes, lofty goals and respectable activities, are
the same traits for sustaining something as clearly destructive as an
addiction.
I will use a
professional athlete as an example.
In time, professional athletes change their life’s goal that they have
been obsessed with. It is a goal they have been focused on for a good
part of their life. It is almost all they know, and it’s a goal that
friends and people have bent over backwards to help them achieve. This is a mirror image of an addiction.
Changing the lifestyle is probably as remote and as difficult, requiring as much soul searching and spiritual reflection as recovering
from a destructive and debilitating addiction.
Society praises one and condemns the other, for obvious reasons.
During my recovery process, it slowly became apparent to me that these
human mechanisms involved with Addiction and Dedication are basicaly same mechanism. They are nearly identical, and this realization led to the evaporation of the inevitable shame and guilt that is present during the addiction and the
recovery process.
It also allowed me to proceed and to finally trust
myself, and trust in my common sense again.
Whether becoming habitualised to something negative like an addiction or something positive like an activity, (sport in this case), these ‘habits’ become an identity… they become something you know A LOT about, something you
can bank on and be at home with, and feel “normal” about.
Whether you struggle to embrace that identity (as an Olympic athlete does) , or eventually find it imprisoning,(as an addicted person does), YOU
PERCEIVE and FEEL IT to be WHO AND WHAT YOU ARE.
It must be traumatic for an Olympic athlete to “surrender” this lifetime goal and identity, the very thing they have spent most of
their conscious life submerged in.
So, also, it is traumatic to leave
the lifestyle and function of an addictive life.
It dawned on me that the trauma of quitting something very familier, is therefore “normal”, or NATURALLY traumatic for any human being, and is not unique to the addicted.
With this insight, I was able to perceive myself as a human being, not simply an “addict”.
A “common sense” about the addiction could be
realized again. I felt like a human being with a problem rather than a human being with an abnormal weakness.
This was to become a very
important distinction, that eventually helped to discover, and have realizations things that
freed me from clinging to the addiction.
It is not too hard to see that if addiction was a weakness, then I would
always be in a state of vigilance and anxiety about keeping the addiction at bay.
and in this everchanging and unpredictable world…it is common sense that in the long run, I would most probably succumb to it at sometime throughout the remaining time of my life.
This alone would undermine any effort of ever feeling realizing a solid,feeling of trust. And how can a person ever re-trust themselves
and lose the self-doubting fear of an addiction, if they feel cannot rust themselves?
Although physically not drinking is a valuable step toward recovery, it was such CHANGES of my MINDSET that was allowing me to FEEL to recovered, because it helped change how I FELT, about what I was desperately struggling to do.
When a MINDSET changes, the FEELINGS can naturally follow, or align with “common sense”.
Basic feelings can then “re-align” away from the daily
addictive life, and return to the person’s interests, concerns, pursuits, passions and pleasures in life.
You do not really “take on a new, consciously fabricated “sober” life, but you can “re-align” with the original design, or person that you are.
Sobriety is a natural state of ALL living things.
At some point in the recovery process it does not need to be consciously “maintained”.
But only the individual can know this, because it is a feeling, not a thought, hope, wish or belief.
In hindsight, it is now quite clear that it was the ADDICTIVE lifestyle that had to be vigilantly maintained and sustained; not
sobriety.
Carlton you are so right and this is some of how I have been thinking of addiction for a long time now. I often use the analogy of the Olympics, a collection of socially lauded addicts who get together every 4 years at ridiculous expense to stroke their egos and get awarded medals for being the best addict in their sport in the whole world. At the same time drug addicts who, as you say are doing exactly the same things but simply often because of economic or social inequality have chosen (or have no choice) a habit that is condemned, are hounded and in places like the Philippines openly killed seemingly without any care from the rest of the world who go about their addictions to power, money and status without similar judgement. We are our habits, and addictions in my meaning are all encompassing habits and are what Duhigg calls keystone habits that dominate and become the person. Zinberg speaks of drug, set and setting and of these factors the culture of the drug user is the most difficult to extricate from and the most likely reason for relapse in those who seek to change major destructive or hindering habits/addictions. I recognise that I am always an addict in some form but I do not need to recover forever and I in essence even with change retain a mindset of the personality of a rebel in so called sobriety, a natural state as you say but one which it is debatable can be re-achieved after addiction has altered the consciousness, often permanently, to some degree. in being recovered though I am now more wise and see the patterns I displayed in everyone in some way and it is fuelled by the natural instinct of anxiety and fear and by the desire to not be alone, to relate to fellow humans equally fearful and insecure. I don’t think about recovery personally at all these days. life without alcohol (in my case) is now the normal and as much a habit as life with it was. its worth more than an essay Carlton this notion that addiction is normal.
Terry,
I am afraid my poor wording and misleading analogy de-railed the main point I was attempting to make.
I will work on it and re-post it in ten or so years.
My rave also missed your point really, There is so much going on it is hard to explain the thoughts – that’s why someone like Marc writes books and we struggle with essays. Grief results for both the athlete and the addict when faced with loosing the trusted friend which was the addiction. in some ways I feel sorry for athletes because their life span as an elite athlete is often very short and then they are faced with no choice but to retire – and so many find that so hard to do but often they shift the focus from being an athlete to being a coach or some other allied role thus not totally leaving the addiction behind. Maturity changes needs and often I see a spontaneous resolution of addiction happen as people “grow up” often much later than the average Jo as there does also seem to be a high degree of emotional immaturity in addicts. In essence too maybe we simply learn to accept ourselves as imperfect and in that way our mindset matures. Perhaps the real (original) and the fantasy (addict mind) me merged in time.
A musician, not an athlete, was the example in an earlier version of the essay, but seemed less familier.
Perhaps I should not use an example so the points are clearer.
i actually think the example of sports people is very relevant to addiction studies especially in the way it highlights the vast difference in social opinion & judgement and the similarity between exogenous and endogenous addiction, or in plainer language drugs taken from without versus those produced naturally in the brain by behaviours. We focus on illicit drug use but the majority of addictive behaviours are probably behavioural, gambling being the most obvious and destructive of those as Marc recently has known by his visit down under. There is in Australia at present some debate about increasing TV advertising for gambling when alcohol, and obviously drugs, cannot be advertised due to the dangers they pose. Cheers
Thanks for your honesty. I also retain addictive tendencies which I’ve described elsewhere.
I’d vote for the “wax and wane” model.
Hi Carlton. I like the idea of falling in and out….of habits, love, addiction, intense interests….many things that become routine…until they’re no longer as compelling as they once were. And, as you know, I don’t much care for the terms “sick” and “cured”.
Mark, yes, and ”No longer compelling” is a similar term to “A change of heart”, which is a universal and familiar occurrence.
Currently, the general and common worry/ belief is that addicts will need to restrain themselves and “remain strong” the rest of their lives.
But saying, “Once an addict, always and addict” is as generalized as saying, Once in Love, ALWAYS in Love”
Although struggling with feelings of love for life is common, it is also understood that falling out of love is a common occurrence also, and happens throughout ones life.
When I have put it in this way to friends and family, it eases their worry about me as an “Ex-addict”, and whether certian events or news will “trigger” me as an ex-addict.
This “analogy” seems to be a clear and empathetic way for people to relate to addiction and recovery, and it does not diminish the seriousness, dangers, or tragedy of addiction.
They also seem to have a new understanding and empathy for people struggling with addictions in general.
What you say about habit rings true to me, Terry. And it’s exactly what I do when I’m doing counselling/psychotherapy with addicts: try to build in other habits that become increasingly incompatible with the addiction habit. As to the ubiquity of habits, you’re in good company. Here’s what William James had to say over 100 years ago:
“What is so clearly true of the nervous apparatus of animal life can scarcely be otherwise than true of . . . the automatic activity of the mind. . . . Any sequence of mental action which has been frequently repeated tends to perpetuate itself; so that we find ourselves automatically prompted to think, feel, or do what we have been before accustomed to think, feel, or do, under like circumstances, without any consciously formed purpose, or anticipation of results.”
Cheers Marc – one can give up destructive drug use and then work on changing their inner being into a non drug using person, because both things are necessary – or they can work on themselves and almost invariably the need for the drug will change and the habit will no longer be needed (this can also happen naturally often in 40-50 age range as addicts belatedly grow up). working on themselves involves changing multiple little habits. it depends on the urgency of the need to change – one obviously takes longer but the later is more likely to result in long term change while the former almost always ends up with relapse, often multiple times, often as Duhigg says when stress occurs and belief (in the ability to change) is absent. Yes many very smart people like James have known these things for many many years and they didn’t have MRI scanners.
Good piece, I spent a lot of time watching people gamble in diff places. The setting is paramount and what I noticed in casinos was the music, it was mellow and nostalgic,like Fleetwood Mac not too fast but interesting enough to keep you engaged in what you are doing but possibly not thinking of the present ?
Also free food, tea, coffee and few places to sit down where there are no machines, all stools apart from a couple are next to machines.
Lack of engagement also between people, it’s almost like Piaget’s parallel functioning mode, there is also the research that points to negative reinforcement of gambling being so powerful because it shifts between positive and negative so quickly no other for of “addiction” seems to do this in such a microcosmic time scale.
I also think that Gambling along with other activities used to be possibly socially beneficial when people participated in order to engage and feel part of and the monetary/reward aspects were, still a major re-enforcer, though not the be all and end all before it became a commodity.
All activity is possibly a form of gambling, fishing, art, cooking as in we invest time in order to hopefully gain a reward, always with a risk that there may be a poor outcome at the end but gambling in its present form is a hyper condensed exploitation of this.
BF Skinner wrote about this, much to my surprise, he was not in favour of his research being applied to gambling methods by casinos. There’s a lot of evidence to suggest that the prob of gambling/other addictions is a prob of dislocation of people from society and Govt’s being too timid to directly raise income from organisations that can afford to pay taxes.
Jim Orford writes about gambling and a lot of his research makes a great deal of sense.
The hyper-condensation of the scale is such an amazing thing. As I describe in the post, there’s a blur of wins and losses coming so quickly that people get into a kind of trance. I think gambling is fundamentally different from substance addictions in that way.
Then, yes, there’s the environment: all the features you mention are calculated to make up for the loss, disappointment, shame, etc, that comes with losing. By making you feel, hey, this is all fun, isn’t it?! Fun, cozy, and cool. So what if you lose a few bucks? In video games they call it the “sweet spot”….a place that works as a compromise between winning and losing.
Terry (above) would agree with you that gambling is much more normal than abnormal. But there’s still something very peculiar in not being able to stop once things get really bad.
When you look at it in terms of environment and setting the stage, you can see how the allure and addiction of shopping emerges. It’s this wonderful social environment, everyone is being nice to you and catering to you, giving you what you want, showing you what you need.
Loneliness is a tremendously overlooked precondition for addictive behavior.
Hiya Marc
I read a book a few years ago called addiction by design by Natasha Dow Schull. She looks in depth at the gamblers and gambling industry in Las Vegas. It’s a fascinating piece of work looking at how much the gambling industry have analysed the compulsivity associated with gambling and, subsequently, designed machines and environments to manipulate it. They make most of their money from problematic gambling and have an overriding ethos to keep you gambling, separate you from as much of your money as possible by trying to encourage social gambling to edge towards problematic gambling. Some of the tricks they use are amazing and always seem to fit in with manipulating neuroplasticity in very sinister kind of ways.
I watched my daughter go through a really heavy gambling attachment using online casinos and, believe me, at times she looked as desperate and dislocated as any heroin or crack addict I’ve come across. The gambling industry today are very similar to the tobacco industry in the 1970s. They use exactly the same tried and tested tactics to find legal loop holes to continue and to hook people young and keep hold of them for as long as they possibly can.
Hi Peter. Thanks for this. Yes, the machine gambling trend is this monolithic tsunami that is really destroying lives at a faster rate than good old-fashioned roulette and so forth. Apparently it’s a really big problem in the UK with…what do you call them…Fixed-odds machines or something like that. Indeed they have scoured the loopholes…they are very good at that.
I just looked at a review of Addiction by Design…yes, it sounds like an important book. The role of the designers working for this diabolical industry is really disturbing. As you know, my wife, Isabel, is researching video games for mental health. There is so much potential to use the “technology of attraction” for good not evil. But capitalism does what capitalism does.
I think I’ll do another post today or tomorrow on the issues of responsibility and technology and how they interface. I heard a lot about that at the gambling conference in Australia.
Nice report tyvm
When I see people at a casino the word Zombie comes to mind !!1
What do we know of the neuroscience here ?
It’s a lot easier to perform tractology analyses on dead brains than living ones.
You are such a good descriptive writer Marc. I’ve decided to poke my head up and comment but I have been keeping up with your past pieces. I have a few close (online) recovery friends who were chronic gamblers and their stories are a mirror image of mine, minus the dripping hollow slivers. It shows us that addiction can not be inherent in the drug itself which is obvious here of course but many believe that’s the case. Great writing as always and I hope all is well!
Thank you, Dustin. I do like descriptive writing a lot….It’s something that’s attracted me since high school. But anyway, sure, as we see in other comments here, there are deep parallels with drug addiction. And I OFTEN use gambling “addiction” as a key argument when I give talks or write stuff arguing that drugs do not cause addiction, though, as you say, that’s become obvious to most people in the field.
Casinos sound to me exactly like the controlling, abusive parent or partner, calculatedly withholding affection and approval at certain times, giving out just enough that the victim keeps trying, making ever bigger efforts. I think that’s why women stay with men who bash them, and how lonely older single women get taken in by those online boyfriend scams.
You need to make those efforts to fight back against the loss of reward…the neural mechanism in what Szalavitz calls the “hedonic treadmill” is pretty clear. Reward prediction error (reduced dopamine with each failure) keeps plunging downward. So you need a bit of a boost if you’re not going to quit entirely.
Spooky analogy with withholding parents!
My girlfriend and I just recently got back from vacation to Niagra fall, and yes we did stop in at the casino. We set a plan before we went in and stuck to that plan. That we would only spend 20$ each. Like the other day calling in to a radio station contest, trying to win 10,000.00 dollars. Calling and calling till this one time I actually heard the phone ringing at the other end, my heartbeat was accelerated, my anticipation was almost overwhelming, like waiting for the dealer, or having my choice of drug at the time and finding a spot to use it. We went into the casino and I put my 20$ in the slot machine and started to pull the handle. It seem right off the rewards would be limited, till the machine started to give off all these bells and whistle indicating I won a free spin. Again my heartbeat rose with anticipation, my dopamine was firer off again like I was about to get that rush. But it turned out to be all false. The free spin only tallied up my loss. again it was the false promise that addictions give people (Myself) included. This is the reason I say I live in Recovery, and must always be aware of all the false promise life can provide to me. Too much of anything… Is NO! GOOD! YA! YA! Except Ice Cream and LOVE…hahaha…
Thanks for sharing Marc.
Beautiful description, Richard! With only $20 as your limit, you’re lucky you even got far enough to hear those bells ring with false promise. At least you got a bit of a buzz. Niagara Falls isn’t Las Vegas, I guess.
Something for little or nothing is a strong reinforcer. It can make you feel powerful, in control, as if you found an oasis in the desert when you were dying of thirst, or food when you were starving in winter. That feeling survival can evoke is a primal elation, like joy and relief combined, like the happy exhaustion of completing a daunting task that helped keep you and yours alive. You beat the odds when they were against you. You survived.
Denying and overcoming the odds to ultimately survive is wired-in, in humans. It’s natural selection at a basic level. The potential reward is huge. You survive, your family survives, the species survives. In early humans, bartering something you might not need as much for something you did, engendered cooperation and sharing— a boon for the survival of the species. And if you ended up getting more than what you needed…even better!!! Gambling is another example of instinct gone off the rails, like all addictive behaviors. The organism needs this to persist and survive. If no human ever risked their own life after understanding their own mortality, we wouldn’t be here right now.
That’s a profound conclusion, Matt. These crazy instincts, the drive to get more than you paid for, to beat the odds, are what propels explorers and inventors and has done so for time immemorial. The Fountain of Youth comes to mind. That gamble took a lot of lives but led to the “discovery” of Florida and…where else? Explorers are chumps, but where would we be without them?
I don’t know that explorers are chumps. Maybe a little gullible, which comes from an openness and desire to look for something better. Our human drive for survival is led by two things: the need for sustenance and the need for safety. No living organism can exist without them. We need nourishment and to stay out of harm’s way. Drugs create the illusion of both, which we need from time to time to press on and revivify. When the illusion is mistaken for the real thing– that’s when we get into trouble.
Marc, The grim reality of your paragraph that begins with:
“What was so spooky about this robotic ritual was the flatness of the facial expressions…”,
This paragraph describes the way most people see scenarios like this too. It is very grim, and not something to pursue of be involved with. It is the same with seeing alcoholics drinking, or a crack house scene, etc.
It is also believed, and known, that addicts can see these same scenes as a triggers and difficult to resist.
Yet a large percentage of ex- addicts also consider these scenes as grim, and not something to pursue of be involved with, and not do to “control” or “resistance”
This is further evidence that a new medical definition of both addiction and recovery is called for, other than addiction being defined and treated as a disease.
But why a “medical” definition? That’s the aspect of your comments that I don’t sync with at all. Otherwise, sure, there’s something intrinsically repulsive about seeing people stuck in a behavioural ditch that’s slowly killing them and going back to it again and again. I guess that’s one of the foundations for the disgust that people feel toward addiction and toward addicts.
Hi Marc,
Perhaps the NIH definition of addiction “as a chronic, relapsing brain disease…”, is not technically a medical definition.. but seems to be the currently “official” definition?
But new, over-arching definition, that allows for various BELIEFS of what addiction is, could be the result of a major change in the understanding of addiction and recovery.
And as long as addiction is DEFINED as a disease, terms like “sick” and “cured” will probably be always be around.
Yes, Carlton, their definition is certainly medical. And I’ve argued against that conceptualization ad nauseum. That’s why I was curious as to why you say “a new medical definition” is called for. I would remove the word “medical” — I agree with the rest.
Marc, this has been a great read and the various responses add to or sometimes take away from what you are teaching. None the less, I find your writing and everyone’s responses eye opening and sometimes revealing when it comes to whether addiction is a disease or not. Like Marc, I use to be addicted to heroin some four plus decades ago, and like Marc I will on occasion will drink a glass of wine or a beer with my dinner. Today I would never introduce myself as an addict however I know that I could relapse if I allow any substance or behavior to rule my life again. So today my freedom yet remain aware that addiction is a slippery slope that I can fall into if I am not careful; therefore I won’t take risks like drinking 3 or 4 beers on an empty stomach or smoke a joint to see it I can handle it.
That sounds like a really fine resolution, Lew. It’s great not to live in fear, irrational fear, of relapse, but to treat your sensitivities and proclivities with some respect. Great that you found that place.
Nice Post! Gambling is the source of enjoyment. But when anyone lose big amount of money in gambling. Then definitely he/she become depressed & start addiction of drug or alcohol as self medicine. So, we can say gambling teaches us about addiction that just play for enjoyment not to lose your mental health. Thanks for this post.
Great read, thank-you Marc. Interesting comment about blunting which makes sense in relation to my clinical work with people experiencing gambling problems. Glad you felt inspired to write this blog. Jodi
Hi Jodi! See? I learned a lot in that week with you guys in Melbourne. Thanks for contributing to my education and helping to get this dialogue going. I’m going to write another one next, about how we assign responsibility for all the harm that comes from gambling and addiction.
Wasn’t there a med that came out that had a side effect in some ppl making them gamble? interesting part to me is absent endogenous drugs, how do the “hi-jacked” brain (Alan Leshner) believers explain behavioral addictions?
Yes, dopamine agonists like L-Dopa, for treatment of Parkinson’s Disease. That provides some people with a level of anticipatory excitement that makes it hard to resist temptations.
…and dopamine agonists used to treat Parkinson’s often set off obsession with sweets and hypersexuality…
Hi Marc, I’ve just begun rereading your book, Biology of Desire. I find myself embarrassingly caught in problem gambling – loser slots just like you describe above. I’m an accomplished high school educator with lots of good things on the go, however, happiness has not come easily to me as I have struggled with depression to some degree since I was 22. I’m now approaching retirement. No one told me that I would be at greater risk of becoming hooked on the drugs that gambling provides because of my serotonin deficiency – so off to the casino I went with my elderly mom, herself a controlled hobby gambler. Lost mom a year ago, but haven’t lost the casino though on all levels I know better (as do all the fine losers who regularly partake).
It’s time to take charge and I fear I can’t. I am most interested in the brain plasticity information. I worry about what you call ‘blunting.’ You say, “addiction neuroscience is pretty clear that dopamine receptors thin out with all that action, so all rewards — both those provided by the addiction and those provided by pizza, sex, and playing with your dog — become flattened, diminished, boring.”
How does one begin to change the pathways so non-casino highs feel joyful again? I wonder if this is even more tricky in someone for whom joy doesn’t seem to come very easily. To that end, my other drug of choice is service to others since I seem to be very good at helping others find happiness and fulfilment, but I seem to do this at a cost to my own well-being. Before that, sports were my thing.
I’ve never written on a blog. On a reread, I cringe at how it sounds like my life’s a cliched country song, but I am at this spot, so here I am writing you. Thanks for your amazing work.