Understanding Addiction

Opium poppy

That’s a quote from a recent reader, and I think it’s a fabulous metaphor. The idea is that brains and the chemicals that run them come from molecules that have been part of the evolutionary marketplace for a very long time. So the “code” that our brains use to operate (and to have fun) is easily mimicked by compounds out there in the world. When we find those compounds and consume them, we hack our own nervous systems.

Indeed, our major neurotransmitters are extremely old. So are the neuropeptides (which include opioids). I read somewhere that male lobsters stand up and rear their claws when they get a spurt of the peptide vasopressin…which comes from their own brainstems. Vasopressin is an important neurochemical for inter-male aggression in humans! A humbling thought. So not only do we share neurochemicals with extremely ancient ancestors and extremely distant cousins, we even share their functions.

Now pre-hominids weren’t much good at extracting stuff from plants. Hands are really useful for that. But hominids have been around for a couple of million years, and even the period of agrarian civilization, about 5-10,000 years old, is plenty of time to experiment with the profusion of plants that make feel-good chemicals. The fact that neurochemicals are cobbled together from existing molecules, as pointed out by the same reader, is hugely important. That’s what improves the odds that our favourite neuromodulators will have cousins in the plant world. All we had to do was find them, refine them, and eat them (or smoke them or snort them or shoot them).

According to Berridge’s theory, dopamine doesn’t make you feel good, but it makes you feel engaged and excited. It’s opioids that make you feel good. The fact that opioids automatically release more dopamine means that liking and wanting are closely bonded. Unfortunately, though opioids increase dopamine flow, the reverse is not the case. Dopamine flow just makes you try harder. Hence, whether you get your dopamine rush from methamphetamine, coke, from planning your next batch of cookies, from anticipating the next rib, or from the vicious cycle of addiction itself, there is no pot of gold waiting at the end of that rainbow. Unless you put it there yourself.

We are indeed a species who hacks our own brains with the stuff we find lying around in nature. And since dopamine and opioids are so crucial to the reward system, it was almost inevitable that we’d find them, use them to hack our brains, use them some more because they work, and then start to work hard to get them. Thus, it’s almost inevitable that we’d evolve into druggies. And, I suppose, just as bad backs are an unfortunate byproduct of upright posture, it’s almost inevitable that many of us would become drug addicts.

A 30% increase in overdose deaths in 2020? Sure, the year of the pandemic. Most agree that isolation has been a huge causal factor, but what does isolation mean in a world patched together by social media? Rat Park and Social Baseline Theory help us see the full picture.

Over the last few months there have been numerous reports of a sharp rise in overdose deaths in 2020. Most recently (last month) the National Center for Health Statistics reported an increase of 21,000 (almost 30%) — totaling 93,000 deaths in one year.  Virtually all experts associate this increase with the pandemic. Many reasons are aired: stretched health-care facilities, less access to naloxone, less access to doctors, housing issues, and…increased isolation.

The experts agree that isolation’s been a major concern. Yet our understanding of the nature of isolation is superficial. Since almost everyone has been on social media this year, madly zooming away the hours, what does it actually mean to be alone, physically, bodily, especially for people living alone, each in their own little box?

We know that isolation makes people more vulnerable to depression. Loneliness = depression. And depression is the gateway to more extreme drug use. But while living in states of lockdown, we’ve spent the year zooming, texting, chatting, tweeting, emailing, Whatsapping, posting to Instagram, following on Facebook… Don’t these explicitly social activities dispel isolation and defeat loneliness? It certainly helps to connect with people any way we can. But  flat screens have their limits. They don’t allow for the spontaneity and ease, the free flow of real conversation, the richness of body language, the way people position themselves, move their heads, their feet, their eyes, when they’re actually, physically together. Never mind pheromones and oxytocin — the good odours that humans exude. So…some degree of closeness must remain out of reach. Maybe a large degree.

What kind of closeness do we humans need in order to feel connected, supported, safe — and free of addiction? Two research programs 30 years apart tell the story.

The first is Rat Park. Most of you are familiar with Bruce Alexander’s research in the 70s and 80s, memorialized in the addiction world as “Rat Park.” These studies showed that isolated rats (kept alone in their cages) chose to drink water laced with drugs like morphine, while those allowed to socialize, cuddle, and have sex in a park-like (for rats) environment avoided the drug solution and drank plain water instead. There are thousands of references to Rat Park online (e.g., here), and Alexander’s own site summarizes the findings and extends them with a whole philosophy on what drives addiction. One of Alexander’s reflections captures the main lesson: “Solitary confinement drives people crazy; if prisoners in solitary have the chance to take mind-numbing drugs, they do.”

But does verbal communication alleviate the damage done by solitary housing? Rats aren’t verbal. When they socialize, they cuddle, play, lick, fondle and fuck. We’re mammals too. How much does verbal communication satisfy our needs?

The second research program has come to be known as Social Baseline Theory (SBT). Starting in 2006, James Coan and colleagues studied the effects of hand-holding on the activation of brain structures responsible for coping with stress. Subjects inside a brain scanner (fMRI) held hands with either a marital partner, a friend, or a stranger positioned outside the scanner. When exposed to (mild) electrical shocks (psychologists’ favourite way to induce stress) these brain structures showed less activation (they were less “aroused”) when the subject was able to hold hands, even with a stranger. In a review of these studies, Coan had this to say:

“According to SBT, the human brain assumes proximity to social resources—resources that comprise the intrinsically social environment to which it is adapted…   At its simplest, SBT suggests that proximity to social resources decreases the cost of climbing both the literal and figurative hills we face, because the brain construes social resources as bioenergetic resources, much like oxygen or glucose.”

The SBT experiments add an critical layer to what we know of isolation and stress: human proximity is processed by the brain as a physical, visceral presence. Other people are recognized by the brain not just via images on a screen or words packed in sound waves, but through actual physical closeness, optimized by the sense of touch. Even being in the same room as others, being close by, provides a fundamental context — a baseline — for handling adversity and stress. Think of being in a movie theatre, a waiting room, or in your own den watching TV with someone else. No speech is required to feel the irrepressible sense of closeness that comes with proximity itself.

I hear my friends and family talking about “Zoom fatigue.” For a reason. Zooming is way way better than no communication at all. But it’s still a partial measure. Texting, Tweeting, Instagram, and other platforms that rely (at least partially) on written characters provide even less of the colour, or tone, or the physicality of mammalian communication. Our brains are full of semantics, words and ideas, and we love exchanging these, exploring and building on them. That’s great. But our brains are part of our bodies, so the sense of comfort and care we get from others comes from an evolutionary heritage tens of millions of years old. A heritage that’s primarily nonverbal.

Even with all the digital media at our disposal, it’s been a lonely year. And that 30% increase in overdose deaths counts as a reflection of how hard it’s been for many of us. We seem to be starting to conquer Covid-19, at least in the Western world. Let’s keep it up, and let’s spread the wealth. That includes getting vaccinated, so we can protect our families and communities while protecting ourselves. It’s gotta be a group effort, and the group includes humans everywhere. People like us, all over the world, who need to come out of hiding.

By Daniel W…

The worst thing to ever happen to me was losing my father at age 60. I was 26. He had suffered a heart attack overnight while sleeping and didn’t survive it. The thought of it to this day stirs up a lot of emotion in me. What makes it even worse for me is the context of the whole situation. I was an active drug addict when he died and had been working for him up until 6 months ago before I got fired for stealing. I went 5 months after that without speaking to him, wanting to but not able to bring myself to do it. Thank god I reached out to him three days before he died, we had a very deep talk and I will be forever grateful for that more than anything else in my life. I couldn’t believe he was gone, death is so final. He died on March 17,2015 and I got sober on May 17, 2015.

The low I reached on the day of his passing is the lowest I ever want to feel. I already was isolated from my family after fleeing New Jersey and going to South Florida because of burning all my bridges getting fired from my father’s company. I went to his service back home and I really was living in a nightmare. I cried myself asleep every night for two months before my mom said she would be able to get me into treatment, it wouldn’t be my first. I went to treatment a completely hopeless, devastated and broken man who missed his father who was his rock.  I would ask myself how can I possibly survive this?

The thing about being hopeless, is that it made me less resistant to things in areas I used to be very resistant in. Things like opening up to people, taking guidance and other things we are asked to do in early recovery that I had usually ignored, I just did it this time. The only thing I knew was that I didn’t want to die, and that I had to make my dad proud no matter where he was. My grieving really occurred for those two months after he died, I felt it hard and I had to feel those emotions and let them out. Now it was time to look at the whole situation and grow from it.

An early realization I had was that ultimately I was grateful to even have had a father for 26 years. I had spoken to many who weren’t even that fortunate. Suddenly the memories and pictures I had with him became much more valuable. He always let me know how much he loved me and we spent so much time together–that would never leave me. This was my key to dealing with his death and walking towards acceptance of it. Showing gratitude for having him in my life.

While I was in treatment, I was desperate. A lot of us see that as a gift in recovery. It was surely something I’d never felt before. Looking back at it, I think that desperation grew from the very genuine desire to honor how my dad raised me and to do what would make him proud. All that mattered to him was that his sons were happy and living a good life. My brother had that taken care of, and now it was my turn. I would spend every morning praying on my bed and talking to him. I felt a tangible connection with him still, and I plugged into that every day. I still talk to him all the time–to this day.

For my first year in recovery I spent a lot of time processing, talking about, accepting and reflecting on his death. At the same time I was moving forward in life and doing better than I ever had at taking charge of my own life. It felt incredible. If I hadn’t done a lot of work on myself and put myself on the right path, I would never have gotten over my loss. By the time the first year anniversary of his death arrived, my life looked so different than that day in March one year earlier. Instead of making it a day to sulk I made it a day of celebration and gratitude.

There are still days I miss him. It almost feels like the longer I go without him the harder it gets. Not a day goes by without me thinking about him, but I still have remained on the path I committed to years ago. I still feel him with me, making him proud. His voice still echoes in my head when I think about what he would say about particular situations. As long as I am building the life he wanted me to have, I raise my head high and keep in mind the good times I had with him.

Daniel Wittler is an Outreach Specialist for Recovery Local, a local addiction/recovery based marketing company. He advocates long-term sobriety by writing for websites like JourneyPure, providing resources to recovering addicts and shedding light on drug addiction. Daniel believes that absolutely anyone can get sober provided they are ready to take action in their own life.