Why Addiction Isn’t a Brain Disease
It is easy to see addiction as a mere chemical hook to drugs. Many argue it is a brain disease due to changes in our reward system. What if I told you this was only partially true?
Understanding the biological roots to addiction is necessary — we’ve learnt a lot from studying the brains of addicted individuals. However, this has led to the belief that addiction is a disease, due to changes seen in the reward system and structure of the brain. Pathologising addiction may act as an obstacle for healing.
Neuroscientist Marc Lewis holds a different view on this. In his excellent book The Biology of Desire, he argues instead of being a brain disease, addiction is an adaptation to to our environment.
The brain is a pretty fascinating thing. It is able to restructure itself by forming new neural connections as a result of and in response to changes in our environment — this is known as neuroplasticity.
Why am I bringing this up, you ask? Well, addiction is part of this process. It can be seen as an adaption to the situation we are in —a learnt behaviour.
But what is learnt, you see, can also be unlearnt.
Humans are natural pleasure seekers. You know this. And addiction is simply an unintended consequence of what the brain does best — seeking pleasure, reward and desire in a world that is uncooperative. So, environment plays a crucial role in the development of addiction.
A classic example — the Vietnam War. During the war approximately 15% of American soldiers were addicted to heroin. With the war ending, there was immense fear over a generation of young men coming back as heroin addicts. However, upon return 95% of the addicted soldiers stopped using heroin completely once home.
How do we explain this? Heroin was used as a coping mechanism — an unfulfilling, terrifying environment where substances helped numb pain. Once back to a fulfilling and meaningful life, the vast majority of soldiers no longer felt the need to use.
Surrounded by stress, fear, helplessness and access to a substance, the pleasure-seeking of drug use begins — allowing for addiction.
We have an innate need to bond and form connections. So, it’s not just a chemical hook but an absence of nurturing social environment and psychological wellbeing. This is largely the reason why addiction develops, a means of seeking fulfilment.
This is one of the reasons why we see high rates of addiction among individuals who have experienced personal trauma. Dr Gabor Maté (a clinician who has worked closely with addicted individuals for decades) argues addiction is not a choice or something born out of a lack of willpower. Rather, he sees it as a complex interaction between personal history, social environment and our psychological wellbeing.
Indeed, the biopsychosocial model (a result of biological, psychological and social factors) is being increasingly used to examine addiction. A holistic view is necessary for such a complex concept. This will help us continue to understand the causes, treatment and prevention of addiction.
So, why is the contribution of environmental factors so impactful? It is helpful for treatment. It highlights the need for lasting changes, putting pleasure back into areas of life which were neglected, resulting in harmful behaviours being unlearnt.
Addiction is a dynamic concept. Now, it’s time we stop seeing it as a brain disease — this is not only reductionist but limits our understanding of why people abuse drugs. Holistic understanding helps comprehend how to treat and prevent addiction.
