Preventing Addiction and Drug Dependency By Gilbert Lawrence
Drug addiction has become an increasingly prominent social and political concern in recent years, particularly opioids, as reflected during the last Congress (examples here & here), the 2018 midterm, and current efforts from the White House. Data on addiction and drug dependency is telling and dramatic. Addiction affects all age groups and socio-economic strata.
In 2017, more than 70,000 Americans died from drug overdose. Reports published by the Center for Disease Control (CDC) indicate that annually 88,000 deaths are alcohol-related. More than 15 million people in America suffer from disorders caused by alcohol abuse, and less than 10 percent of these individuals receive treatment.
The reality is that addiction can begin at an early age and can take various forms such as over-eating or attachment to social media. Often, over time the addictive behavior transitions into substance dependency. So, our battle to fight addiction should start long before the potentially fatal slide.
Forms of addiction
Addiction is defined as human behavior that we undertake despite our knowledge that the activity is not beneficial. Additional criteria for addiction occurs when the intensity and frequency of the behavior escalates in order to overcome "tolerance." Sometimes, this behavior starts as a chic-fashion statement and provides an emotional boost-- the best example of which is nicotine addiction.
Following World War II, smoking became a fashion statement two generation ago, and was popularized on billboards and in the movies. Doctors and politicians, who were well aware of the dangers of tobacco, did not have the courage to expose the tobacco industry. Over the decades, society developed other forms of addictions, including to electronic devices such as TV, video games, etc. Today, there are new risks associated with social media, texting, and digital forms of "emotional experiences."
In addition to the chemical arousal of the emotional brain through the use of alcohol, marijuana, opioids, and other drugs, there are other forms of addiction--behavioral (gambling); dietary (sugars, chocolate, caffeine, etc.); risky behavior; shopping (oniomania), other manias, and even too much of a good thing like "runner's high." Being over-weight may be linked to dietary addictions which affect 35% of adults; with 25% of all adults being obese--a major health risk. Thus addiction is a much wider problem than drug dependency.
Why is today's society so addiction-prone?
Therare several factors that increase the risk for addiction. Yet, they all operate in a backdrop of modern society. Is it despite or because of a high standard of living? In my view, the human brain was never designed to function in the social environment in which we now live.
Hominids have been around for two million years and lived as "social animals." The first humans were hunter-gatherers and lived that life-style for 1.99 million years. This life-style involved three to five families living as a nomadic unit, moving from one hunting ground to another. The group, comprising 20-25 individuals (including children), provided mutual support and helped hunter-gatherer groups spread from their cradle in central-east Africa to the rest of the world.
About 12,000 years ago, agriculture began with the domestication of wildlife and grasses. The prey-hunter became the prey-herder. About 5,000 ago, civilization started with families living in small dwellings close to each other. The food-gatherer was now the food- grower. Many relatives lived under one roof as a joint-family. About 200 years ago, as a result of industrialization, families began moving to urban areas, and lived under different roofs but as "effective joint-families" in the same neighborhood.
Over the last 60 years, families became mobile, smaller, with one or two children, and homes became larger. There was a marked decline in close social interactions, which is needed to arouse the emotional brain, especially the Insula and specifically VEN cells. Today, most adults and seniors have just one or two close companions, a far cry from just two generations ago when they had the emotional-social support of 20 or more individuals who belonged to various age groups. The human brain is not designed for this deprivation of personal interactions. Against this background, everyday stresses make the brain seek other forms of emotional rewards leading to various addictions and other mental problems, including Alzheimer's and other forms of dementia.
Dysfunction of the emotional brain
The biological basis for the important role the emotional brain (Insula) plays in our everyday well-being has only recently been discovered. The dominant Insula in the right brain interacts with the cognitive and memory brain and helps with learning, while reducing the incidence of school dropouts, truancy, youth and gang violence, and ADHD. In adults, dysfunction of the emotional brain plays a role in "emotional distancing" which is the first phase on the path to divorce.
Today, most adults and seniors have just one or two close companions, a far cry from the emotional-social support of 20 or more individuals. Psychologists complain that from youth we live in an age-segregated society, something nature had not designed.
To fill the void, addictive behavior provides the emotional brain with quick gratification, relieving it of its "stress neurotransmitters." Over time, such external emotional rewards and behavior escalates, making it difficult for the victims to extricate themselves from that reliance. The cravings of addiction impacts judgment and cause uncontrolled dependency. This limits and harms their personal lives and health, and affects their relationships with those around them. Thus the addictive behavior ends up dominating their lives to their detriment.
Making the individual addiction-resistant
There are biology-based, recommended steps designed to nurture the emotional brain and reduce the risk of addiction for all age groups. For parents, the task is to make their children addiction-resistant, a duty that starts from the time the child is born and includes parental bonding and breast feeding. As nature designed it, the process of brain maturation during the teenage years, when the brain rewires itself, includes curiosity to learn and be exposed to new experiences. The challenge is to welcome these fixations without going over-board. For all age groups, the old adages apply:
· Everything in moderation.
· Variety (of activity) is the spice of life.
· Reduce stress.
· Physical and neurocognitive exercises.
· Arousal by internal receptors like those in the muscle and joints (propioceptors)
· Arousing the brain needs a “balanced diet” from the five sensory organs.
In a no-touch society, this can be as simple as, “a hug a day may help keep drugs at bay.” There is biological basis for hugs, with the touch receptors arousing the emotional brain. Neuroscientific research over the last decade has new insights into the functioning of the emotional brain and the stimuli that arouse it. There is much interest in the interactions of the emotional brain with overall brain function and pathology. The challenge is for us to use socially accepted ways to nurture the emotional brain.
Mental illness is the third most common healthcare problem in today's society; it affects one in four adults and one in five children, with a lifetime risk of affecting one in two individuals, as per statistics from the National Institute of Mental Health (NIMH). Lack of emotional support is a fertile background that aggravates everyday personal and work-related stresses. We all live under stress, as well explained in Sanjay Gupta’s book and HBO-TV series “One Nation Under Stress.” Americans in the 1960s had the longest life spans in the world. Now we are at the bottom in the Western world. Worse still, our life expectancy since mid-2010 is declining.
Nature designed society to be cohesive units of nuclear and extended family for safety, feelings, physical, emotional, psychological, and other support. Our mental and physical lifestyle, changing with every decade, is not conducive to the blue-print of our brain-function which has been adapted and refined over two million years of evolution. Just as a car's performance is based on its design capabilities, so does our brain.
Gilbert Lawrence is a M.D. in Utica, New York and co-author of Your Happy Brain: Why and How to Hug It