Nikki D. was a Ventura resident who, in 1998, suffered a double catastrophe that left her almost incapable of carrying on. First, in February, her 3-year-old son, Alex, died of a congenital heart disorder. The tragic aftershock destroyed her marriage, and her husband left in November.
Nikki’s despondency left her limp and hopeless. She actually considered suicide, but, as she remembers it today, “I couldn’t even summon the energy to try to kill myself.”
Her doctor offered some pharmaceutical relief in the form of Prozac, an antidepressant, and Xanax, an addictive anxiety reliever. But Nikki had seen her sister become addicted to drugs and eventually die penniless and insane.
So she chose another “addiction” — running.
“I ran up and down the ocean six times a week, sometimes two times on days after I missed a run. I wouldn’t do less than seven miles, and on days off from work I did at least 13. I ran three L.A. Marathons in three years. I would lie in bed aching physically after each run, but the physical pain and the endorphins somehow took away the mental agony.”
Today, Nikki is a more moderate runner — not an “addict” — but she believes that her addiction to running saved her life.
Little has been written about how “addiction,” consciously harnessing the brain’s reward system, can actually be a useful process.
Researchers, therapists and counselors have customarily confined their use of the term “addiction” to drugs that foster physical and psychological dependence. But new knowledge suggests that, as far as the brain is concerned, a reward is a reward, whether it comes from a chemical or an event.
Alice Cooper, the original Goth rock star, has on several occasions credited golf as having played a major role in helping him to overcome his addiction to alcohol, and has even gone as far as to say that when he took up golf, “It was a case of replacing one addiction with another.”
Justin Pearlman was addicted to heroin at a young age, and although he comes from an upper-class Jewish upbringing in Arizona, he was in real trouble in 2005. He couldn’t stop using heroin, and he couldn’t stop “catching cases” (getting arrested), to the extent that he was looking at prison time in his home state.
So he came to California and did a stint at a sober living facility in Ventura, where he met some great heroin connections and continued to use. Finally, his parents sent him to Pasadena Recovery Center, where he got clean after two tries in 2006 and 2007. He wasn’t a great patient in rehab — in fact, “I was probably one of the worst clients ever,” according to Pearlman. “I was disrespectful to staff and broke all the rules. I slept through groups. But I loved the softball games we played every Friday. I dreamed about softball. I played catch in the parking lot, sometimes by myself, and I lived for the chance to prove myself on the field every week. If I had a great game, it would make my week.”
Pearlman is two years clean now, and he says, “I don’t go to many meetings — I don’t have a real sponsor.” But he’s still addicted to softball, playing as much as five times a week, besides going to school and pursuing his law degree. “I traded addictions. I am by nature an obsessive person, and I believe the only way for me to stay away from heroin was to find and keep other obsessions.”
Most experts don’t adequately emphasize the value of replacing drug addiction with another, less harmful addiction. It’s often stated, for example, that the reason addicts and alcoholics need a 12-step program is so they won’t trade addictions, like food or sex, for drugs.
But it’s obvious that in cases like Pearlman’s, even though the new addiction may be harmful if stretched over a long period, it can work at least temporarily in reducing the inevitable anxiety and depression of the newly recovering alcoholic.
Addiction and the brain
For the most part, addictions are not that well understood. There is, for example, no cure for addiction.
As the late Dr. Lee Bloom, founder of Pasadena Recovery Center (home of “Celebrity Rehab”) used to say, “What we do is a little better than witchcraft, but not much.”
But we are learning more and more, and we are beginning to understand the addicted brain.
“The addicted brain is distinctly different from the nonaddicted brain,” writes Alan Leshner, the former director of National Institute on Drug Abuse. “Changes in brain structure and function are what makes it, fundamentally, a brain disease. A metaphorical switch in the brain seems to be thrown as a result of prolonged drug use.”
The brain consists of billions of neurons, or nerve cells, communicating with each other. The neurons pass messages back and forth within the brain, the spinal column and the peripheral nervous system. This coordinates and regulates everything we feel, think and do.
The brain controls your thoughts, feelings and activities; it regulates basic body functions; and it enables you to understand and respond to everything you experience.
The brain area most affected by substance abuse is the limbic system, which contains the brain’s reward circuit. It links together a number of brain structures that control and regulate our ability to feel pleasure. Feeling pleasure motivates us to repeat behaviors — such as eating, sex and exercise — actions that are critical to our existence as a species. The limbic system is also activated when we become addicted to drugs and activities. In addition, the limbic system is responsible for our perception of other emotions, both positive and negative, which explains the mood-altering properties of addiction.
“Good” addictions also hijack the brain, but in a way that is useful in overcoming negative emotions and fixating on activities we want to master.
Whether an addiction can be a good thing, of course, depends on how you define it. Most people are not so clinical in defining addiction. The late singer Robert Palmer sang of a girl who was “addicted to love,” and most psychotherapists believe that sex and love addictions exist.
There are great and sometimes heated debates around the definition of addiction, with parties falling into two main camps: the disease model and the behavioral model.
Addiction has been defined with respect only to psychoactive substances (for example alcohol, tobacco and other drugs), which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain.
Alan I. Leshner, Ph.D., director of the National Institute of Drug Abuse, National Institutes of Health, says that “The essence of addiction is uncontrollable, compulsive … seeking and use, even in the face of negative health and social consequences. This is the crux of how many professional organizations all define addiction, and how we all should use the term.”
Another widespread definition of addiction is simply “an unhealthy relationship with a person, place or thing that continues despite negative consequences.”
Counselors and therapists use this definition to counter the retort, when they suggest 12-step meetings to clients, that “That’s just replacing one addiction with another.”
There is no mention of addiction in the DSM (Diagnostic and Statistical Manual of the American Psychological Association, the “Bible” for therapists). The substance use disorder section has two levels of disorders ⎯ “abuse” and “dependence” ⎯ where dependence is most like addiction. There is no mention of sex addiction (though that may change in the new edition), and behavioral addictions like pathological gambling are considered to be impulse control disorders.
But for the majority of the population and in most standard dictionaries, the term “addiction” is used to describe “an obsession, compulsion or excessive psychological dependence.”
We might also add the following colloquial definitions for a couple of related words:
Obsession: the domination of one’s thoughts or feelings by a persistent idea, image, desire, etc.
Passion: a strong or extravagant fondness, enthusiasm or desire for anything, e.g., a passion for music.
It seems from the above that addiction is a physical behavior, while obsession and passion are mental or emotional.
Obsession and achievement
Matt W., a former Ventura resident, is now a successful guitarist who teaches and plays with a band in San Jose.
When Matt was 12, he got his first guitar and, for two years, “That’s all I thought about.”
“I would get on the guitar when I got up in the morning before school and practice for a couple of hours. Some days I would skip school and literally play all day. The only friends I had were people willing to play with me. I skipped meals. I avoided my parents. I didn’t go out with girls, go to movies, watch TV or play sports, all of which I used to love. When I went on vacation, all I though about was music, and I was obsessed.”
Some experts would opine that Matt was addicted to music, and in some ways, this addiction may have been unhealthy. But something else happened in the process: He became a professional-level guitarist.
Matt’s obsession ended when he was 16, and he finished high school and college. But he doesn’t regret the time he spent “addicted” to guitar. “I would never have been good enough if I hadn’t totally immersed myself.”
We all know and instinctively understand that potentially addictive activities like exercise, food and sex can be extremely soothing. And our ability to “self-soothe” is integral to our mental well-being. (Drug addicts are notoriously bad at self-soothing.)
Extended, continuous exercise and immersion in focused activities contribute to a sense of well-being that may represent increased production and release of endorphins, neurotransmitters found in the brain that have pain-relieving and soothing properties similar to opiates.
Endorphins reduce the intensity of pain, both physical and mental. Besides ameliorating the experience of pain, endorphins affect other psychological activities, including euphoric feelings, appetite and the release of sex hormones.
Scientists believe that endorphins, or something like endorphins, are responsible for the sense of euphoria that has been popularly labeled “runner’s high.”
More important, the scientific phenomenon of endorphins (or something like endorphins) is central to our thesis that addiction can be a useful thing, at least temporarily.
The history of addiction
Addiction has probably existed since before man became civilized, or before humans walked the earth.
According to Ronald K. Siegel, a pharmacologist who has studied intoxication in animals, it is common for animals to intentionally experiment with plant toxins. When an intoxicant is found, the animal will return to the source repeatedly, sometimes with disastrous consequences: Cattle will devour locoweed until they die; bighorn sheep will grind their teeth to useless nubs, scraping a hallucinogenic lichen off rock; elephants will eat fermented bananas, get drunk and come back repeatedly to get high.
Siegel suggests that some of these “addicted” animals serve as our scouts in the garden of psychoactive plants.
Goats may have discovered coffee and lithium, a drug used to treat bipolar disorder. Snails will climb to the top of intoxicating plants, feed from the intoxicant and drop to the ground in a stupor. Then they come back the next night and do it all over again. (Sound familiar?)
Pigeons spacing out on cannabis seeds (a favorite food of many birds) may have tipped off the ancient Chinese (or Aryans or Scythians) to that plant’s special properties. Peruvian legend has it that the puma discovered quinine: Indians observed that sick cats were often restored to health after eating the bark of the cinchona tree. Tukano Indians in the Amazon noticed that jaguars, not ordinarily herbivorous, would eat the bark of the yaje vine and hallucinate; the Indians who followed their lead say the yaje vine gives them “jaguar eyes.”
And animals don’t just have substance addictions. Any casual viewing of Cesar Millan’s “Dog Whisperer” will show you any number of canines who are addicted to barking, addicted to fighting, addicted to toys, addicted to food, addicted to their owners.
Nature or nurture?
The genetics v. environment (nature/nurture) aspect of addiction, particularly alcoholism, has been well studied. Most experts agree that there is a strong genetic component in addiction, though no clear “addictive gene” has been identified. Nor is there any known cure.
If both of your parents are alcoholics, for example, you may be 10 times more likely to become an alcoholic yourself, according to the American Institute for Preventative Medicine. But that doesn’t mean that you have to have addicts in your lineage to be an addict; nor are you “in the clear” if you have no such background.
Personality traits like risk-taking and novelty-seeking tendencies are also important. (These may be part of what we commonly call the “addictive personality.”)
Mental disorders, too, are major conditioning factors in drug addiction. You have at least a five times greater chance of becoming an addict if you are bipolar, schizophrenic or clinically depressed.
According to Dr. Nora D. Volkow, director of the Drug Abuse Institute, “Part of, the answer probably has to do with genes underlying genetic variations that may play a role in common brain mechanisms that fuel addictive disorders.
Heredity probably accounts for 40 to 60 percent of the risk for addiction.”
But other factors play a role, too. Availability and independence are big risk factors for kids. And it stands to reason that if your parents introduce you to drugs, you will have an increased risk for addiction.
Certain tragic events, like losing a parent, spouse or child, can also spur drug abuse, which may actually change a person from a “normie” to an addict, because addiction in and of itself significantly changes the structure of the brain.
Addiction, passion and obsession probably evolved for very practical reasons. Obsessive activities and all-encompassing yearnings may actually contribute to our survival. We’re hard-wired that way, it appears.
Most of us are addicted to love, or addicted to accomplishment, things that we crave, things we can’t stop from doing that actually enhance our lives.
Preoccupations and compulsions can lead to amazing discoveries or to amazing feats, so why not just accept that some people need to build huge muscles in their bodies, while others can’t stop looking at or even making YouTube videos?
George (Butch) Warner, MA, MFTI, CADCA is an Addiction Specialist and Therapist at Pasadena Recovery Center.