Addiction Research: All Brain and No Soul?
But in science—although not in the media—suggesting a theory is only the first step toward proving it. We don’t yet know how these systems work normally—for example, from sexual arousal to orgasm and afterglow—so it’s impossible for us to know what happens when they go wrong. We need this addiction research, but we also need to be vigilant about its limits.
Since we can’t currently describe how free will works in the absence of addiction—or whether it even exists—it’s a bit premature to claim certain brain changes indicate that someone has lost control. No studies yet find a universal difference between addicts and non-addicts; none predict relapse or recovery accurately based on brain factors.
Some drugs in some people in some situations may indeed produce this type of effect—but right now, we’ve got no scientific evidence for that.
To understand addiction, we need to know more than that someone has taken a drug that he likes. We need to know about the rest of his life, about his social support, his history of mental illness, education, employment, as well as his values and sense of meaning and purpose.
We need to know the dose of the drug and the setting where he takes it. We need to know his age and how his culture views behavior related to that drug and something about the level of stress and trauma he experienced as a child.
In fact, social factors like unemployment, education level, traumatic life experience and amount of social support for recovery are currently better predictors of recovery than any brain factors yet discovered. So far, pretty brain pictures don’t necessarily tell us much. A recent study, in fact, found that simply presenting data with such images—relevant or not—made people more likely to be convinced by the authors’ claims.
In short, addiction doesn’t begin—or end—with “pleasure centers in the brain.” If we’re going to address it effectively, we need to recognize this reality and devote as much time and money to studying social factors as intensely as we do the brain.Of course, that might mean looking at issues like unemployment, child abuse and poverty that are far more uncomfortable than saying “nucleus accumbens” or “brain disease” and being done with it.
Maia Szalavitz is a columnist at The Fix. She also is a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).