The best way to describe addiction is to compare it to chocolate cravings, Dr. Nora Volkow, a well-acknowledged general in the drug war, said in a recent episode of PBS’s The Open Mind. The director of the National Institute on Drug Abuse (NIDA), who pioneered brain imagery to investigate the toxic effect of illegal drugs, used her own love of chocolate to show how some people can control cravings and others can’t.
Volkow, like other chocolate lovers, can control her cravings most times, but sometimes she can’t and she gives in and indulges. It’s usually when she’s tired or frustrated. Even the most disciplined person gives in and indulges in something at times. That is part of human nature. This is how it works with addicts, but according to Volkow, due to the fact that their brains are damaged by drug use, they can’t turn it off, they can’t say no. There is no moderation.
“When you transition from that stage where most of the time you are able to self-regulate the desires and control and manage your behavior even though you want to do it, you say it’s not a good idea—when you lose that capacity consistently, that’s when you start to get into the transition of addiction,” she said. “If these areas of the brain are not functioning properly, which is what repeated drug use does to your brain, it can affect the capacity of frontal cortical areas. Your ability to make optimal decisions gets dysfunctional.”
People who are not addicts assume that addiction is a lack of self-control. Because if they do drugs and don’t give in to overuse or abuse, then why can’t the addict? But the fact of the matter is that drugs affect us all differently. Dysfunction in the frontal cortex, which helps us analyze things and make decisions, can make people’s ability to say no to that chocolate bar diminish. Addiction is more than just a behavioral problem.
“Addiction is fundamentally a learning disorder that involves dysfunction in the circuits that are typically used to drive parenting and love,” says Maia Szalavitz, the author of Unbroken Brain: A Revolutionary New Way of Understanding Addiction, “and when we understand that people pursue drugs despite negative consequences because there’s some kind of mis-learning in this circuitry we then have a lot better idea about what to do about it.”
The brains of addicts simply cannot resist grabbing another chocolate bar, again and again and again. There’s a big difference between the mind of an addict and a person who can do things in moderation. But if it’s a learned behavior, it can be unlearned. These neurological ideas are supported by years of research, a 2011 paper by Volkow and a mid-aughts report that determined addiction is a learned behavior due to changes in the frontal cortex. “Every 20 minutes there is an American that dies from an overdose,” Volkow said. “We are coming up with strategies to revert this epidemic.”
Check out The Open Mind episode featuring Volkow below: