Whoever coined the slang term "dope" for drugs was onto something, because all addictions, whether to drugs or behaviors, involve dopamine. Dopamine is the essential neurotransmitter in the motivation system, without which all mammals are inert, inactive, and lacking all incentive. A hungry laboratory mouse whose brain is artificially denuded of its dopamine apparatus will starve himself while tanding in front of a plate of food. In fact, every addict is a dopamine fiend, outsourcing the hunt for the homegrown chemical hit that makes the present moment exciting and vibrant. For virtually every "positive" feeling or people derive from their substances or behavior of choice, there are endogenous -naturally occurring- brain chemicals implicated. Addiction begins as an attempt to induce feelings that we were biologically programmed to generate innately, and would have -if unhealthy development hadn't got in the way.
San Diego internal medicine specialist Dr. Vincent Felitti one of the lead investigators of the now famous (though not fa mous enough) Adverse Childhood Experiences (ACE) Study The study emerged after Felitti decided to listen to the life his tories of patients at an obesity clinic who all reported childhood traumas. Carried out in the 1990s in California's Kaiser Permanente health care network, the research showed that among cohort of over seventeen thousand mostly Caucasian, middle class persons, the more adversity a child had been exposed to the greater the risk of addictions, mental health issues, and other medical problems they faced in adulthood." Adversity was categorized under three general headings: abuse (psychological, physical, sexual); neglect (physical, emotional); household dysfunction (alcoholism or drug use in the home, divorce or loss of a biological parent, depression or mental illness in the home mother treated violently, imprisoned household member). The impacts of such experiences did not merely add up; they multplied each other. An adult reporting an ACE score of 6 had a risk of intravenous drug use forty-six-fold greater than a child with none of the adversities named.
Whatever the degree of injury, all addiction is a kind of refugee story: from intolerable feelings incurred through adversity and never processed, and into a state of temporary freedom, even if illusory. Again, try saying no to that.
This definition (of addiction) is not restricted to drugs. The same drive that often devotes itself to substances can activate any number of behaviors, from compulsive sexual roving to pornography; from inveterate shopping to the internet (both of which habits I know well); from gaming to gambling; from any sort of binge eating or drinking to purging; from work to extreme sports; from relentless exercising to compulsive relationship-seeking; from psychedelics to meditation. The issue is never the external target but one's internal relationship to it.
thr three main hallmarks of addiction are
- short-term relief or pleasure and therefore craving;
- long-term suffering for oneself or others; and
- an inability to stop.