Addiction - are we all turning into addicts?

I have been studying for sometime addiction, more specifically the 'addictive brain'. Having specialised in perfectionism, it felt natural to investigate and become more self aware of addiction and of course its manifestation.  Furthermore, having now worked closely with organisations and individuals whereby 'entertaining' or 'bonus trips for the successful' are often part of the job, I wanted to be able to communicate to my network how this way of behaving is contributing heavily to the demise of the many. 

Stigma and addiction 

For most, when we think about addiction we will automatically start thinking about drug addicts or alcoholics, some of us may even think about gambling or sex addiction. However, addiction affects almost all of us.

A drug can typically be considered to be any substance other than food that changes biological functioning when introduced into the body from outside. So yes, cocaine and heroin most certainly can satisfy this definition, however, so can antibiotics so what is the difference? One of the major big differences is that cocaine and heroin are psychoactive whilst antibiotics are not.  Psychoactive drugs affect the function of that brain that produces psychological effects like changes in mood, perception, and cognition. Psychoactive drugs are often addictive.

However psychoactive drugs are not limited to cocaine or heroin - nicotine, alcohol, and caffeine are all also psychoactive drugs.

How do we know we are addicted?

A hallmark feature of addiction is dependence. One of the main symptoms is physical dependence, whereby the body needs more of the drug to get the effect they want. Another symptom of physical dependence is withdrawal. Many addicts will actually say that they physically need the drug just to feel normal; they don't function anymore without them. The third hallmark feature is craving. When the addict does not have the drug they can feel an extremely strong desire or urge to use their drug, they may even find it difficult to think of anything else and become completely obsessed with getting more.

As science has progressed, we have begun to realise that it is also possible to be addicted to things that are not drugs, for example, pathological gambling or work for example which satisfies many of the major criteria of addiction. Many scientists now consider such behavioural or process addictions like gambling to be the same kind of addictive disorder as chronic drug abuse.

So how does addiction hijack the brain?

Well basically there are three basic changes that contribute to addiction: Repeated overstimulation of the brain's reward circuit numbs the response in the brain's pleasure centre the nucleus accumbens; repeated overstimulation also strengthens associations with addiction-related cues, which increase cavings; which weakens inhibition from the prefrontal cortex, which undermines self-control.

We will self stimulate the nucleus accumbens over and over for hours given the opportunity.

Addictive drugs/behaviour overstimulate the nucleus accumbens, meaning that they produce activity levels that are well beyond the normal range, is this happens a lot, then it can eventually lead to a numbed pleasure response. When this happens the body has mechanisms that maintain an internal equilibrium, this is called homeostasis - producing a molecule called CREB, which triggers the production of dynorphin, which inhibits the stimulation of the nucleus accumbens. This overstimulation continues over time, the dynorphin will continue to turn it down, and over time the individual will receive less pleasure from the drug. The high won't be as rewarding - this is what is know as numbing of the pleasure response.

As the nucleus accumbens becomes less sensitive to all types of stimulation, everyday pleasures such as seeing a friend or reading a book might also feel numb.

Dopamine, a chemical neurotransmitter also plays a central role in addiction. In fact, it is often called the addiction molecule. Studies have found that most addictive behaviour/drugs of abuse lead to a significant increase in dopamine when they are taken or acted out. For a long period of time, scientists have assumed that dopamine was associated with pleasure and liking, however recent evidence has suggested that that view is wrong. In fact, many scientists now believe that dopamine release is associated with wanting or craving, rather than liking. This kind of wanting or craving is an impulse urge, not a thoughtful long-term goal. So how does it contribute to addiction? Repeated use leads to changes in the dopamine system, the first change is what is called 'incentive sensitization'.  This is when the 'wanting' becomes particular salient and strong, and that dopamine signal conveys that strong incentive.

Further more, this dopamine signal is a reward prediction error which triggers learning in the brain. The brain begins to learn that such behaviour or drugs that trigger a reward are to be 'paid attention to' so that such 'rewards' might show up again in the future.  Unfortunately, addictive behaviour/drugs trigger larger-than-normal releases of dopamine, and much of what is learned is more harmful than helpful. 

Conclusion and my thoughts

First and foremost considering what we now know about addiction, I ask all organisations and customers to consider their own part to play in creating the environment in which addiction can thrive.  I have discussed how addictive behaviours and drugs hijack our brain, yet we continue to, and expect to 'entertain' and 'be entertained'.  As customers we have come to often expect to be taken out by our clients, and believe me, this puts a huge pressure on the employee to take part in activities which are harmful to their health.  Whilst we have maybe come along way since the Jordan Belfort days, we cannot ignore or pretend that drinking, gambling, women/men, drugs etc. do not play a part in such 'entertainment'.  Furthermore, there are organisations that take their most successful for 'reward weekends' that consist of an all-inclusive paid for the weekend to places like Ibiza where behaviour such as alcohol and drugs are part of the scene.  It can be very intimidating to say no, especially if you recognise you have a problem.  Working in such industries can often sabotage efforts to recover or remain abstinent.  Employees should not have to leave their jobs or industries to remain healthy human beings. 

Organisations and customers are therefore huge influencers on the manifestation of addiction.  THIS NEEDS TO CHANGE.

Secondly, I have found the neuroscience of reward and the numbing of the pleasure receptors exceptional invaluable in my learning.  In my opinion, the constant striving for perfection creates the same effect and contributes to our addiction to work.  No matter how you look at this, never knowing when to stop (craving) WILL cause burnout and a lack of appreciation and enjoyment for many things in our lives.  Furthermore, we often reward this striving and reinforce the behaviour with bonuses, reputational enhancements and job promotions (encouraging this larger-than-normal increase of dopamine).  As clients of organisations we can also be fiercely demanding in our unrelenting expectations which are often unrealistic, unobtainable and detrimental to the individuals that carry out services for you (take lawyers for example - it has become almost 'normal' for clients to demand you work more hours than you are capable - seriously, what does that say about us as human beings or in fact you as a client?). 

Final thoughts - addiction is a huge problem for us all, and as a dopamine-dependent society we must be responsible for ourselves and others, as employers, employees and as customers.  

This article was written by Stacy Thomson, Founder of the Performance Club. She is a coach, speaker and trainer. 

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