Review of “Rethinking Everything We Thought About Addiction”
By: David Smack, M.D.
Addiction is a growing problem that affects many individuals and families around the world. In fact, the number of alcoholics and drug addicts continues to rise every year. This article addresses the lack of advance in medical treatment for substance abuse, as well as the benefit of a 12-step program. The author talks about the parts of the brain that are affected by one time and repeated substance use/abuse. Despite a wide range of recovery treatment options, relapse rates remain high. There is an urgent need to improve treatment and increase access to quality care (Sack, 2012). The medical communities and the 12-step program both have beneficial pieces to the puzzle of substance abuse treatment, but they will need to work together to be successful in long term recovery.
Scientific studies have taught us that addiction is a chronic brain disease (Sack, 2012). However, the latest scientific evidence challenges long-standing beliefs about addiction. Dopamine is a neurotransmitter that is released into the nucleus accumbens (the brain’s pleasure center) when we participate in activities that make us feel good. Similarly, addictive substances cause pleasure by flooding the nucleus accumbens with dopamine. Addictive drugs typically release 2 to 10 times more dopamine than their naturally occurring counterparts (Sack, 2012).
If dopamine is the primary driver of addiction, then everyone who uses a drug should automatically become addicted and different drugs should be interchangeable. Science shows that neither is the case, less than 10% of people who use alcohol and other drugs become addicted, and addictive substances are not interchangeable (Sack, 2012). Repeated drug use actually causes physical changes to different parts of the brain. Drugs affect brain regions that influence learning, memory, feelings, and mood. New studies continually show that it’s these