Never Enough by Judith Grisel
Never Enough by Judith Grisel
Never Enough by Judith Grisel
Addiction stems from the brain's nucleus accumbens and how it responds to drugs.
THC stimulates the whole brain and makes us feel that everything is a little special.
Opiates function like the body’s own painkillers, but consuming them can be
seriously dangerous.
Some people are at greater risk of developing alcoholism than others.
Cocaine affects neural communications in an interesting way, but it’s highly
addictive.
Tranquilizers calm users by affecting specific cell receptors, but they, too, are highly
addictive.
There is a genetic component to addiction, and epigenetics might also play a part.
Early exposure to drugs is dangerous, and adolescents are particularly at risk.
Final summary
The truth is, it doesn’t really matter whether the drugs are illegal or not. They all affect brain
chemistry, and if you don’t know how they or you as an individual operate, you might find
yourself hopelessly addicted.
In these blinks, we’ll take a deep dive into our brains. We’ll figure out why drugs feel so
good but also why they so often lead to addiction and destruction.
The conclusion was obvious: the nucleus accumbens must be the brain’s reward center. The
experiment sounds simple enough, but what Olds and Milner discovered unlocked a deeper
understanding of drugs and addiction.
Developing the research further, their experiments ultimately demonstrated that drugs do to
human brains what those zaps did to the brains of rats. They stimulate the nucleus
accumbens. This, in turn, triggers the release of dopamine, a neurotransmitter that creates
pleasurable feelings. The result is that humans, like those lab rats, keep coming back for
more.
But the brain’s hardwiring is only part of why drugs are so addictive. As the drug consumer
gradually gets hooked, another process is at work; it’s called habituation, and it’s what makes
life seriously tough for addicts.
The brain doesn’t only release dopamine in response to drug consumption; it also produces
hormones or neurotransmitters whose effect is the exact opposite of that induced by the drug.
This is the body’s attempt to balance its internal systems and maintain equilibrium. If you’re
a morning coffee drinker, then you’re probably familiar with habituation. The day’s first cup
will fire up your brain activity, but this initial burst is soon followed by a decrease in that
activity.
So, if you drink coffee regularly, the baseline activity in your brain is reduced, making it
harder to wake yourself up unless you’ve had your daily cup.
Habituation is a major element in addiction: once the body’s used to a particular drug, it
becomes very difficult to go without it.
In the grand scheme of things, coffee’s not so potent, so let’s take a look at some other drugs
that are.
As for the author, her favorite drug is marijuana. If she were stranded on a desert island and
only had access to one stimulant, it would be that.
What makes marijuana special is its active ingredient, THC. THC stands alone in its ability to
stimulate regions across the entire brain. This makes its effects not only wildly, but also
widely entertaining.
Other drugs, such as cocaine, don’t work that way. They only act on one specific part of the
brain or on one type of brain receptor, so only a restricted range of consistent outcomes is
possible. You might feel a rush of euphoria, for instance, but not much else.
THC, in contrast, intensifies all environmental inputs. So music, jokes and food will all be
enhanced. Or you might find yourself laughing inexplicably or waxing lyrical about
everything around you.
The effects of THC on the brain were examined by American neuroscientist Miles
Herkenham in 1990.
THC attaches to and activates receptors that are normally stimulated by the neurotransmitters
anandamide and 2-arachidonoylglycerol, which are otherwise naturally produced by the
brain.
However, there’s still a great deal of room for research on the precise function of
neurotransmitters like anandamide. Generally speaking, it seems that they indicate to us what
is important or relevant in our surroundings.
It makes sense: when we’re walking through the world, we need a method to discriminate
between sensory inputs, so we focus on those that are important for survival. That could be
anything from food or friends to a potential mate.
It appears, therefore, that anandamide and similar neurotransmitters stimulate regions across
the brain to ensure we observe and recognize special and positive experiences.
THC imitates anandamide’s actions, attaching itself to the same receptors. Consequently, the
brain believes that everything, even the most mundane stimulus, is amazing.
Of course, that’s the problem with marijuana, as with other drugs. They transform the dreary
and prosaic into a burst of lyrical poetry. But that soon leads to repeated consumption and,
eventually, addiction.
Opiates are brutal. They make you feel secure and loved, but then they wear off, leaving you
feeling as though you’ve been abandoned on the moon with no oxygen supply. How?
Opiates such as heroin, fentanyl and oxycodone, all imitate endorphins, the natural
painkilling hormones produced by the brain.
Livingstone later wrote that instead of feeling torturous pain – as one might expect – he
entered a dreamlike state.
The endorphins in his body had muted the pain while also subduing panic and anxiety. In this
calm state, Livingstone kept a clear enough head to look for, and execute, an escape.
However, for all of opiates’ pain-subduing greatness, they also have a dangerous downside,
from which there’s no escaping.
Soon after a blissful opiate high, the effects begin to wear off, and the body starts producing
anti-opiates. These magnify any suffering or pain you might feel.
From an evolutionary perspective, this makes sense. If, say, you’ve survived an attack and
managed to run away, you have to know exactly how badly you’ve been hurt so you can look
for help. That pain will also mean you’ll be more cautious next time you’re in a similar
situation.
The same is true of opiates: once their effects wear off, the addict is left with an abundance of
anti-opiates and a feeling of emptiness. There seems to be but one path to relief: more drugs.
That's why opiate addicts will do desperate things like pull out their own teeth to get another
prescription for more opiates.
It’s easy to overlook the fact that it’s exactly these sorts of drinkers who are at risk of
succumbing to alcoholism.
Beta-endorphins are actually quite commonplace and are naturally produced by the body.
They make you feel good, relaxed and connected to others in social situations.
Critically, Dr. Gianoulakis demonstrated that individuals with naturally occurring low levels
of beta-endorphins are particularly susceptible to alcoholism. That’s because they’re drawn to
using it in social situations as a social lubricant.
Unfortunately, that can soon lead to addiction and further serious consequences.
Excessive drinking results in heart disease, strokes and high blood pressure. The liver is also
put under strain: fatty liver disease and cirrhosis can develop. Finally, it has been proven that
drinking increases the likelihood of developing various cancers.
And you don’t escape the ill effects by drinking moderately either. An extensive 2018 study
conducted by Dr. Angela M. Woods demonstrated that just one drink a day could increase the
risk of diseases such as cancer or heart disease. Drink more, and it gets worse. Just two drinks
a day reduces life expectancy by up to two years.
Finally, we mustn’t forget that alcohol can lead people to engage in inexcusable actions, such
as sexual assault.
Every year in the United States alone, an average of 700,000 students between the ages of 18
and 24 are assaulted by other students who've been drinking.
Alcohol consumption may be socially accepted, but its dangers shouldn’t be underestimated.
You don’t need to hear the author’s experience to know that cocaine is a devastating drug,
but what makes it so destructive? Let’s look at how cocaine works.
When you take cocaine, it feels good, since the drug has a direct effect on neural
communication in the body. Normally, two neuronal cells communicate with each other
through a synaptic connection – in other words, the gap between them.
Neurotransmitters such as dopamine, norepinephrine and adrenaline are released into this gap
by the first cell. They then latch onto the receptors of the next cell, relaying a given message
in the process.
When released dopamine attaches to neuronal receptors, for instance, it conveys a message of
pleasure or reward through the neural circuit.
In normal circumstances, once the dopamine has completed its task, it is ferried back into the
first cell, where it can be recycled and reused.
But cocaine interferes with that process. It stymies the transporter that brings the dopamine
back for recycling.
Instead of returning to the initial cell, the dopamine stays put in the synaptic gap for much
longer. It repeatedly stimulates the second cell’s pleasure receptors, provoking feelings of
intense pleasure.
These intense feelings of pleasure do not last forever, though, and addiction is the result.
According to pharmacologists, cocaine's pleasurable effects last for around 30 minutes. In the
author’s experience, however, the real high holds on for around three minutes.
Soon after this, feelings of anxiety and sadness set in. Cocaine users find themselves drawn to
snorting bump after bump. Before long, they are expending all their energy and funds on
securing a regular supply of the drug.
Tranquilizers, which are also known as sedatives, have had a certain respectability attached to
them. But they’re in need of a closer look. Tranquilizers slow and relax the nervous system
by imitating the neurotransmitter gamma-aminobutyric acid – or GABA, for short.
There are two classes of receptor that respond to GABA: GABA-A and GABA-B.
Tranquilizers mostly target the GABA-A receptor, which is located in the neuron’s
membrane and made up of five proteins organized in a ring. These proteins, in turn, form a
gate that opens and closes.
The neurotransmitter GABA activates the receptor, resulting in the gate opening. This allows
chloride ions to rush into the cell. These chloride ions’ negative charge inhibits the cells,
slowing neural transmission between them and inducing a sense of calm.
That’s due in part to the fact that the body soon develops a tolerance to them by reducing the
number of GABA-A receptors present. Since there are now fewer locations where a
tranquilizer can attach, you need to ingest increasing amounts of any given sedative to
achieve the desired effect. At best, this leads to addiction; at worst, to overdose.
What makes the situation even worse is that sedative use results in patients becoming unable
to sleep at all without the help of these drugs. This insomnia makes it especially hard for
users to give up tranquilizers.
You would think that American doctors would be aware of this and take care when
prescribing such dangerous drugs. But that’s not the case. According to a 2016 study by
American medical researcher Markus Buchhaber, benzodiazepine prescriptions increased by
67 percent between 1996 and 2013. Given the negative, addictive effects of these drugs, this
– to put it mildly – is an extremely worrying development.
Some people are simply more at risk of becoming addicts because of who they are. That’s to
say, there’s a genetic element to addiction.
One of the study’s findings was that twins are twice as likely to both have addictive habits
compared to mere siblings, who share about 50 percent of their genetic material.
Additional research confirmed this finding: another study demonstrated that children born in
families with histories of addiction were at a high risk of becoming addicts themselves. And
that was even the case if they were adopted at birth into families without histories of
addiction.
So far, so clear: genetics has an impact on addiction. But what’s even more fascinating is that
epigenetics may have a similar impact.
Epigenetics is a new field. Simply put, it’s the study of how individual traits emerge as
responses to specific life conditions, and of how those traits are passed on genetically from
one generation to the next.
Here’s an example.
A 2015 study devised by Henrietta Szutorisz suggested that the same process might occur
with drug usage. In the study, parent-generation rats were regularly exposed to THC.
And, interestingly enough, their offspring were more likely to evince mood disorders, as well
as to self-administer opiates.
When it comes to drugs, it’s important to consider upbringing and environment, which can
also put children and teenagers at heightened risk of drug abuse.
This was indicated in a 2015 survey conducted by American medical researcher Moshe Szyf.
It would seem that embryos, children and adolescents who had been exposed to drugs such as
THC became less sensitive to rewarding feelings as adults, including feelings stimulated by
drugs.
The implication is that such individuals are more likely to take higher doses of drugs if they
start using them.
On top of this, there’s another environmental factor to consider: the gateway effect. The idea
behind the term is that if you start taking one drug, you can find yourself succumbing to
others.
For instance, David M. Fergusson, a New Zealand psychologist, looked at the effects of early
exposure to cannabis in a 2014 study.
He found that cannabis usage before adulthood resulted in an increased risk of addiction to
drugs more generally in adult life.
But Fergusson went further than mere observations; for him, neuroplasticity, the brain’s
ability to change and develop over the course of a lifetime, was also key. Young brains are
particularly plastic; that’s what leads to social and identity development.
However, this youthful plasticity also means that strong neural inputs like those produced by
drugs leave much deeper imprints. In short, the younger you are, the more vulnerable you’ll
be to the effects of drugs.
And it doesn’t stop with brain plasticity. The prefrontal cortex in the brain is the last part to
develop, only becoming fully functional once you’re an adult.
That’s important because it’s the prefrontal cortex that controls impulsive behavior and
abstract reasoning. In other words, it’s what you use for weighing the consequences of an
action against the immediate perceived benefits.
Since adolescents lack those abilities, they are especially at risk of first taking drugs and then
going too far.
The take-home here is clear. If you care for adolescents, be sure you let them know the
effects and risks of taking drugs, particularly at their susceptible age.
Final summary
The key message in these blinks:
Drugs have many different effects, but they have one thing in common: whatever
entertaining or pleasurable responses they may produce at first, the next phase is going
to be the polar opposite. This period of anxiety, depression or pain makes people reach
for another dose of their drug of choice. However, because their bodies counteract the
effects of the drug and become less sensitive to it, users need ever-higher doses to
experience relief. This is the cycle of addiction, and it is hard to break. But sound
knowledge about drugs and their effects, as well as an understanding of the
development of the human brain, can help addicts break free of this cycle.
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As you've just learned, the effects that drugs have on the brain aren’t to be underestimated.
But you’ve also seen that it’s not just about the drugs. The basic structure of the brain goes a
long way toward explaining why we respond to stimuli the way we do.
In this book in blinks, you’ll learn why different experiences, from taking heroin to giving to
charity, from overeating to orgasm, all feel sort of the same.
So if you’d like to get to grips with the brain’s pleasure circuitry and learn even more about
the true nature of addiction, we highly recommend popping over to the blinks to The
Compass of Pleasure, by David J. Linden.
Next blink