Friday, March 4, 2016

The Importance of Reading With a Keen Eye


TIME posted a very interesting article a few years ago relating to a recent increase in media attention to addictions. You can find the article here, and it is written by Maia Szalavitz. After hearing Dr. McGehee speak about nicotine-related mechanisms behind addiction forming, I was a little surprised at what I read in this article. By this, I mean I am surprised by how much the author undermined neuroscience research for addiction mechanisms.
Before we dive down and examine this article, it is important to keep two things in mind. First, this article was written in 2011. Although this time is still contemporary, less research about addiction was available to the author. Next, this article was written during a craze where “media headlines scream daily about new neuroscience findings…” on addictions. Some opinions could be exaggerated or biased towards whatever the mass’s opinion was (thank you, de Tocqueville).
This article starts off by claiming that “addictions hijack the brain’s pleasure systems” is circular reasoning and confuses the real purpose of the brain’s pleasure pathways. Szalavitz reasons that brain pathways are intended to make evolutionary activities (i.e., sex and eating) fun and enjoyable. Continuing, she states that drugs cannot be said to hijack the reward system to create addiction because that would also be to say that healthy urges like eating and sex would not cause addiction. To conclude her point, Szalavitz says sex and eating can become addictions by activating brain regions that generate pleasure from drugs, and that is why hijacking is not the appropriate description.
To be honest, Szalavitz’s logic can be pretty confusing. I almost agreed with her when it was stated that activities and substances cannot “hijack” a reward system because the system is meant to get us to pursue food and sex relentlessly. This made me think about what Dr. McGehee stated in his nicotine addiction findings. He stated during his presentation that the amount of cigarette packs a human smokes will plateau after 2-3 packs per day. The body can form needs and desires for a drug, but with some substances the body can also say “enough is enough.” I believe the same idea works for food too. I cannot pursue Chipotle endlessly. I will undoubtedly become sick of it after 1.5-2.0 burritos and not want to see food for a good half day. I believe Szalavitz needs to be more careful with saying that we endlessly pursue sex and food. A tribal and sensory-driven view of humanity undermines our agency and ability to reject certain sensations.
Lastly, Szalavitz states that “no study has ever isolated a simple brain change that is always seen in addicts and never in non-addicts. And although some studies have found changes that can predict an addict’s odds of relapse, they’re not always accurate.” I would like to note here how the first sentence in Dr. McGehee’s paper, from 2011, titled “Nicotine Potentiation of Excitatory Inputs to Ventral Tegmental Area Dopamine Neurons” began. It states, “Drug-induced changes in synaptic strength are hypothesized to contribute to appetitive behavior and addiction.” This shows first that Szalavitz may not have been quite up to date with neuroscience literature before writing this article. Secondly, Szalavitz assumes that addiction is a black-and-white mechanistic process. Continuing with Dr. McGehee’s study, there are varying levels of smokers. Accordingly, the long-term potentiation in Ventral Tegmental Area dopamine neurons may also vary with the level of addiction (i.e., a process hypothesized to underlie nicotine addiction can vary with level of addiction). Assuming that a process will either be present or absent depending on addiction undermines the complexity of understanding addiction circuits.

To conclude, it is always important to read news articles with a critical eye. In this case, hearing that no study has been conducted to isolate a simple change in addict’s or non-addict’s brains is true, but very misleading. The fact of the matter is that addiction is much more complex than one change. Understanding the summation of many changes in neural networks will ultimately be a key to understanding addiction and to help us better treat it. 

No comments:

Post a Comment