Questions about addiction (from biological and psychological perspectives)

Factual Questions
1

The question I’m asking has several subsets to them, and forgive me if I don’t ask them as eloquently or as intelligently as they should be asked.

I come from a family of addicts. My father has suffered almost his entire life with alcohol and in later years, prescription drug dependencies. His sister is an alcoholic, big time. My father’s great grandfather was a severe alcoholic who died young as a result. On his father’s side, his great uncle was a gambling addict who once lost 10k (in 1940s era money) on a bet. On his mother’s side, his uncle was also an alcoholic.

On my mom’s side, her father was a severe gambling addict, to the point that it cost him his career and almost prison time, as was his younger sister, and my aunt experienced issues with gambling addiction as well as spending addiction at points in her life. She had to declare bankruptcy at one point due to her spending, and my mother had to bail her out from loan sharks in the 80s. My mom’s grandfather on her mother’s side was a bad alcoholic as were most of her uncles, who died young from alcoholism or complications of it.

While not blood, one of my male role models was an alcoholic and cocaine abuser, and a non-blood relative is a heroin abuser.

While I’ve never suffered from any chemical dependencies, I suffer from compulsive spending, especially when under stress. I spend way outside of my means and when I do I feel powerful and sort of a rush. The act of buying is a high and then usually once the shit I buy arrives or I’ve used it a few times, it loses all allure and I probably never use it again and am onto something else, the next big thing to get. When under psychological stress, spending makes me feel comforted. Soothed. I have an allure for horse races but I’ve never actually gambled (more because OTB is gone…)

So that said, my questions are:

  1. What determines what a person will be addicted to? For example, I’ve told you about the addictions in my family - why is my father addicted to pills and not horses? Or myself addicted to spending and not alcohol? Why did the addiction gene skip my mom?

  2. From a biological standpoint - in terms of brain chemistry - are they all exactly the same? What are the differences?

  3. Psychologically speaking, is the mindset of say, a coke addict or a compulsive sex addict much different from a gambling addict or spending addict? Do all addicts of every stripe have the same “rush - comfort” feeling with addiction?

  4. What determines how severe an addict is? For example, my brother in law - while an alcoholic - functioned. He was never clearly inebriated, but he was the type of person who steadily drank all day to maintain a constant buzz as a way to mellow his mind. Yet others will lose their entire livelihoods because of their addiction. What determines that?

Any answers would be appreciated! Thanks in advance.

3

Biologically - I recall reading something by a former meth/heroin addict. he said the rush you get from that first shot - like an orgasm only 20 times stronger and much longer. Now think about how much effort many people ( many men) put into getting laid. Any surprise some people take up drugs in a big way? And of course, whether alcohol or other drugs - the body builds up a tolerance and demands more and more to get the same effect.

His logic went like this… Nobody says “I’m going to be an addict and inject heroin.” They start doing something like meth, taking pills or something. They get that huge rush. It’s intoxicating, they want to do it again. they find it’s faster and more productive to smoke instead of ingesting. Then they get desperate, switch to heroin which apparently is cheaper than meth. (?) Then realize when they need a high and are short of drugs, that injecting will make the same quantity go 4 times farther… then they’re hooked and injecting and nowhere to go but downhill.

4

As an alcoholic in recovery for 20yrs, I can give you my perspective on what my experiences were like:
My grandfather was an alcoholic but it skipped my mom & 3of my aunts; however, 1 auntie is a pretty severe alcoholic but it seems only in the past 10 yrs to have gotten out of control [she’s 67yrs old]. I’ve seen scientific studies that pretty much confirm there is a genetic basis to addictive personality & that 's the brain chemistry you asked about; I look at as the wiring of the brain, how I as a person & my brain as the center of my human chemistry were wired to respond to alcohol. That kicked in when I got my teen-age heart broken & turned to drinking after school to soothe the drama in my thoughts & emotions.
Like Jaimeteddy says above, my brain felt soothed by the introduction of alcohol into my brain chemistry & so I felt compelled to keep turning to that to feel better when stressed or upset; that’s another of the scientific theories about addiction=>the soothing is actually a result of the dopamine and/or serotonin that one’s brain produces as a response to the alcohol/cocaine/gambling/shopping/whatev’s. Addicts seem to lack the full set of chemical responses most people are born with, the feel good chemicals one’s brain produces when one accomplishes something/wins some $$/falls in love, the normal human experience that one gets a sort of rush from<=that’s dopamine & serotonin, a normal product of brain chemistry. Addicts seem to be low on those chemicals & 1thing or another will seem to produce the dopamine/serotonin that’s lacking. What one is addicted to is almost incidental; if you’re wired w/an addictive personality your brain will latch onto 1thing or another as the “answer” to your stress, the activity that seems to produce what chemicals are lacking.
And from 15 years old on, I was always trying to get the fullness of satisfaction I felt from my 1st afternoon drinking sessions. But, like md2000 mentions, one’s brain & body build up a tolerance & it takes more & more to get the same calming effect, more drinks, more shopping, again whatever your particular addiction is. You seem 2b getting that rush from shopping & I would say that’s what your brain chemistry is finding 2produce the serotonin/dopamine your wiring may be lacking.
Severity of addiction seems 2b a roll of the dice - I knew people who had steady drinks all day too but kept going 2work & doing their jobs; that’s the behavior pattern that worked for them but 4the life of me I could never seem to alter my addictive behavior to that pattern. So I went to AA, followed the program & listened to the experiences & behavior changes that other addicts did to get clean; that was key because they had something that I wanted. So I did what they had done, kept going to meetings & that slowly helped me change my behavior patterns, which I felt were the wiring of addiction. After a year it got MUCH easier & that’s because a new behavior pattern had been established, in a sense my brain had been re-wired.
There are support groups for any kind of addiction & compulsive spending/shopping seems to be one of the more well-known ones. Seek them out, listen & take it slow, keep going back even if you slip & relapse, just keep going back & it will all work for you Kennedy1960… If I can do it, ANYONE can do it. Goodluck! :cool:

5

Full disclosure: I have never myself been an addict, but I did work as an administrator at a methadone clinic for four years. While I was not a counselor or medical worker I did have a lot of contact with several thousand addicts over those four years. So, this is from the perspective of an outsider looking in, but an outsider who did a lot of looking.

No worries - the important thing is that you’re asking, not how pretty your words are.

The truth is that no one really knows the answer to this one.

However, addiction is a combination of biology AND environment. It’s also more complex than just one gene

Maybe your mom didn’t inherit an “addictive biology” OR maybe she found a different and healthier way to cope with stress. Even if I met your mom in real life I wouldn’t be able to say, and I doubt any professional could say for sure, either. It’s like asking why someone in a family with no history of addiction becomes an addict - no one really knows that, either.

As to WHAT a person becomes addicted to… there’s no way to know that in advance, either. It is also possible for one addiction to be replaced by another. Again, no way to predict that, either. Nor is that always a bad thing - some alcoholics become as compulsive in attending AA and working the program as they were at drinking, so arguably they’ve replaced an addiction to alcohol with an addiction to AA - but the latter has a lot fewer negative consequences so overall they’re better off.

One of things that IS known about addiction is that the addiction causes activity in the parts of the brain associated with pleasure and reward. The details - exact parts of the brain, exact brain chemicals, the intensity, etc. - will vary but the common thing is that ALL of these things trigger parts of the brain that, when active, is what makes you feel pleasure.

Sort of.

My observation was that while some addicts with horrific backstories a lot of it was just to numb the pain - psychological pain being real pain as much as that caused by physical injury or illness. But relief from that sort of pain is a pleasurable sensation. For others it was just about chasing the rush. On one level or another doing whatever it was resulted in the addict feeling better in some way or another.

This is another “nobody really knows”.

Someone like your brother-in-law MIGHT have been self-medicating. He MIGHT have had some sort of anxiety disorder and a steady, low-level buzz “took the edge off” - if he had gone to a doctor first he might have wound up with some type of pill to do that. Or a recommendation for counseling.

Someone who drinks themself unconscious every night might be self-medicating due to something traumatic.

Some people get such a rush of pleasure from that first hit of “X” - drugs, gambling, sex, whatever - that they’ll ruin themselves chasing it to the exclusion of everything else.

I’ll throw this in, even though you didn’t ask about it - there is more than one way to get control of addiction. 12-step programs are well known, but they don’t work for everyone and there are other options. It’s also quite common for a person to need more than one attempt to get control over an addiction before they do in fact do that. If you feel you have a problem, or that you might have a problem, then please do look into getting some help. There are also groups and programs for the family and friends of addicts (Al-anon is the one for those close to alcoholics - there’s no reason you couldn’t go to one of those given your family history) to help them cope better with the problems addiction causes bystanders and loved ones.

And finally - we have some recovering addicts on this forum who might check in later, some of them with medical training who might be better able to answer your questions regarding medical details and biology. So check back later to see if they’ve shown up.

6

Not an answer to the question but an interesting data point. Drugs called dopamine agonists are used to treat various conditions but most notably Parkinson’s. One of the very common complaints about these drugs is stimulating addictive behaviors in the patient.

As dopamine agonists, these drugs are stimulating the same receptors as dopamine. This seems to validate earlier mentions in this thread about dopamine playing a part in addiction. Too much dopamine (or too much of a drug that simulates dopamine) appears to cause addictive behavior in people who didn’t have these behaviors before.

Which begs the question: what is different in the brains of people who are naturally susceptible to addiction? Are they more sensitive to the effects of dopamine thereby causing addictions that stimulate the release of dopamine? Do the people who take dopamine agonists have extra receptors that aren’t simulated until there’s excess of a dopamine agonist?

7

Different substances addict in different ways. If it’s a dopamine agonist like alcohol or cocaine or meth, then the drug activates your brain’s reward pathway.

To really understand what that means, the feeling of reward is the rush you get when you accomplish something. You got an A on the test, you closed the big deal at work, you asked her out and she said yes. Or - more to the point of the OP - you bet it all on a 50:1 pony and won. That’s the reward system. It’s not happiness per se, it’s not relaxation, it’s a distinct sense of reward.

Some people have a big need for that feeling, or it’s harder for them to get that feeling, so they’re more susceptible to drugs or behaviors that give them that kind of reward. Cocaine, meth, alcohol, gambling, sex. Or if your work involves taking big risks and getting big payoffs, work can be like a drug. If you do that drug or behavior enough, you stop being able to feel rewarded by normal things, so you do more and more of the drug.

Since OP seems mostly asking about reward-system behaviors, I won’t mention opiates. Suffice to say that many drugs engage systems other than the reward system (although seeking and getting the drug indirectly activates the reward system)

8

I would expand upon question #2, because physiologically, if someone is ingesting chemicals, it seems logical that those chemicals have the potential to alter the release and regulation of dopamine in the brain. It further seems logical that the physiological presence of these chemicals in the brain has potential to cause long-term or even permanent change in brain chemistry and functioning.

But gambling doesn’t involve any physiological ingestion of chemicals, so how does it cause long-term or permanent change in the regulation of dopamine? I can understand how the brain would physiologically shut down dopamine receptors in response to the effects of the excessive presence of certain chemicals, but how does that work with something like gambling? How is it that an activity can induce the same kind of physiological response that the presence of chemicals naturally does?

9

Because reward-seeking behaviors are also chemically mediated. These behaviors trigger that surge of dopamine that tells the brain “great job, you’re a genius, you should do that thing more.” The brain has a hard time telling cocaine from dopamine, it responds to both very similarly.

10

This is not a universal explanation, but there is a condition called “Reward Deficiency Syndrome” that can cause addictive behaviors and seems related to some genes that govern dopamine transport.

I don’t know if that relationship is conclusively established, but yes, it seems like some people are genetically predisposed to have dopamine malfunctions and addictive behaviors that come along with it.