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Providing straightforward information pertaining to drugs, drug use & drug policy. The Grey Pages promotes drug-related literacy and advocates a system of viable and tolerant drug policies. This is my personal collection of commentaries, essays, tid-bits, and other such writings on everything ranging from drug use, drug policy and drug-myths, to drug-science, addiction, human behavior, and the workings of the human brain. I started this blog with a particular focus on opioids, and over the past year have found my interest gravitate toward the intriguing, ever-changing world of designer intoxicants (i.e. "research chemicals" or "designer drugs").

Friday, April 13, 2012

4 Major Distinctions Between Real Disease States and the "Disease of Addiction"

The changes seen in this brain scan are actually not
so unique after all
(1) The symptoms of cancer cannot be changed with behavioral choices. The symptoms of cancer cannot be unlearned. While the process of neuroplasticity strengthens the brain circuits related to drug use, and creates pathways connecting memory, positive emotions, reward with drug related environmental and pharmacological stimulus, the same is true in reverse - these same brain circuits and pathways can be weakened over a period of different drug taking habits, while the areas associated with the new behaviors are strengthened instead - all through the same process of neuroplasticity (discussed further below). Simply put, neuroplasticity mediates the brain changes which take place when we learn information, form memories, develop skills, form memory/sensory connections, and learn behavioral habits, and so forth. Just as we can develop new skills and learn new habits, we can un-learn such skills and habits as well. It simply takes time, commitment, and consistency.

(2) In the case of an actual disease, the tissue of the body is in a state of abnormal biological functioning. In the case of addiction, the tissue of the body is not in a state of abnormal biological functioning; the neurobiological characteristics seen in the drug addicted brain are not abnormal, and are analogous to the neurobiology of most other learned behaviors. Neuroplasticity refers to the recently demonstrated ability of the brain to change its structure and function. This allows the brain to expand and strengthen particular circuits that are frequently used, and to shrink or weaken other circuits that are rarely used. The study of neuroplasticity has shown brain changes reflecting ones own lifestyle experience, personal habits, and environmental input. So, when proponents of the disease model claim that drug addiction is marked by "changes in the structure of the brain", these changes are not so novel whatsoever, and neither is the process which induces these changes. A process which occurs, and reverses itself, over time, at every level of the brain, depending on ones behavioral habits and environment. 

(3) In the case of an actual disease, the abnormal biological functioning of the tissue causes undesirable symptoms. The symptoms of the drug addicted brain state are not symptoms at all, as there is a crucial element of conscious personal choice lying between the brain pathology and the behavior (or so-called "symptom") of drug use. This is not the case with a disease such as cancer or diabetes, where manifestation of disease symptoms are not subject to judgement, choice, or restraint.

(4) One major difference between a disease such as diabetes and the supposed disease of addiction, and one which further demonstrates that drug use is not involuntary, is the ability for the addicted to turn down drug use when offered a positive or negative incentive. A diabetic is certainly not able to lower his blood sugar in the face of a threat such as a gun to the head, or a reward for doing so. Recent research in addicts has shown the use of incentives to be succesful in leading the addicted to abstain from drug use, and in the process begin devoting their time to more rewarding pursuits through the prizes received for clean urine screens, such as sporting goods and movie tickets - this approach is known as contingency management.

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