The widespread, and much publicized, damage, and deaths from excessive opiate use have clearly emphasized the deep-rooted health crisis of addiction. Yet, the problem of addiction involves substances and behaviors of abuse beyond just drugs and alcohol. And it is so pervasive that even if it does not affect you personally, you can be sure that it is haunting other friends or family members that are close to you.
When you consider the prevalence of heart, lung, liver, and brain damage/disease, cancer, obesity, and diabetes generated by the compulsive abuse of alcohol, tobacco, other drugs, meat, dairy, salt, sugar, processed oils, and refined, processed junk food, addiction is arguably the most significant cause of disability, disease and death.
Therefore, having some understanding of the addictive process, and how our awareness and choices can modify this process, can remarkably promote the opportunity for successful weight regulation, improved health and quality of life.
To better understand the nature of addiction, I present the definition used by the American College of Addictionology and Compulsive Disorders. This definition clarifies the distinctions between addiction, abuse, and compulsive behavior. Addiction is the continued or compulsive use of any substance or behavior without regard for negative consequences.(1) The outcome of negative consequences defines the dis-ease of addiction. The individual knows that their behavior is either causing them obvious personal harm or is hurting family members or other people and they continue to do it anyway.
The blatant disregard, and especially the denial, of the dangers and consequences of compulsive behavior, is fundamental to the addictive process. For example, since the compulsive and excessive use of food can promote obesity and an increased risk of heart attacks, diabetes, strokes, and cancers, an obese person or a diabetic that disregards and denies the potential harm of their over consumption of all food, including junk food, would satisfy this definition. However, the person who uses alcohol or other drugs, or overeats, etc. in a more moderate way, without experiencing negative consequences to themselves or others, is considered an abuser but not an addict. Just keep in mind that negative consequences and denial are the hallmark signs of true addiction.
Pleasure and The Model of Brain Reward
A model has emerged that is fundamental to our experience of pleasure and our understanding of addiction. It is called the Brain-Reward Cascade and describes the waterfall of chemistry (neurotransmitters and neuropeptides) flowing in specific pathways and locations in the brain (the limbic area), that is associated with our ability to experience pleasure, joy, and reward from the simple acts of life.(2)
Typically, neurotransmitters are made in specialized cells (neurons) in the brain and nervous system and released from the endings of these nerve cells following their electrical stimulation. When these chemicals are released, they travel across a small space — the synapse — before they attach to special proteins (receptors) in the membranes of adjacent nerves, muscles, or organs.
This chemical connection manifests the communication and transmission of information between billions of nerve cells every second of every day in a wave-like series of chemical and electrical events. Thereby controlling every organ and function of the body while translating the endless field of electro-magnetic frequencies around us into the objects and experiences of day-to-day reality.
All of our joys, pleasures, ups, downs, and the emotional value we give them, occur as a result of the integration, balance, dynamic communication, and feedback of the pulsing, shimmering chemistry of the brain, nervous system, and the brain-reward cascade.
In fact, we are all capable of feeling satisfaction, peace of mind, and a high degree of pleasure from simple basic life situations like the hug of a mate, the laughter of a child, a walk in the park, the exhilaration of a sunrise or sunset, a good meal, a sensual kiss, etc.
The chemistry associated with the brain-reward cascade (especially the neurotransmitter dopamine) provides the chemical environment and foundation for the experience of pleasure and satisfaction.
And on a very basic level, we all typically make the routine choices we do because we have associated these choices with pleasure, reward, and survival. This also holds true for people in the throes of addiction.
Over many years, I have worked with many drug and food abusers and addicts, including myself. I have yet to find even one addict where, at least in the early stages, their addiction was not a friend in the night. It was how that person created some pleasure and survival value because they did not have the inborn capability, personal resources or cognitive tools to do it in a more supportive, healthy way.
It is important to know that there is also a well-recognized genetic defect of one of the dopamine receptors (the D2 receptor) that is present in a large segment of the human population and is a major cause and predisposing factor for decreased brain reward and the disease of addiction.
This genetic defect of the dopamine receptor in the brain’s limbic system interferes with the production, attachment, and action of the major pleasure transmitter, dopamine.
In addition, this genetic defect can also alter metabolic pathways in the brain to produce highly addictive toxic chemicals that dramatically enhance the addictive process.
Reward Deficiency: The Foundation of Addiction
A well-known constellation of factors can contribute to the outcome of addiction. These factors, including genetic modification, compromised neurological function due to physical, emotional, and chemical trauma, poor nutrition, chronic stress, and sleep deficiency, can disturb and/or deplete the brain chemistry involved in brain reward. As a result, you can experience a deficiency and dysfunction that is viewed as the common denominator in all forms of addiction, The Reward Deficiency Syndrome (RDS).(3,4)
As a result of the RDS, it is no longer possible to effectively experience pleasure and joy from the simple acts and joys of life. This can lead to feelings of emptiness, need, and craving. As the breakdown of the reward cascade continues and the RDS is maintained, feelings of isolation, loneliness, depression, and anxiety will ensue.
The self-centeredness and isolation so typical of addicts are classic examples of this distress. But no one wants to feel discomfort, emptiness, and isolation. In fact, the brain naturally drives our desire to be happy, feel good, and get naturally high. And if you can’t feel good from the routine physical, emotional, and spiritual activities and experiences of your life, you’re going to seek out any substance or behavior that will stimulate and enhance the normal feel-good pathways of the brain-reward system in order to relieve the discomfort of your own craving, emptiness, and need.
As a result, you will tend to self- medicate your RDS with any one of the five major forms of addiction: food, drugs (including alcohol), sex, risk-taking/gambling, and compulsive behaviors (process addictions) including work, internet, phone obsession, and shopping.
A variety of personal and lifestyle factors will contribute to your addiction of choice, but your addictive process will be driven by your RDS.
Therefore, addictive behaviors create an illusion of well-being, even sociability and function, by chemically or behaviorally stimulating the brain reward cascade. But it is a false sense of feeling good because over time the initial pleasure becomes harder to come by, as you “chase the first high” and never quite get there. With repeat use, the person needs more and more of the substance or behavior to get off. Until, ultimately, there is very little pleasure, and you’re using now just to quiet your discomfort and pain, to just get out of bed in the morning, to just get by and create some modicum of function.
At this point, you are in the throes of dependency as the more primitive, limbic, survival part of the brain hijacks the intellectual part of the brain and screams the message that without this food, this substance, or this behavior, you cannot survive.(5)
This is a very strong reason why willpower alone cannot resolve the problem of addiction.
It is also what makes resolving addiction an extremely difficult task unless you address the physical, cognitive, metabolic, emotional, and spiritual factors that are at the foundation of substance and behavioral use, to truly satisfy your unfulfilled needs for comfort, healthy sociability, and balanced function.
The complete array of key neurotransmitters of the brain reward cascade (dopamine, serotonin, norepinephrine, GABA, and opiates, enkephalins, endorphins, and dynorphins) are made by specific biochemical reactions that combine protein building blocks — amino acids — with some key vitamins and minerals.
These nutrients are typically provided by whole food, plant-based nutrition. But since they may be more chronically depleted in long-term addiction, some period of supplementation over months or longer can help balance brain chemistry and naturally treat the deficiencies of the RDS. A specific cocktail of amino acids (L-glutamine, D,L phenylalanine, L-tryptophan and L tyrosine) has been shown, in over 30 years of clinical research, to provide this balance and support as an important part of addiction treatment and recovery. I share this with you as a general program. These should not be taken without the consent, care, and evaluation of your professional health care providers.
In addition, these supplemental amino acids also block the action of a specific enzyme in the brain, enkephalinase, that ultimately inhibits the release of the pleasure neurotransmitter dopamine. As a result, this supplement program promotes an increase in the release of dopamine and healthy normal brain reward. These amino acids can also help you stay on a healthy track of recovery when the pain of withdrawal tends to promote relapse.
- Holder JM. American College of Addictionology and Compulsive Disorders, Certified Addiction Professional (CAP) Training Program, Module 1.
- Blum K, Kozlewski GP. Ethanol and Neuromodulators Interaction: A Cascade Model of Reward. In Alcohol and Behavior, Ollat H, Parvez S, Parvez H (Eds) (Utrecht, the Netherlands VSP Press, 1990).
- Blum K et al. Reward Deficiency Syndrome (RDS): a biogenic model for diagnosis and treatment of impulsive, addictive and compulsive disorders. J Psychiatric Drugs 2000 Nov: Vol 32 Supplement.
- Holder JM. Beating Addiction: from bondage to freedom. Alternative Medicine 1999 May:37-40.
- Miller M, Miller D. Staying Clean and Sober (Orem, UT, Woodland Publishing 2005).
This is Part One of a two-part series.