The
APA has an article called “Cognition is central to drug addiction”
which further explains what the textbook mentions about people with
pre-frontal lobe damage behaving similarly to substance-dependent
people. They talked about a study that used a gambling experiment on
drug users and a control group. About a third of the drug users
behaved the same as the control group, another 25% behaved exactly as
patients with frontal lobe damage and a full 40% were hyper-sensitive
to any rewards, whether short or long-term. The researcher in charge
sees the differences as different vulnerability levels to addiction.
The first two groups can benefit from some kind of addiction
treatment but the last one would probably have a very hard time
stopping using due
to severe decision-making impairments. Another related fact they
found was that craving for cocaine wasn't linked to heightened
activity in the reward center of the brain but in fact was linked to
activity in the areas of the
frontal
cortex that regulate decision-making and motivation. This information
explains why some people can use drugs but not get addicted and
others get so addicted that they never stop and eventually die from
it. In twelve-step meetings they acknowledge this effect and mention
that there are some unfortunate people who, for whatever reason, just
can't stop no matter how much
help they get.
I
find the stats from the study very sad and they confirm what I
learned in rehab, only 10% of addicts try to get help. The number of
those who actually recover must be even smaller. I
met an alcoholic at rehab who I think is clearly in the last group.
He's relapsed many many times, including twice since I met him and
his liver is dying. He wanted so bad to stop, he suffered so many
horrible things because of alcohol intoxication. Now I don't know if
he's alive or dead. What
can be done for the 40% who seem doomed to be forever addicted? I
suppose harm reduction approaches are the best for them for now.
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