The real cost of addiction

drug

(Pina Messina, Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Judith Grisel, Professor of Psychology and Neuroscience, Bucknell University


I was twenty-two. I’d been on the good end of a bad drug deal. In the wee hours of some morning late in 1985, behind a nameless restaurant in South Florida, a dealer gave me and a friend the wrong bag. I was the “winner” in this deal with substantially more drug than I was obliged to pass on to a friend of a friend somewhere in the Midwest.

Homeless at the time, my compatriot and I ended up checking into a cheap motel in Deerfield Beach. Predictably, we used the surplus along with what we owed. Toward the end of that binge, the stash mercifully depleted, both of us exhausted and on edge, my friend inexplicably announced that there would never be enough cocaine for us. While the prophecy struck me as true even in my overwhelmed state, I also knew it was irrelevant. As with every addict, my days of actually getting “high” were long past. My using was compulsive and aimed more at escaping reality than at getting off. I’d banged my head against the wall long enough to realize that nothing new was going to happen—except perhaps through the ultimate escape, death, which frankly didn’t seem like that big a deal.

About six months later, through a series of circumstances rather than personal insight or strength of character, I was clean and sober for the first time in years, and therefore not quite so numb. I saw that I had a life-or-death choice. I could continue colluding with my mental illness as it inexorably consumed me, or I could find a different way to live.

In my experience, very few faced with those possibilities choose life, and I first went with the majority. The cost of abstinence seemed too high: Without drugs, what would there be to live for anyway? However, in a demonstration of tenacity almost diagnostic of an active addict, it dawned on me that I might be able to find another way. After all, I thought, I’d come through many tight situations: bad deals in condemned buildings or police stations, with or without loaded guns, and miles from anything friendly or familiar. Aware now for the first time of the medical model of addiction, I figured that my disease was a biological problem that could be solved. I decided to cure addiction so I could somehow eliminate the problems caused by using.

With what may seem like exceptional fortitude to some, especially given that I’d been kicked out of three schools by this time, I went on to get a Ph.D. in behavioral neuroscience and to become an expert in the neurobiology, chemistry, and genetics of addictive behavior. This accomplishment would seem almost unremarkable to most addicts, who know firsthand that there is nothing we would not do, no sacrifice too great, to be able to use. It ultimately took seven years to graduate from college, including about a year of dramatic change starting in a treatment center, plus another seven years of graduate school to earn that degree.

This book is a summary of what I have learned over the past twenty or so years as a researcher studying the neuroscience of addiction. Though I’ve received grants from the National Institutes of Health and possess a controlled-substance license from the Drug Enforcement Administration (DEA), I regret to say that I haven’t solved the problem. I have, however, learned a lot about how people like me differ even before they pick up their first drug and about what addictive substances do to our brains. My hope is that sharing this information might help loved ones, caregivers, and crafters of public policy make more informed choices. Perhaps this understanding may even help the afflicted ones themselves, because it’s quite clear to me that the solution isn’t coming in a pill.

Addiction today is epidemic and catastrophic. If we are not victims ourselves, we all know someone struggling with a merciless compulsion to remodel experience by altering brain function. The personal and social consequences of this widespread and relentless urge are almost too large to grasp. In the United States, about 16 percent of the population twelve and older meet criteria for a substance use disorder, and about a quarter of all deaths are attributed to excessive drug use. Each day, ten thousand people around the globe die as a result of substance abuse. Along this path to the grave is a breathtaking series of losses: of hope, dignity, relationships, money, generativity, family and societal structure, and community resources.

Worldwide, addiction may be the most formidable health problem, affecting about one in every five people over the age of fourteen. In purely financial terms, it costs more than five times as much as AIDS and twice as much as cancer. In the United States, this means that close to 10 percent of all health-care expenditures go toward prevention, diagnosis, and treatment of people suffering from addictive diseases, and the statistics are similarly frightening in most other Western cultures. Despite all this money and effort, successful recovery is no more likely than it was fifty years ago.

There are two primary reasons for the incredibly broad, deep, and persistent costs of drug addiction. First, excessive use is remarkably common, cutting across geographic, economic, ethnic, and gender lines with little variation. It is also highly resistant to treatment. Although reliable estimates are hard to come by, most experts agree that no more than 10 percent of substance abusers can manage to stay clean for any appreciable time. As far as illnesses go, this rate is almost singularly low: one has about twice as good a chance of surviving brain cancer.

Despite a statistically bleak outlook, there are some reasons to be encouraged. Some addicts, once desperate cases, do get clean and stay clean, and even go on to live productive, happy lives. While neuroscience hasn’t been able to thoroughly parse the mechanisms behind this transformation, we have learned quite a lot about the causes of the problem. We know, for instance, that addiction results from a complex web of factors including a genetic predisposition, developmental influences, and environmental input. I say complex because each of these factors is very dense. That is, hundreds of genes and innumerable environmental contributions are involved. The factors also depend on one another. For example, a particular strand of DNA may enhance a liability for addiction but only in the presence (or absence) of other specific genes and along with certain experiences during development (either pre- or postnatal) and in specific contexts. So, while we may know a lot, the complexity of the disease means that we are still unable to predict whether a particular individual will develop an addiction.

While in the end there might be as many different paths to addiction as there are addicts, there are general principles of brain function that underlie all compulsive use. My aim in writing this book is to share these principles and thus shed light on the biological dead end that perpetuates substance use and abuse: namely, that there will never be enough drug, because the brain’s capacity to learn and adapt is basically infinite. What was once a normal state punctuated by periods of high, inexorably transforms to a state of desperation that is only temporarily subdued by drug. Understanding the mechanisms behind every addict’s experience makes it very clear that short of death or long-term sobriety there is no way to quell the screaming need between exposures. At the point where pathology determines behavior, most addicts die trying to satisfy an insatiable drive.

Excerpted from Never Enough by Judith Grisel. Copyright © 2019 by Judith Grisel. Excerpted by permission of Doubleday. All rights reserved.

Advertising

Advertising

Advertising

Advertising

Advertising

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

ECOFIN: Protecting bankers and tax-evaders

Young people meet in Malta to shape the future of Europe

Iraq: Over 150,000 children endangered by ‘freezing’ temperatures, warns UNICEF

The COP24 Agreement: Yes, it happened at last

‘The time for action is now’ senior UN peacekeeping official says, urging support for regional force combating Sahel terrorism

Migration surge leaves children stranded, begging on Djibouti’s streets

The West – the EU and the US – is writing off Turkey’s Erdogan

IMF: When high yield goes boom

Climate adaptation could make the world more peaceful

“Asia-Pacific takes stock of ambitious development targets”, written by the Heads of UNFPA and ESCAP

Brexit: European Commission recommends the European Council (Article 50) to endorse the agreement reached on the revised Protocol on Ireland / Northern Ireland and revised Political Declaration

UN Chief ‘strongly rejects’ Guatemala decision to expel anti-corruption body

G20 GDP growth nudges up to 1.0% in the second quarter of 2018

Huge data gaps’ hampering ‘evidence-based’ national migration policies

EU: 13 major banks may pay fines 10% of worldwide turnover

In DR Congo, UN Security Council says December polls are ‘historic opportunity’ for country

Nauru President warns of possible climate change ‘economic Armageddon’

The last goodbye of JADE’s Executive Board 2019

The revenge of the fallen

INTERVIEW: Poverty, education and inclusion top new General Assembly President’s priority list

GSMA Mobile 360 – Africa on 16-18 July 2019, in association with The European Sting

EU allocates €50 million to fight Ebola and malnutrition in the Democratic Republic of Congo

EU economy: Between recession and indiscernible growth

UN experts cite ‘possible exploitation’ of workers hired to clean up toxic Japanese nuclear plant

More hiring freedom can reduce teacher shortages in disadvantaged areas

Brexit negotiations: Can May’s Britain bounce back?

Ensuring the ‘lungs of the planet’ keep us alive: 5 things you need to know about forests and the UN

Real EU unemployment rate at 10.2%+4.1%+4.7%: Eurostat Update

Africa’s future is innovation rather than industrialization

Seaweed, enzymes and compostable cups: Can ‘Big Food’ take on plastic and win?

Sweden must urgently implement reforms to boost fight against foreign bribery

Can China deal with climate change without the U.S.?

Lessons from the Global Entrepreneurship Index

UN expert ‘shocked’ by Egyptian reprisals against human rights defenders she met

What’s happening to Greenland will affect the whole world – and our leaders need to understand why

Claude Akpokavie, Senior ILO Adviser:“Engaging in policy debates and organizing workers, are two key challenges faced by unions in Export processing zones”

This 12-year-old built an underwater robot to fight plastic pollution

Saudi Arabia expresses ‘regret and pain’ over Khashoggi killing, during UN rights review

EU shapes its ambitious strategy on India

UN agency chiefs condemn Saudi-coalition led air strike that killed dozens in western Yemen

The EU approves a new package of budget assistance to the Republic of Moldova to support rule of law and rural development reforms

EU supports recovery and resilience in Nigeria with additional €50 million

Protecting farmers and quality products: vote on EU farm policy reform plans

Fairer and clearer rules on social benefits for EU mobile workers agreed

How to help companies become global defenders of LGBTI rights

Costa Coffee products (Copyright: Costa Coffee; Source: Costa Coffee website, Press area)

The start of the “Caffeine rush”: Coca-Cola acquires Costa Coffee days after Nestlé-Starbucks deal

5 things you probably didn’t know about global health

The Government of China and UNIDO partner to develop technical guidelines for standards of small hydropower development

5 lessons for the future success of virtual and augmented reality

The Commission tells Berlin it is legally obliged to help Eurozone out of stagnation

Climate change: won or lost in cities or by cities?

More refugees being helped by family, work and study permits, finds OECD and UNHCR study

EU unveils plan to accelerate Capital Markets Union ahead of London’s departure from the bloc

Parliament demands ban on neo-fascist and neo-Nazi groups in the EU

2014 will bring more European Union for the big guys and less for the weak

EU’s tougher privacy rules: WhatsApp and Facebook set to be soon aligned with telcos

Draghi: A bridge from Brussels to Berlin

Six ways to cut through the Middle East’s geopolitical fog

Boardroom warriors: how CEOs are becoming champions of change

New state aid rules: Commission increases national support to farmers up to €25,000

More Stings?

Trackbacks

  1. […] Click here to view original web page at europeansting.com […]

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s