Unbroken Brain: A Revolutionary New Way of Understanding Addiction

by Maia Szalavitz

Being present focused and prioritizing whatever good experience you can actually get right now is certainly part of what can lead to addiction—but it can also be an effe...

as I became more addicted, I also became less and less capable of making good decisions—even though I clearly retained some ability to plan and delay.

What’s tricky about addiction is that choices become less freely made. They aren’t entirely automatic, though—even in the worst parts of it.

Consider a prisoner who is locked in a cell that contains a completely hidden trapdoor to an escape route. On the surface, there is no way out:

If the prisoner does not know that the possibility of escape exists via the trapdoor, she is not “free” to choose it—even though another prisoner who does have that information can easily liberate himself.

while addicted, there are alternative behaviors available to you—and you sometimes even recognize that they do exist—but you simply can’t enact them or believe with enough conviction that they will genuinely help to power yourself through the necessary changes.

anhedonia

But I couldn’t take love in, couldn’t feel any of the acceptance or the comfort normally given in relationships—except, sometimes, through drugs.

Surprisingly, these reductions in quality of life are not only seen during the toughest times when children are at their neediest; studies find it to be true throughout the adult lifespan of parents.

Either something is missing in our measures of happiness (which is quite possible) or children often don’t bring the pleasure that they seem to promise.

Even though culturally, we tend to diminish and dismiss such pleasures as cheap and sentimental, the reality is that they are the foundation for the human ability to form lasting connections, first with our parents, then with our friends, relatives, lovers, and, perhaps, children and grandchildren. The fact that addictions can be built on the same system is not an insult to parents or to the meaning of love—but a testament to their strength and power.

Before you can break out of prison, you must realize you are locked up. —ANONYMOUS

I also didn’t know that I was almost certain to relapse since I hadn’t learned alternative ways of coping and was still living in a drug-filled environment.

I continued to believe that addiction was primarily driven by physical dependence. Since I was free of that, I thought I was well.

addiction is not defined by dependence on a particular substance to function or by a desire to avoid withdrawal or by simply being obsessed with the object of the addiction.

Instead, addiction is defined by using a drug or activity in a compulsive manner despite negative consequences.

And “negative consequences,” of course, is simply a less morally charged phrase for a whole range of experiences that can be experienced as punishing; the terms are fundamentally synonymous.

In other words, if punishment worked to fight addiction, the condition ...

While there are many experiences that are not common to all addictions, the compulsion to continue using no matter what is its essence.

In this light, the idea that other sorts of threats or painful experiences will stop addiction makes no sense.

Addiction is an attempt to manage distress that becomes a learned and nea...

Adding increased distress doesn’t override this programming; in fact, it tends to...

If learning were occurring normally during addiction, addicted people would soon learn not to take drugs because the consequences are so bad. The fact th...

about two thirds of people with substance addictions showed an elevated emotional response to the prospect of monetary gain—an overvaluing of reward.

For these addicted people, similar to what is seen in teens, there appears to be a heightening of desire for reward that may occlude consideration of future punishment.

But more interestingly, the remaining third of the participants did not respo...

Even after they’d learned that drawing cards from one particular deck resulted in more loss than gain, they continued to select cards from it, showing the characteri...

Similarly, other studies have found reduced brain activation during punishment (typically monetary loss) in people addict...

how we came to use punishment to “treat” a condition that is literally defined by its resistance to punishment,

As Michelle Alexander points out in her bestseller The New Jim Crow, selective enforcement of harsh drug laws created a new—and apparently legal—way to segregate, control, and incarcerate black people.

Just when you think you’ve hit rock bottom, you realize you’re standing on another trapdoor. —MARISHA PESSL

McLellan, one of the leading academic researchers on addiction treatment and a former deputy drug czar, admitted that when he needed it, even he didn’t know how to find evidence-based treatment for his own addicted son.

can look back now and think that it’s odd that my family didn’t take me right to a rehab, but at the time, even highly educated and medically literate people didn’t know what to do. Addiction was unspeakable.

the disgrace of my arrest and incarceration did not push me to seek recovery; it only made the craving worse.

Shame and guilt didn’t provide any new tools that would allow me to change.

Without a clue as to alternate ways of coping, I couldn’t see any way out. I was just like the prisoner in the cell with the hidden trapdoor: with no hope for escape or information that would make it possible, I ...

A systematic review of the research on criminal recidivism (including drug crimes) overall found that in 11 of the 23 studies included, probation or other community-based sentences were superior to prison in cutting repeat crimes. Only two studies suggested positive results of incarceration—and the rest found no difference.

A study of over 1,300 injection drug users in Baltimore interviewed repeatedly between 1988 and 2000 found that people who had been incarcerated during that time were half as likely as those who were not to be among the 20% who successfully quit injecting during the study.

recent incarceration cut the odds of recovery by nearly half.

One study of over 100,000 American children arrested betw...

found that those who received custodial sentences were three times more likely to be incarcerated as adults, regardless of the severity of the initial crime, as compared to those given alternative sentences in...

for youth, prison is essentially three times worse than do...

adult arrest rates for people who had any contact with the juvenile justice system were seven times higher than for those engaged in a similar level of delinquency who weren’t caught.

odds of adult crime were more than 37 times higher if the teen was actually locked up in a reform school or juvenile prison. (The

some of the countries with the toughest drug policies have the worst addiction problems.

America, which leads the world with its incarceration rate, also tops the charts in marijuana addiction and cocaine addiction, suggesting again that the criminal justice system is not an effective way to reduce drug-related harm.

it’s not the United States, although we do lead the world in painkiller misuse. But hard-line countries like Russia, Afghanistan, and Iran—some of which have the death penalty for drug offenses—have higher rates of illegal opioid misuse.

A full 2%–3% of their populations have taken heroin or opium in the past year, compared to 0.55% for the United States as of 2012.

Funding for the drug war, which is concentrated primarily on law enforcement, international interdiction, and supply-side efforts, went from $100 million a year in 1970 to more than $15 billion annually in 2010,

During that same time, addiction rates either remained flat or rose.