Unbroken Brain: A Revolutionary New Way of Understanding Addiction

by Maia Szalavitz

Among people ages 21 to 25, 60% have taken an illegal drug at least once—overwhelmingly marijuana—and 20% have taken one in the past month.

Moreover, around half of us could suffer from physical withdrawal symptoms if denied our daily coffee.

irritability, craving, depression, and sleep disturbances.

I was at greatest risk of taking heroin again when I felt better and decided that withdrawal hadn’t been so bad and that I could use occasionally and avoid becoming physically dependent.

I had three emotional states in detox: depression, euphoria, and boredom.

Kids who are praised for being, say, smart or athletic or artistic or musical tend to develop a “fixed” view, while those who are rewarded and encouraged for their effort in a particular area learn to see ability and character as something that can grow with experience.

One 2007 study of nearly 400 seventh graders in New York City found that those who saw intelligence as malleable tended to have improvement in their math grades in junior high—whereas those who saw it as unchangeable plateaued.

A second experiment involved 82 ninth graders who were starting algebra I in a high school in a middle-class neighborhood in California. Teachers had found that kids who haven’t passed this class by the end of their freshman year tend to drop out of school, in part because most academically oriented students are already in algebra II by this point. The researchers wanted to find out if teaching the kids that effort matters and intelligence is not fixed at birth would make a difference. To make sure they weren’t simply teaching optimism, they taught one group that intellectual ability can grow with hard work, while teaching the rest that athletic skill was primarily due to effort rather than natural talent. The intervention worked. And, it had the biggest impact on the kids who needed it most.

As the dopamine circuits rewire themselves, the previously reliable pleasures of childhood play start to grow old. What you love becomes boring and loses its flavor. Sugar itself tastes less sweet and feels less fun. (This may be why candy somehow never tastes as good as it did when you were a kid.)

But offer the prospect of a huge reward and the teens’ response is greatly magnified, compared to the adults’. The prize looms large, far out of proportion to thoughts of the future and potential risks.

In fact, the teen brain responds to a small reward as though it’s an insult or a punishment, which may explain some of the ingratitude and sarcasm teens display when adults praise them, feed them, and ferry them around to their activities.

Psychologically, if you always use drugs to cope at a time when you are supposed to be learning healthy ways to manage social fears, you don’t develop better alternatives. This, too, makes you more likely to get hooked.

In teens and young adults, unmyelinated nerve cells that haven’t yet been insulated don’t transmit information as quickly or efficiently as myelinated ones do.

Once an addict has elevated tolerance, in order to simply experience a normal range of feelings—one that includes good moods, joy, contentment—the drug must be taken, because otherwise the opponent processes keep dopamine levels too low. Addictive learning here is driven simply by the desire to feel okay.

“I can remember many, many times driving down to the projects telling myself ‘You don’t want to do this! You don’t want to do this!’ But I’d do it anyway.” “[M]y body’s saying no and my mind’s saying no, but … we started all over again. I didn’t need it, I didn’t want it … it’s like some kind of

But I couldn’t learn to stop myself before I took it.

In addiction, this means that because being addicted escalates wanting more than liking, the drug experience gets deeply carved into your memory. Anything you can associate with achieving a drug high, you will. As a result, when you try to quit, everything from a spoon (you could use it to prepare drugs) to a street (this is where the dealer lives!) to stress (when I feel like this, I need drugs) can come to drive craving. Desire fuels learning, whether it is normal learning or the pathological “overlearning” that occurs in addiction. You learn what interests you with ease because desire motivates. In contrast, it’s far more difficult to learn something you don’t want to understand or care to comprehend.

until my reeling consciousness, nausea, racing heart, and bloated capillaries told me that death was near. Later that night, I begged myself to stop.… But the urge would not relent.”

“Wanting” for a drug is sensitized and attention is drawn to drug-related cues far out of proportion to their value. “Liking,” however, falls prey to tolerance, meaning that the joy leaches out of the drug experience, and even other pleasures become muted.

Large doses, given irregularly and unpredictably in varied environments, tend to produce sensitization;

It’s hard to tell when one starts losing control over a certain behavior, when the line between what you feel like you “want” and what you think you “need” becomes blurred.

The valuation systems in my brain were shifting.

out. I was usually still able to end binges to meet commitments, if barely.

Soon, relevant cues like sights, sounds, and smells will spur relapses into obsessive behavior.

Psychology, having rejected evolutionary ideas about human behavior because they were tainted by associations with racism, sexism, and eugenics, saw individuals as completely self-sufficient. Biology was irrelevant.

The role of oxytocin, dopamine, and opioids in wiring future cravings to past memories of our passions means that we learn love and addiction much more permanently than we do things we care less about.

Emotions, in fact, are probably best described, as the neuroscientist Antonio Damasio pointed out, as decision-making algorithms honed by eons of evolution.

I thought drugs were necessary. They were nonnegotiable and if others didn’t like it, it was their problem.

The second way in which his story seemed different was that he talked mainly about what he’d gotten from recovery—not what he’d had to give up. He discussed falling in love and getting married. The joy he took in his wife and children shone in his eyes. He also described enjoying his career and activism, which made him feel like he was making a difference. His qualification was fascinating and quirky—quite the opposite of the catchphrase salad I associated with meetings. Perhaps most importantly, I could see that he was actually happy without drinking or taking drugs, not just trying to make the best of a bad lot.

Since I’d left Columbia, I’d found my future unbearable without drugs.

“don’t compare your insides to someone else’s outsides,”

“put gratitude in your attitude”

HALT, which stands for “Don’t get too Hungry, Angry, Lonely, or Tired,”

In sharing my sins and foibles, I realized that I’d always felt subhuman because the standards I had for myself were superhuman.