Never Enough: The Neuroscience and Experience of Addiction

by Judith Grisel

Though they might have begun taking anxiolytics to help them cope with a specific event or stressor, adaptation to these drugs is robust and inevitable, guaranteeing a particularly anxiety-ridden day if one skips a dose. The same is true for those who regularly take any benzodiazepine to help with insomnia. The benefits dwindle over time, at least for patients, if not for pharmaceutical companies. Again, it’s a bit of a double bind because, like anxiety, insomnia is a major problem. Around a quarter of adults report insomnia symptoms, and a chronic lack of sleep contributes to increased risk of cardiovascular and metabolic disease (including heart attacks and obesity), cancer, psychiatric illness including substance abuse, and impaired cognition and behavior. In the United States, about two million drivers fall asleep at the wheel every week, and drowsy drivers crash every twenty-five seconds. So obviously a lack of good sleep is problematic. It would be terrific to be able to pop a pill and experience a deep, restful sleep whenever we wanted. Unfortunately, unless this is a rare practice, the opponent process makes it impossible. On the first night, the drug does work like a charm, quickly and effectively transporting one to the land of nod. But like all drugs that produce their effects by altering activity of the brain, the honeymoon period doesn’t last long.