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Stanton Peele

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So You Think That Sibling Study in Science Proves Something About Addiction?

Posted: 02/ 8/2012 8:09 pm

Have you heard about the earth-shaking new study "proving" that addicts inherit a brain dysfunction that causes them to have poor impulse control? Published in the most prestigious fundamental research journal in the world, Science, investigators at Cambridge found that siblings, half of whom were drug-abusers/addicts and half of whom were not, shared this trait. This proved to the researchers that the brain anomaly preceded the drug abuse, and was not a result of it.

Here, let's turn to Nora Volkow (as Science itself did) for an explanation:

"The inferior frontal gyrus is really one of the main 'brakes' of our brain," says Dr. Nora Volkow, director of the National Institute on Drug Abuse, who wrote a commentary accompanying the study in Science. "[Drug users and their siblings] have less connections that are linking the rest of brain with the inferior frontal gyrus [and other key regions] that form a network that allows you to inhibit responses."

Run that by me again. A study showing a brain dysfunction that somehow causes addiction led half of siblings to drug abuse but not the other half? Doesn't that make us want to learn what accounted for the siblings with the brain anomaly not becoming addicted?

The most casual reading of these results points to a fundamental problem with the conclusion that brain function causes addiction. Let's grant that we can reduce impulsivity to a single brain structure (which isn't itself true*). Instead of saying this study provides evidence that addiction is inborn, it is equally true -- truer -- to say that it suggests that impulsivity and brain structure have no impact on addiction. After all, only a coin flip could tell you the chances of two people who share these traits becoming addicted or not.

Really, the study -- since it measured no natural populations -- tells us nothing about whether this brain condition is any more prevalent in addicts at large than it is in non-addicts. (Do you remember the ballyhooed 1990 study in the Journal of the American Medical Association that found the gene for alcoholism and addiction in one group of alcoholic cadavers? It was never replicated among any general alcoholic-addict population.)

Nothing daunted, Volkow (as described by addiction reporter Maia Szalavitz for Healthland) builds a whole edifice on such nothingness:

But the big question, as Volkow points out, is why the siblings in the current study ended up following such different paths when they shared the same vulnerabilities to addiction. Why did one become addicted, but not the other?

Additional results from the brain scans may provide intriguing hints at an explanation. For instance, people with addiction -- but not their siblings -- showed decreased activity in their medial orbitofrontal cortex (OFC). "That area is crucial in terms of enabling you to have flexibility and to shift your behavior as a function of changes in [the] environment," says Volkow.

Well, that explains it, doesn't it? To account for why some impulsive people abuse drugs and some don't, Volkow offers their (hypothetically) deficient functioning in another area of their brain. These poor souls are doubly diseased!

Ain't science grand? I'm being ironic, of course -- this isn't science. It's as though, having found something in the brain -- but something not able to account for addiction -- the writer doubles down on her brain-behavior bets. This is known as reductionism: the ironclad belief that describing events in biological terms comprises a scientific advancement no matter how hypothetical the explanation is and how little it improves our understanding of -- or ability to influence -- outcomes.

And reductionism is catchy. Forbes magazine's coverage of the Science study purported to defy its results: "Your Brain May Be 'Wired' For Addiction (But You Don't Have To Surrender)." But it actually reified them by fantasizing that the resiliency against addiction in half the subjects must have stemmed from some yet-to-be discovered "variations in the brains of the un-addicted siblings."

Brains, brains, brains. Nothing in the addicts' and non-addicts' lived experiences had any impact? The researchers carefully controlled for childhood experiences, and ensured that the siblings' upbringing was similar (they found high levels of family dysfunction and abuse in the early lives of both the addicted and non-addicted siblings). Since abuse also causes addiction (we are told), then certainly abuse plus genetic predisposition must equal addiction. Except, then, we still have the one addicted sibling and the one non-addicted one, given the presence of both factors. That's because negative childhood experiences are just as inexact predictors of addiction when actually measured in general populations as is brain structure.

Isn't there any other possible explanation for the differences in siblings' addictiveness? How about the role of purpose, social support, learned skills, etc.? The reason to suggest these things is that another government agency, the Substance Abuse and Mental Health Services Administration (SAMHSA), spent a year surveying leading behavioral mental health professionals in order to uncover the common current elements in people's lives that lead to recovery from mental illness and addiction. SAMSHA identified these psychological and environmental conditions that prevent and dispel addiction: health, home, purpose, and community.

But you can't find those things in a laboratory. And that is why the revolutionary SAMHSA initiative has received virtually no media attention from the likes of Time Healthand. I guess it depends on how you define science: is it the result of work by people wearing white lab coats, or is it identifying the things that make a difference in comprehending and dealing with the world? The factors identified by SAMHSA seem so prosaic. Their only advantage is that they are prosaic, because these are the fiber of human lives, the things parents and people themselves can strive to attain, the things society and social agencies can encourage.

Oh, and these factors actually account for which people resist addiction, and tell us how and why they are able to do so.

If that isn't science, then nothing is.

*One of the most critical -- and best-researched -- areas in psychology is Walter Mischel's work on delay of gratification. People who can't put off experiencing rewards just don't do as well in life. But this trait is strongly influenced by social class. So do the Science results tell us that impulsivity and inability to delay gratification are biologically based differences that account for why people occupy the lower rungs of our society?

 
 
 

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This user has chosen to opt out of the Badges program
06:06 AM on 02/21/2012
Impulse control? Stopping urges? Wrong. Stop reacting to the urge, and the urge will dissipate over time by itself. Changing behavior changes unwanted thoughts/urges. Not the other way around. The Obsessive-Compulsive person reacts/compulses to alleviate the anxiety-provoking thought/obsession.

But like the addict, catering to the urge just reinforces the pattern. Urges/obsessions only stop after reacting/compulsing stops. Some will say - the addict has no control. BS. The cancer patient has no control over his disease. No one/nothing forces an alcoholic to lift hand to mouth. Urges cause overwhelming anxiety & need to alleviate anxiety. But anxiety in and of itself aint so bad - aint gonna kill u. Catering to it might.
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05:49 AM on 02/21/2012
In my view, ending addiction via preventing urges/impulses is flawed on it's face. Behavior should be focus- how you react to the urge is crucial. It makes no sense to me to try and fight the feeling of an urge or unwanted thought. If I told u not to think about smoking, you inevitably think about smoking. I'm not sayin it's easy, but If the addict practices to not react - to not cater to urge by acting on it - the urge will dissipate over time.

To use Obsessive-Compulsive Disorder as an example, in order to ever stop obsessing/anxiety-provoking thought, one must first stop compulsing/reacting to that thought. Changing reactions/behavior leads to a change in beliefs/thoughts. Addiction urges may be overwhelming and produce great anxiety, but anxiety in and of itself aint so bad - it aint gonna kill ya. Reacting to the urge/anxiety by catering to it alleviates anxiety in short term, but only reinforces the destructive pattern.

I do not judge any addict, and the response to my comment may be - addicts have no control. BS. No one/nothing forces an alcoholic/cigarette smoker/gambler to lift their hand to act - call it too simple, but it is a choice, a voluntary action. That is why I dislike the disease classification - cancer is a disease. One has no control over that. Maybe it's just semantics, but I believe dependence is a better, more healthy definition.
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Brooke123456
God is ....(fill in the blank how you like)
02:53 PM on 02/17/2012
I think you are arguing a strawman here....they are drawing a corelation, not a causation.
Anecdotal evidence of this works and that doesn't, cannot be repeated on a consistent basis, study's like this will tell whether there is a higher risk or not, predictably!
Science is predictions, not what you claim... is it identifying the things that make a difference in comprehending and dealing with the world?" What you said there, is NOT science!
Science is looking at data, and making an hypothesis about that data that will "PREDICT" something. Finding stuff that works and not comes from this type of basic research that you seem to be criticizing. If disfunction in that part of the brain is highly co-related with addiction, there may be a physical treatment that assists people a way out.
Why the brother didn't fall into the addiction can probably be explained by social interactions and other random events that happened to him over his life, as opposed to his sister/brother who is addicted, but we can't control that....stuff happens!
03:49 PM on 02/24/2012
I have to agree with Brooke123456. So glad you wrote it so I can be lazy. I don't think people are ignoring that community support and family support helps addicts on the road to recovery. But scientist are just now starting to look at brain activity to help explain some types of behavior. I didn't think anything that you quoted from the study suggested that those researchers thought they knew what "caused" addiction.
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bertvan
http://30145.myauthorsite.com/
03:30 PM on 02/15/2012
Science may find causes of human weaknesses and destructive behaviour, but free-will must surely play a role. Some people may face more difficult problems than others, but if free-will exists, it includes the option of failure, and science is not going to find a deterministic explanation for it. Some people, deterministic materialists, seem under the impression that life’s failures are natures’ mistakes - something science is supposed to repair. They denigrate the role of volition. Some even insist that free will doesn’t exist, that we are deterministic physical mechanisms, and ‘are supposed to’ all lead successful lives. (Once science discovers a way to repair all the errors.)

Personally, I regard free will as my essence, my defining characteristic. I prefer to think of myself as an active participant in a creative universe, rather than a passive observer of a mechanical reality.
Berthajane Vandegrift
A Few Autistic Questions about Freud Marx and Darwin. (available on the internet)
03:11 PM on 02/10/2012
Thank you, Mr. Peele! It is distressing when "groundbreaking studies" get one prime-time media spot after another, and rebuttals or failures to replicate always get the fine print on the back page. I hope your piece at least dims the sensationlism a bit and that there are more and more like it in the future.
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Rus Viking
"The opposite of courage, is conformity."
02:06 PM on 02/10/2012
"The most casual reading of these results points to a fundamental problem with the conclusion that brain function causes addiction."

Really?

Did they check for addictions other than drugs and alcohol.
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Steven Slate
12:30 PM on 02/10/2012
Great article Stanton.

The "stop signal task" test used in the study measures your ability to respond to someone else's goals- and then how fast you can reverse your response when commanded to. This is supposed to measure your inhibitory ability (or 'brakes'). But these are not your own goals that you're following or "inhibiting" (not to mention we're parsing differences ranging in the milliseconds). So even if it's true that "addicts" do bad on this test, I'm not sure how this measurement actually relates to the extremely personal quest for happiness that lies at the heart of substance use.

Plus, the entire premise that ending an addiction is a matter of inhibiting impulses is fatally flawed. I quit my own heroin/cocaine habit 10 years ago, and I've felt no "impulses" to use heroin or cocaine since the first few weeks that I was abstinent. I don't live with impulses that need to be inhibited - because I dared to believe that this wasn't a matter of disease, but rather a matter of chasing happiness - and that I could find greater happiness in other activities - and then I proved that to myself. My life simply isn't a daily struggle to inhibit impulses to use hard drugs. I abhor any approach which teaches people that this is their lot in life - because when they believe that, it will become their reality - and they'll completely miss the point of how to create lasting change in their lives.
07:55 PM on 02/10/2012
You share the experience of not having an urge to take drugs with everybody who never had an addiction problem. Others are not so lucky, which points to clear biological differences between non-addicted, addicted who can overcome their addiction and those who can't.

And congratulations on your success!
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Steven Slate
08:58 PM on 02/11/2012
Hi Jonathan,

Due to the 250 word limit, I couldn't go into full detail, but I did have what *seemed* to be irresistible urges for a period of 5 years before I finally solved my problem for good. During those 5 years, I was regrettably involved with rehabs, 12-step groups, methadone clinics, and other treatment nonsense. I finally stopped with a non-treatment non-12-step approach which taught me to throw the disease concept in the trash, and some of the other ideas I mentioned above - that did the trick!

I think those people who live with urges don't need to, and they can be taught to end the urges.

Here's the extended version of my take on the study: http://www.thecleanslate.org/what-impulse-dissenting-opinions-on-the-latest-smoking-gun-in-the-disease-debate/
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wakawaka09
Capitalism is a cult.
08:30 AM on 02/10/2012
The manifested patterns of abuse with dependance is unique to each "addict" or "alcoholic". That's much of the reason why 12 step based recovery programs have such an abysmal success rate.
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Rus Viking
"The opposite of courage, is conformity."
02:05 PM on 02/10/2012
As opposed to which method that has a high rate of success?
07:51 PM on 02/10/2012
The reason we pool people into these recovery programs has nothing to do with success rate. It has everything to do with economics... we do not want to pay individual therapy for individual addicts.

Having said that... the abysmal rate of success of individual therapy among celebrities who can afford any level of therapy effort indicates that there may be no silver bullet, at all.
04:52 AM on 02/10/2012
All I know is: people who accept that addiction is a disease, physical and mental, and work on it, get better. Those that sit around trying to figure it out, make excuses, or 'manage' an addiction through measured doses, of anything, fail. This is not new, and does not need a study to back it up.
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09:16 AM on 02/09/2012
We are all different. Everyone of us is special. Addiction is not a simple subject to discuss, partly because people become emotionally charged. There is no simple explanation or cure (except maybe psychedelics).
04:43 AM on 02/09/2012
I know plenty of very intelligent people who, for medical reasons, were prescribed addictive drugs, mostly pain killers. Not one of them has become addicted.

I once threw an almost full bottle of a strong opioid based pain killer away... something addicted people would prostitute themselves for. I didn't even use them for their intended purpose. The pain was easier to bear than the nausea this stuff caused me.

Not to mention that alcohol does absolutely nothing for me, except that it makes me feel dizzy.

Now come again and tell me that biological reaction to drugs has nothing to do with addiction. Right.
11:27 PM on 02/08/2012
Does this guy genuinely not know what a biological diathesis is? I haven't seen so many straw-men smacked around since the last time Romney talked about Obama.