For the third consecutive year, Brighton and Hove has had the most drug related deaths anywhere in the UK.
24.2 per 100,000 people died from drug related deaths in the city (that’s 51 people in a single year period), compared with the second worst area, Dumbarton, which had only 13.4 per 100,000 people.
Living in the city myself, this does not surprise me. I have seen people injecting heroin in the park, I have tripped over used syringes in the streets and both me and pretty much every one of my friends in the area has been approached and offered drugs on the seafront (prevoking mild concern as to what this says about us….!)
I’m not going to try and explain why Brighton specifically has ended up this way, essentially because I have no idea, (although Dr Adenekan Oyefeso from the National Programme on Substance Abuse Deaths at St George’s University of London has offered some clues in this brief BBC article) instead I am going to consider, from the human givens approach, exactly how this process of addiction – which has ended at least 51 peoples lives in my city (if I make the assumption that the victims were addicted to the drugs rather than being unfortunate first-time or ‘responsible’ users) – actually works.
Any one of us can become addicted to almost anything that gives us pleasure – from both desirable or undesirable sources. But gradually, the more we repeat the pleasurable behaviour, the pleasure “dial” is turned down, and as a result we need more and more of the behaviour to get the same amount of satisfaction. When we stop the pleasure seeking behaviour suddenly, we experience often debilitating withdrawal symptoms – even if the behaviour is detrimental to our health (e.g. the neuron warping effects of drugs, the toxins in smoking, the self destructive behaviour of eating disorders and the poisons in alcohol).
Despite the apparent contradictions behind these facts, it is now clear that addiction is propelled by a biological process in the brain, involving the dopamine circuitry of the amygdala and the anterior cingulate within the brain (however it is important to remember that this does not mean that addiction is a biological disease in itself).
So, why have we evolved these bizarre mechanisms? You could be forgiven for assuming that nature had in some nonsensical way designed us to become addicts…however – there is a reason for addiction, and sometimes just understanding this reason is enough to get someone out of their addictive behaviour and continue their lives:
From the day we are born until the day we die – we develop physically, emotionally, intellectually and spiritually. If we stop developing, we find ourselves with no direction, meaning or goals and this alone is enough to render some people depressed, as having meaning in your life is a basic human need. The impetus to keep trying new things, develop and be creative is driven by the ‘pleasure’ response that occurs either as a natural ‘buzz’ – the high from achieving something new or attaining a goal. The pleasure ‘dial’ is designed to turn down in order to spur us on.
This is all very well – until a crucial thing happens which can tip the scales over from the natural reward process to the unnatural excessive behaviour of the addict – when other needs are not met, pleasurable behaviours are abused to create the high required to fill the resulting hole in people’s lives. Compulsive behaviour does not happen if all needs are being met, and addictions grow out of an unnatural desire and quest for excessive amoungs of either natural (e.g shopping/gambling) or artificial (e.g nicotine/alcohol/cocaine) pleasure rewards.
Understanding the brain chemistry behind this is invaluable to realising why addiction is so powerful and how withdrawal symptoms can be understood and controlled.
As I don’t need to tell you, less and less pleasure is gained from an addictive behaviour the more you do it – you always crave more. And, as I also don’t need to tell you, the craving and repurcussions for something often outweighs the actual pleasure gained, you feel sick after that much imagined delicious danish pastry, you find the week-long comedown from the one crazy night on ecstacy unbearable, you feel tremendous guilt after the expensive shopping trip where you bought whatever you desired – addictions don’t deliver. Your expectations are never realised.
This post is getting longer than I thought it would so I will split it into two parts.
In part two (which I will post on the blog tomorrow) we will explore exactly how the brain uses dopamine to trick us into thinking that our expectations will be fulfilled.
Posted by Eleanor