Saturday, December 06, 2008

BB3: George Koop: Addiction vs Flourishing

This is the seventh in a series of posts on presentations given at Beyond Belief 3: Candles in the Dark"

You can find a list of all Atheist Ethicist blog postings covering Beyond Belief 3 at the Introduction post

And I would like to encourage you to give a contribution to the Science Network, who makes these presentations available for free.

The last presenter in "eudemonia" group at the Beyond Belief conference was George Koob, Professor and Chair of the Committee on the Neurobiology of Addictive Disorders at The Scripps Research Institute.

Koob was there to talk about the relationship between addiction and well-being. Specifically, he showed us a schematic of “the addiction cycle”

This is a presentation that drew heavily on the slides that the presenter used. Koob showed us a graphic of "the neurocircuitry of addiction" – the pathways through the brain that lead to addiction and that tell us what addiction is (in physiological terms).

The slides are difficult to read in the presentation. If a reader is interested, I found on the web a PowerPoint presentation from George Koob that covered the same material, only more deeply. See: The Neurobiology of Addiction

This presentation was actually of interest to me. One of the things I have faulted television for is its failure to provide us with useful information. With addictions being such an important part of the world around us, it would seem that it would pay us to have at least a layman's understanding of addiction, so that we can make effective policy choices. Yet, nowhere do I see anybody presenting the science of addiction to people in easy-to-understand terms. I believe we would benefit if this were changed.

In fact, if there were ever an atheist television network, one of the things that I would hope that it would provide is a scientific account of what is involved in socially relevant phenomena such as addiction.

Anyway, back to the presentation, Koob argued that, with respect to

Once [the] positive reward system is engaged, there is a payback time. There is no free ride in the brain hedonic circuits.

According to Koob, there is a negative reward system (an opponent process that is put there to limit reward. There is a reason why we are wired to in such a way that people suffer a hangover as a result of too much drinking, or a crash after taking certain types of drugs. These are not just unrelated side effects. These are a part of a negative reward system geared to keep people away from certain types of harmful behaviors.

Koob compares two different views of this opponent process.

The classic view, championed by Richard Solomon was that this opponent process got larger and larger over time.

Koop's view (that he presented at the conference without having time to defend it) is that the opponent process does not get larger but that, instead, the whole cycle of addiction is on a downward slope – so that peaks and valleys both decrease over time.

Ultimately, a drug addict, somebody who is hooked on drugs, is trying to claw their way back to a normal motivational state, and they never quite get there. And in the process – and this is the key point – in the process of getting back to this normal hedonic state they are making that hedonic state worse. They are digging themselves into a hole, and that’s called allostasis

On other words, when people begin an addiction they use the drug of abuse for the purpose of obtaining pleasure. However, over time, the use of the drug of abuse is used, not to obtain pleasure, but to avoid pain and discomfort. The drug 'high' aims to bring the biological system from a state of severe discomfort (withdraw) to a state of mild discomfort (high) – which is nonetheless valued because it is better than severe discomfort.

Koop then goes on to discuss "the philosophical implications of this" – which he called Hedonic Calvinism

A "hedonic Calvinistic" approach would be to restrict the use of the reward system within a homeostatic boundary (e.g., no development of negative affect)

The trick, according to Koob, is to avoid those types of behaviors that generate a negative aftereffect. If you have a hangover after drinking, this tells you that you have knocked your system out of its homeostatic range into an allostatic range – the body finds itself in a new state where one must overindulge in whatever triggered the opponent process.

If you wake up with a hangover, you are to use that information to decide never to drink as much again in the future. If you are uncomfortable as a result of over-eating, then you are to tell yourself not to eat so much again. Use this information to say, "This is the limit beyond which I should not go because, though it feels good at the moment, it will set off an opponent process, and that which sets off an opponent process is that which knocks my body out of a healthy equilibrium."

A part of my own philosophy is to pay attention to experts – particularly experts who can back up their claims by explaining and predicting events in controlled scientific conditions. This would be one of the key benefits of the Atheist Television Network I mentioned above. Would it not be nice to have a channel devoted to giving advice limited to that which is backed by peer-reviewed science, and just filter out of the garbage?

I will leave Koop's suggestion as a matter of practical advice.

1 comment:

Luke said...

"Would it not be nice to have a channel devoted to giving advice limited to that which is backed by peer-reviewed science, and just filter out of the garbage?"


I attempted to do that a few years ago with my reviews of dozens of self-help books, but I moved on to other things because (1) nearly all self-help books are really horrible, and (2) I'm not as qualified as I would like to evaluate the books.

By far the best self-help book ever written is, nicely enough, available for free online:

It is basically a summary of the available peer-reviewed studies on every self-help subject that has been studied, as well as speculation by the researchers working on these problems. It begins with a kind of introduction to critical thinking and why you should ignore trendy new self-help books that say comforting or fantastic things but make no attempts (or false attempts) to back up their claims with science.