Meeting her now, it is hard to believe that the Mexican-Russian great-granddaughter of the revolutionary Leon Trotsky ever felt the need to impress her friends. But the universal teenage urge to look more glamorous drove a young Nora Volkow, then in high school, to smoke her first cigarette. It could have been the first step toward a nasty habit, but something in her neurochemistry rebelled. She hated it.
Volkow, now one of the country's most prominent drug addiction researchers and the director of the National Institute on Drug Abuse (NIDA), doesn't think that her disgust for cigarettes had anything to do with morals or self-control. She says she's just naturally intense; the additional stimulation provided by the nicotine was simply too much for her. "I like coffee, but I cannot even drink it because I get so wired," she says. "I was probably born like that. I'm very protected against drugs. It's my neurobiology, and I'm lucky."
Listening to her explain her theories about addiction and the brain, her self-diagnosis sounds right on target. Even though she's petite, with a jogger's lean physique, she dominates the room. She speaks very fast, with a Spanish accent that rounds her vowels, and ideas tumble out one after the other so quickly that it's almost impossible to keep up.
She's a fast-moving example of one of her most interesting theories: that addiction may be a malfunction of the normal human craving for stimulation. Volkow thinks that drugs and other addictive habits tap into some of the deepest forces within us—our lust for newness, our yearning for vitality and the deep-down thrill of being alive. "We all seek that intensity," she says. "There's something very powerful about that."
This idea is based on a new understanding of dopamine, the brain chemical involved in motivation, pleasure and learning. Because addictive drugs like cocaine and nicotine cause a flood of dopamine in the brain, researchers once thought that the neurochemical was a simple pleasure switch, the body's own "reward" button. Yet something didn't add up. If dopamine delivers the pleasure message, addicts should be in a continual state of bliss—but most of them get very little pleasure from the drug, despite the surge of neurochemicals. "I've seen hundreds of addicted people, and never have I come across one who wanted to be addicted," says Volkow. As she began doing brain-imaging studies with drug addicts, that contradiction haunted her.
In response, Volkow and other researchers are developing a new understanding of addiction. Rather than just telling us to feel good, dopamine tells us what's salient—the unexpected bits of new information we need to pay attention to in order to survive, like alerts about sex, food and pleasure, as well as danger and pain. If you are hungry and you get a whiff of a bacon cheeseburger, Volkow's research team has shown, your dopamine skyrockets. But the chemical will also surge if a lion leaps into your cubicle. Dopamine's role is to shout: "Hey! Pay attention to this!" Only as an afterthought might it whisper "Wow, this feels great." So maybe addicts aren't just chasing a good time. Perhaps their brains have somehow mistakenly learned that drugs are the most important thing to pay attention to, as crucial to survival as food or sex.
The salience theory of dopamine also provides new explanations for other self-destructive human tendencies, from binge eating to gambling. It may explain why we crave the stimulation of new information. The experiments that Volkow and her team are conducting may also reveal some of the most powerful behavioral machinery in our brains, the equipment that motivates and inspires us. If they are right, dopamine is more than a joyride. It's more like the drug of life. Its mission is more profound and philosophical: to connect us to the world and supply us with the will to stay alive.
Nora Volkow has science in her blood. Her father is a chemist, her grandfather and her great-grandfather were physicists. But her family, which emigrated from Russia to Mexico in the 1930s, has another intellectual legacy. One of her great-grandfathers was the brilliant Bolshevik leader Leon Trotsky, and Volkow grew up in the Mexico City home where he spent the last days of his life—and where he was killed on Stalin's orders in 1940. Parts of the house became a museum of Trotsky's life, and when Volkow was a child, people like the Nobel Prize-winning novelist Gabriel Garcia Marquez would stop by.
Volkow, though, was more interested in psychiatry than in politics. She graduated at the top of her medical school class at the National University of Mexico, then came to the United States to pursue the new science of brain imaging. During the 1980s, at New York University and then at University of Texas, Austin, she used brain imaging techniques to study schizophrenia and cocaine addiction—and established herself as a leader in the field. She then moved to Brookhaven National Laboratory in Upton, New York, where she won a reputation as an intellectual powerhouse, respected for her creativity as well as for her productivity. "Nora has that enthusiasm, that spark," says NYU Medical Center psychiatry chair Robert Cancro, who worked with her early in her career. "She'd get excited about things, talk 160 words a minute—and that was in English!"
Her colleagues say she is a bold and unconventional thinker. Early on, she demonstrated that cocaine physically damaged the brain. It took years before this controversial finding was accepted, but other research eventually proved her right. She was also an early champion of the idea that drug addiction is a medical problem, rather than a lack of willpower or moral fiber. That formerly radical view is now considered mainstream.
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addiction,
addiction and the brain,
addictive drugs,
alcohol,
attention,
brain chemical,
brain researchers,
dopamine,
drug addiction,
drugs,
nasty habit,
neurobiology,
neurochemistry,
NIDA,
Nora Volkow,
right on target,
self control,
self diagnosis,
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