Nicholas Kristof, New York Times columnist, becomes the latest to add to the list of nonsense about the nature of addiction in his—not so much review, as paean—to another reductive vision of addiction: by "David J. Linden, a neuroscientist at Johns Hopkins University medical school . . . in his fascinating new book, The Compass of Pleasure." But Kristof's treatment of the book actually reveals the fundamental non-sequiturs underlying the whole conception he and Linden (and the NIDA and Nora Volkow) are selling.
Kristof and Linden begin with the old rat studies claiming that, since rats will stimulate pleasure centers until they die --> cocaine stimulates pleasure centers and so mammals will take cocaine until they die --> cocaine is so addictive to humans you'll die if you take it, or if you take a lot of it, or if you become addicted to it. As Kristof put it (leading to the ultimate non-sequitur in the book and his column): "Male rats ignore females in heat to get a fix."
In fact, as my review with RIch DeGrandpre of the animal literature shows, animals choose cocaine from among a range of reinforcers and will take less cocaine when exposed to higher doses of sugar solution. As to sex, in his classic "rat park" experiments, Bruce Alexander showed that rats previously habituated to morphine solution continued to take the drug unrestrainedly in an isolated cage, but rejected it in favor of water when placed in a spacious cage (rat park) with rats of the opposite sex. In other words, rats reject an opiate on which they are dependent in favor of sex.
Which is sort of the point of Linden's book and Kristof's column!
Who knew that orgasms, in men and women alike, light up the pleasure centers much like cocaine?. . . .Linden argues that there is such a thing as a genuine biological addiction to sex. The public’s failure to recognize this, he says, means that people often don’t receive treatment.
But, wait, didn't we just see that rats stimulated their brain's pleasure centers—and presumably take cocaine—in lieu of sex? Are Kristof and Linden acknowledging the point of rat park, that sex is a more powerful reinforcer than drugs? (Bruce tends to say that it is the fecund rat environment of RP that rules out addiction—I say it is the availability of sex.)
Of course, once we understand that love and sex are more powerful forces than drugs (which was my point in my 1975 book, Love and Addiction), then it tends to bring drugs back down to life size, where they belong, to wit:
- The large majority of cocaine users, abusers, and—yes—addicts quit and cut back on their own (which was the point of Erickson et al.'s The Steel Drug a quarter of a century ago).
- We all know the pleasures of sex—yet relatively few of us become sex addicts. Why is that? Well, because we have other purposes in life—spouses, children, work—that balance out sexual urges that can otherwise be preoccupying.
- On the other hand, if love and sex are the most addictive of experiences, what—should we ban them?
- And, on yet the last hand, DSM-V has belatedly decided to expand the addiction concept to cover gambling, but not the sex and exercise that Kirstof's column is preoccupied with— what's up with that?
- Since it turns out that sugar -- and even altruism(!) -- light up the "brain's pleasure circuits," what exactly do these circuits tell us specifically about addiction?
What Linden's and Kristof's analysis really says is this: Many experiences are powerful to the point of being able to overwhelm us. Drugs do not belong in a special category of their own as addiction-causing agents. Yet, for the most part, people resist—or, ultimately, overcome—the addictive temptations of these experiences in service of larger life goals and involvements. Only Kristof, Linden, Volkow et al. can't recognize this truth because they are blinded by biochemistry.
Welcome to what it means to be human and to live.
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