This post is in response to The Disease Theory Succeeds by Failing Part 2: Drug Cures by Stanton Peele

In a recent blog post, I described how addiction is nothing more and nothing less than a high-jacking of this normal reward circuitry, a high-jacking that can eventually rob people of their free will to choose.

I explained how this high-jacking occurs: Some substances (and behaviors) put this reward system into overdrive, causing release of dopamine (and other neurotransmitters) at levels several times higher than the brain is designed to handle. The brain responds to this challenge by "destroying the machinery", that is, atrophy or other structural changes to neurons in this system, and by producing physiological responses that are the opposite of the drug's affect when cues are detected that are associated with drug use. The outcome of both of these processes is to blunt the impact of the drug on the brain's reward circuitry. I pointed out that some people, because of they carry variants of particular genes that regulate this system, are particularly sensitive to the effects of these drugs. And finally, I described what to do to avoid becoming a slave to substance abuse—to avoid giving up one's free will.

Fellow PT blogger Stanton Peele read this blog and drew the conclusion that I was advocating "medicine to cure addiction". I fail to see how he came to this conclusion since I made no such claim and advocated no such course of action anywhere in the piece. I suspect he jumped to this conclusion for the reason many people do: If biology is involved, then a medical intervention must be required. This is a fallacious belief.

 At one point in his post, Peele claims the following:

In a study of Vietnam vets addicted to heroin in Asia, fewer than 10 percent remained addicted stateside—even though a third used a narcotic here. It isn't really surprising to learn that soldiers addicted in a war zone ceased relying on the drug when they returned home. Unless, that is, you are one of the anointed addiction "experts" who claim that a person, once addicted, can never escape this fate.

I assume he believes I fall into this last category. Except that the study he refers to is in fact part of the evidence cited in support of the opponent process theory of drug dependency, which I described in my blog post. In fact, in my book The Other Side of Psychology, I describe it this way:

In September of 1971, fourteen thousand soldiers were brought home from Vietnam. Twenty percent (or two thousand eight hundred) had become addicted to drugs while serving there. Congress was aware of this, and significant social problems, including a high incidence of drug-related crimes committed by the vets, were expected when they came home. In fact, the relapse rate for Vietnam vets turned out to be only 7 percent . The veterans left their drug associated environments behind them, making it easier to kick their addiction habits. In comparison, Vietnem vets and other men of comparable age and socioeconomic status who developed addictions at home and then tried to kick their habits evidenced a 70 percent incidence of relapse.

As is apparent, I, too, advocate that informed choice and control of one's environment are crucial to avoid (or escape) addiction. Where Peele and I apparently diverge is that I do not deny the plain fact that addiction takes place in –and changes--the brain, and that the steps one takes can avoid or modify those changes. Far from telling addicts that they must helplessly wait for medical science to rescue them with a pill, my goal was to empower them (and those not addicted) to better understand the mechanisms underlying addiction, the factors that put one at risk, and the way that information can be used to keep oneself safe.

I recommend that Dr. Peele take a deep breath and re-read my blog post with an open mind.

Copyright Dr. Denise Cummins February 9, 2014

Dr. Cummins is a research psychologist, a Fellow of the Association for Psychological Science, and the author of Good Thinking: Seven Powerful Ideas That Influence the Way We Think.

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