Does Limited Choice Encourage Opiate Addiction or Prevent It?

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By R Carter

In light of a nationwide, US policy on limiting access to opiates as a means of thwarting addiction, I and many others have been asking the question, will it really stop the opiate crisis as claimed? A valid question when you consider the fact that the brunt of the policy lands on the back of chronic pain patients prescribed opiates by a physician and does little to nothing to stop the import of illicit opiates into the US by foreign entities.

In my previous post, The Role of Delta FosB in the Neuroplastic Brain Reward Circuitry I reviewed recent research on the connections between epigenetic biology and its impact on the reward circuitry of the human brain.  The purpose was to show that addiction is deeply intertwined in our core genetic makeup because of the manner in which our brain reward circuitry is hijacked by both behavioral processes and chemical substances. I wanted to show that no one can escape addictive and compulsive behavior when the reward system is overwhelmed by certain types of repetitive behavior. Such outcomes are literally hardwired into our genetic and biomolecular makeup when certain conditions are allowed. In this post I’m building on that concept by showing how limited choices are a contributing factor for when our brain reward system gets hijacked by an addictive process or substance and that process occurs in all aspects of life and to everyone, often in ways to subtle to be evident.

We’ve heard terms such as; you are what you eat, absolute power corrupts absolutely or birds of a feather flock together. These truisms reflect something beyond their specific intent, they reflect the fact that certain behaviors tend to repeat themselves under certain conditions but more importantly, each of these share a more common and universal truth about our humanity. That each occurs because the individuals they apply to are acting on motivations driven by both real and perceived rewards.

When you look at neuroanatomy, neuro-circuitry, neuro-chemistry in the light of behavior, it’s quickly evident that our brains are built from the ground up for a single purpose, to help us survive. And to do that it processes experiences as rewarding or not rewarding. From simple and obvious behaviors such as eating, drinking and staying warm, to more complex behaviors such as reproduction, rational problem solving, planning and prioritizing, so that our basic needs can be met. It’s a marvelously complex system with many facets of expression and levels of hierarchy, but at the end of the day, we do what our brains tell us is rewarding or avoid what is unrewarding.

One of the earliest insights into the fundamental facts surrounding reward seeking and its expression through basic levels of need, up to more complex needs, was the work done by Abraham Maslow in his 1943 paper “A Theory of Human Motivation”. Following that publication he refined his theory to create a classification system which reflected the universal needs of society at its base up through more complex acquired emotions. The classification system was later called Maslow’s Hierarchy of Needs as seen in Figure 1.

Figure 1

The classification system and his theories behind it, incorporate this concept of reward seeking and prioritization which takes place in the human psyche, with each subsequent hierarchy only realized as the more basic ones are met, with each hierarchy none-the-less, driven by more complex reward seeking behaviors. It’s an optimized view, in that it assumes altruistic behaviors and does not take into consideration deviant behaviors seen in society which are in fact self-destructive but still based on some type of reward seeking.

As I mentioned earlier, reward seeking can be based on real or perceived rewards. Not all perceived rewards are beneficial or conducive to long lived survival. Some are in fact short term and self-destructive, can be both obsessive and compulsive but considered socially acceptable and therefore non-threatening to the individual. But often contextual assessments demonstrate threats to others which become destructive for the species even though they may benefit the survival of the individual. This is why we have laws, to ensure balance and equality between groups and individuals, but laws are still subject to the perceived benefits of those who pass them.

In the 1960’s – 1980’s researchers began experiments that looked into deviant examples of how our reward system resulted in short term self-destructive behaviors. Tests were conducted on rats and other animals in an effort to demonstrate how the rewards system could be hijacked and overrun by addictive chemical substances. At face value the conclusions drawn from these experiments seemed to indicate that certain chemical substances were capable of overriding rational judgments. So much so that even basic survival motivations such as eating, drinking, sleep, reproduction and others became threatened by the use of such chemical substances.

Such experiments don’t even justify the label as being scientific or of being good research as they had very subjective perspectives and a great deal of bias designed into them. They created environments in which choices were so limited that the only natural expression for behavior was to use chemical substances as they provided the only rewards available to the animals in the environment. The only objective conclusion that could be drawn from them was that some chemical substances were highly addictive by means of their ability to hijack the reward system of the brain. Beyond that, they had no redeeming value to science, none-the-less they offered a simple explanation to a complex problem and human beings driven by the rewards of looking for quick simple answers, latched onto such findings as a black and white explanation for how substance addiction was more powerful than human rationality and judgement.

I never fully bought into the conclusions of these experiments or the media’s preponderance for latching onto them as the answer to all questions regarding substance addiction. During that period though, trying to find research which challenged the conventional thinking was all but impossible. Such efforts usually are when ideas take hold that have so many useful and rewarding benefits for those who can exploit them for personal benefit or they offer simple answers to complex problems.

And herein lies the problem with research, scientist are supposed to be rational, objective, open-minded and skeptical before drawing conclusions, but scientific researchers have to pay the rent just like the rest of us.  This makes them vulnerable to reward seeking behaviors which may in fact, taint their ability to be rational, objective, open-minded and skeptical.

My conclusions, it’s this type of reward seeking behavior which corrupts the foundation of a system we place our faith in as both rational and objective every day. The truth is, it’s as corruptible by the needs of the individuals who practice it, as those who indulge in substance abuse and addiction.

Fast forward twenty years and dozens of experiments later and we begin to see the flaws in those original experiments. Case and point, one of those who participated in those original experiments has since published a new perspective on how they were conducted and why the conclusions, retrospectively, were bogus.

Bruce K. Alexander, Professor Emeritus, Simon Fraser University has written a book on the subject, “The Globalization of Addiction: A study in poverty of the spirit”, Oxford University Press, 2008. He has a website where he discusses his experiences during that time, “Addiction: The View from Rat Park (2010)”. In his article from the website he discusses how limited environmental choices skewed the results of the original experiments and how he challenged those original conclusions by repeating experiments where animal subjects were given a broader set of choices, many of which led to normal long lived survivability. As such, the results showed that addiction to chemical substances becomes far less of a threat when subjects have equal and individual opportunity to thrive and grow in the face of multiple avenues of choice.

It’s a good read, one that should be required for researchers in the field of addiction. It points out fundamental flaws in the research process and how researcher bias confines results to outcomes which support pre-experimental beliefs and then contributes to misinformation which taints the remainder of the scientific community. But more importantly, it points out how individuals who do not stringently adhere to the scientific process, who do not remain rational, skeptical, objective and open-minded, do more harm than good.

What’s the cure for addiction, is it medication assisted treatment, just say no, simple abstinence or does it require something less simplistic, something more complex which can hold its own in the face of our complex brain reward circuitry? Ask any recovering addict with more than ten years of sobriety and you’ll get your answer. Treatment, education and an opportunity to grow beyond where they were before they became addicted. In other words, multiple options and choices for life and living. You see we can’t get rid of that reward circuitry in our DNA and brains, so what we have to do is learn to feed it something else, that’s why opportunity and choice are central components for avoiding addictive behavior.

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