Drug addiction: The complex truth

We’re told studies have proven that drugs like heroin and cocaine instantly hook a user. But it isn’t that simple – little-known experiments over 30 years ago tell a very different tale.

Drugs are scary. The words “heroin” and “cocaine” make people flinch. It’s not just the associations with crime and harmful health effects, but also the notion that these substances can undermine the identities of those who take them. One try, we’re told, is enough to get us hooked. This, it would seem, is confirmed by animal experiments.

Many studies have shown rats and monkeys will neglect food and drink in favour of pressing levers to obtain morphine (the lab form of heroin). With the right experimental set up, some rats will self-administer drugs until they die. At first glance it looks like a simple case of the laboratory animals losing control of their actions to the drugs they need. It’s easy to see in this a frightening scientific fable about the power of these drugs to rob us of our free will.

But there is more to the real scientific story, even if it isn’t widely talked about. The results of a set of little-known experiments carried out more than 30 years ago paint a very different picture, and illustrate how easy it is for neuroscience to be twisted to pander to popular anxieties. The vital missing evidence is a series of studies carried out in the late 1970s in what has become known as “Rat Park”. Canadian psychologist Bruce Alexander, at the Simon Fraser University in British Columbia, Canada, suspected that the preference of rats to morphine over water in previous experiments might be affected by their housing conditions.

To test his hypothesis he built an enclosure measuring 95 square feet (8.8 square metres) for a colony of rats of both sexes. Not only was this around 200 times the area of standard rodent cages, but Rat Park had decorated walls, running wheels and nesting areas. Inhabitants had access to a plentiful supply of food, perhaps most importantly the rats lived in it together.

Rats are smart, social creatures. Living in a small cage on their own is a form of sensory deprivation. Rat Park was what neuroscientists would call an enriched environment, or – if you prefer to look at it this way – a non-deprived one. In Alexander’s tests, rats reared in cages drank as much as 20 times more morphine than those brought up in Rat Park. 

Inhabitants of Rat Park could be induced to drink more of the morphine if it was mixed with sugar, but a control experiment suggested that this was because they liked the sugar, rather than because the sugar allowed them to ignore the bitter taste of the morphine long enough to get addicted. When naloxone, which blocks the effects of morphine, was added to the morphine-sugar mix, the rats’ consumption didn’t drop. In fact, their consumption increased, suggesting they were actively trying to avoid the effects of morphine, but would put up with it in order to get sugar.

‘Woefully incomplete’

The results are catastrophic for the simplistic idea that one use of a drug inevitably hooks the user by rewiring their brain. When Alexander’s rats were given something better to do than sit in a bare cage they turned their noses up at morphine because they preferred playing with their friends and exploring their surroundings to getting high.

Further support for his emphasis on living conditions came from another set of tests his team carried out in which rats brought up in ordinary cages were forced to consume morphine for 57 days in a row. If anything should create the conditions for chemical rewiring of their brains, this should be it. But once these rats were moved to Rat Park they chose water over morphine when given the choice, although they did exhibit some minor withdrawal symptoms.

You can read more about Rat Park in the original scientific report. A good summary is in this comic by Stuart McMillen. The results aren’t widely cited in the scientific literature, and the studies were discontinued after a few years because they couldn’t attract funding. There have been criticisms of the study’s design and the few attempts that have been made to replicate the results have been mixed.

Nonetheless the research does demonstrate that the standard “exposure model” of addiction is woefully incomplete. It takes far more than the simple experience of a drug – even drugs as powerful as cocaine and heroin – to make you an addict. The alternatives you have to drug use, which will be influenced by your social and physical environment, play important roles as well as the brute pleasure delivered via the chemical assault on your reward circuits.

For a psychologist like me it suggests that even addictions can be thought of using the same theories we use to think about other choices, there isn’t a special exception for drug-related choices. Rat Park also suggests that when stories about the effects of drugs on the brain are promoted to the neglect of the discussion of the personal and social contexts of addiction, science is servicing our collective anxieties rather than informing us.

This is my BBC Future article from tuesday. The original is here. The Foddy article I link to in the last paragraph is great, read that. As is Stuart’s comic.

View the original article here

The complex motivations for self-harm

If you ask the average person in the street why some people cut themselves you’ll get the answer that they’re trying to ‘get attention’ which is a common but unhelpful stereotype.

The reality is that motivations for self-harming are complex. Some people find it helps control their intense moods by externalising the pain, other are punishing themselves, others are responding to psychosis, others self-harm for a combination of reasons.

A new study in the Journal of Adolescence looks at motivations in online accounts of self-harm and gives an insight into the various ways young people describe their actions.

The research aims to examine ‘magical thinking’ in explanations of self-harm but this doesn’t necesarilly mean magical thinking in the sense associated with psychosis (i.e. unknown forces and jumping to conclusions) but in terms of how metaphors and symbolism and woven into young people’s explanations.

Part of the article gives examples of various forms of symbolic ‘magical thinking’. It’s a bit wordy but it illustrates some of the psychological complexity of self-harm.

1. Magic substitutions. This term refers to the magic belief in the transformation of one category of phenomena into another, e.g. emotional pain into physical, bad self into blood. For example, “I can’t handle mental or emotional pain, so I turn it into something I can handle, which is physical pain.”

2. Transanimation of objects. Scored if an inanimate object, such as the blood, body or cutting instrument, is described as an active subject independent of the self. For example, “the blade is always so nice, like with every cut it lets the pain flow out; it lets it flood like a river of blood.” This example would also be scored as a magical substitution, where blood magically substitutes for emotional pain.

3. Transanimation of processes. Scored as present if a behaviour or phenomenon is seen as having autonomous agency. For example, “I still cut myself. Because to me that is my only true friend.”

4. Auto-relatedness. Scored if the narrator wrote about himself or herself as a separate person or a poorly integrated part. For example, “Don’t worry me, me will take care of you. It’s okay me, me is here now.”

5. Split between inside and outside. Scored if the narrator describes a metaphysical difference between the inside and outside of the body. For example, “I feel so ugly inside, so dark and cold, on the outside I’m not exactly warm, but I’m not as cold.”

6. Scars reminding and communicating. Scored if scars or cuts communicate with or remind the narrator or others. For example, “I feel better when I see the cuts on my arms, I don’t know why, I mean I hate them. But they seem to make me feel like I guess someone gets it, gets why I do this to myself.”

Unfortunately, the ‘doing it to get attention’ stereotype is also maintained by lots of health professionals as self-harm is also stigmatised by the people who treat these young people.

It’s a complex and frustrating behaviour and, therefore, one that needs some of the most careful consideration in psychiatry.

Link to locked study on magical thinking in self-harm.

View the original article here