Posted in Doc Talk on November 12, 2013
Last modified on May 8th, 2019
Addiction Is Not a Matter of Choice, The Right Step’s Dr. Jason Powers Says in Texas School Appearance
Many of us have heard the story of the starving lab rat that will choose cocaine over food and water, and, just last month, how Oreos light up a rodent brain’s “pleasure center” more than cocaine or morphine.
Armed with such studies, researchers in neuroscience have brought popular opinion around to the realization that addiction is, indeed, a disease.
The science behind addiction was the topic of a recent talk at Alamo Heights Middle School in Texas by Dr. Jason Z.W. Powers, chief medical officer for The Right Step and author of “When the Servant Becomes the Master,” which lays out the new science and what it means for those suffering from addiction.
As a recovering addict, Powers speaks from experience. He described ending up in rehab, where he feared patients would no longer seek his services as a physician. He had learned little about addiction in medical school, where only about 1 percent of the curriculum focuses on a problem that affects some 10 percent of the public.
“There is still so much misunderstanding and stigma around addiction,” Powers told a crowd of about 400 in the school’s auditorium.
In eras past, Powers said, the addict was dismissed as being “weak-willed” or having poor control. Now, advances in neuroscience and brain imaging have uncovered the brain mechanisms that underlie addiction. The studies on rodents show that addiction occurs in the older, “reptilian” part of the midbrain, an area beneath consciousness that governs basic survival needs like food, safety and sex. Addiction doesn’t involve the prefrontal cortex, the seat of reason, decision-making and other higher-order thinking.
Drugs and alcohol “hijack” the brain of the addict, Powers said. The surge of the neurotransmitter dopamine — the “reward” triggered by chemical use — takes on the very aspect of a survival need.
Addiction, Powers said, is “the only disease that tells the sufferer he doesn’t have a disease.”
But what about those who remain unimpressed with the science, who continue to view addiction as personal choice?
Dr. Powers acknowledged that addiction does involve an element of personal choice, but that’s true of most chronic diseases, such as diabetes, high blood pressure, heart disease, even some cancers, he said. In high school, when most young people take their first drink or drug, few contemplate the possibility of addiction down the road.
“I chose to drink, but I didn’t choose addiction,” Powers said. “When you choose to eat a cheese pizza, are you choosing to have a heart attack?”
What’s worse is the new neurological pathways created by addiction are permanently established, making addiction a chronic, incurable disease that can nonetheless be managed, like diabetes, he said.
And like with diabetes and other chronic diseases, relapse is not uncommon among those trying to recover from addiction, Powers said. But for at least half of those who enter treatment or attempt recovery, long-term sobriety is a reality.
Powers’ talk was part of a larger wellness program created by the Alamo Heights Independent School District in Texas to help keep students safe and healthy.
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