Neuroscientist Woody Hopf opens a cabinet in his alcohol research laboratory at the University of San Francisco, California. Inside is a cage containing a rat that is being taught addictive behaviours. The rat has been conditioned to press a lever to release a squirt of alcohol when it hears a beep. Hopf closes the cabinet so that the rat will not be distracted by the sights and sounds of human visitors. Just as it takes time for people to undergo the characteristic brain changes that enforce addiction, he says, it will take time for his rat to become dependent on alcohol.
Researchers such as Hopf view addiction as a disease of the brain circuits responsible for pleasure, stress and decision-making. “Addictive substances come at the brain in different ways,” says George Koob, director of the US National Institute on Alcohol Abuse and Alcoholism (NIAAA) in Bethesda, Maryland. “But in the end, they’re activating some of the same circuitry and patterns of behaviour.”
George was The Man on addiction research at UC San Diego in La Jolla. His crew there is still coming up with stuff like this.
The very rapidly evolving field of epigenetics has done a lot to foster what Hopf and others are doing, but the notion that addiction is addiction is addiction goes back at least to Hamilton & Timmons in 1990 (see Hamilton, L.; Timmons, C. R.: Principles of Behavioral Pharmacology, Englewood Cliffs, NJ: Prentice-Hall, 1990).
Ed Khantzian’s famous paper from 1997 is all over it (see Khantzian, E: The self medication hypothesis of substance use disorders: a reconsideration and recent applications, in Harvard Review of Psychiatry, Vol. 4, No. 5, Jan-Feb 1997).
And Hal Shaffer et al’s work in the early '00s blew the dam open for good (see Shaffer, H.; LaPlante, D., La Brie, R.; et al: Toward a Syndrome Model of Addiction: Multiple Expressions, Common Etiology; in Harvard Review of Psychiatry, Vol. 12, 2004).
Most of the sophisticated addiction medicine people accept now that all addictions are the same once the dopamine receptors in the ventral tegmentum have been “tickled.” And knowing that – plus getting increasingly sophisticated with respect to the mechanisms of epigenetic methylation and de-methylation – the pros are now headed toward both behavioral and medicinal interventions that will do exactly that in the precise neural tracks that foster and prevent addictive impulsivity.
The medicinal interventions are faster, but they’re “cruder” and cause a lot more “collateral damage” in the form of unwanted sfx. The behavioral interventions are slower, but they’re like (very) “smart bombs” that tend to hit the intended target only.