Permanent and Reversible? More double-talk from addiction researchers.

How can something be both permanent and reversible? It can’t. These are contradictory terms describing mutually exclusive concepts. For something to be permanent, it cannot be reversible – and vice versa. Yet this doesn’t seem to phase the jerks pushing the disease model of addiction in the slightest. They’re happy to unload their BS on the public with direct out in the open contradictory claims that make no sense whatsoever. They say in one breath that addiction changes the brain permanently, then they do research to understand how these “permanent” brain-changes eventually reverse.

The core explanation for what makes addiction a disease-caused behavior over which we have no control and lasts forever, is the fact that heavily repeated drug use changes the brain (i.e. neural adaptation). At some unspecific point after using drugs for long enough, the brain has supposedly changed so much that it is said to have been “hijacked by drugs”, and that a drug user becomes a disease drug addict for whom drug use is a completely involuntary behavior. Their diseased brain makes them use drugs, and they have no choice in the matter.

Fortunately for us, and unfortunately for the disease-model-pushers, this theory is plainly incorrect. The brain is not hijacked, and “addicts” remain in full control of their substance use, and are perfectly capable of changing their pattern of substance use at any given point in time (I have an article that goes in depth on this brain disease model at this link).

The “hijacked brain” model is a total farce, and easily disproven by the existing evidence. Nevertheless, it lives on (we’ll get to debunking it in a minute). What shocks me most about it though, is how it contains glaring contradictions that any layperson should easily pick up on. The entire model is built on the principle of neuroplasticity – that the brain changes through repetition  – yet this very principle is then denied, as the researchers espousing the brain disease model claim that the brain changes are permanent. Why should they be permanent? There is no evidence that they are, and the only reason those brain changes occurred in the first place is that the brain is fundamentally malleable (i.e. “neuroplastic”). The changes can be undone. The brain can change again.

It’s shocking that the government can hand out millions of dollars to researchers who utter these contradictory claims back-to-back such as David Dietz, a researcher who just received a two million dollar grant to study cocaine addiction – as reported in a recent article in The University of Buffalo Reporter:

Dietz explains that an addict’s brain undergoes these dramatic and profound changes, known as neuroplasticity, while being exposed to cocaine. This plasticity, he says, includes cellular changes that, in turn, control changes in the shape of neurons and the number of connections they have with other neurons, ultimately causing changes in the addict’s behavior. “These changes persist and become permanent,” Dietz continues. “The addict’s brain is forever rewired.” “The question is, how can we interfere with those changes?” he asks. “How can we either prevent the rewiring in the addicted state or somehow reverse it?” A key component of the grant is the ability to understand how the brain changes at different time-points following abstinence from drugs.

Is he serious? In one breath he says that the brain changes are permanent – that “the addict’s brain is forever rewired”, and in the next breath he says his goal is to find out how to reverse it. BY DEFINITION, something which is PERMANENT is IRREVERSIBLE. And he got the grant so that he can do research to help him “understand how the brain changes at different time-points following abstinence from drugs.” Yet he has the balls to say these brain changes are permanent!!!

I am flabbergasted. Obviously, the brain changes are not permanent, he knows this. Yet the entire “helpless addict in need of lifelong treatment” model depends upon those changes being permanent (as well as it obviously depends on the changes “causing” continued substance use, which they do not). This is shocking for it’s brazenness. He, and all the other addiction-as-disease pushers obviously think us laypeople are complete idiots.

Please, stop saying these brain changes are permanent. They are not. ANYBODY can get the information showing that they are not permanent, such as this brain scan image from a 2001 journal article, which has been used in a popular NIDA propaganda piece on the brain disease model of addiction first published in 2007 (and still published today):

Drug Induced Brain Changes ARE NOT PERMANENT - So stop saying they are.
Drug Induced Brain Changes ARE NOT PERMANENT – So stop saying they are.

Does the brain disease model hold up to scrutiny?

As I said above, I have an article that goes in depth on this brain disease model at this link. But don’t just take my word for it – researcher Gene Heyman PhD made short work of it in a 2013 Journal article:

“…persistent heavy drug use leads to structural and functional changes in the nervous system. It is widely – if not universally – assumed that these neural adaptations play a causal role in addiction. In support of this interpretation brain imaging studies often reveal differences between the brains of addicts and comparison groups (e.g., Volkow et al., 1997; Martin-Soelch et al., 2001) However, these studies are cross-sectional and the results are correlations. There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug. For example, in a frequently referred to animal study, Robinson et al. (2001) found dendritic changes in the striatum and the prefrontal cortex of rats who had self-administered cocaine. They concluded that this was a “recipe for addiction.” However, they did not evaluate whether their findings with rodents applied to humans, nor did they even test if the dendritic modifications had anything to do with changes in preference for cocaine in their rats. In principle then it is possible that the drug-induced neural changes play little or no role in the persistence of drug use. This is a testable hypothesis. Heyman Remittance Chart

First, most addicts quit. Thus, drug-induced neural plasticity does not prevent quitting. Second, in follow-up studies, which tested Robinson et al.’s claims, there were no increases in preference for cocaine. For instance in a preference test that provided both cocaine and saccharin, rats preferred saccharin (Lenoir et al., 2007) even after they had consumed about three to four times more cocaine than the rats in the Robinson et al study, and even though the cocaine had induced motoric changes which have been interpreted as signs of the neural underpinnings of addiction (e.g., Robinson and Berridge, 2003). Third, Figure 1 shows that the likelihood of remission was constant over time since the onset of dependence. Although this is a surprising result, it is not without precedent. In a longitudinal study of heroin addicts,Vaillant(1973) reports that the likelihood of going off drugs neither increased nor decreased over time (1973), and in a study with rats, Serge Ahmed and his colleagues (Cantin et al., 2010) report that the probability of switching from cocaine to saccharin (which was about 0.85) was independent of past cocaine consumption. Since drugs change the brain, these results suggest that the changes do not prevent quitting, and the slope of Figure 1 implies that drug-induced neural changes do not even decrease the likelihood of quitting drugs once dependence is in place.

Heyman, G. M. (2013). Addiction and Choice: Theory and New Data. Frontiers in Psychiatry, 4. doi:10.3389/fpsyt.2013.00031

So, regardless of the brain changes we see in “addicts”, they still manage to quit – and the vast majority of them quit without any sort of treatment – and certainly even the ones who are “treated” do not undergo any sort of medical treatment in which their brain is surgically altered with a scalpel or some such thing. Usually the treatment consists of talking to counselors. Usually, if they get treatment, people quit upon the first day of entering their treatment program – that is before they’ve been treated. Then, over time, their brain changes yet again as they abstain from drugs. So we must remember this – addicts change their behavior freely – despite the fact that their brain is in a changed, so-called “hijacked” state at the time that they quit. The brain doesn’t change first – the behavior changes first, and then the brain follows, just as it most likely did when the “addict” first initiated their heavy substance use patterns years prior. The dramatic brain scans we see show us only correlation, not causation.

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By Steven Slate

Steven Slate has personally taught hundreds of people how to change their substance use habits through choice - while avoiding the harmful recovery culture and disease model of addiction.

7 comments

  1. My personal experience does not fit the clean slate model.I’m convinced we should be talking about “Addictions” not “Addiction” Like the snowflakes no 2 addicts are identical.And even in the book Alcoholics Anonymous there is a discussion of the types of alcoholic (and non alcoholic). The “heavy drinker” who looks just like the alcohol addict but can stop on his own with sufficient reason.Clinically impossible to distinguish in my experience until the event.

    I am troubled by the assertion that a “real alcoholic” as AA describes that form of alcoholism can return to drinking.I BELIEVE THE RAND STUDY OF 1976 THAT ATTEMPTED TO PROVE THAT ENDED UP WITH MOST IF NOT ALL OF THE PARTICIPANTS DEAD FROM ALCOHOLISM?

    The final thought I had about the Household Survey that shows the untreated numbers may be better is than the treated for ongoing addiction is that the treated population lives longer/long enough to be able to participate in the survey.

    There is no doubt CHOICE plays a big role.The book ALCOHOLICS ANONYMOUS talks of alcohol drinker who “HAVE LOST THE POWER OF CHOICE in drink” and for reasons not understood at certain times “HAVE NO EFFECTIVE MENTAL DEFENSE AGAINST THE FIRST DRINK” thereby setting in motion the phenomena of craving Dr Silkworth so aptly describes in his article “The Doctor’s Opinion”.It was his observation that only this class of alcohol drinker experienced this phenomena which over took their lives so that drinking alcohol was paramount to all other interests/ the only thing focus and purpose in life until ? This is why he concluded these people were PHYSICALLY DIFFERENT and that their drinking was not “solely a problem of the mind”.(article found in ALCOHOLICS ANONYMOUS)
    This insanity is much like the anorexic who looks at their emaciated body in the mirror and sees a fat person while all we can see is someone who is starving themselves (perhaps to death).No amount of mirrors or talk will convince any of these people to stop .It seems to take some type gestalt miracle for spontaneous resolution.Willpower doesnt work on diarrhea
    either-but it will work on the TREATMENT of diarrhea.

    So we have I believe the “alcoholisms” and hence interesting nu,mbers suggesting not ALL alcoholics are of the type described by Dr Silkworth .But the ones who are need to respected for what the first drink does to them

  2. I would just like to say calling addiction and alcoholism a disease is really no big deal. The definition of disease is simply; you are not as ease.

    1. I would just like to say that the fact that you actually typed that comment in response to this article and hit reply shows your complete disrespect and disdain for all rational discussion of any kind.

  3. Personally, I believe the AMA classified Alcoholism a disease when they came to the conclusion that it would be beneficial to the medical community, including physicians, hospitals, and later and most importantly, expensive rehabs. The Big Book was written in 1939, which included the theory that alcoholism is a disease, which was a theory that had been around since the 1800’s. However, until 1956 this theory did not have much ground to stand on. In 1956, the AMA declared Alcoholism an illness and then in 1966 they declared it a disease. By the 1970’s the rehab industry took off and has only continued to grow since, charging ridiculous prices for their services. Thanks to the changes the AMA made, these services can now be paid for by insurance companies. In 2013, the AMA decided that Obesity is also a disease. Just think of all the new surgical procedures for obesity that will now be covered by insurance! I personally believe in truth, and that is just as true in the medical community. Lynn Hohensee, knowing rather something is really a disease or not makes a big difference, it tells us how to treat a condition. Given your definition of a disease is simply; you are not as ease, would mean I would have to classify Alcoholics Anonymous a disease, because I can assure you I was not at all at ease in 12-Step rehab or AA meetings. From the get go, being told I was powerless did not set well with me at all. You see I drank abusively from 16-20 and quit on my own without knowing a thing about AA. For 30 years I neither drank nor was I a “Dry Drunk.” A series of tragedies over a period of a year led me back to alcohol as an escape and over 11 months in 2012 I drank to a point that put my health in serious jeopardy. I was not able to safely withdrawal from alcohol and ended up in the hospital, followed by rehab. I had no idea that most rehabs were indoctrination into the world of AA and I had no idea what AA was about, but I soon found out and I was and still am disgusted that I was not told the truth up front. I am not powerless, I don’t need 12-Steps to get clean, I need the God of the Bible, but most certainly not the gods of the Big Book, I am not diseased, I have will power, and while I needed detox, I certainly did not need the BS I received in rehab and the AA meetings I continued to attend for 9 months till I woke up from the brainwashing I received at that expensive facility. What I did need was grief counseling to overcome the tragedies and losses I had experienced that led me back to an abusive cycle of drinking, none of which was touched on at that overpriced rehab. I was not at ease from my first day in class following detox when they asked me to read the steps and I couldn’t get past Step 1, because I had already proved it wrong. I asked to leave and was told if I did I would be responsible for the bill instead of the insurance because I would be leaving against medical advice. I stayed because I couldn’t afford not to, that is just plain deceitful. It’s partly my fault for not checking into it before I signed on the dotted line, but the condition I was in when I arrived was not exactly one of thinking clearly. In my case 12-Step rehab and AA did more harm than good. My depression grew worse while in the program because the root cause of my alcoholism was never addressed and instead I was given a faulty, outdated, cure, created by a womanizing, demented, nutcase from the 1930’s, whose methods belong in a traveling medicine show of that era and not a 21st century rehab facility. Furthermore, please don’t preach to me about the thousands of lives AA has saved, the only part AA may play in saving lives is the camaraderie and support that comes from the program. However, it’s message and methods can be destructive for many of us. In the 9 months I spent in AA I was institutionalized 3 times. Before that period and since I left I have been institutionalized 0 times. My last visit was because of my first and only attempt at suicide where I nearly saw death. I took a serious look at the program after that episode and left AA and will never attend another meeting, period. What’s that the program says about, “Jails, Institutions, and Death?” It appears that was what was in store for me if I remained in the program. I left, started seeing a Christian counselor who didn’t preach the 12-Steps and finally received the help I truly needed.

  4. I am all points bulleting this: I am just copying and pasting it to all relevant sites, I wrote the original:
    —————————————————————————————————–

    hopefully this link works as intended… A reporter who works for VICE news and other outlets is looking for people to share their experiences with the 13th step….. I contacted VICE they verified the email, but I am not sure this story is for VICE. I am linking the post here:

    http://nadaytona.org/alcoholics-anonymous-votes-no-to-protect-members-from-predators/#comment-64197

    Read her words there, as her desire for the story gets even better.

    ————————————————–

    Hi Steven I wanted to email this to you as I did not know where to put this on your site. Great site. Keep up the great work. Mind If I link you on my site(s)?

    Oddnes

  5. I am currently an addiction counselor, and after reading your article I have to agree that many of the statements that come out stating that people are permanently addict can be exaggerated; however heavy consist drug use has been shown to long term damage on the brain.
    Over time as a heavy drug user enters a period abstinence their brain begins to regain and regenerate brain activity in drug affected areas such as the VTA. After some time the brain finds balance again, and heals. Ideally long term recovery from addiction is best achieved in this time frame.
    Where you article gets it wrong is when it asserts that the brain will regain and regenerate %100 back to its previous use state. Like most other part of the human body when the brain is damaged it can over time heal, but depending on how extensive the damage is in the brain, will determine on how much activity will return. For instance many athletes in recent years have torn their ACLs. These athletes have their ACLs surgically fixed, and over time the body, like the brains of addicts, fix and heal the affected areas. However for the majority of ACL injuries, there is high likely hood of re-injury if put under the same amount of stress as before there injury. Simply put heavy drug users brains are damaged, and although they can be healed over time, they are not what they were or what they could have been without the heavy use of drugs, and this fact makes it more likely that will relapse despite having many thoughts and choices not to do so.

    1. I fail to see where I said or implied that “the brain will regain and regenerate %100 back to its previous use state.”

      I also fail to see why it matters. I offered evidence that these brain changes don’t compel substance use or preclude quitting.

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