The great philosopher, mathematician and Nobel-laureate Bertrand Russell was once asked why he continued to smoke when the evidence suggested it was shortening his life. Russell was famously one of the most rational humans on the planet. Yet he had two pipes on the go continuously while he worked.
He notes in the interview that smoking actually saved his life. He was seated in the smoking section in the Bukken Bruse plane crash in 1948 and escaped from the wreckage into the Norwegian fjord. All those in non-smoking were killed. Russell died in 1970 at the age of 97.
A different state of brain
The addicted brain is not rational. In fact, we might take Russell’s anecdote as confirmation of O’Brien’s assertion that addiction is a fundamentally different state of the brain.
But now Elon Musk’s Neuralink might be about to fix addiction once and for all. Neuralink (and its competitors) have made it their business to translate brain signals into digital outputs.
There are today around 200,000 people already wearing brain implants, although much of the tech is at the trial stage. Brain implants have helped paralysed people to communicate.
Human trials on implants for those with Parkinson’s disease, OCD and epilepsy have been ongoing for some years. A patent has been filed for a bioelectric interface to treat blindness. The US FDA has approved targeted brain stimulation therapy for major depression. Musk claims that one day Neuralink will manage addiction too.
Problem is: addiction is really freaking complicated.
Neuralink works by reading the messages the brain is giving and providing the user with this data.
So you might assume that if someone’s brain was releasing an unusual amount of dopamine when viewing, say, a gaming app, Neuralink might be engineered to provide some mitigating feedback. And this would control the addiction.
But this doesn’t tackle the root. And this is important because humans can become addicted to almost anything.
Addiction, defined as a compulsive behaviour that is rewarding at some point in the process but has a negative impact on the subject’s life, is never entirely about the stimulus.
It doesn’t matter whether that stimulus is gambling, sex, food, pornography or even drugs of abuse, such as heroin.
It ain’t just the stimulus
While there are some genetic risk factors for becoming an addict, even chemical addiction, in most people, is not entirely subject to the stimulus. Most people who receive large doses of medical morphine for prolonged periods don’t become addicted to heroin.
And heroin, cocaine and other drugs of abuse can trigger the release of pleasurable neurotransmitters (like dopamine) on a scale that can’t be replicated naturally.
How do we know? For many years, the addictive potency of heroin was ‘proven’ by the lab rats that became addicted to it. In 1978, Bruce K. Alexander repeated the experiment (rats given their choice of plain water, or water mixed with a morphine solution). However instead of isolating the rats, he let them move into Rat Park.
This was a kind of rat utopia, with lots of physical activities, spaces to hide, other rats to play with and plentiful food. Surprisingly, Alexander discovered that under these happy conditions, the majority of rats avoided the morphine.
In later studies, even rats who had been addicted to morphine prior to entering Rat Park would avoid the morphine. They would even endure painful physical withdrawal symptoms rather than return to it.
Bertrand Russell also investigated the subject of happiness. In later life, he simplified his formulation, as:
“The secret of happiness is this: let your interests be as wide as possible, and let your reactions to the things and persons that interest you be as far as possible friendly rather than hostile.”
Curiously, this verdict seems to have been shared by Rat Park’s rats. They avoided the misery of addiction because they had a varied, stimulating, social environment. Even when physical withdrawals meant this hurt.
Even in animals considered closer analogues to humans in terms of brain chemistry, such as macaque monkeys, these results are repeated. As living conditions for laboratory animals have improved, scientists studying addiction have been forced to create new animal strains in order to obtain subjects that will mimic a human cycle of addiction.
Most disturbingly, investigation into these models has involved an attempt to mimic Early Life Stress (ELS) in the subject animals. We have known for decades that those most likely to suffer from addictions are people who had a traumatic childhood. This even holds true for those whose drug addictions began during active military service in war zones.
Epigenetic studies suggest that ELS changes the brain permanently. To the extent that gene expression is altered.
Put simply, our genes express during development to help us exist in our environment. Babies and children with caregivers who don’t respond to their distress (crying) see the genes that express certain neurotransmitters repressed.
There’s little point in the infant expressing distress when there’s no response. So these systems then fix to reduce the level of distress the infant feels and thus expresses.
In later life, the adult experiences less of the full emotional range in normal life. These people are consistently more susceptible to engaging in behaviours that provide the intense emotional stimulation they missed as infants.
The behaviours aren’t a problem in themselves. But these individuals should be seen as vulnerable to full addiction.
That’s regardless of whether their addiction is to cigarettes. To extreme sports. To sexual promiscuity. To drugs of abuse. And yes, to gambling.
The role of a neural implant
It’s not easy to imagine how a mildly-invasive brain implant could mitigate any susceptibility to addiction that arose from this.
Even if it could, in many cases a childhood full of challenges might be something that we wouldn’t want to erase after it had happened. For all the risks it would bring, it might also bring wisdom. And a desire to ensure future generations do not suffer the same.
Even when brain implants are used as interventions in less complex issues, the changes in brain chemistry can be difficult to cope with.
Users have experienced changes in personality, identity and feelings of autonomy. There have been changes in sexual expression. Users have attempted suicide.
Anna Wexler, assistant professor of philosophy in the Department of Medical Ethics and Health Policy, University of Pennsylvania, says:
“Of course [the brain implant] causes changes. The question is what kinds of changes does it cause, and how much do those changes matter?”
The benefits of restoring sight to a blind person, or the ability to communicate to someone with locked-in syndrome might be so profound that any unanticipated changes can be overlooked.
But it seems likely that with something as complicated as addiction, these changes will either be little more than a sticking plaster on the real problem (a dysfunctioning attachment system!), or so invasive as to alter the user’s entire identity.
As such, we shouldn’t expect Neuralink or its competitors to eliminate addiction any time soon.
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