Why do young mothers buy a daily pack of cigarettes instead of spending this money on nutritious food for their children? Why are treatments that help roughly 33 percent of people overcome their substance use and have a 70 perfect relapse rate hailed as “gold standard” by the National Institute of Drug Abuse (NIDA)? In other words, why are addictions so hard to overcome? Our brains are set up to learn. From an evolutionary perspective, when we come upon a good source of food or water, it is helpful to remember where it is. When we discover something dangerous, that memory is helpful too. And this reward-based learning system, that is conserved all the way back to the most primitive of nervous systems (the sea slug with roughly 20,000 neurons), in its most basic form has three elements: trigger, behavior, reward. We see berries, we eat them, and if they taste good, we lay down a memory to come back for more. Fast forward to modern day. Food is plentiful and our environment is relatively safe, yet our brains have the same reward-based learning system. Under the names of operant conditioning, associative learning and positive and negative reinforcement, a lot more is known about how it works. This is the good news. The bad news is that over time, humans have stumbled upon substances that literally hijack this reward-based learning system.
-JUDSON BREWER The bad news is that over time, humans have stumbled upon substances that literally hijack this reward-based learning system. In fact, every substance of abuse from tobacco to crack cocaine affects the same brain pathways – the mesolimbic pathway which mainly acts through the neurotransmitter dopamine. And each time we do a line of cocaine and feel the high or smoke a cigarette when we are stressed out and feel better afterwards, we reinforce the “habit loop.” This combination of tapping into the dopamine system and behavioral repetition is deadly. For example, smoking is the leading cause of preventable morbidity and mortality in the US.
Mindfulness is probably the cure for most things.