The Second Eclectic

What we do shapes who we are. And technology shapes what we do. Exploring the shapes.

Addiction: What Science Can't Solve

A pill to help kick addiction? The idea, at first, seems like a good one. Why wouldn’t we want to help alcoholics and drug addicts get their lives back on track? And wouldn’t society be better for it too? The answers seem straight-forward, but the pill oversimplifies the problem. In fact, would a drug even help with the real problem?

A recent Wall Street Journal piece by Jonathan Rockoff reported on new medical research—an article titled "Go Cold Turkey? Science Seeks Better Way to Beat Addiction." That "better way" refers to a drug, known generically as gabapentin, that would tackle some of the addictive qualities of alcohol and drugs.

The results seem impressive: "About 45% of the 150 alcoholics who took the highest dose of the drug . . . either stopped drinking altogether or did so only occasionally." These results sound great, especially in light of the later claim that "support groups like Alcoholics Anonymous and Narcotics Anonymous only work in a fraction of alcoholics and addicts." Yet elsewhere, the article explains that "many try to quit, but studies show that 60% or more of alcoholics and drug users relapse within a year of trying to kick their habit." This makes me start to wonder: If, under general conditions, 60% of people relapse, that means about 40% don’t. Does that mean gabapentin improves this number by only 5 percent? I haven't seen the data of the drug research, but the answer isn’t clear.

There’s a bigger issue at stake though. Let’s get at it by first asking this question: "What problem is this drug trying to solve?"

The article explains one reason why alcohol and drugs are so addictive: “drinking and drug use trigger feelings of anxiety and tension that can only be eased by more consumption.” They change the very “chemical architecture” of the brain to depend on them even more. Hence, dependency. Addiction. This is where gabapentin steps in to restructure and remove that need.

This goes a long way to answering our question, "What problem is this drug trying to solve?" The answer is, "Gabapentin is trying to alter our brain’s addictive response to drugs and alcohol." In other words, the pill goes to work after those substances have entered our system. But what about before?

Gabapentin tackles addiction only after users have turned to alcohol and drugs, only after drinking and drug use have begun to reformat the brain. But the pill has no bearing on the numerous reasons led people turn to drugs and alcohol in the first place. Thus, even if a pill could remove the brain’s need for drugs or alcohol, the circumstances that first led them to the drugs and alcohol may still be in play. This pill can’t cure that problem.

Rockoff’s WSJ article never points this out, even though the environmental triggers are clearly at work. He tells about one woman’s struggle with alcohol: "Kathy Selman says she failed several times to wean herself from alcohol because struggles to stay afloat amid the recent economic downturn propelled her to drink again. Ms. Selman, a 57-year-old sales and marketing professional from San Diego, says she slipped into alcoholism around 2007, after her husband lost his job and the couple lost three parents, their savings, and then their rental properties and home."

Ms Selman faced a number of traumatic experiences in a row. However, these are environmental factors, not neurological ones, and they are rightly recognized as reasons she returned to drinking. Gabapentin, meanwhile, does nothing to resolve any of this. While the drug may be beneficial to a degree, it wholly disregards the circumstances leading to drinking. A lost job. A broken relationship. A lack of close friends or family. Increasing isolation due to busy-ness. Less human contact due to increased social media use. Whatever the circumstances, these other triggers cannot be addressed by a pill.

And whatever the circumstances, simply taking a pill actually reinforces many of those circumstances: The pill is presented as more effective than support groups, implying that the addict can pop a pill on his or her own, without needing relationships. Yet, research published last year in Neuron found that rats who were isolated during adolescence were more susceptible to addiction. One researcher explained, “The social isolation leads to addiction more quickly, and it's harder to extinguish” (link). The same is likely true for humans, who are much more social creatures.

Triggers like isolation are associated with substance abuse in the first place, yet gabapentin does nothing to reduce isolation and instead reinforces it. So not only can the drug not cure the social problems that lead to addiction, but it in fact makes them harder to solve. This is hardly a “better way” as the article’s headline suggests.

Instead, the "better way" out of addiction is one that restores relationships, rebuilds communities, empowers people, prevents mass corporate layoffs, and diminishes isolation. All things that no pill can do.

A drug like gabapentin may certainly have some narrow benefit for addicts, but in the long run, it cannot cure the real triggers behind addiction. What “science seeks” to do is address a single factor of addiction—the brain on drugs—but wholly ignores more critical social factors where addiction begins. Yet, the pill’s allure is its promise to free us from addiction, distracting us from the hard work of restoration and rebuilding, and in fact making the hard work even harder.

A pill to help kick addiction? The idea, at first, seems like a good one.

Why wouldn’t we want to help alcoholics and drug addicts get their lives back on track? Of course, we do want to. Only, the pills have clear limits and are not the only, or even the best, options. And their promises can distract us from attending to the more critical social issues and can even make those issues more, not less, beset with problems.

And wouldn’t society be better with gabapentin on the market? Well, not necessarily. If the pill increases the isolation for addicts, then No, society is not better off. Society benefits when people are connected to one another in healthy, meaningful relationships. There simply isn’t a drug for that.