Biology, environment, or psychology? Which is most important in addiction?

I get asked this question a lot, both by people who are fully committed to the biological (or brain) model of addiction and ones who thinks it’s crap and that it’s all about psychology, experience, and motivation.

The thing is that it is absolutely impossible to separate the influence of the brain, environment, and psychology since they all intertwine and interact to deliver the final condition… I was reading an article about marketing in the new Internet age yesterday and it included a joke that I thought was relevant, so I’ll steal it. Instead of focusing on addiction, this joke centered on the question of which part of the body is most important? Maybe it’ll do a good job of explaining why asking the question of which of the above is most important is to some extent useless.

So – The brain, blood, lungs, and Legs were all fighting each other on the question of which of them was most important in the human body. Along came the anus and argued for its own place as The King of all that is human. The first four all laughed in its face, thinking the idea that the anus is King a funny joke. In protest, the anus shut down, a little upset at being made fun of. Three days later the rest of the body sent a notice that the anus has won the debate and begged it to get back to business.

You see, the brain runs the body, upon which it relies for everything and together those two interact with the environment in ways that alter them both. Then you place thousands and millions of people together in the environment and they interact to create a psychological reality that affects everything else that’s already there. It’s completely impossible to separate the parts sice they all rely on each other and are affected by the others.

This is why behavioral interventions, medical interventions, and environmental conditions have all been shown to affect the probability of addiction developing and of addiction ceasing. They all contribute so they all have the power to affect it, though the mix is probably different in different people based on their own experiences, biology, etc…

Make sense?

Conversation with an addiction expert – Jeanne Obert

Jeanne Obert of the Matrix InstituteFollowing up our successful and informative short interview with Chris Evans, we now turn our attention to Jeanne Obert, a founder and the Executive Director of the Matrix Institute. Matrix is an outpatient treatment center that is associated with the UCLA’s Integrated Substance Abuse Programs (ISAP).

Jeanne is a developer of the Matrix Model of Intensive Outpatient Treatment as well as the Matrix Model for Teens. She is a Licensed Marriage and Family Therapist and Supervisor.  Jeanne also has a master’s degree in business management (MSM) and works as a consultant for the National Institute on Drug Abuse and the Center for Substance Abuse Treatment.

Office conversations – 11 Questions for an addiction expert

1 ) How did you become interested/specialized in addiction research?

I was trained as a clinician and worked with a researcher who brought research into our clinics that we founded.

2 ) If you had to sum-up your “take” on substance use disorders (SUD’s) in a few sentences, what would those be?

SUD’s are a chronic relapsing condition from which recovery is entirely possible. Those people who are successful at recovery operate within the limits they recognize as necessary to sustain their sobriety. These people’s lives are quite often more meaningful and fulfilling than the lives of many people who never had to deal with SUDs.

3 ) What have been the most meaningful advances in the field in your view over the past decade?

The recognition and growing acceptance of #2. The emergence of brain imaging techniques and the degree to which those discoveries have advanced our understanding of these disorders.

4) What are the biggest barriers the field still needs to overcome?

There are still many people who believe people with addictive disorders “did it to themselves”. The continuing recognition of #2 is critical. There is also the distinct possibility that addiction disorders will become an underfunded and often ignored subset of mental health.

5) What is your current research focused on?

In our organization we do medication trials as well as behavioral research with many diverse foci.

6) What do you hope to see get more research attention in the near future?

Marijuana (THC) and it’s affect on users as well as the dissemination of evidence based practices.

7 ) How do you think the Health Care reform recently passed will affect SUD treatment?

Wide open question. The effects of the legislation will be totally determined by the political quagmire it needs to work its way through.

8 ) What is your view regarding the inclusion of behavior/process addictions in the field?

Just as important as any other aspect of the disease. We need to look at the disease of addiction from as many perspectives as possible.

9 ) The question of nature Vs. Nurture (or biology versus behavior) is an ever-present one. What is your view on the relative importance of each?

Neither can be ignored so we need to recognized the importance and contribution of each. Most people can understand they have to use behavioral change to overcome the biological hand they were dealt.

10 ) In your view, what are some of the biggest misconceptions that the public still holds about addiction?

See #4.

11 ) What is the most common question you get from others (public?) when it comes to addiction or when they find out you study addiction?

Right now many people ask, “Is pot addicting?” They also want to know how to tell whether a family member is “addicted”. The question of whether someone “can be cured” is also a frequent question.