Misunderstanding dopamine: Why the language of addiction matters | Cyrus McCandless | TEDxPortsmouth

Summary

The speaker, a neuroscientist, emphasizes the critical distinction between true addiction to drugs and the colloquial use of 'addiction' for non-essentials like smartphones or junk food. They argue that misusing the term 'addiction' hinders effective dialogue and solutions to the drug crisis. The speaker clarifies that dopamine, contrary to popular belief, isn't a 'feel-good' chemical but a motivator, directing our attention and energy towards significant stimuli. They explain how addictive drugs artificially inflate dopamine levels, creating an overwhelming 'success' signal that overpowers other motivations. This biological response, not a moral failing, is at the core of addiction, demanding a sophisticated, research-informed approach to treatment.

Takeaways

• 🧠 The speaker is a neuroscientist with extensive experience studying consumer behavior, decision-making, motivation, and addiction.
• 🚫 There's a call to action for marketers, app developers, and journalists to stop equating common activities like using iPhones or playing games with addiction to drugs.
• 🌟 The speaker emphasizes the importance of understanding addiction correctly to address the current drug crisis effectively.
• 🏥 The current punitive approach to drug enforcement is criticized for not considering the biological nature of addiction and for limiting treatment options.
• 📈 There's been significant progress in the science of addiction over the last thirty years, which has not been fully adopted in treatment approaches.
• 🍔 The speaker clarifies that liking and wanting are processed differently in the brain, and dopamine's role is not about feeling good but about focusing on important things.
• 📊 Dopamine's role in addiction is explained through the 'surprise success' signal it sends when addictive drugs are used, unlike natural rewards like food.
• 📉 The speaker contrasts the dopamine response to natural rewards with the overwhelming response to drug use, highlighting the difference in intensity and duration.
• 🔄 The script discusses how addictive drugs hijack the brain's reward system by creating a false sense of 'surprise success' that leads to a focus on drug-seeking behavior.
• 🧬 Addiction is framed as a biological issue rather than a moral failing, requiring a sophisticated response that acknowledges the brain's motivation mechanisms.

Q & A

What is the speaker's professional background?

The speaker is a neuroscientist who has spent over 11 years studying normal consumer behavior and decision-making, and prior to that, studied motivation and addiction in the lab.

Why does the speaker believe the misuse of the term 'addiction' is problematic?

The speaker believes that misusing the term 'addiction' for non-essential behaviors like using iPhones or playing games can hinder productive conversations and solutions to the serious drug crisis, potentially leading to the loss of lives.

What is the current approach to drug enforcement according to the speaker?

The current approach to drug enforcement is aggressively punitive, under the assumption that being hard on addicts will deter them, which the speaker suggests is not working as evidenced by the worsening drug crisis.

How has the scientific understanding of addiction evolved in the last thirty years?

The scientific understanding of addiction has made significant progress in the last thirty years, but this knowledge has been slow to be adopted in new approaches to treatment and policy.

What is the difference between 'liking' and 'wanting' according to dopamine's role?

Dopamine is involved in the process of 'wanting' rather than 'liking.' It teaches us how and where to get things we need or like, and it does this by focusing our attention on important things and prioritizing them over less important ones.

How does dopamine respond to the first unexpected occurrence of a positive event?

Dopamine responds to the first unexpected occurrence of a positive event by signaling surprise and prompting the brain to remember the events leading up to it, in order to predict and seek out similar rewards in the future.

What is the difference in dopamine response between natural rewards like food and addictive drugs?

Natural rewards like food cause a dopamine response that is proportional to the value of the reward and is based on learned prediction. In contrast, addictive drugs cause a direct and artificial increase in dopamine, creating a 'surprise success' signal that is much stronger and longer-lasting than natural rewards.

Why does the speaker argue that addiction is not a moral failing but a biological one?

The speaker argues that addiction is a biological issue because the brain's response to addictive drugs is a direct and overwhelming release of dopamine that creates a 'surprise success' signal, which is much stronger than any natural reward and teaches the brain to seek more of the drug regardless of other motivations or consequences.

What does the speaker suggest is a more effective approach to addressing addiction?

The speaker suggests a sophisticated response that recognizes the biological nature of addiction, focusing on helping addicts regain control over their behavior rather than punishing them for a loss of control that is beyond their ability to predict or prevent.

How does the speaker relate the understanding of dopamine to the broader conversation about addiction?

The speaker relates the understanding of dopamine to addiction by explaining how dopamine's role in 'wanting' versus 'liking' and its response to unexpected rewards can lead to a biological vulnerability to addiction, which is a key factor in the development and persistence of addiction.

Outlines

00:00

🔬 Understanding Addiction vs. Normal Behavior

The speaker, a neuroscientist, emphasizes the importance of distinguishing between addiction and normal consumer behavior. They argue that the misuse of the term 'addiction' for non-essential behaviors like smartphone use or playing games trivializes the serious issue of drug addiction. The speaker expresses concern that this misunderstanding hinders effective dialogue and solutions, leading to a punitive approach to drug enforcement that doesn't address the root causes. They highlight the progress made in the science of addiction over the past thirty years and the need to adopt new approaches based on this research. The speaker also clarifies that while checking a phone frequently may feel compulsive, it is different from the loss of control seen in drug addiction.

05:01

🧠 Dopamine's Role in Motivation and Addiction

The speaker delves into the role of dopamine in motivation and addiction, correcting the common misconception that dopamine is a 'feel-good' chemical. Instead, dopamine is shown to be a signal for attention and motivation, directing energy towards important things and away from less important ones. The speaker explains how dopamine responds to unexpected rewards, such as the first taste of a cheeseburger, and how it learns to predict and seek out these rewards. They contrast this with the direct effect of addictive drugs on dopamine, which bypass normal mechanisms and create an overwhelming 'success' signal that the brain learns to seek out at all costs. The speaker uses this to illustrate the profound difference between the brain's response to natural rewards and the artificial, exaggerated response to drugs, which can lead to addiction.

10:02

🌟 Addressing Addiction as a Biological Issue

In the final paragraph, the speaker calls for a shift in perspective on addiction, viewing it as a biological issue rather than a moral failing. They argue that understanding the biological mechanisms behind addiction is crucial for developing effective treatments and responses. The speaker suggests that by recognizing addiction as a biological phenomenon, society can move towards supporting individuals in regaining control over their behavior, rather than punishing them for a condition that is beyond their control. The speaker concludes with a strong statement that addiction is a biological crisis inherent to human nature, and that this understanding is essential for making progress in addressing the issue.

Keywords

💡Addiction

Addiction refers to a chronic brain disease characterized by compulsive engagement in rewarding stimuli, despite adverse consequences. In the video, the speaker clarifies that addiction, particularly to drugs, is distinct from common behaviors like checking a phone frequently. The script emphasizes the serious nature of drug addiction and the need for a more nuanced understanding to address it effectively.

💡Motivation

Motivation is the internal drive that directs a person's behavior towards a goal. The speaker discusses how motivation is linked to addiction, explaining that while we might think we want things because we like them, the brain processes of 'liking' and 'wanting' are distinct. Motivation is a key factor in understanding why people continue to seek out addictive substances despite negative outcomes.

💡Dopamine

Dopamine is a neurotransmitter associated with the brain's reward system. The video script challenges the common misconception that dopamine is a 'feel-good' chemical, explaining instead that it plays a role in attention, learning, and predicting rewards. Dopamine's role in addiction is highlighted by how addictive drugs artificially stimulate dopamine release, creating a strong 'surprise success' signal in the brain.

💡Drug Crisis

The drug crisis refers to the widespread misuse of addictive substances, leading to significant health and social issues. The speaker expresses concern about the current approach to drug enforcement and treatment, arguing that misunderstanding addiction exacerbates the crisis. The video calls for a more scientifically informed response to addiction.

💡Punitive Approach

A punitive approach involves the use of penalties or harsh measures to deter undesirable behavior. The script criticizes the punitive approach to drug enforcement, suggesting it is ineffective and overlooks the biological nature of addiction. The speaker advocates for treatments that consider the latest scientific understanding of addiction.

💡Treatment

Treatment in the context of addiction refers to medical or psychological interventions aimed at helping individuals overcome substance dependence. The video discusses the limitations of current treatment options and the slow adoption of new approaches based on scientific research, emphasizing the need for more effective and accessible treatments.

💡Biological Vulnerability

Biological vulnerability implies the inherent susceptibility of individuals to certain conditions, such as addiction, due to genetic or neurobiological factors. The speaker explains that addiction is a biological vulnerability, not a moral failing, and that understanding this can lead to more effective strategies for helping addicts regain control.

💡Reward System

The reward system is a group of neural structures responsible for motivation and feelings of pleasure. The script explains how the brain's reward system, particularly its response to dopamine, is hijacked by addictive drugs. This system is designed to reinforce behaviors necessary for survival but can be subverted by drugs that artificially stimulate it.

💡Predictive Coding

Predictive coding is a theory suggesting that the brain makes predictions about future events and updates these predictions based on new information. In the context of the video, dopamine is described as a predictive coding mechanism that helps the brain learn to predict rewards, which is subverted by addictive drugs that provide an overwhelming and inaccurate prediction of reward.

💡Misunderstanding

Misunderstanding, as used in the video, refers to the incorrect or incomplete interpretation of a concept or phenomenon. The speaker argues that the widespread misunderstanding of addiction, particularly the conflation of normal consumer behavior with addiction, hinders effective solutions to the drug crisis.

💡Journalists

Journalists are mentioned in the video as having a role in perpetuating misunderstandings about addiction by using the term loosely to describe behaviors like excessive phone use. The speaker calls on journalists to use more precise language to help educate the public and facilitate productive conversations about addiction.

Highlights

The misuse of the term 'addiction' for non-essential behaviors like phone use or gaming can hinder understanding and addressing the real drug crisis.

The current approach to drug enforcement, which is punitive, has not been effective and has limited treatment options.

Significant progress in the science of addiction over the last thirty years has been slow to influence policy and treatment.

The speaker argues that addiction is a biological issue, not a moral failing, and should be treated as such.

Dopamine is not a 'feel-good' chemical; it plays a role in motivation and attention, not in indicating how much we like something.

Dopamine helps prioritize goals by focusing our attention on what's important and relegating less important things.

The brain processes 'liking' and 'wanting' differently, which is a key distinction in understanding addiction.

Addictive drugs hijack the dopamine system by directly affecting dopamine release, unlike natural rewards like food.

The dopamine response to drugs is a 'surprise success' signal, indicating an unexpected reward that is much greater than anticipated.

The speaker illustrates the stark difference in dopamine release between natural rewards and drug use with a graph from a 1988 study.

Addiction creates an overwhelming 'success' signal in the brain, which can override other motivations and focus solely on obtaining more of the drug.

The speaker emphasizes that addiction is not about liking drugs but about the brain's response to the overwhelming reward signal they provide.

Understanding the difference between normal likes and addiction is crucial for developing effective responses to the addiction crisis.

The speaker calls for a sophisticated response to addiction that recognizes the biological nature of the condition and the progress in addiction research.

Addiction should be addressed by helping addicts regain control, not by punishing them for a loss of control they couldn't have anticipated.

The speaker concludes by reiterating that addiction is a biological crisis, not a moral one, and this understanding is essential for effective change.

Transcripts

so I'm a neuroscientist I've spent the

last 11 years studying normal consumer

behavior and decision-making but before

that I spent even more years studying

motivation and addiction in the lab and

I believe that if we have any chance of

solving our current drug crisis the

marketers app developers and most of all

journalists need to stop using the word

addiction when they're talking about

iPhones candy crush saga or

cheeseburgers if our only problems were

too much junk food or apps that took up

too much of our attention then our

misunderstanding of addiction wouldn't

be a big deal but we've got a really

serious problem to deal with right now

and I worry that by misunderstanding

addiction or loosing our chance to have

productive conversations and to find

solutions that really work we've lost

tens of thousands of lives to drug

addiction last year and it's getting

worse but we continue to take the same

aggressively punitive approach to drug

enforcement under the presumption that

if we're just hard enough on addicts

they'll stop and we've severely limited

the kinds of treatments that are

available and the availability of those

treatments and we've been very slow to

adopt new approaches from the science of

addiction where we've made huge progress

over the last thirty years if our

current approach worked

don't you think things would be getting

better and stead of worse marketers and

journalists have perpetuated a key

misunderstanding that what feels like

your addiction to your phone is the same

thing as addiction as real addiction to

addictive drugs and while it may feel

like a compulsion to check your phone

every couple of minutes you're still

very much in control over that

relationship and I hope that if we all

understand a little better the

difference between these two kinds of

relationships with substances it will be

in a better position to make some

progress on this crisis and this

misunderstanding is related to a

long-standing misunderstanding

about dopamine so McDonald's is probably

where you learned about cheeseburgers

for the first time as a child right

that's where you learned that you like

them where you learned that you wanted

them and it's how you figured out how to

get them how many people in the audience

liked cheeseburgers how many people want

a cheeseburger right now and you might

really want a cheeseburger right now but

are you motivated enough to stand up

right now and go get one anybody leave

the theater no okay

well you're experiencing it's called

competitive reinforcement some goals are

more important than others we may like

cheeseburgers

and we may even want cheeseburgers but

it's not important enough to you to get

up right now and abandon what you're

doing to go get one but we need to

breathe and most of us feel like we need

to find our kids if we don't know where

they are so we have priorities we all

tend to think that we want things

because we like them but if you really

think about that for a minute you'll

find a lot of situations where that

doesn't strictly apply so you might want

a cheeseburger right now and you might

think that you want a cheeseburger

because you like cheeseburgers and it's

mostly harmless to think that you want

cheeseburgers just because you like

cheeseburgers scientists also used to

think that we like things because we

want them or we want things because we

like them it seemed obvious but recently

we figured out that the brain process is

liking things and wanting things in

different ways they're not equal and I

want to focus on motivation so it turns

out that dopamine is not the feel-good

chemical that we thought it was dopamine

does not make us feel good and it

doesn't tell us how much we like things

don't mean teaches us how and where to

get the things that we need or just the

things that we like and it does this in

a deceptively simple way

dopamine makes us pay attention to

things that are important put our energy

into the things that are most important

and let less important things wait and

to do this it depends on a nice clear

signal from dopamine neurons in the

brain

it's delivered with precise timing first

we're surprised the first time we get a

cheeseburger right someone hands us a

cheeseburger out of the blue and

dopamine says hey something good just

happened something I didn't expect but

what it's really doing is it's telling

us to remember all the things that

happened before we got that cheeseburger

and try to figure out which of those

things are actually related to it

actually predict the fact that we're

gonna get a cheeseburger

so after you've had that first

cheeseburger the next time you get a

cheeseburger don't mean does something

very different now dopamine response the

signs that it has learned predicts the

appearance of cheeseburgers so now

you're driving down the road and you see

those signs they say I'm thinking of a

burgers coming right

burgers ahead and what happens now when

you get that cheeseburger nothing don't

mean doesn't care how much you like that

cheeseburger it only cares about the

things that predict that cheeseburger

that it was surprised by once in the

past so what's the other thing that can

happen here what happens if you see the

prediction that a cheeseburger is coming

and then cheeseburger doesn't come

dopamine actually stops and that teaches

the brain then maybe these weren't such

great predictors after all when

something more important than something

else is going to happen dopamine

responds more strongly to things that

are more highly valued but addictive

drugs don't affect dopamine the same way

that cheeseburgers and iPhones do

addictive drugs go directly into the

brain and effect the release of dopamine

directly you take the drug and after you

take the drug if you take a sufficient

dose of it you're releasing a whole lot

of dopamine so what does that look like

it looks like that surprise success

signal right so what you're seeing here

for all of these drugs are getting this

huge release of dopamine and what it's

saying is surprise this is a success

this is way more than it may way more of

a success than I thought it would be

because normally when you predict that

something good is gonna happen to you

dopamine doesn't respond at all right

now but dopamine in there artificially

and it's acting as though this drug has

presented you with this huge surprise

success

so here I'm surprised when it starts out

now I'm more surprised as time goes on

and I get even more surprised as time

goes on and that signal goes on for

hours this means that you're getting way

more reward than you thought you would

so you need to upgrade your prediction

of how much your reward you're gonna get

when you take this drug next time just

to kind of keep your dopamine stable now

I want to show this to you in one other

way that this comes from a paper from

1988 and I just want you to get a feel

for how dramatic the differences are

between you know that little blip of

dopamine that you get for eating a

cheeseburger for the first time or

predicting a cheeseburger versus taking

one of these drugs now this isn't

dopamine this is dopamine recorded in

rats who are taking very high doses of

drugs right so the highest dose of

alcohol that you see there that peak of

that chart is the equivalent of taking

about 17 shots in about five minutes

which would kill anyone here is not an

alcoholic but that's what it that's

what's happening right every time you

take a big dose of an opioid if you're

tolerant to them and you can tolerate

those big doses you get this huge

surprise success signal right this

overwhelming dopamine response happens

every single time you take a big dose of

these drugs the drug is telling the

brain whatever just happened was

surprisingly good you've succeeded

you've succeeded way more than you ever

expected to whether you enjoyed it or

not this huge success signal always

takes your brain by surprise because

you're directly creating this big

surprise success signal it's bigger than

any other reinforcement signal that you

get and it keeps going for much longer

in a lot of cases hours this dopamine

signal tells all of your competing

motivations to leave you alone you've

got more important things to do and they

tell you to focus on this one thing

above all else this place this situation

this little baggie of drugs is the place

to be anything to do getting more of

this drug is the most important thing

that you can do right now and your brain

knows exactly how to get that big reward

that big surprise success signal and

it'll climb over all of your other

motivations to get it now sure those

times that somebody took heroin or meth

before they were addicted those were

probably bad choices to make but the

amount of reward that your brain gets

from those drugs is always much bigger

than you expected

to be you can never accurately predict

how much reward you're going to get your

brains always getting this huge surprise

success signal that says you should

really focus your energy on this and do

more of it because it was surprisingly

good and it's no matter how much you

think you know or how much experience

you have and if you don't understand

that liking and wanting are really two

different things then you're vulnerable

to this this is not a moral failing it's

a biological one and the same biological

vulnerability exists in all of our

brains addicts want their drugs far more

than you could ever even conceive of

wanting your iPhone or Facebook or

anything else it's not because they like

the drugs it's because when they take

these big doses of drugs those doses of

drugs are teaching their brain to seek

out more and more drugs no matter the

cost

addiction demands a sophisticated

response one that recognizes what we

know about motivation and the progress

that we've made in drug based research

over the last three decades we the

health addicts regain control of their

own behavior and not punish them for a

loss of control that in a very real

sense they couldn't possibly have seen

coming when we understand that addiction

isn't anything like our normal likes and

wants I think we stand a much better

chance of addressing this problem

effectively let me say that again

addiction is not a moral crisis but a

biological one and that's something

we'll never change as long as we're

human thank you

[Applause]