It would be interesting to know what the social costs for individual addictions are. For example, do the healthcare costs associated with obesity far outstrip the healthcare costs of other addictions? Do people who choose to eat a healthy diet pay for those who don't? How much per capita?
13
I am eager to see the results of Volkow's investigation in to the role of the media and advertising industry in promoting use disorder behavior. In fact, the media war underway is a 'use disorder' of its own. We are increasingly addicted to the internet and our cell phones, the designers of which 'win' in that media space by tapping in to those D2 receptors ever more successfully. Bubbles narrow our focus through a 'reward' circuit that, like those for opiates, alcohol, and food for the obese, take increasing amounts of time and energy at the expense of other things. In part this is due to the ever increasing demand in the hunt for more, and in part due to the lack of dopamine responsiveness to anything else.
10
Don Solomon- You made a good observation
Yes, ancient hindu and Buddhism scriptures say a lot of wise things, if one is willing to open ones mind and find out.
Gautama Buddha simply stated 4 tenets:
If one tries to follow those 4 simple principles, life will be peaceful.
Why western folks decided to confine Buddha to their bath rooms instead is beyond me.
Yes, ancient hindu and Buddhism scriptures say a lot of wise things, if one is willing to open ones mind and find out.
Gautama Buddha simply stated 4 tenets:
If one tries to follow those 4 simple principles, life will be peaceful.
Why western folks decided to confine Buddha to their bath rooms instead is beyond me.
11
I think that there are personalities prone to addiction, whatever form the addiction may take, and personalities who are not. In essence, one is either hard-wired or one is not. It seems to me that the two major views of addiction, immorality vis a vis disease, are incompatible.
My favorite former girl-friend is an alcoholic, as was her father. And, yes, she started drinking heavily at a stressful time in her life. Yet, she firmly believes it is the 12 strep program of Hazelden that keeps her sober. I suppose that as long as she remains sober the means is justified.
I quit excessive drinking in college. I may have a dozen beers and a few glasses of wine in a year. I have a bottle of supposedly excellent Scotch single malt whiskey, unopened still after almost 30 years. I keep it because someday someone may ask for a taste.
I quit smoking because it was 1)unhealthy, 2)expensive and 3)verboten at work.
I do smoke a little weed occasionally, but less and less as time goes by.
My favorite former girl-friend is an alcoholic, as was her father. And, yes, she started drinking heavily at a stressful time in her life. Yet, she firmly believes it is the 12 strep program of Hazelden that keeps her sober. I suppose that as long as she remains sober the means is justified.
I quit excessive drinking in college. I may have a dozen beers and a few glasses of wine in a year. I have a bottle of supposedly excellent Scotch single malt whiskey, unopened still after almost 30 years. I keep it because someday someone may ask for a taste.
I quit smoking because it was 1)unhealthy, 2)expensive and 3)verboten at work.
I do smoke a little weed occasionally, but less and less as time goes by.
10
#1 reason for disease and death in America can be traced back to obesity. Heart disease, several forms of cancer, and diabetes to name a few.
Because no one ODs on a box of macaroni and cheese, obesity is not treated with the seriousness it deserves.
Meth can't hold a candle to prescription drug opioids, either. The addictive properties in opioids can be almost instantaneous.
Instead of fighting the obesity and prescription drug epidemics, our government looks the other way.
Because no one ODs on a box of macaroni and cheese, obesity is not treated with the seriousness it deserves.
Meth can't hold a candle to prescription drug opioids, either. The addictive properties in opioids can be almost instantaneous.
Instead of fighting the obesity and prescription drug epidemics, our government looks the other way.
4
Have you noticed the increased use of gratuitous animated graphics in the NYT? The animated illustration that accompanies this article is an egregious example of the problem; the animation repeats endlessly while providing no information to the reader. These animated graphics are simply distracting and annoying. I'd like to implore the editors to leave out any needless animations that simply serve as decoration but do nothing to educate the reader.
47
Let's not forget that when you are addicted to particular foods, you also are changing your gut microbiota to favor microbes who like that food. Then if you try to deny yourselves that food, it is not just your mind, but also your gut bacteria that will scream bloody murder. To change food addictions, you may also need to change your gut microbiota through one of the various means available.
15
Drug dealers - that is for marijuana, cocaine, heroine - are not allowed to advertise their product - and make no mistake that's what it is. A product for sale. Driven by the market - huge supply and demand - pure free market - a capitalist's dream.
High demand - scarcity of supply - high profit - people to go to great risk for great reward just like the market And just like those Wall Street and political players that get busted and take money and go to jail every year, the demand far exceeds the supply and there is A LOT of money to be made and people will take high risk to make it.
Competition for this free trade? You betcha. Best price, most responsible reliable delivery, lowest risk (most people paid off and have a piece of the action and are poorly paid and highly at risk DEA and Border Patrol that can be cut in pieces or can be obscenely paid with their families safe, paid to make small busts they make to make the Gringos look good.
And the people in the administration- as civil servants, just recently seen to make less than $200,000 a year - chump change - for what? Republicans known to sacrifice for the public good? Patriotism? These guys?
If you believe that, i want a Wall I can sell you for only $25 billion that won't work, Mexico will pay for and it will cost much much more by the time T and friends will be long gone
So sue me.
So the two things drug czars hate" for real? Less demand and legalization. Any questions gringos?
High demand - scarcity of supply - high profit - people to go to great risk for great reward just like the market And just like those Wall Street and political players that get busted and take money and go to jail every year, the demand far exceeds the supply and there is A LOT of money to be made and people will take high risk to make it.
Competition for this free trade? You betcha. Best price, most responsible reliable delivery, lowest risk (most people paid off and have a piece of the action and are poorly paid and highly at risk DEA and Border Patrol that can be cut in pieces or can be obscenely paid with their families safe, paid to make small busts they make to make the Gringos look good.
And the people in the administration- as civil servants, just recently seen to make less than $200,000 a year - chump change - for what? Republicans known to sacrifice for the public good? Patriotism? These guys?
If you believe that, i want a Wall I can sell you for only $25 billion that won't work, Mexico will pay for and it will cost much much more by the time T and friends will be long gone
So sue me.
So the two things drug czars hate" for real? Less demand and legalization. Any questions gringos?
7
Thank you, Dr Friedman, for weaving together the different threads of research about food and drug addiction, as well as the contributing influences of stress and the processed food industry
1
The two other epidemics that are holding our younger and not so younger generation hostage are:
Video gaming addiction and Internet based social media and entertainment (fb, whatsapp, youtube and etc.) addiction
As a mother of a teenager I am alarmed how screen based entertainment can wreck a young adult's ability to function as a normal human being. I see children as young two years hooked on smart phones and tablets for extended hours. What would do this do young mind? There is no room for appreciating fruits of labor nor creative thinking. There will be a whole new generation with need for constant and instant gratification. It's scary
Video gaming addiction and Internet based social media and entertainment (fb, whatsapp, youtube and etc.) addiction
As a mother of a teenager I am alarmed how screen based entertainment can wreck a young adult's ability to function as a normal human being. I see children as young two years hooked on smart phones and tablets for extended hours. What would do this do young mind? There is no room for appreciating fruits of labor nor creative thinking. There will be a whole new generation with need for constant and instant gratification. It's scary
25
The food industry has people snowed into thinking obesity is a complicated problem--a problem that is also due partly to laziness. In fact, if sugar and low-fiber carbohydrates had been demonized in the 1970s the way saturated fat was, people would be healthier today than ever before. Instead, we have companies in a race to produce ever sweeter "food" products, to gain a competitive edge and addict consumers. Just look at Starbucks' menu for a worst case--sugar is the main attractant.
It's the lack of fat in our diet and the over abundance of carbs without fiber that is causing so many health issues.
See books: "The Case Against Sugar"
"The Art and Science of Low Carbohydrate Living"
"Pure, White, and Deadly"
Also youtube videos by UCSF Prof. Robert Lustig
It's the lack of fat in our diet and the over abundance of carbs without fiber that is causing so many health issues.
See books: "The Case Against Sugar"
"The Art and Science of Low Carbohydrate Living"
"Pure, White, and Deadly"
Also youtube videos by UCSF Prof. Robert Lustig
18
The obesity epidemic in the US is undeniable (not sure of global statistics). It is also recent, say the last 10-15 years (I am aware that epidemics don't have crisp, easily-delineated start and stop dates).
As explanations, one hears everything from fallen morals (the agency/personal responsibility explanation) to the environment (the "not my fault" explanations). My guess is that it's complex, some of both & different for different people. As H.L. Mencken said: "For every complex problem, there's an explanation that's clear, simple and wrong."
I do have a question, though: evolution works on lengthy timescales, (almost) infinitely longer than the 10-15 years of the obesity epidemic. So, why were there far fewer obese people 50 years ago (when I was a kid), when there were lots of sugary treats to eat? Has that much changed in our environment? Or, is there something of an argument for a decline in personal responsibility/social acceptance of obesity? I'd love to hear some reasoned arguments, based on data (not mere opinion rants, or political statements).
I confess, I do worry that, as we make obesity more of a "medical" problem, and lessen the role of personal responsibility, obese people will become a legally protected class. Once this happens, the medical-industrial complex will take over, and obesity will become an illness to be managed, not a condition to avoid or fix. There's lots of money in disease management; little to none in disease prevention.
As explanations, one hears everything from fallen morals (the agency/personal responsibility explanation) to the environment (the "not my fault" explanations). My guess is that it's complex, some of both & different for different people. As H.L. Mencken said: "For every complex problem, there's an explanation that's clear, simple and wrong."
I do have a question, though: evolution works on lengthy timescales, (almost) infinitely longer than the 10-15 years of the obesity epidemic. So, why were there far fewer obese people 50 years ago (when I was a kid), when there were lots of sugary treats to eat? Has that much changed in our environment? Or, is there something of an argument for a decline in personal responsibility/social acceptance of obesity? I'd love to hear some reasoned arguments, based on data (not mere opinion rants, or political statements).
I confess, I do worry that, as we make obesity more of a "medical" problem, and lessen the role of personal responsibility, obese people will become a legally protected class. Once this happens, the medical-industrial complex will take over, and obesity will become an illness to be managed, not a condition to avoid or fix. There's lots of money in disease management; little to none in disease prevention.
14
There really isn't any new research or original thought put into this piece. It must be hard for addicts to be exploited by their guardians...
"...the advertising industry may play a role." Aww...gee, Wally...
7
About the Free-will thread that the, less well compassionate empathic commenters claim is behind their stellar behavior and resistance to addictive behavior: unconscious behavior. We all do it. It's what allows us to chew our food at dinner while contributing scintillating conversation. It's also what causes you to fall in love, bite your fingernails or whatever nervous habit you have (and everybody has them, even the self proclaimed virtuous commenters here) as well as shapes what you choose to do as a career, raise your children, and yes, what you like to eat. It shapes why you like to eat food you don't even really like to eat but do anyway.
Under stress, unimformed by having done the mental work it takes to have a bit of insight to the few tip offs to what is beyond our everyday awareness of who we are, what we think and feel and what we do because of it, it is in everyone's risk to succumb to repeated, destructive behavior that gives a false reward.
I didn't see any mention of that here, or even a more serious discussion of why being in toxic groups does to most of the people (or monkeys) and why so annoyingly, the virtuous commenters here keep suggesting group support to those who are suffering in the group.
I hope to hear more about this subject from the Times in the future.
Under stress, unimformed by having done the mental work it takes to have a bit of insight to the few tip offs to what is beyond our everyday awareness of who we are, what we think and feel and what we do because of it, it is in everyone's risk to succumb to repeated, destructive behavior that gives a false reward.
I didn't see any mention of that here, or even a more serious discussion of why being in toxic groups does to most of the people (or monkeys) and why so annoyingly, the virtuous commenters here keep suggesting group support to those who are suffering in the group.
I hope to hear more about this subject from the Times in the future.
6
As a physician, I'm confused by Dr. Friedman's terminology.
He appears to consider the words "dependence" and "addiction" as being synonymous.
In fact, these are two very different terms. Physical dependence can occur with any opioid if taking long enough and in high enough dose. This means if the drug is suddenly discontinued, the user will go into withdrawal. Addiction is a combination of psychological and physical factors. No matter how much opioid or, for that matter, food or alcohol you ingest, you cannot be turned into an addict. The only commonly used drugs that are exceptions are cocaine and nicotine which are quite addictive to any user.
He appears to consider the words "dependence" and "addiction" as being synonymous.
In fact, these are two very different terms. Physical dependence can occur with any opioid if taking long enough and in high enough dose. This means if the drug is suddenly discontinued, the user will go into withdrawal. Addiction is a combination of psychological and physical factors. No matter how much opioid or, for that matter, food or alcohol you ingest, you cannot be turned into an addict. The only commonly used drugs that are exceptions are cocaine and nicotine which are quite addictive to any user.
4
Lets be fair, this article is rehashed buzzword soup heated up in the microwave till rubbery and served with a snarl and dangling cigarette making people feel like they might have learned something because it was such an unpleasant experience. If I'm not mistaken the article is filed under the opinion section. Just another piece of formulaic blatant agenda driven tripe only designed to seek further conditioning of the herd that their minor ailments are insurmountable and hopeless so why try? Oreos are practically like smoking meth you see, so why try tackling those few extra pounds? Its just too hard, go back to sleep, aren't you sleepy, whats on TV, why don't you check, thats it wrap the blanket around you, no no, don't pick that up, thats a science journal, not meant for people like you, thats it just wrap the blanket around you and doze off until that little box with the glowing red numbers informs you that its time to jump out of bed and rush to that one spot on the other side of the city like you do every 5 mornings a week. Do something mindless and unfulfilling in that one spot with your name on it for 8.50 hours a day and then spend 3 hours battling your way across the grey unforgiving Kafkaesque landscape to the street with the special name on it with the building with the special number on it that has the door with the special number on it with the soft blanket, glowing box, and couch that has the imprint of your dying soul on it. Thats better, now we are well.
I'm in at the beginning of a life-long process of changing my eating habits. I just passed 13 weeks with no sugar, dairy, or processed flour. It was hard for about the first week and now I'm so much happier! I didn't notice how much my energy was affected by sugar spikes. Now my energy is much more consistent throughout the day and I sleep better at night. I am really noticing the taste of my foods - before I tried to almost hide the taste of things by adding dairy or sugar. I've lost more than 20 lbs and I hope to keep going.
But, all that said, I still can feel that I have cravings for sugar and I have to really consciously work on avoiding it, but it's hard. Sugar is in EVERYTHING!! I bought organic chicken broth for making homemade soups and when I got home I saw on the label that sugar is added. Even almond milk has added sugar (you can find it without, but you have to look). Sugar is so addictive and harmful, yet we are being fed it all the time.
I'm still working helping my brain be "plastic" and adjust to new eating habits, but it does take conscious work and planning. Wish our food manufacturers and restaurant owners would make it a little easier!
But, all that said, I still can feel that I have cravings for sugar and I have to really consciously work on avoiding it, but it's hard. Sugar is in EVERYTHING!! I bought organic chicken broth for making homemade soups and when I got home I saw on the label that sugar is added. Even almond milk has added sugar (you can find it without, but you have to look). Sugar is so addictive and harmful, yet we are being fed it all the time.
I'm still working helping my brain be "plastic" and adjust to new eating habits, but it does take conscious work and planning. Wish our food manufacturers and restaurant owners would make it a little easier!
19
Go, you! Every action we take is a choice, which is something that hit home for me about 8 years ago when I decided to start exercising daily and cutting out crap food. (Because I felt like crap.) I'm 64, walk 5 miles every dang day, am 35 pounds lighter (keeping those pounds at bay is no longer up for negotiation), and am clear-headed. I "choose" to only buy healthy food and would no more buy a fast-food meal than I'd stick a knife in my eye. It has absolutely no appeal,
Be patient and kind to yourself. I'm happier than I've ever been. And healthier.
Be patient and kind to yourself. I'm happier than I've ever been. And healthier.
14
The impact of this message was blunted by the multiple references to density of calories as the cause of obesity. Dr. Friedman should stick to neuroscience and psychiatry and not use his pulpit to repeat the now defunct fallacy that obesity is caused by a calorie in/out imbalance. The impact of refined carbs and sugar on the brain and on metabolism is the problem, not will-power and total calories.
8
obesity is obvious if you LOOK. Fifty percent or more of us are HUGE-- another 25% moving in that direction. Are you the person who denied this situation 10 years ago?? OBESITY is the visible symbol of our decline which as Real Admiral Mullen said is SLOW. At least opioids work fast.
6
I recently brought a stash of Costco's newly baked variety of cookies in a plastic box on sale for $5.99. After eating three, I wouldn't dare to eat more for the rest of the day regardless how delicious it is. While it wouldn't hurt to savor your sweet tooth, eating three doesn't mean you'll generally be obese, but filled with that extra sugar in your body. Just grab either two glasses of warm water or some unsweetened tea to mellow it down as a balancer.
If it were meth, the multiple dosages would only force me to ask for another at a later time. All the while, I'd be as high as a kite. Also, it'll let me know that the experience from it would make me even hungrier than three cookies. I'd ruin my day by eating my entire box of cookies, then some sandwiches, and run across the street for some oily filled Philly cheesesteak strombolis from the local pizza shop while flying with wings a la Red Bull. Trust me, I've seen how people grab the drunken munchies while high. It's not a pretty sight.
If it were meth, the multiple dosages would only force me to ask for another at a later time. All the while, I'd be as high as a kite. Also, it'll let me know that the experience from it would make me even hungrier than three cookies. I'd ruin my day by eating my entire box of cookies, then some sandwiches, and run across the street for some oily filled Philly cheesesteak strombolis from the local pizza shop while flying with wings a la Red Bull. Trust me, I've seen how people grab the drunken munchies while high. It's not a pretty sight.
6
My husband of 47 years, a compulsive, charming, success-driven salesman who scratched and clawed his way over his peers to become EVP of a big national corporation and COO of another, died in 2015 in a sleazy motel room of a meth overdose. The meth addiction began in 2005, we discovered in his journals, after he and I were separated (but not divorced).
His father, and his father's five siblings, were all destructive alcoholics. This made my husband wary of habitual drinking. No cocktail hours in our house; that's paving the way to ruin. So we were shocked (that word is too small) at the news of his meth "problem" after his death.
So while he blockaded the front door to alcohol, meth sneaked in through the back. Genetic tendencies are powerful and sneaky, and I worry for my children's battles as they approach middle age.
His father, and his father's five siblings, were all destructive alcoholics. This made my husband wary of habitual drinking. No cocktail hours in our house; that's paving the way to ruin. So we were shocked (that word is too small) at the news of his meth "problem" after his death.
So while he blockaded the front door to alcohol, meth sneaked in through the back. Genetic tendencies are powerful and sneaky, and I worry for my children's battles as they approach middle age.
24
When I kicked opiods it was because I removed myself from the situatiob I was in, moved 1500 miles away, went to rehab for 40 days, then spent 10 months going to nothinf but a temp job and AA.
This study says you can beat addiction by changing your environment. That is exactly what I did.
This study says you can beat addiction by changing your environment. That is exactly what I did.
14
Congratulaions and VERY best wishes!
P. S. Have you thought to reward yourself with a new hobby such as painting, writing, or hiking? Please do! And don't wait to do it. Today is good.
P. S. Have you thought to reward yourself with a new hobby such as painting, writing, or hiking? Please do! And don't wait to do it. Today is good.
4
Atta girl! It works when you come to meetings. Bill W. must be proud of you.
4
The facts born of painstaking and replicative research are enlightening, but their ultimate utility lies in reaching the proper conclusions. And when the bread crumbs lead, once more, to the evil nexus between corporate agribusiness and big pharma certain conclusions should be obvious. We are treated as clay to be molded - shaped to first, desire, then covet, and ultimately to need the poisons they sell. Sophisticated advertising, dumbed-down educations, elimination of physical activities in schools, sedintary technological pastimes, fat-laden foods, dehumanizing "jobs". Only the willfully blind cannot see, right? Or those in on the scam. Which are all of you?
6
Why is SMOKING, the biggest killer of all not mentioned?
2
The question is, as always, "Follow the money."
I recall that when I was a children 50+ years ago, you entered a hardware store to build hardware.
Today, when you enter a hardware store, there is also a junk food section.
(To buy drugs, go to the alley behind the hardware store)
Edward Abbey described our economic system best when he wrote, "Growth for the sake of growth is the ideology of a cancer cell."
I recall that when I was a children 50+ years ago, you entered a hardware store to build hardware.
Today, when you enter a hardware store, there is also a junk food section.
(To buy drugs, go to the alley behind the hardware store)
Edward Abbey described our economic system best when he wrote, "Growth for the sake of growth is the ideology of a cancer cell."
4
Dear NYT: I beg of you, I implore you, PLEASE STOP with the garish, lurid, distracting animated illustrations, everywhere in your on-line paper, but most certainly in the Sunday Review. For God's sake, it's the visual equivalent of inviting a shouting, crack-addled Tourette's syndrome sufferer into the reading room of a library. Your doing this shows utter contempt for your readers who, you might be surprised to learn, subscribe to the NYT to--wait for it--READ and CONTEMPLATE. I'd like to think that the NYTs is better than this, but . . .
16
Like 'Brave New World' (written in 1931). Where recreational drugs were state policy (to keep the leaders in control). I can't remember if the book said anything about cookies; or overdosing. Maybe Big Pharma is presently trying to develop an opioid that can get you high and addicted, but never quite kill you.
2
Dean Ornish M.D. published his book in 1993: Eat More, Weigh Less
Dr. Ornish covers the subject of how to maintain not only physical health but
mental health as well...starting with what NOT to eat or drink...
However the mental health analysis really comes first....which is to manage
your mental well being; your self image...every day......and yes stress is the
enemy of health....so Dr. Ornish has given us the answer to the enemy...called
stress; the answer to the enemy...low self esteem....
Suggest you Google Dean Ornish M.D......and I think you will feel a lot better
even today....I say believe in your ability to be well...the idea of you can do
anything you put your mind to...believe in yourself....yes I can ...yes I can...
and you will.
Dr. Ornish covers the subject of how to maintain not only physical health but
mental health as well...starting with what NOT to eat or drink...
However the mental health analysis really comes first....which is to manage
your mental well being; your self image...every day......and yes stress is the
enemy of health....so Dr. Ornish has given us the answer to the enemy...called
stress; the answer to the enemy...low self esteem....
Suggest you Google Dean Ornish M.D......and I think you will feel a lot better
even today....I say believe in your ability to be well...the idea of you can do
anything you put your mind to...believe in yourself....yes I can ...yes I can...
and you will.
5
Great article. It doesn't mention those unregulated "flavor enhancers" that cause people to become addicted to food and, well, eat like pigs. These are variations of chemicals that ARE fed to pigs, cattle and chickens to fatten them up. And they fatten profits just as readily.
6
I recently had a bout of stomach flu that kept me bedridden and mildly nauseous at the thought of food for days. I stared mindlessly at the TV and slowly became aware of a sad truth. We are literally bombarded by ads for food and alcohol 24/7.
Ads for food in one form or another are in every commercial break. People having fun in a restaurant that brags about their huge portions and their never ending buffets with all the roast beef and potatoes and pasta and desserts you can eat (not care to eat), close ups of their signature dishes hot and greasy and lit and posed like a centerfold. Ads for fast food joints where you don't have to get dressed or get out of your car to get burgers, or pizza or buckets of deep fried chicken. I noticed more because I was nauseous but it goes on all the time.
And alcohol. Glorified, romanticized or advertised for how much you can get how cheap, where. People laughing and drinking beer at barbeques and on boats and at the beach - a social drink for happy social people and occasions and for the world's most interesting man - and also incredibly cheap in large amounts - great for young people - and alcoholics. Wine - once the choice of "wino's - now the choice of a little older and more sophisticated group - but you can still get it cheap in big bottles or boxes. And liquor - for those with discriminating tastes or who just want to get really drunk really fast.
America's finest advertising minds and biggest dollars at their best.
Ads for food in one form or another are in every commercial break. People having fun in a restaurant that brags about their huge portions and their never ending buffets with all the roast beef and potatoes and pasta and desserts you can eat (not care to eat), close ups of their signature dishes hot and greasy and lit and posed like a centerfold. Ads for fast food joints where you don't have to get dressed or get out of your car to get burgers, or pizza or buckets of deep fried chicken. I noticed more because I was nauseous but it goes on all the time.
And alcohol. Glorified, romanticized or advertised for how much you can get how cheap, where. People laughing and drinking beer at barbeques and on boats and at the beach - a social drink for happy social people and occasions and for the world's most interesting man - and also incredibly cheap in large amounts - great for young people - and alcoholics. Wine - once the choice of "wino's - now the choice of a little older and more sophisticated group - but you can still get it cheap in big bottles or boxes. And liquor - for those with discriminating tastes or who just want to get really drunk really fast.
America's finest advertising minds and biggest dollars at their best.
9
Good article! Throw in diagnosed depression into this mix of available sugary food and drugs (prescription or otherwise) and you have a population struggling to function.
6
Spend any time in Trump country, where a perceived loss of status in previously "dominant" whites is rampant, and you'll find increased addiction and obesity. Ironic that the people who supported Trump most strongly, thinking that he'll restore their industrial jobs, are from states that rely most heavily on Medicare funding for opiate addiction.
8
That you would ascribe obesity to a political party for any reason says a lot about you, but leaves little content otherwise.
8
The real question is, why aren’t Friedman or Volkow looking into the links between dopamine and addictions to money, belief systems, safety/power, approval/acceptance/attention, esteem/status? And the answer is because, like all addicts, they’re not interested in acknowledging the insatiable cravings responsible for driving them (and other power seekers) to control the institutions responsible for defining addictions.
If that weren’t the case, the world would already understand how the most common and destructive addicts are in the process of destroying our species’ chances of survival because, like our POTUS, they’re addicted to money, approval, status, and belief systems they use to score the same neurotransmitter junkies trigger with heroin.
Same dopamine, same self-deception, same denial.
DopamineProject.org
If that weren’t the case, the world would already understand how the most common and destructive addicts are in the process of destroying our species’ chances of survival because, like our POTUS, they’re addicted to money, approval, status, and belief systems they use to score the same neurotransmitter junkies trigger with heroin.
Same dopamine, same self-deception, same denial.
DopamineProject.org
9
These experiments with monkeys are unethical.
2
Misleading headline - not much about cookies here :(
4
34 years ago, the Duke Brothers (Randy and Morte) conducted a similar experiment with similar results...for those unfamiliar with their scientific wager, go watch "Trading Places".
Glad to see all the progress scientists have made over three decades!
Glad to see all the progress scientists have made over three decades!
2
Mortimer was the second brothers actual name and it was a very funny movie. Especially the scene in Jamie Lee Curtis's apartment when she took Dan Ackroid home with her (hey, I was in my teens!).
Isn't there such a thing as an addictive personality? Does stress always play a role? I don't think so. Addicts, whether to food, drugs, gambling, shopping, (and so on) have psychological and emotional issues that are not necessarily stress related. There are umpteen books claiming to explain the cause of addiction. Some people are helped with 12 step groups, others are not. Further, with eating disorders, you can find people who have been both anorexic and compulsive overeaters. Is that stress? This is too complex an issue to have one answer.
5
Hey don bring Cannabis into this. Cannabis affects endocannabinoid receptors, which may indirectly affect D2 levels. However, that effect is no where near as powerful as cocaine or meth.
I am one of the people who extract the cannabinoids into shatter and wax and distillate and a bunch if other products. Our concentrates are safe and allow consistent dosage, and are tested for residual solvents. potency, and biocontaminants in the state of Colorado. You cant say that about meth, thats for sure.
I am one of the people who extract the cannabinoids into shatter and wax and distillate and a bunch if other products. Our concentrates are safe and allow consistent dosage, and are tested for residual solvents. potency, and biocontaminants in the state of Colorado. You cant say that about meth, thats for sure.
1
I have a couple of problems with this:
1) The writer is a psychiatrist. Doesn't he know that the more one takes an anti anxiety drug, the more anxious one becomes without it, and that the more one takes an anti depressant drug, the more depressed the person may be without it.
If the writer wanted to study the matter, he might find that anti depressant medication lowers the number of dopamine receptiors in the brain. Anti Depressants, after all, are a petite form of speed: They increase the level of electical charges streaming across the neuronic synapses of the mind.
I think the author should admit that his field is part of the problem.
2) He thinks stress might increase addiction. (I think I have heard this since grade school.) He says we should reduce stress (What an original idea. I thought he would champion more stress.)
Some psychologists posit that many young people today are weak from being too pampered, having too many social workers keep them away from anything disurbing, and going to colleges that create "safe spaces" where one is shielded from disagreeable ideas. Therefore, we could follow the doctors advice, and try to get rid of more stress, but then our progeny would be even weaker.
Allen Dulles went to a school where boys had to do mental arithmetic before breakfast while standing at attention. That Generation defeated the Nazis. I doubt if today's America would have won.
1) The writer is a psychiatrist. Doesn't he know that the more one takes an anti anxiety drug, the more anxious one becomes without it, and that the more one takes an anti depressant drug, the more depressed the person may be without it.
If the writer wanted to study the matter, he might find that anti depressant medication lowers the number of dopamine receptiors in the brain. Anti Depressants, after all, are a petite form of speed: They increase the level of electical charges streaming across the neuronic synapses of the mind.
I think the author should admit that his field is part of the problem.
2) He thinks stress might increase addiction. (I think I have heard this since grade school.) He says we should reduce stress (What an original idea. I thought he would champion more stress.)
Some psychologists posit that many young people today are weak from being too pampered, having too many social workers keep them away from anything disurbing, and going to colleges that create "safe spaces" where one is shielded from disagreeable ideas. Therefore, we could follow the doctors advice, and try to get rid of more stress, but then our progeny would be even weaker.
Allen Dulles went to a school where boys had to do mental arithmetic before breakfast while standing at attention. That Generation defeated the Nazis. I doubt if today's America would have won.
8
What of the low ranking monkies who console themselves from their captivity? I'd like to know if they do better even if put in a cage by themselves with sufficient food and items for mental stimulation and exercise? What is the answer for over the over dominated? The article more addressed the dominant monkeys and what happens to them when put alone but what of those who are made ill by an environment of domination and suppression?
I was struck that three out of the four editor's pick comments in some way wanted to still tell the other monkeys what to do think and feel, Their voices obviously taking the dominant monkey position in their judgement of others,
These voices are the problem, not the solution they are peddling. Rising inequality, inability to have effective solutions to resolve the problems arising systemicly much larger than any one person can address on their own and being blamed for succumbing by such as JB, John Smith and Stephanie ARE the problem, not the solution.
I was struck that three out of the four editor's pick comments in some way wanted to still tell the other monkeys what to do think and feel, Their voices obviously taking the dominant monkey position in their judgement of others,
These voices are the problem, not the solution they are peddling. Rising inequality, inability to have effective solutions to resolve the problems arising systemicly much larger than any one person can address on their own and being blamed for succumbing by such as JB, John Smith and Stephanie ARE the problem, not the solution.
2
Interesting article. But I ask you, please, please NYT, stop those moving illustrations. I find them very distracting. I may be the only over sensitive reader to react to them, but I really just don't see the point.
15
I wonder if addition to social media, games, and smart phones can also be explained in the same mechanism?
Anyone, please give me some insights.
Anyone, please give me some insights.
4
Sigh. Psychologists/psychiatrists have been fighting the nature/nurture/is it physical/is it psychological battle for the past century and it seems we're regressing.
1. You are aware of a desire for (fill in the blank - shopping, meth, cookies, gambling, tweeting,
1a. You allow the desire to pass.
1b. You follow through on the desire, acting on it.
There is not a single finding in neuroscience nor anywhere in psychology nor anywhere in modern science - not Libet (as Libet himself told us, again and again) which can give us the least insight as to how to move from "1b" to "1a".
Nobody here - not one commenter - has provided any insight as to how it is that some people get stuck at 1b and others stay at 1a.
This is NOT a scientific question. It is not something that any of our objective tools can give us one iota of insight about.
yet the answer is obvious. It is literally staring us in the face (I do mean literally, not figuratively, though seeing this involves turning inside out all our notions of what "subjective" and "objective" mean.
There is only one Awareness (known as "Chit-Shakti" in Sanskrit).
To the extent I believe the desire represents "me" (the "me" being a construction of Awareness), then to that extent I am a slave. If medication helps overcome the desire, or support groups, or therapy, or whatever, it doesn't make me one whit less a slave.
if I am able to see that the desire is not "me," I'm free.
It's that simple.
1. You are aware of a desire for (fill in the blank - shopping, meth, cookies, gambling, tweeting,
1a. You allow the desire to pass.
1b. You follow through on the desire, acting on it.
There is not a single finding in neuroscience nor anywhere in psychology nor anywhere in modern science - not Libet (as Libet himself told us, again and again) which can give us the least insight as to how to move from "1b" to "1a".
Nobody here - not one commenter - has provided any insight as to how it is that some people get stuck at 1b and others stay at 1a.
This is NOT a scientific question. It is not something that any of our objective tools can give us one iota of insight about.
yet the answer is obvious. It is literally staring us in the face (I do mean literally, not figuratively, though seeing this involves turning inside out all our notions of what "subjective" and "objective" mean.
There is only one Awareness (known as "Chit-Shakti" in Sanskrit).
To the extent I believe the desire represents "me" (the "me" being a construction of Awareness), then to that extent I am a slave. If medication helps overcome the desire, or support groups, or therapy, or whatever, it doesn't make me one whit less a slave.
if I am able to see that the desire is not "me," I'm free.
It's that simple.
7
Thank you so much for sharing this insight!
It's amazing me that drug addiction and deaths are now a cause for concern, and worthy of study and funding, now that lots of white people are dying.
4
Relapse commonly occurs not during the 2-3 weeks of horrific physical withdrawal and detox, but in the 3-12 months afterwards when he or she feels no spirit, interest in, or reward from work, family, friendships or anything else. It's difficult for most of us to grasp just how empty and soulless it feels to walk around with a crippled reward system in your brain. It's not the early withdrawals that terrify addicts, it's the later emptiness of a dopamine-starved existence. Many would rather die that live that way -- and many do.
The answer lies not in opioid replacement drugs -- for one thing, the incidence of cross use between buprenorphine and heroin is sky high.
The only real solution is for medical researchers to come up with a treatment that kick-starts the production of D-2 receptors again and revitalizes the reward system to a more functional, survivable level.
All this money spent on buprenorphine, which is infinitely harder to kick given it's much longer half life, is in some sense a mirage. Sure it helps some addicts stabilize enough to hold down a job. And that's important. But go online to any suboxone (buprenorphine) forum and you'll see hundreds of users talking about their continuous cycle of relapse back to back to their drugs of choice. Many treat buprenorphine as a short-term band-aid when heroin is unavailable, staving off withdrawals until they can get more dope.
We need top focus on restarting the reward system. That's the only true cure.
The answer lies not in opioid replacement drugs -- for one thing, the incidence of cross use between buprenorphine and heroin is sky high.
The only real solution is for medical researchers to come up with a treatment that kick-starts the production of D-2 receptors again and revitalizes the reward system to a more functional, survivable level.
All this money spent on buprenorphine, which is infinitely harder to kick given it's much longer half life, is in some sense a mirage. Sure it helps some addicts stabilize enough to hold down a job. And that's important. But go online to any suboxone (buprenorphine) forum and you'll see hundreds of users talking about their continuous cycle of relapse back to back to their drugs of choice. Many treat buprenorphine as a short-term band-aid when heroin is unavailable, staving off withdrawals until they can get more dope.
We need top focus on restarting the reward system. That's the only true cure.
2
People have to protect themselves from addiction. Saying no is difficult. We need to know how much food we need each day and stick to that. We need to be clear that we will be happier in the long run by not partaking in alcohol or drugs. It's almost an impossible task.
Is it stress or boredom? I'm pretty convinced boredom is the biggest driver of drug addiction, especially where middle class folks are concerned. Plenty of folks with jobs get addicted to drugs; the problem is we're bored out of our minds.
5
This is ridiculous. Throughout history, people have lived under stress--in some eras and parts of the world, infinitely more stress than we face today. Life was so terrible that religions had to be invented to keep people from committing suicide. Modern man is very adept at inventing reasons why behavior is really not anyone's fault--it's a disease. Tell that to the addicted at birth, neglected and abandoned children of these drug addicts. They are not too stressed to have children and perpetuate this miserable stress that they can't endure. It's time for people to take responsibility for their choices. While addiction can be hard to cure or manage, starting to take drugs is a personal choice. Let's stop trying to absolve the addicts for all the harm they do.
4
I am curious to know the effect of television on stress. I am sure it is a surprise to no one that many people keep the TV on nearly all the time. What is the reason behind this dependence, and does it lower stress or increase it? Especially, on comedy shows there is a laugh track, on talk shows the audience is kept screaming and cheering... does this increase ratings, lower the viewers' resistance to commercials, or both? Does it lead to a loss of self-control when it comes to eating or the "need" for self-induced passivity? I watch almost no TV; as a child I was neglected and basically raised myself because my parents couldn't stop with the TV long enough to take an interest. As far as I am concerned, we overstimulate ourselves in some ways, and then compensate with depressants that keep us passive and self-hating.
2
limiting exposure to high-calorie foods and recreational drugs would naturally reset our brains to find pleasure in healthier foods and life without drugs.
?????????
If you don't find relief in drugs or food to your stressful job you might just seek out worse habits like sex addiction, gambling, or even criminal behavior that stimulates excitement.
?????????
If you don't find relief in drugs or food to your stressful job you might just seek out worse habits like sex addiction, gambling, or even criminal behavior that stimulates excitement.
1
"Even the most self-disciplined can fall prey to a food or drug addiction under the right mix of adversity and stress."
Sorry, but I'm not buying this argument. No amount of adversity or stress is going to make me put a needle in my arm.
Sorry, but I'm not buying this argument. No amount of adversity or stress is going to make me put a needle in my arm.
3
I appreciate your perspective, but what you've said does not answer the author's argument.
Eating (to the point of morbid obesity, or to the point of significant risk for such obesity) does not involve needles. Different people will ultimately succumb to different addictions. I personally have no weakness for drugs or alcohol and no desire to use them, but know not to buy chocolate. Ever.
Eating (to the point of morbid obesity, or to the point of significant risk for such obesity) does not involve needles. Different people will ultimately succumb to different addictions. I personally have no weakness for drugs or alcohol and no desire to use them, but know not to buy chocolate. Ever.
1
I share your aversion to injecting drugs. Nevertheless, what we have seen is that many people's thought process changes after they take prescription opioids for chronic pain. Any one of us could have major surgery or a severe accident. Pain medication plays a legitimate role in recovery. But after taking it for a while, it changes the user's experience of pain. Too many people who started out healthy have gone down this path for us to be 100% certain how we would handle it, especially if the underlying condition simultaneously cost us our support systems, like jobs, exercise habits, and relationships.
When talking about "deaths of despair," Dr Friedman mentions poor job prospects and stress from "steady erosion in social status," but fails to take note of the stress that results from the breakdown of the nuclear family and the abandonment of faith that characterizes our younger generations. Until Americans recognize that the collapse of society is tied inextricably to our disavowal of God, the devastation of the white middle class will march on, unchecked... as it did thru the inner city decades ago.
4
A half a cookie is the same as 3, you just have to follow 'it' up with
a half an apple and half of a hard sweet pear. It works it really dose.
And remember it takes 20 minutes to shut off the control thoughts.
a half an apple and half of a hard sweet pear. It works it really dose.
And remember it takes 20 minutes to shut off the control thoughts.
2
I would disagree with the implication that the rise in obesity is due to "...cheap, calorie-dense foods that are highly rewarding to your brain..." The dramatic rise of obesity in the last 30 years is (IMHO) due to two things: 1) vilification of fat by Drs. in cahoots with the sugar industry; 2) the drop in the rate of smoking. Cause number 2 may (or may not) have been worth the trade off but cause number 1 was promulgated (wrongly and with harm) by know-it-all health professionals. That said, the conclusion reached here - try to manage your environment to reduce stress - is hard to disagree with. How many millions did it take to come up with that one?
9
truly, the smoking element does deserve mention. the habit served as a weight maintenance program for millions.
5
The standard American diet of high saturated fats - meats, fish and dairy - is killing Americans and making them obese and diseased, suffering chronic pain and inflammation. then instead of looking at our diets the AMA and the Pharmaceutical companies just add pills. This is a blindness and an addiction to the wrong way of life and has predictible poor outcomes. Not only that but our animal "farming" industries are leading to the output of higher levels of greenhouse gases than the entire scope of transportation modes. Plant based diets (low fat and low processed) have the potential to reverse health conditions, decrease obesity, and improve the health of the planet - but America's addiction to burgers and cheese is killing all of us.
4
And those cheeseburgers and fried potatoes are nearly always ingested with large soft drinks and milkshakes.
Dr. Friedman pretty much summarizes what has been generally known for sometime, however, he did miss a few critical points. In many ways food addiction is far more difficult to break then drug addiction, and food addiction is the ultimate gateway to drug addiction.
Consider that when you break a drug addiction you don't normally keep the drug around for ready access. Imagine how near impossible it would be to quit cocaine, OxyContin, or smoking if you had packs of them sitting around in your refrigerator and every day took even just a little bit of it. Yet when it comes to food, not only must we eat every day, several times a day, even the healthiest diet is still going to contain sugar, salt and fat that appeal to our dopamine system. In other words we are constantly reinforcing our addiction even as we are trying to break it.
Meanwhile, food with its high amounts of sugar, salt, and fats that is carefully designed, manufactured, and marketed with brainwashing like techniques to maximize consumption ("bet you can't eat one") lowers the dopamine threshold that helps open the gateway for new and increased stimulation.
Consider the fact that the obesity epidemic pretty much coincides with the drug epidemic and also that the food industry especially targets children with their marketing campaigns and high levels of sugar, salt, fat in everything from baby food to big macs; cereals in cartoon character boxes to everyday snacks.
Consider that when you break a drug addiction you don't normally keep the drug around for ready access. Imagine how near impossible it would be to quit cocaine, OxyContin, or smoking if you had packs of them sitting around in your refrigerator and every day took even just a little bit of it. Yet when it comes to food, not only must we eat every day, several times a day, even the healthiest diet is still going to contain sugar, salt and fat that appeal to our dopamine system. In other words we are constantly reinforcing our addiction even as we are trying to break it.
Meanwhile, food with its high amounts of sugar, salt, and fats that is carefully designed, manufactured, and marketed with brainwashing like techniques to maximize consumption ("bet you can't eat one") lowers the dopamine threshold that helps open the gateway for new and increased stimulation.
Consider the fact that the obesity epidemic pretty much coincides with the drug epidemic and also that the food industry especially targets children with their marketing campaigns and high levels of sugar, salt, fat in everything from baby food to big macs; cereals in cartoon character boxes to everyday snacks.
8
Agree with this article's premise.
Readers, let's take it to the next step. What positive behaviors have you engaged in to raise your levels of dopamine without excessive sex, alcohol/drugs or junk food?
I've done well with a breath-based yoga practice, meditation and more time outside. Journaling helps me monitor the sources of my stress and the success of my ability to work through it without engaging in destructive behavior. My husband runs, goes through spiritually counseling at his church, and also spends more time outdoors. We have a dog.
Last point, I'm probably just as dependent on my yoga as I used to be to on alcohol. Sometimes I need to keep going with the yoga to a point of physical injury to keep the stress down. That is a better poison than drugs or alcohol, but still not a fully benign lifestyle.
What are other people doing? Music, art, reading good fiction? Please share.
Readers, let's take it to the next step. What positive behaviors have you engaged in to raise your levels of dopamine without excessive sex, alcohol/drugs or junk food?
I've done well with a breath-based yoga practice, meditation and more time outside. Journaling helps me monitor the sources of my stress and the success of my ability to work through it without engaging in destructive behavior. My husband runs, goes through spiritually counseling at his church, and also spends more time outdoors. We have a dog.
Last point, I'm probably just as dependent on my yoga as I used to be to on alcohol. Sometimes I need to keep going with the yoga to a point of physical injury to keep the stress down. That is a better poison than drugs or alcohol, but still not a fully benign lifestyle.
What are other people doing? Music, art, reading good fiction? Please share.
10
I quit going to religious services and OA meetings, where the expectation is always to let God handle everything. I stopped outsourcing my strength to God. I learnt to live with the addiction, not against it. I do not eat anything I haven't prepared at home. I read every label and compare the ingredients to the list of the 55 names for sugar. And I read. There is a lot of wisdom in literature. I have been abstinent from sugar, sugar substitutes, and refined flour products for seven months and have released 35 pounds. I have declined attending a July 4th family reunion and cookout because I know that toxic food products will be abundant. I don't care a whit what they think; saving my life comes first.
Find what works, do it, and don't stop doing it.
Find what works, do it, and don't stop doing it.
12
I take cannabiods, stick to a ketogenic noninflammatory diet, meditate and walk or swim outside daily. I am a physician and I have been able to decrease my pharmasuticals from 15 per day down to two per day. I have been able to stop the antidepressants, anxiolytics, sleeping agents, antihypertensives, and nonsteroidal antiinflamatory agents. I am almost 70. I enjoy better health than when I was in my twenties and I have lost 40 pounds over the last year.
5
I have found certain podcasts (especially one-on-one interviews) gift me with a depth of humanity lacking in my daily life. Two years ago we moved from our home of 20 years in a city to a semi-rural area in a different state. I have been into podcasts for about 6/7 years but now they are more essential to my sanity than ever. I work all day and have often thought I would love a t-shirt which says "So many podcasts, too little time." (I just dated myself, those who survived the 80s will get that reference.)
I exercise, I pray and I've stopped making excuses for my coffee and chocolate consumption. I've been sober for 31 years this month and it's still simply, and imperfectly, one day at a time.
I exercise, I pray and I've stopped making excuses for my coffee and chocolate consumption. I've been sober for 31 years this month and it's still simply, and imperfectly, one day at a time.
7
if we treat drug addition with drugs to moderate dopamine, why isn't that also used for overweight people.
perhaps because overweight is considered a personal failure that just requires the person to control. much like drug addition is, though now is more understood to be a medical problem.
and it seems that both are considered to be moral failures by many.
perhaps because overweight is considered a personal failure that just requires the person to control. much like drug addition is, though now is more understood to be a medical problem.
and it seems that both are considered to be moral failures by many.
6
This is not news. The food "industry" knows it and engineers their foods for profit accordingly. So do the drug sellers.
Whether it is drugs, food, behavior or activity - choose those that work best for you with consequences that reward, impede or damage your well being.
Whether it is drugs, food, behavior or activity - choose those that work best for you with consequences that reward, impede or damage your well being.
The fact that psychiatry is now only recognizing environment's role in addiction, speaks volumes about the quality and level of interest that this profession really has in solving societal problems. With Donald Trump in the White House, and the accompanying deafening silence from the mental health profession, maybe it's time we concluded health professions motivated out of self-interest and self-preservation have become detrimental to society.
1
Stress can make drug use more attractive. That is not news. Because in fact the problem is - that drugs work. But that is among normal people. After an addiction is in place within an addict's brain, the use of the addictive substance is not intended for any reason - not even for relief of stress. It has become pure behavior with no expectations at all. And that that point the environment means nothing, stress means nothing. The addict uses purely because he is incapable of not using. So get off the psychology schtick, which explains how one becomes addicted, but not why they behave as they do once in the addicted state. Alcoholics do not drink to get drunk. That is what normal persons do. Alcoholics drink simply because they are addicted to alcohol. Get it?
3
Former FDA Director, Dr. David Kessler in his 2009 book, The End of Overeating describes how packaged goods food marketers have engineered foods to be addictive. One part of the outcomes described in this editorial is the triumph of marketing science in designing products that manipulate our behavior, and when profits are involved, that manipulation can occur even if there are significant social costs.
6
Interesting article but I get the sense that the author would recommend banning OJ and persisting with the failed drug war rather than reforming the elements of our social structure that induce suicidal levels of stress.
1
In 1958, a book called Social Class and Mental Illness reported a study done in New Haven CT. It found that persons lower down the socioeconomic ladder were more likely than those higher up to suffer from psychiatric problems. Then, in 1962, a book called Mental Health in the Metropolis appeared. Conducted in Manhattan, it, too, focused on the relation of socioeconomic status and mental health, and like the earlier study it found that lower status correlated with psychological impairment. In the years since, other studies by social scientists, psychiatrists, and now neuroscientists, have confirmed and extended the original findings.
The earlier studies, along with accounts of the poor by journalists, and the work of leaders such as Martin Luther King, led to national and local policy initiatives to ameliorate poverty. Lyndon Johnson, in his 1964 State of the Union Address, called for a war on poverty, and that call was embodied in the 1964 Economic Opportunity Act. At the local level, in New York City, for example, an organization called Mobilization for Youth was formed. Designed to bring educational and work opportunities to poor youths, it lasted from 1961 to 1970.
While some gains were made, we're now going backward. Dr. Friedman says that ',,.while we can't change or genetics, we can change our environment.' True. But anyone who thinks Trump & Co, is going to change the environment in a that will help the poor, and thus diminish addiction, should think again.
The earlier studies, along with accounts of the poor by journalists, and the work of leaders such as Martin Luther King, led to national and local policy initiatives to ameliorate poverty. Lyndon Johnson, in his 1964 State of the Union Address, called for a war on poverty, and that call was embodied in the 1964 Economic Opportunity Act. At the local level, in New York City, for example, an organization called Mobilization for Youth was formed. Designed to bring educational and work opportunities to poor youths, it lasted from 1961 to 1970.
While some gains were made, we're now going backward. Dr. Friedman says that ',,.while we can't change or genetics, we can change our environment.' True. But anyone who thinks Trump & Co, is going to change the environment in a that will help the poor, and thus diminish addiction, should think again.
16
Thank you Mr. Friedman for an excellent article and thanks also Mr. Suffet for a response of more information. Everything in the US is not going backward very quickly.
Overlooking that healthcare is a human right is grievous and reprehensible.
The US needs Medicare for all! A health care system that really works for everyone. Other countries can do it. (again US is running backwards)
What does it say about the US when people like GOP leaders Ryan/McConnell and company want to destroy healthcare, the environment and basically the country?
Overlooking that healthcare is a human right is grievous and reprehensible.
The US needs Medicare for all! A health care system that really works for everyone. Other countries can do it. (again US is running backwards)
What does it say about the US when people like GOP leaders Ryan/McConnell and company want to destroy healthcare, the environment and basically the country?
Correlation does not imply causation. Perhaps the addicted are in lower socioeconomic environments because of their addictions. This article addresses a scientific issue, not a political issue.
2
why do the problems seem more common in the usa than other western countries--especially given the whole exceptionalism thing?
12
One guess might be more equal access to health care in every other OPEC country. Here, unless you're well-employed with health care provided, you get to use the stigmatized Medicaid if you get health care at all.
7
lauren...that was my guess. however, the extremes of wealth and poverty in the states are also worse, i think. probably something to do with that too.
nice being in a country with single payer. i just show my card at any hospital, clinic or doctor in the country and that's the end of it--even tho each province has its own system.
the biggest expense for a visit to the hospital is parking. if i park on the street and walk about 3/4 of a mile i don't even have that.
nice being in a country with single payer. i just show my card at any hospital, clinic or doctor in the country and that's the end of it--even tho each province has its own system.
the biggest expense for a visit to the hospital is parking. if i park on the street and walk about 3/4 of a mile i don't even have that.
5
Maybe instead of safety nets we should be constructing comfort bowls. The current debate about healthcare is a good example. It's almost all about Medicaid.The very term implies help for those who don't have the means to pay for what they need, aka the poor.
When a "bread winner" works hard all day to support his or her family, but must rely on Medicaid to sustain the family's health, society has a ready set of applicable stigmas: poor, dependent, lack of motivation, freeloaders, plus others applied specifically to race and ethnicity. My guess is that these stigmas , which have little rational basis, consume a lot of dopamine receptors.
The comfort bowl solutions such as Medicare for all, single payer, or, God forbid, universal health care paid for by the government using, again God forbid, tax proceeds. I think eliminating the healthcare uncertainty will be a real dopamine receptor producer for tens of millions of Americans.
Good public schools are another comfort bowl essential. Interestingly, Ms DeVos, Trump's Secretary of Education, would like to throw in some uncertainty about that.
A personal, non-scientific, observation is the prevalence of obesity of supermarket shoppers in poorer locals vs those in wealthier locals. Yes, much less among the wealthier.
When a "bread winner" works hard all day to support his or her family, but must rely on Medicaid to sustain the family's health, society has a ready set of applicable stigmas: poor, dependent, lack of motivation, freeloaders, plus others applied specifically to race and ethnicity. My guess is that these stigmas , which have little rational basis, consume a lot of dopamine receptors.
The comfort bowl solutions such as Medicare for all, single payer, or, God forbid, universal health care paid for by the government using, again God forbid, tax proceeds. I think eliminating the healthcare uncertainty will be a real dopamine receptor producer for tens of millions of Americans.
Good public schools are another comfort bowl essential. Interestingly, Ms DeVos, Trump's Secretary of Education, would like to throw in some uncertainty about that.
A personal, non-scientific, observation is the prevalence of obesity of supermarket shoppers in poorer locals vs those in wealthier locals. Yes, much less among the wealthier.
22
When that breadwinner can't pay for that family's health care, it's proof that they're irresponsible to have that family. The time and attention demands of my low wage job, coupled with my boss' and clients 24/7 expectations keep me from having the time, energy and finances to afford even a social life, much less a family. They'll get no sympathy from me.
Sugar is not be an addictive substance in the way we normally think of addiction, but to leave it off the list of destructive, addictive substances being pushed to the masses is wrong. Capitalism works to produce devoted consumers, and will always find ways to legitimize the sale of a profitable commodity, no matter how destructive it is, and the more addictive the better. One could argue that people who spend all their money on heroin and ice cream are simply the most evolved form of consumer.
6
sugar is one of if not the most addictive chemical we ingest. insulin production in anticipation of the next sugar fix tells the story.
6
Want to make a lot of money? Invent something cheap and addictive. Works every time.
In addition to the many thoughtful comments here on the ways contemporary American culture has reduced and dismissed so many of the good things that make life pleasurable and meaningful (appreciation of nature, face-to-face conversation, reading, the arts in schools, time spent with children and other relatives, etc): the standard American diet itself is highly stressful, emotionally and physically. So many of us ingest calorie-laden and bland foodstuffs nearly devoid of actual nutrition out of plastic cartons alone in our car or carrel. The food many children, especially low-income children, eat is simply appalling. I fear we have raised a whole generation who hardly how healthy pleasures look, feel, taste, or sound.
14
The things you suggest to be "meaningful" are completely subjective and cannot be quantified, making them meaningless. The most important factor in any organization, be it the workplace, the home, schools or public spaces is the maintenance of good order and discipline. Quantifiable factors (like profits earned, hours worked) fall into place when we are serious, focussed and disciplined.
1
How many fortunes were made in industries that peddle over-consumption and/or addiction? Alcohol, tobacco, processed food, addictive legal drugs, e.g. opioids (and, some would claim, some anti-depressants).
Our capitalist society is built around rapacious business practices including the use of research-backed psychological manipulation to get people to consume. The more addictive the product, the more profitable.
The whole "it's their own fault" attitude towards suffering doesn't take into account the societal pressure put on people to eat, drink, and be pharmacologically merry. This article and the research mentioned was a great step in the right direction towards understanding how environment and biochemistry sets people up for addiction.
As long as money rules politics, we are not going to see a reduction of stress economically, limits on selling or marketing addictive products, or financial support for effective addiction treatment and research. Treating and preventing addiction on a large scale is fundamentally incompatible with unrestrained capitalism. High levels of addiction is the inevitable cost of our way of doing business.
Our capitalist society is built around rapacious business practices including the use of research-backed psychological manipulation to get people to consume. The more addictive the product, the more profitable.
The whole "it's their own fault" attitude towards suffering doesn't take into account the societal pressure put on people to eat, drink, and be pharmacologically merry. This article and the research mentioned was a great step in the right direction towards understanding how environment and biochemistry sets people up for addiction.
As long as money rules politics, we are not going to see a reduction of stress economically, limits on selling or marketing addictive products, or financial support for effective addiction treatment and research. Treating and preventing addiction on a large scale is fundamentally incompatible with unrestrained capitalism. High levels of addiction is the inevitable cost of our way of doing business.
16
The principle of creating shareholder value has fed the pharmaceutical business monster to the point that it is destructive to health.
That's because investment bankers run pharma and do not have to honor, "first, do no harm."
Ban advertising of prescribed pharmaceuticals as a first step.
That's because investment bankers run pharma and do not have to honor, "first, do no harm."
Ban advertising of prescribed pharmaceuticals as a first step.
3
Boy it sure woulda been nice to have been walked through this info when I was in high school but of course I wouldn't have listened.
8
Very interesting article. But it doesn't mention depression; only stress. I don't see that as being the same at all. And it doesn't discuss the huge benefits of exercise for reducing both depression and stress (and appetite). I've read about studies that showed that moderate regular exercise was as effective as Prozac and similar drugs at reducing depression.
11
Inner city minorities have been dying in large numbers from the stress of living in a low value/high stress environment yest as the numbers of white rural opiod abuse climb, suddenly 'environmental stress' is in the news. Electronic gaming is training young brains to expect immediate gratification. Physical activity is considered something we do only at the gym or on a run in our free time. Where I live, in a rural county about 2 hours from nyc the unemployed whites don't even apply to do these jobs anymore forcing farmers to import families from Latin America to do all the real work on farms and orchards. At the same time, elites from the cities are choosing to eat better and farms that serve that population are growing. There is an irony here - the jobs that require hard work and build muscle are the ones that build dopamine and D2 receptors, and those same jobs are considered socially so low that only immigrants are doing them? What if it were well known that immigrant laborers can earn $30,000 in just four months picking apples. Maybe we could attract inner city minorities to the farms for part of the year, and change some live lived in stress and addiction, in the process.
14
$30,000 dollars per year, which is what those farm laborers actually earn, since those 4 month jobs are the only ones they can find, is not a living wage. Especially in the inner city. What would you do if you had no hope of finding a job that would allow you to live or raise a family with dignity while all around you confronted the evidence of the extreme wealth of those few billionaires, most of whom, like Gates and Zuckerberg, amassed their fortunes through crimes like thievery and breaking anti-trust laws? Would you still believe in The American Dream?
No one will do it as long as the taxpayer hammock, I mean social safety net is there. Remove it and once those on the door get hungry enough, they'll flock to those jobs.
1
Maybe we should think twice before dismissing the risk of cannabis as a gateway drug.
9
For some people, it can be, just as beer can be for alcohol.
1
@sgdfish -- from another perspective, illegal cannabis is a gateway to illegal / black markets where the pusher / proprietor sells other, more profitable and actually addictive drugs. Legal cannabis is sold with known potency by vendors with no incentive to expose the customer to actually addictive pharmaceuticals or knockoff synthetics.
4
Indeed. I've been using cannabis for 45 years, and all I have to show for it is a Master's degree and a comfortable retirement.
Obesity increased. What changed? Look around. Constant use of electronics instead of getting out of the house and moving. While electronic game makers and other electronic gadget traps are making money, kids (and adults) are putting on the pounds. Sad to think monkeys are being used for research when all we have to do is figure out how to overcome the electronics outrage. That would/should not require animal usage in research, just common sense.
14
Sugar is the culprit, not electronics.
1
Sugar is likely the cause but we've lost the means to address it though manual labor and physical activity.
1
I worked with substance abusers in a homeless shelter. We couldn't leave the sugar out because those residents who were going through withdrawal would eat it all. That included prescription drug users.
We gave them vitamin C to help with the withdrawal and cravings. It worked.
Studies show that vitamin C reduces stress and anxiety and decreases the severity of depression. Vitamin C levels are significantly lower in drug and sugar addicts.
We gave them vitamin C to help with the withdrawal and cravings. It worked.
Studies show that vitamin C reduces stress and anxiety and decreases the severity of depression. Vitamin C levels are significantly lower in drug and sugar addicts.
20
The discussion on the genetic element and the interaction of genetics with environment (epi-genetics) is interesting. The submissive ('beaten') monkeys are stressed by their beaten status, and, with access to cocaine, take more of it to flood their brains with an alternative reward. Could the effects of epi-genetics over generations explain how 'beaten' populations and their descendants resort to drug-induced comfort? Could the alcohol and drug problems of Native Americans, Maori, Aborigines and former slave and conquered populations everywhere be partially related to the stresses their ancestors experienced and descendant populations never overcame, due to being born in poor and deprived circumstances? Another thought - as primates in the wild (including humans) naturally form groups with dominant and submissive individuals, how did/do the submissive individuals cope without access to drugs/alcohol/sugar on demand?
10
This is very interesting. The Irish had a very tough time emigrating to this country and being accepted. I presume that alcoholism rates among Irish Americans are far greater than the rates for the Irish in Ireland, where the bars all close at 10:00 PM
This setup for addiction is highly promoted by the free market. Capitalism drives and thrives on instant gratification. In so doing, it has insidiously begun to squeeze meaning and purpose out of human life: jobs are lost to better market opportunities elsewhere; true neighborhoods/small communities are not economically sustainable; health is a commodity; robots work efficiently while humans seek other (unhealthy) means to occupy their time. We need to inject some rational oversight into this system before we are all hollowed out, perpetually unhappy shadows of lost human potential, seeking comfort and stimulation from experiences that ultimately will not provide it.
7
To "cure" addiction we have to do a lot more to make the lives of the people better. What a revelation!
Our society is determined to make our lives even more stressful. We start pushing our children at an increasingly early age to succeed. We demand more and more while offering fewer rewards (material or psychological).
Now we're shocked that we have a problem. As always we are more than willing to blame-the-victim rather than change the system.
Our society is determined to make our lives even more stressful. We start pushing our children at an increasingly early age to succeed. We demand more and more while offering fewer rewards (material or psychological).
Now we're shocked that we have a problem. As always we are more than willing to blame-the-victim rather than change the system.
18
Well written message here in this article. The truth speaks for itself. Mental illness manifested by behaviors such as addiction to drugs or food should be viewed in the context described in this article. The government's role is important and the balance between freedom of choice and government control ever so difficult. Our current American public is faced with a catastrophic failure to the health of our citizens. Under these dire circumstances a greater degree of government participation and yes, control should be desired by all. The key is to rely on science and that is easier to do with a medical problem like a broken bone as contrasted with destructive behavioral disorders. The great impediment to properly applied political will is that our politician's behavior is too influenced by big business and misled or ill informed constituents. Most of them are educated and complex thinking people so I think enough of them understand what needs to be done but collectively they can't without risking their future political prospects too much. Not good.
8
Obesity has been soaring globally the last decades, more among the poor than among the well-offs. This coincides in time with the neoliberal destruction of solidarity and social awareness.
As a source of increasing stress, neoliberal austerity concerning the common sphere is a self-evident culprit. But we who can afford a new car now and then are obviously prepared to pay the price - since it don't affect us.
As a source of increasing stress, neoliberal austerity concerning the common sphere is a self-evident culprit. But we who can afford a new car now and then are obviously prepared to pay the price - since it don't affect us.
1
How about becoming a nation addicted to reading, to admiring the visual arts, to participating in the welfare of the community and to becoming politically involved to assure the well- being of the citizenry? Now those are addictive behaviors that we can all agree upon!
The last addiction should be to common decency, on and off the Internet.
The last addiction should be to common decency, on and off the Internet.
37
If my boss learned of my doing any of those things, he'd declare it proof that I an under worked and over paid. And my pay and hours would be adjusted accordingly.
Right in the early part of the article, the author states: stress makes people more likely to search for solace in drugs or food. If people are getting stressed about "poor job prospects, a steady erosion in their social status" then the problem is conflating ones bank balance with social status, and likely spending much more than saving while employed. In other words much stress seems to be not about legitimate worries like providing basic food and shelter but ability to keep earning more each year, and certainly presuming to be besting one's parents.
But these are fake standards to live one's life by. If we could start living within our means and derive pleasure with activities that seldom cost much money such as walking outdoors, developing stimulating conversation clubs, reflecting into nature of stress and boredom, to name a few -- all to help with a ready reserve of dopamine -- then chances are we are NOT going to be so vulnerable to the shallow temptations of richer, sweeter, saltier foods and drugs.
Partly, I think, the Constitution is to blame that grants everyone the "pursuit of happiness." Maybe it made sense when Americans were poor and rather miserable. Today we should ask more: A flourishing life, as Aristotle seems to have envisioned long ago.
But these are fake standards to live one's life by. If we could start living within our means and derive pleasure with activities that seldom cost much money such as walking outdoors, developing stimulating conversation clubs, reflecting into nature of stress and boredom, to name a few -- all to help with a ready reserve of dopamine -- then chances are we are NOT going to be so vulnerable to the shallow temptations of richer, sweeter, saltier foods and drugs.
Partly, I think, the Constitution is to blame that grants everyone the "pursuit of happiness." Maybe it made sense when Americans were poor and rather miserable. Today we should ask more: A flourishing life, as Aristotle seems to have envisioned long ago.
23
You can't have a "flourishing life" through personal technology.
Almost all personal e-devices, including the I Phone (which I don't own), are designed to make the user lazier and stupider.
Almost all personal e-devices, including the I Phone (which I don't own), are designed to make the user lazier and stupider.
Oh my goodness. Do you imagine that everyone has a job which gives them the means to live?
Take a closer look at how the bottom three quintiles must live. You can find plenty of reliable information on that issue. Take a look at how labor force participation has plummeted, and the SSDI rolls have soared, since 2008. Take a look at how many people are involuntarily working several jobs or part-time, and need side "gigs" in addition to those, simply to live. And carry credit card debt for essentials, like food.
We're close to the point where the fundamental economic problem of our society might not be capable of being solved, at least not within the present system. The "solution" will be that certain people will have shorter lifespans and fewer surviving children. You know what that "solution" ressembles.
Take a closer look at how the bottom three quintiles must live. You can find plenty of reliable information on that issue. Take a look at how labor force participation has plummeted, and the SSDI rolls have soared, since 2008. Take a look at how many people are involuntarily working several jobs or part-time, and need side "gigs" in addition to those, simply to live. And carry credit card debt for essentials, like food.
We're close to the point where the fundamental economic problem of our society might not be capable of being solved, at least not within the present system. The "solution" will be that certain people will have shorter lifespans and fewer surviving children. You know what that "solution" ressembles.
Our government is doing everything possible to remove existing safety nets for the unemployed, sick and uneducated. We imprison more of our fellow citizens than most other countries - including communist China. Good food is not readily available and where it is, very few people know how to cook it. Very few of us know how to eat simple food, I.e. Healthy and not a hamburger or sugar filled. In families, both parents work long hours and have no time to care for their children. If they cut back their working hours, they loose benefits. Education is too expensive. Clean air and water is too expensive. Adequate housing for many is too expensive. All very stressful.
49
If I may add one more point. President Eisenhower warned us of the "Military-Industrial Complex" where the incestuous relationship between the Military and the Defense industry was driving not only our defense spending but in many ways our foreign policy that promoted higher and higher spending and greater military influence.
Perhaps what he also should have warned us about is the Medical and Food Industrial Complex in which food driven causes of sickness and premature death, such as cardiovascular illness, kidney disease, and many forms of cancer have risen dramatically with the obesity epidemic which in turn has driven exploding medical costs. In other words firs we pay the food industry to make us sick and then we have to pay the medical industry to try and keep us alive. Meanwhile politicians are rewarded for pretty much staying out of their way. Quite a nice arrangement between them if weren't like something out of a bad horror movie.
Perhaps what he also should have warned us about is the Medical and Food Industrial Complex in which food driven causes of sickness and premature death, such as cardiovascular illness, kidney disease, and many forms of cancer have risen dramatically with the obesity epidemic which in turn has driven exploding medical costs. In other words firs we pay the food industry to make us sick and then we have to pay the medical industry to try and keep us alive. Meanwhile politicians are rewarded for pretty much staying out of their way. Quite a nice arrangement between them if weren't like something out of a bad horror movie.
58
Is this really saying that "just say no" is the course follow? Self-limiting, internal control?
2
We are more finely tuned to our environment than we like to think. For example, int the past, the sugar Fructose was only available in the fall when fruits ripened. This natural cycle caused us to gain weight for the coming winter. Now, we've discovered how to extract and refine Fructose, and we add it to foods to make them more desirable. No wonder diabetes and obesity are now epidemic.
The cure is easy. Refined Fructose needs to be thought of like a drug and removed from 80% of our foodstuffs. A calorie is not just a calorie when it is an addictive drug.
Not addictive you say? Try going cold turkey for a couple of weeks.
The cure is easy. Refined Fructose needs to be thought of like a drug and removed from 80% of our foodstuffs. A calorie is not just a calorie when it is an addictive drug.
Not addictive you say? Try going cold turkey for a couple of weeks.
28
We don't like to think we are tuned to our environment, finely or otherwise.
We are humans, we tell ourselves, not animals.
We humans think own the environment, and we try to run it for our supposed profit.
We are humans, we tell ourselves, not animals.
We humans think own the environment, and we try to run it for our supposed profit.
I have to wonder, too, about I have to wonder,too, about the role of sensory deprivation in addiction--in schools and communities where there is little or no opportunity to make or see and hear art, music, theater; in homes where no one cooks, much less grows food; in towns where libraries have shut down or cut their hours. Do some people have fewer receptors because they have grown up with so few sensory pleasures?
43
What people should be asking is -what changes happened in American Society in the past 25 years to engender and precipitate the dangerous levels of obesity and opioid use. I believe it is very important to understand the social and cultural milieu-as well as the physiological changes which may predispose. It is one thing to understand brain changes, dopamine involvement and other parameters related to unhealthy habits but what is going to lead Americans to improve-or better, change the cultural settings in America which can lead to a more satisfying cultural and lifestyle experience.
And the most serious question of all-given that cultural settings are factors and Americans continue to pursue their quest for food and drug pleasure-is there any reason to hope for real change?
And the most serious question of all-given that cultural settings are factors and Americans continue to pursue their quest for food and drug pleasure-is there any reason to hope for real change?
10
The change that has occurred is that we no longer raise generations like the Greatest Generation. We're coddled and protected and soft. During Hurricane Sandy, people were lost without electricity for two weeks. My father grew up on a remote farm that didn't have it available until he was 14 and they couldn't afford it until he had a steady paycheck in the Army four years later. He never felt cheated nor owed something.
2
That farm surely had a well for water, a wood-burning stove for cooking, and oil lamps for light. The typical suburban home is harder to run without electricity. Having said that, I agree not so much that people have become "soft" but that many of us have lost essential skills that would serve us well to recover. These include growing gardens (for those with yards), cooking healthful food from scratch (and freezing or preserving it), home repair, and household and yard maintenance. Being able to do these tasks has numerous benefits. They keep people active and limber, they are satisfying, and they confer a sense of pride. If people would turn off the TV and do just about anything instead they'd be ahead.
1
I find the article interesting but a bit oversimplified.
1) Humans are pleasure seeking animals. If we receive pleasure from something, we persist in that behaviour;
2) The human nervous system is designed to normally experience altered consciousness, i.e., we are biologically designed to "get high", whether through running, sex, or taking drugs. A person who has not/does not experience altered consciousness is a person who is seriously medicated or dead.
There is only one culture in the history of civilisation that has not used psychoactive compounds, the Inuits, and that was because they lacked access to plants.
3) As with other stories in this paper that I have recently commented on, but in all fairness this writer at least alludes to but does not fully articulate, the 600 lb. gorilla in the room that we do not discuss or in any way whatsoever constructively address in this country is SELF MEDICATION. In a society where the provision of health and social services is so costly, haphazard, and tenuous,it should come as no surprise that so many of our fellow citizens find life so painful. What a sad state of affairs, and epidemiologically this is an unprecedented health crisis in the sense that in excess of 90% of these opioids are being prescribed/consumed in the U.S.! I doubt that we Americans share some unique neurochemical pathway that the other 96.5% of humanity does not.
And last but not least, what about cooccurring disorders?
1) Humans are pleasure seeking animals. If we receive pleasure from something, we persist in that behaviour;
2) The human nervous system is designed to normally experience altered consciousness, i.e., we are biologically designed to "get high", whether through running, sex, or taking drugs. A person who has not/does not experience altered consciousness is a person who is seriously medicated or dead.
There is only one culture in the history of civilisation that has not used psychoactive compounds, the Inuits, and that was because they lacked access to plants.
3) As with other stories in this paper that I have recently commented on, but in all fairness this writer at least alludes to but does not fully articulate, the 600 lb. gorilla in the room that we do not discuss or in any way whatsoever constructively address in this country is SELF MEDICATION. In a society where the provision of health and social services is so costly, haphazard, and tenuous,it should come as no surprise that so many of our fellow citizens find life so painful. What a sad state of affairs, and epidemiologically this is an unprecedented health crisis in the sense that in excess of 90% of these opioids are being prescribed/consumed in the U.S.! I doubt that we Americans share some unique neurochemical pathway that the other 96.5% of humanity does not.
And last but not least, what about cooccurring disorders?
17
The problem is a lack of self-discipline and the social acceptance of an entitlement mentality. And no, you don't have to be dead to not pursue pleasure.
1
Republican ideology forbids the obvious solution.
Having worked in most major U.S. and Canadian cities and living in Europe for the past eight years, I continue to be astonished at the level of "recreational" drug use and of obesity in the U.S. It seems obvious that the American working class is under extreme stress. It is an American problem.
As this article makes clear, the solution to the problem lies in stress reduction. However the typical American response is to throw money at a problem, especially if someone can make a buck out of the deal. So the Senate now contemplates devoting billions to fighting the opioid crisis, all of which money will bring big profits to political donors. This money will go to treating the symptoms, but not the disease.
The only viable solution is to reduce the stress on the working class through universal health insurance, job creation and retraining, affordable education, higher wages, etc. such as I have seen in Canada and Europe. But that would require acknowledging that a systemic approach is required, that government intervention is required, that human beings are social animals who live in a society, and it is the society that must be fixed, not only the individual.
Good luck with that!
Having worked in most major U.S. and Canadian cities and living in Europe for the past eight years, I continue to be astonished at the level of "recreational" drug use and of obesity in the U.S. It seems obvious that the American working class is under extreme stress. It is an American problem.
As this article makes clear, the solution to the problem lies in stress reduction. However the typical American response is to throw money at a problem, especially if someone can make a buck out of the deal. So the Senate now contemplates devoting billions to fighting the opioid crisis, all of which money will bring big profits to political donors. This money will go to treating the symptoms, but not the disease.
The only viable solution is to reduce the stress on the working class through universal health insurance, job creation and retraining, affordable education, higher wages, etc. such as I have seen in Canada and Europe. But that would require acknowledging that a systemic approach is required, that government intervention is required, that human beings are social animals who live in a society, and it is the society that must be fixed, not only the individual.
Good luck with that!
218
The problem starts with how our children begin life- parents are severely stressed with trying to work and pay for child care, and maternity leave is severely insufficient. Child care workers are stressed because society's ills show up in the behavior of young children and their jobs typically don't pay a living wage. If we had universal high quality early care would we create a society less susceptible to addiction? Protecting young children from toxic stress (making the well being of young children a top priority) is critically needed in the US.
6
Exactly, the ideology of the Central Committee of the Chinese Communist Party under Chairman (falsely called president) Xi is not so different from the ideology of the Trumpublican Party or the Putin regime.
Why isn't this a NYT Pick?
Hope to influence the editors! :)
Hope to influence the editors! :)
Well said which I can vouch for.
4
We should not underestimate the value of the Humanities -- literature, fine arts, classical music -- in stabilizing our affect by connecting us to a wide, unfolding conversation across generations, shielding us, to some extent at least, from existential angst and personal setbacks. By valuing the Humanities, we are able to value ourselves as members of a thriving humanistic civilization. We participate in a cultural environment that feels collective and meaningful. We "read" ourselves in classical novels, hear ourselves in poetry, see ourselves in Matisse, feel our own emotions in a Chopin Nocturne. When we are stripped of our cultural patrimony through cuts in education and MBA-misguided educational policies, we lose a sense of belonging and self-worth, we turn to shopping, eating, consuming, drugs. Alienated from the humanistic authority of philosophers and artists, we easily believe in the authority of advertisements...
47
Sunspot, works for me and you're absolutely - but I had a strong public school education with teachers free of classroom crowding and a mandate to teach the test, followed by humanities at university, world travels, and natural curiosity about the meaning of things, all encouraged by middle class parents who wanted nothing more than for me to be comfortable in a disquieting, challenging world. Education in America is no longer the spring board for a humanistic life, which unfolds far too slowly for a people obsessed with possessions, wealth, and celebrity. Without addressing the state of education - and I don't mean universal access to a college - we are doomed as a first world nation.
12
Well said. We must somehow restore education as a wellspring for an ordinary humanistic life -- standing up with every fibre of our being to interpretations of happiness based on the pursuit of wealth, possessions, celebrity. I find that students respond well to Montaigne, who says, basically, that simply being a human/humane is the most glorious thing we can ever be. They experience his view as a revelation..
16
Your last sentence sums it up both beautifully and elegantly, thank you.
If the D2 hypothesis were true, then antipsychotics, which block D2, would treat addiction. They do not, and in fact are associated with weight gain. And clinically, eating cookies is not associated with dose escalation, tolerance or criminal behavior. The notion that aberrant reward circuits are related to complex addictive behaviors remains unproven at best.
4
You appear from the article, to have read things backwards. The less D2 the more addiction, the more D2 the less addiction. If antipsychotics block D2 and that leads to weight gain that supports the D2 hypothesis--in other words the blocked D2 leads to dullness, flatness of perception and increases the need to stimulate oneself in some way, such as overeating. Blocked D2 increases addictive tendency, not decreases it. Science should study how much treating a mental patient with antipsychotics is causing a tradeoff, a perhaps increased stabilization of patient but also an increased tendency on part of patient to addiction to substances or food (low D2 receptor situation).
10
Actually not. Dopaminergic antagonists with use lead to up-regulation of post-synaptic DA'ergic receptors. In chronic use, even with 5HTD2's one observes signs of this such as in tardive dyskinesia. Further, therapy with DA agonists does not attenuate addictive behavior. The monoamine theory of stimulus-bound activity is simply outdated and over-simplified.
I don't think that economic challenges are the only, or even necessarily the main, source of the stress these white middle class Americans are experiencing. What has changed dramatically for this group in the past decade or so is family and household composition. The number of men living alone has doubled in the past decade or so. Two-parent households and extended-family households are becoming scarcer, and nothing has arisen yet to replace the support and companionship of these older arrangements. People are more stressed and more likely to be isolated in their stressed condition.
25
Many people have the same addiction to shopping. This is probably evolutionary also. The more materials and supplies you have, the better you can survive. There was a recent article in the real estate section on hoarding. It would be interesting to see if there is an animal equivalence to hoarding.
21
Well yeah, it's called caching, if you've ever had a hamster you know that given infinite access to food they'll cache all of it in their little nests.
1
Oh, good: something ELSE to ban or to tax out of existence -- cookies.
5
Humans are complex creatures, so even if what Dr Friedman says is true it does not necessarily apply to every single human being. I do not have an addictive personality, when the dentist gives me hydrocodone for dental surgery I will take only a few over a couple of days after the surgery.
The rest stay in my refrigerator until my back is killing me and I take a couple to relax the muscles in my back. 10 hydrocodone pills last me 6 months, most likely because another study has shown that some people get pleasure from opiates while others like me only get the pain-killing effect.
Right now I have been unemployed for over 6 months and if I don't find a job soon I may lose my house. So my stress levels are sky high but paradoxically I stopped drinking and using drugs and have started eating less.
Maybe it is that I am Hispanic and my genetic make up is different from the White Americans who lose their jobs and then start eating more and using opiates. And engaging in self-destructive behavior like voting for so-called President Donald Trump.
Dr Friedman, are these studies statistically valid? Are the sample sizes large enough? Are the samples truly randomly selected? All these factors affect whether or not the statistics generated from the sample are valid.
Given some Doctors are generating bogus data to justify their pet theories or to get drugs approved for Big Pharma paying them off I would double- and triple-check these studies to make sure they are not rigged.
The rest stay in my refrigerator until my back is killing me and I take a couple to relax the muscles in my back. 10 hydrocodone pills last me 6 months, most likely because another study has shown that some people get pleasure from opiates while others like me only get the pain-killing effect.
Right now I have been unemployed for over 6 months and if I don't find a job soon I may lose my house. So my stress levels are sky high but paradoxically I stopped drinking and using drugs and have started eating less.
Maybe it is that I am Hispanic and my genetic make up is different from the White Americans who lose their jobs and then start eating more and using opiates. And engaging in self-destructive behavior like voting for so-called President Donald Trump.
Dr Friedman, are these studies statistically valid? Are the sample sizes large enough? Are the samples truly randomly selected? All these factors affect whether or not the statistics generated from the sample are valid.
Given some Doctors are generating bogus data to justify their pet theories or to get drugs approved for Big Pharma paying them off I would double- and triple-check these studies to make sure they are not rigged.
12
You're one person. One person does not validate or invalidate a study, which is pretty close to what you're implying.
9
DO not keep prescription meds in the fridge unless it says to do so on the label. The chemical breakdown of the drugs will speed up every time, so in 2 weeks your hydrocodone 10 mg will have the potency of 8 mg or less.
5
Dr. Volkow has much in the way of education and experience regarding addiction. Her work is spot on and probably less likely to be tainted by Big Pharma, given her role as Director of NIDA.
2
The good doctor doesn't mention that a high percentage of the new opioid addicts start with pills prescribed by doctors...While his research maybe valid, reducing opioid deaths doesn't need fancy research, it needs fewer prescriptions,
14
Insurance pays for treatments that have been well studied and which have shown to give reliable, specific "beneficial" results.
In order to have fewer prescriptions, we need more drug-free options to be covered by insurance.
Instead, the Trumpublican Party is proposing to strip tens of millions of people of their health insurance.
And Big Pharma makes money by selling as much of a product as possible to as many people as possible for as long as possible. In this sense opioids are a gold mine because a person can take opioids for a very long time without damaging her/his non-brain organs...until he or she reaches the toxic level.
In order to have fewer prescriptions, we need more drug-free options to be covered by insurance.
Instead, the Trumpublican Party is proposing to strip tens of millions of people of their health insurance.
And Big Pharma makes money by selling as much of a product as possible to as many people as possible for as long as possible. In this sense opioids are a gold mine because a person can take opioids for a very long time without damaging her/his non-brain organs...until he or she reaches the toxic level.
False meme
Opiates and drugs or food does not cause addiction
The human condition does
Create full lives and supportive communities and addiction stops
Opiates and drugs or food does not cause addiction
The human condition does
Create full lives and supportive communities and addiction stops
Another fantastic NYT piece from Dr. Richard Friedman. Here's another recommended reading from NPR published in 2012 that highlights the powerful effects of environment in addictive behaviors: http://www.npr.org/sections/health-shots/2012/01/02/144431794/what-vietn...
3
"Reward circuit" is a simplified and outmoded concept. The function of the circuit is to stimulate interest and pursuit. More dopamine is released *before* the reinforcing event takes place; it plummets afterward. The circuit is just the process for learning what works and what is worth pursuing -
sugar, scientific discoveries, fame and fortune, close relationships. Drug dependence is a learning disorder. Dopamine Dependence develops after the organism is reinforced by the stimulus.
Dopamine is not a magic bullet. Heroin, cocaine and alcohol are not magical substances that instantly addict haples victims.
Yes, rats will drink too much or stimulate themselves to death with various substances. If they are starkly alone, isolated in a cage in an monotonous, sterile environment, with no prospect for change and nothing else to do. Give them something better to do, and they will only nibble at the forbidden goodies.
Humans, too, will destroy themselves with distracting pleasures, if they have no hope and feel that are not worthy or capable of human connection.
sugar, scientific discoveries, fame and fortune, close relationships. Drug dependence is a learning disorder. Dopamine Dependence develops after the organism is reinforced by the stimulus.
Dopamine is not a magic bullet. Heroin, cocaine and alcohol are not magical substances that instantly addict haples victims.
Yes, rats will drink too much or stimulate themselves to death with various substances. If they are starkly alone, isolated in a cage in an monotonous, sterile environment, with no prospect for change and nothing else to do. Give them something better to do, and they will only nibble at the forbidden goodies.
Humans, too, will destroy themselves with distracting pleasures, if they have no hope and feel that are not worthy or capable of human connection.
9
The article refers to laboratory research on monkeys' use of cocaine to explain human behavior. In light of recent field observations on how chimps seem to change behavior when they are being observed by humans (http://www.bbc.com/news/science-environment-40348890), maybe the behavior of not only observed but imprisoned monkeys should be looked at with some skepticism?
9
The use of imprisoned primates is a problem since all higher primates, including humans, live in social groups in which intra-group stress imposed by alphas on the rest for no other reason to the maintain the social hierarchy is part and parcel of the primate social structure.
This is an excellent piece on addiction. Here in France, addiction among the young is tragically on the upswing among the young and is out of control!
7
This article was truly captivating. It's amazing to learn about the true addictions of a person and how they affect there daily lives. A fascinating fact that I learned was that stress can drive a person to be addicted to something just to feel safe and secure. Another reason why people stay addicted is because of their environment. The article stated that addicts create their own environment and that this environment plays a big role in their addiction. Also another interesting fact was that not only do people get addicted to drugs but also overeating food when they are stressed, sad, depressed, and even happy. This shows that an addict will always have a reason why to keep doing their bad habits.
3
Wow, I must have read a different article because I don't see anywhere where it states that "addicts create their own environment".
Stressors are frequently caused by things outside of our control, i.e., loss of a job, inability to find work, divorce, death. During such periods people turn to "stress relievers" that they find available -- food/drugs because a physical change is occurring -- a decrease in D2 receptors.
It will be interesting to see if this holds up in clinical studies of large numbers of humans.
I might be misreading your comment, but it appears to me that you read into the article what you brought to it -- that addicts are addicts because they refuse to exercise control over their bad habits.
You might want to reread the article again.
Stressors are frequently caused by things outside of our control, i.e., loss of a job, inability to find work, divorce, death. During such periods people turn to "stress relievers" that they find available -- food/drugs because a physical change is occurring -- a decrease in D2 receptors.
It will be interesting to see if this holds up in clinical studies of large numbers of humans.
I might be misreading your comment, but it appears to me that you read into the article what you brought to it -- that addicts are addicts because they refuse to exercise control over their bad habits.
You might want to reread the article again.
7
And where does alcohol fit in?
Also, where does weight gain just by getting older fit in? I think the pace of activity slows down, metabolism slows down, yet consumption stays around the same, maybe based on habit, which must be somehow strongly ingrained.
Also, where does weight gain just by getting older fit in? I think the pace of activity slows down, metabolism slows down, yet consumption stays around the same, maybe based on habit, which must be somehow strongly ingrained.
9
And alcohol is a co-factor in most overdose deaths
Addiction is obviously a complex issue, seemingly having many possible causes...psychological, biological, social, environmental and combinations thereof. The reason people get addicted to drugs, overeating, gambling, smoking, etc. is most likely as varied as the individuals themselves. We have technology now that has allowed us to discover more about the way our brains work than ever before and while we thought that most people's brains were wired similarly, we find that not to be true. That may help in general terms, to explain why one person can do drugs recreationally without getting addicted, while another cannot. And yes, life has become more and more stressful, with our options for relief, more plentiful.
The opioid epidemic started out with prescription narcotics being peddled to doctors by Big Pharma with lucrative incentives and doctors prescribing in great quantities. However, recent state legislation (NJ) has made the problem even worse, by limiting the number of pills a doctor can prescribe per patient to 5 days worth of meds. That and the increased price of pills on the street over time has made the already addicted person turn to a cheaper and more lethal high...that of heroin & now fentanyl. There has to be an understanding of this social problem if we are to make any advances in treatment. It's time to give up the war on drugs and instead, find a compassionate treatment for helping our troubled citizens find their way back to health.
The opioid epidemic started out with prescription narcotics being peddled to doctors by Big Pharma with lucrative incentives and doctors prescribing in great quantities. However, recent state legislation (NJ) has made the problem even worse, by limiting the number of pills a doctor can prescribe per patient to 5 days worth of meds. That and the increased price of pills on the street over time has made the already addicted person turn to a cheaper and more lethal high...that of heroin & now fentanyl. There has to be an understanding of this social problem if we are to make any advances in treatment. It's time to give up the war on drugs and instead, find a compassionate treatment for helping our troubled citizens find their way back to health.
9
A person does not become addicted from a pain medicine prescription
Negative life problems are a necessary factor
Otherwise pain pills are just pain pills
Fix people, don't blame inanimate objects
Negative life problems are a necessary factor
Otherwise pain pills are just pain pills
Fix people, don't blame inanimate objects
So much learned, so much more to learn. I look forward to the new research on subliminal (and overt) advertising and it seems likely the conclusion will be that we should all avoid video based advertisements.
3
This is truly interesting science. The comments about insulin, addiction,etc. overeating, results of stress on humans make me realize what complicated things we mortals are! Now, what about the gut, satiety,etc. If I drink more than two drinks of alcohol, I get sick, but friends in programs tell me they could drink for days. Some friends are addicts and some are not. Clearly there is a lot more science to this to learn. But it seems for the present, we should be more empathetic until we know what we think we know.
9
I am a practicing attorney. As of last week, 27 clients have died from overdoses since 2008. Three attorney friends of mine have lost adult children to heroin in the last four years.
23
I lived in West Springfield MA for six months in 2005. I remember driving around and thinking, if I were a young adult here, I would be on drugs. The place is so physically run down, I once saw too three story wooden apartment buildings that had literally collapsed onto each other. Deserted factories were all over the place. As I was leaving the big event was the opening of a Starbucks. You could see that the town's heyday was in the 1950's. Like so many other areas in New England, the factories went to the South and are now leaving the South for Asia.
If you were an 18 year old what would you do? The only jobs were retail or fast food. Another option was the Army.
If you take an addicted kid out of Springfield and treat him or her for addiction and put him back in Springfield guess what will happen?
If you were an 18 year old what would you do? The only jobs were retail or fast food. Another option was the Army.
If you take an addicted kid out of Springfield and treat him or her for addiction and put him back in Springfield guess what will happen?
1
I am so sorry that you have been so personally affected.
Wow. That's just beyond comprehension. I am so sorry.
Good start here: environment plays a significant role in addiction. This we know to be true. The article would have had a stronger finish had the author revised his ending paragraph, noting that we can control our genes: they too respond— turn on or off— depending on environmental factors.
5
In terms of obesity, there are some factors that have nothing to do with genetics and little to do with present environment. For an equaling fascinating read, see
The Body Keeps The Score by Bessel Van Der Kolk, a study on trauma and its devastating impact on identity and behavior. (Thank You, Suzanne for this.)
The Body Keeps The Score by Bessel Van Der Kolk, a study on trauma and its devastating impact on identity and behavior. (Thank You, Suzanne for this.)
7
The happiest man science has ever identified (through brain imaging) was focused on compassion. Go out and do something good for your fellow man and you won’t need to eat cookies or take addictive drugs. Mother Teresa had no material possessions and by all accounts found great joy in her work and her mission. Become addicted to compassion!!
47
And yet we just elected one of the least compassionate humans the Earth has every known as our leader.
5
PERFECT!!! William M, from a fellow Scotch Plains, NJ, person
1
If all of this was true then rates of addiction would not vary by country nor vary by race - spend two secs looking at actual opioid addiction data by country and by race and you will find the fly in the ointment of this particular hypothesis.
Any wagers on who has the higher rate of abuse?
USA vs. Switzerland vs. UK?
Any wagers on who has the higher rate of abuse?
USA vs. Switzerland vs. UK?
2
Apparently you missed the part where he explained the effect the environment can have on D2 receptors. It makes sense that different countries have different rates of addiction since they provide different environments and different levels of access. Similarly, when people are segregated by race (as they often are), people within a country can live in vastly different environments.
6
I don't follow your point. The article is saying that environment, including perceived status, level of stress, job security, etc.--affects the likelihood of being addicted. So, there should be variation in addiction rates as environments vary from country to country and race to race, as indeed they do.
6
List of countries by prevalence of opiates use From Wikipedia, the free encyclopedia:
Rank Country % prevalence* (Year)
16 United Kingdom 0.73 2012
24 Switzerland 0.6 2000
27 United States 0.57 2009
* Percentage of population who have consumed the drugs at least once in the past year.
So what's your point?
Rank Country % prevalence* (Year)
16 United Kingdom 0.73 2012
24 Switzerland 0.6 2000
27 United States 0.57 2009
* Percentage of population who have consumed the drugs at least once in the past year.
So what's your point?
1
Next time you're in the supermarket cereal aisle, notice how many sugar cereals there are. In my market, they're about half divided between sugar-added cereals with their bright colors added, and normal cereals with no sugar or artificial colors. And this market has chosen to arrange them this way. The half of the shelves on the right are flakes, puffs, shredded grains, all natural and healthy. The half on the left is a riot of oranges, purples, yellows, and reds, soaked in sugar.
Who buys the sugar cereals? Parents do. At least my parents sometimes did when we whined enough. But so do other adults who just enjoy getting another does of sugar to "feel good". Remember the standard joke on 'Seinfeld' where Jerry turned to cereal so often, and the cereal shelves were visible in nearly every episode? It wasn't shredded wheat, I suspect. That sort of sugar consumption to feel better was becoming far more common in the era of that show, the 1990s, but it began much earlier as the Baby Boomers were growing up and being treated by harried parents with sugar cereals.
What the federal government could do is to require more than its present ingredients labels. It could require marking all packaged foods with an indicator of amount of sugar added. Sugar is now routinely one of the primary ingredients added to many foods. Read the labels, and avoid them. I've stopped sifting a spoonful of sugar onto my breakfast cereal. It's not needed once you lose your sugar craving.
Who buys the sugar cereals? Parents do. At least my parents sometimes did when we whined enough. But so do other adults who just enjoy getting another does of sugar to "feel good". Remember the standard joke on 'Seinfeld' where Jerry turned to cereal so often, and the cereal shelves were visible in nearly every episode? It wasn't shredded wheat, I suspect. That sort of sugar consumption to feel better was becoming far more common in the era of that show, the 1990s, but it began much earlier as the Baby Boomers were growing up and being treated by harried parents with sugar cereals.
What the federal government could do is to require more than its present ingredients labels. It could require marking all packaged foods with an indicator of amount of sugar added. Sugar is now routinely one of the primary ingredients added to many foods. Read the labels, and avoid them. I've stopped sifting a spoonful of sugar onto my breakfast cereal. It's not needed once you lose your sugar craving.
13
Great point, however, there is an added layer that you might not even realize. Breakfast cereal, as a concept, isn't particularly healthy at all. Most cereals, including the "healthy ones" are a mega dose of highly processed carbohydrates. What's more, you're encouraged to eat it with skim milk, which is highly processed nutritionally diminished sugar water. Like so many things in our modern world we are left patting our backs for making "healthy choices" that are far two often simply the lesser of two evils.
9
I put a cap on cereals, max 8gr sugar, kids end up eating more. It's all about reaching the bliss point for them.
Anyhow, what is the purpose of the article, educate, scare, denounce?
Anyhow, what is the purpose of the article, educate, scare, denounce?
We know where opioids come from, pharmaceutical companies. They aren't smuggled in or grown in the woods reconditely. So why aren't production and prescriptions more tightly controlled? We should follow the money.
15
Anonymous Lake Orion, Michigan you bring up an excellent point. Physician friends have sarcastically noted that the motto of the pharmaceutical companies is Make a need and Fill it!
NPR NYTimes have done many pieces that note the pharmaceutical companies using FDA data encouraged doctors to prescribe heavy pain meds, and it was only after an outcry to the FDA demonstrated how addictive Oxicodone was that it now carries a warning 'High risk for addiction and dependence. Can cause respiratory distress and death when taken in high doses or when combined with other substances, especially alcohol.'
But just as physicians get very little training in nutrition it seems they get very little training in addiction as well.
NPR NYTimes have done many pieces that note the pharmaceutical companies using FDA data encouraged doctors to prescribe heavy pain meds, and it was only after an outcry to the FDA demonstrated how addictive Oxicodone was that it now carries a warning 'High risk for addiction and dependence. Can cause respiratory distress and death when taken in high doses or when combined with other substances, especially alcohol.'
But just as physicians get very little training in nutrition it seems they get very little training in addiction as well.
>"Even the most self-disciplined can fall prey to a food or drug addiction under the right mix of adversity and stress."<
He presents zero empirical evidence that this is true (because there is none). I believe there is a significant percentage of the population that would not "fall prey" to addiction regardless of adversity or stress. What is presented here is a piece of the puzzle, but it surely is not the whole picture.
He presents zero empirical evidence that this is true (because there is none). I believe there is a significant percentage of the population that would not "fall prey" to addiction regardless of adversity or stress. What is presented here is a piece of the puzzle, but it surely is not the whole picture.
6
What type of person do you think might never fall prey to addiction? What would be the basis that protects them?
Buddhist monks and nuns, orthodox Christian monks and nun who live somewhat cloistered lives don't seem to have addition issues and some studies suggest its because of a sense of community. a support system which creates less stress and fear.
3
If I lost my job, my family, and/or my home, I don't know that I wouldn't be susceptible to addiction.
2
The ancient Greeks said Prometheus gave humankind, along with foresight, the gift of opium; and the god Dionysus gave mortals wine.
Cannabis or bhang was given to the ancient Indians (so they have believed since Vedic times) by the Mahasheva or great god Shiva.
Native Americans used peyote to commune with the Great Spirit.
Cannabis seeds have even been found in Neanderthal graves!
And alcohol, said William James, is the poor man's mysticism.
My point is that different cultures have been using psycho-active substances continually since pre-historic times. To posit a "drug using" versus a "healthy" lifestyle is a contrived & artificial dichotomy.
Having said that, any truly scientific research in this field should be welcomed, considering how fear and irrationality seem to rule it now.
Cannabis or bhang was given to the ancient Indians (so they have believed since Vedic times) by the Mahasheva or great god Shiva.
Native Americans used peyote to commune with the Great Spirit.
Cannabis seeds have even been found in Neanderthal graves!
And alcohol, said William James, is the poor man's mysticism.
My point is that different cultures have been using psycho-active substances continually since pre-historic times. To posit a "drug using" versus a "healthy" lifestyle is a contrived & artificial dichotomy.
Having said that, any truly scientific research in this field should be welcomed, considering how fear and irrationality seem to rule it now.
15
Bam! Three points to you.
Big Pharna: Start your engines! The race to create DopeUp, a D2 receptor up-regulator, is now on! So much more practical than actually reducing economic and status anxiety.
PS, as my contribution to public welfare, I hereby gift my "DopeUp" trademark rights to the public domain.
PS, as my contribution to public welfare, I hereby gift my "DopeUp" trademark rights to the public domain.
18
In all that has been written about this epidemic, I have not read anything about how these deaths will impact society in the long term. I.e. The effect on the gene pool......it seems logical to me that 60,000 deaths annually will have some long term effect? The question will be what.
4
David B Sonoma, Darwin's survival of the fittest?
We were having a heady discussion the other day about how since time began nature allowed the weak to die in order to strengthen the gene pool.
Then mankind in the quest to play god decided to tweak nature and now we have Narcan™ an opiate antidote for those who choose to use heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin even though they know they shouldn't and yet they overdose over and over and over.
We were having a heady discussion the other day about how since time began nature allowed the weak to die in order to strengthen the gene pool.
Then mankind in the quest to play god decided to tweak nature and now we have Narcan™ an opiate antidote for those who choose to use heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin even though they know they shouldn't and yet they overdose over and over and over.
1
60,000 annually
A drop in the bucket
A drop in the bucket
It would be interesting to get a D2 reading from our Dear Leader. His lack of impulse control and prediliction for fast food seems to bear out many of the signs for low D2.
15
That's me on cookies!
5
So it may be that the answer to addictions of various kinds, besides limited our exposure to high-calorie foods and recreational drugs, is to seek out or create situations where we get lots of social goodies. All those old bowling leagues, lodge meetings, church groups, Thursday night socials, McDonalds breakfast groups, etc, that proliferated until a couple of decades ago were also responsible for helping us to remain healthy. It sounds so simple, but perhaps -- for those who have the time and energy -- getting out the door and volunteering or joining a group that really matters to you is another part of the health equation.
26
Nancy in London you are spot on with your observation!! A sense of community, neighborhood provided accountability, encouragement and a sense of purpose. Now it seems with social media people look at a screen and text, and never have any real interaction with another person.
Which makes me think its also why people who text all the time tend to feel so powerless and lost and tend to lash out and say things online folks in past generations would never have needed to say because they had a community who did care.
Which makes me think its also why people who text all the time tend to feel so powerless and lost and tend to lash out and say things online folks in past generations would never have needed to say because they had a community who did care.
I discovered Cummings work with the genetic transmission of potential for addiction (D2A1 allele) when I wrote "She Bets Her Life," my book on women and gambling addiction. His research is compelling and his findings illustrate the power of dopamine transmission malfunction in the addict brain. To accept that is to understand that addiction is not a "moral" failure, and to fully grasp how hard it is for an addiction to "just quit." An addict will always have an addictive brain, but we can learn how to live with that difficult truth. I believe that the 12-step programs are one of the ways to not use and continue not using. They allow the clean addict's brain to heal as much as is possible.
9
For those seeking an alternative to the 12-steps, there are science-based programs like SMART Recovery.
1
I agree with many of the statements on dopamine and drug addiction. But to make the leap from drugs to food requires more than just dopamine analogies. You can't talk about food addiction without talking about insulin. That would be to ignore a large body of published evidence that links sugars and things that trigger an insulin response to overeating. So to put sugar and all fat in the same category is evolutionarily unwise here. Which fats you're talking about are important. Calories alone do not cause obesity, the New York Times has published multiple articles on this in the last years...
3
This problem seems to be grounded in our consumer culture. American society as a whole is addicted to being made happy and excited. Everything gets caught up in this: social media, internet shopping, consumption of news, of music, travel, even education. Everything is gulped down too fast to actually savor and appreciate it - then it's back to checking Facebook again, to making sure we haven't missed something. This is the real power behind the NRA. Violence is part of our cultural addiction.
We've even elected a president whose drastic governance and tweeting provides unceasing "entertainment" by which I mean that the president has created a new addiction - the unquenchable desire to keep up with his latest outrageous behavior. No wonder his popularity doesn't suffer - we're all addicted to the dopamine rush his daily tweets and bad behavior provides us.
We've even elected a president whose drastic governance and tweeting provides unceasing "entertainment" by which I mean that the president has created a new addiction - the unquenchable desire to keep up with his latest outrageous behavior. No wonder his popularity doesn't suffer - we're all addicted to the dopamine rush his daily tweets and bad behavior provides us.
16
It is amazing to me that when non-white people are addicted to drugs they are criminalized, while when white people are addicted, here come the studies that show that stress can tilt a person toward addiction. Excuse me, when are we going to wake up to the incredible stressors- economic and physical- that many non-white Americans live with, and have lived with for decades. When are we going to include this population in our empathy and understanding as well?
142
I've been thinking about this with the disparate responses to the crack epidemic and the opioid epidemic (also the mentally ill loner vs. the muslim terrorist). There seems to be concern and sympathy and empathy for crises for white people, but minorities have poor family structures or weak morality or are uncivilized. I wish that our society could see all its members as fully human.
1
So true: the mental toll of poverty is an untold story
"But studies of monkeys suggest that our environment can trump genetics and rewire the brain. The good news is that while we can’t change our genetics, we can change our environment."
When I was 14, I worked for a summer in a suburb of Chicago, taking care of a family's children. It was my first time being away from home. The husband and wife took many trips, leaving me to care for their 5 and 3 year old kids at their home. I was terrified. It was also the summer of the Charles Manson killings so of course, a 14 yr. old's imagination running wild coupled with being away from her mother led me to find the only solace I could - sugar, i.e., ice cream, chocolate, cookies, anything and everything I could find. Some how I survived that ordeal, but when I returned home, I was 30 pounds heavier. My mother could not believe her eyes. Since that summer and to this day, I struggle with weight issues and a daily internal battle over sugar. I realize that feelings such as fear, insecurity, and depression are constant triggers for my sugar addiction, but I also realize that once I can truly overcome these demonstrative emotions, the sugar addiction and my weight issues will slowly but surely subside. That old saying, "mind over matter" is a mantra I tell myself on a daily basis. I also know that if I stay clear of sugar, that addictive gene will not kick in because sugar is the spark and the match to that internal fire I fight every day of my life.
26
I'm sorry that you were put in a situation that caused you so much stress. Even adults have difficulty single parenting young children; for you as a 14 year old, no matter how experienced or independent, it must have been overwhelming.
6
Thank you for your kind words Leonardo. Looking back, I had no idea what I was in for. Had I known the oldest child had major learning disabilities and that the woman was 6 months pregnant, I would never had taken the job. I'm sure my mother would not have allowed it either. Oh well, live and learn I guess. Thanks again for your thoughtful post.
2
I babysat for my aunt's kids when I was 14; we all lived on my grandfather's ranch, so it was a natural thing. However, I did not babysit for any kids whose parents were gone on vacation. I would never have been allowed to travel to another place or town to babysit at 14. There is a missing piece in your story: why were you traveling away from home to babysit at 14?
1
Long after I parted ways with alcohol, tobacco (gratefully, no firearms!) and overeating at meals, I am still battling with sweetened foods, breads and caffeine. I think food attachment in childhood becomes food addiction in adulthood. My attachment to spicy Neapolitan spaghetti sauce in my mother's kitchen was definitely an early trigger. Fresh bread from Costanzo's in Buffalo dipped in that thick, sweet onion-drenched sauce was a Saturday ritual. Then there were Snickers bars and above all Sky bars. Those two attachments destroyed my on-off switch.
Yet your article has great merit. I have only binged a few times since last year, but they all stemmed from the constant barrage of bad news here and abroad. I eat my fears in those cases. The result is a severe migraine. I have wonderful help from a homeopath who is helping me edge away from bad food choices and also with anxiety. I can't change the outside but I can work at changing my inside — it's that simple.
Yet your article has great merit. I have only binged a few times since last year, but they all stemmed from the constant barrage of bad news here and abroad. I eat my fears in those cases. The result is a severe migraine. I have wonderful help from a homeopath who is helping me edge away from bad food choices and also with anxiety. I can't change the outside but I can work at changing my inside — it's that simple.
17
I was about 20 pounds overweight for years. I finally lost the weight. My prescription? Eat exactly what you want. Eat the most delicious and satisfying food you can think of. But eat small portions. Also, it helps to avoid already-prepared food. If you have to actually prepare whatever you're going to eat, sheer laziness is likely to prevent obesity.
7
Let food be your Medicine
and Medicine be your food
and Medicine be your food
"What Cookies and Meth Have in Common" By Richard A. Friedman
The article's title truly intrigued me because I was very curious to see how Richard A. Friedman compared cookies to drug addiction. The first connection that I agreed with is that people who are more stressed are prone to addiction. I understand the phrase 'comfort food' which offers solace in people who are stressed. Friedman mentioned how the environment influences our stress level. If people can change to a more peaceful environment then they will hopefully feel less stressed. Another similarity, is that the brain releases dopamine which tells the brain that " this is important", which is common in both people that take drugs or are addicted to food. Some people have a reward circuit that is wired to food like cookies or candy, while others are wired to drugs. I may not be obese, but I certainly do have a food addiction. During times or stress when I have too much homework or too much studying, I go straight to my food cabinet and start eating. This helps me take my mind off of all of the stress that is going on. It is very difficult for anyone to have self-control all the time. I agree with Friedman with comparing drug addiction to cookies because drug and food addictions both could potentially have harmful outcomes, because both can damage your body and could eventually lead to death.
The article's title truly intrigued me because I was very curious to see how Richard A. Friedman compared cookies to drug addiction. The first connection that I agreed with is that people who are more stressed are prone to addiction. I understand the phrase 'comfort food' which offers solace in people who are stressed. Friedman mentioned how the environment influences our stress level. If people can change to a more peaceful environment then they will hopefully feel less stressed. Another similarity, is that the brain releases dopamine which tells the brain that " this is important", which is common in both people that take drugs or are addicted to food. Some people have a reward circuit that is wired to food like cookies or candy, while others are wired to drugs. I may not be obese, but I certainly do have a food addiction. During times or stress when I have too much homework or too much studying, I go straight to my food cabinet and start eating. This helps me take my mind off of all of the stress that is going on. It is very difficult for anyone to have self-control all the time. I agree with Friedman with comparing drug addiction to cookies because drug and food addictions both could potentially have harmful outcomes, because both can damage your body and could eventually lead to death.
6
I'm glad to see an article that plumbs both the biological and behavioral (environmental) aspects of addiction.
Not so an opinion piece in last Sunday's Globe, "Addiction is not a disease" which resurrected the old "moral failing" argument that anyone who wants to stop can, which is proof positive that the disease model of addiction doesn't exist.
As an example, the authors (both psychologists) maintained how say, people with an alcohol problem could easily stop provided there was sufficient incentive from a spouse's ultimatum, an upcoming wedding or graduation, etc.
Anyone recovering from alcoholism would likely challenge that fact, learning from experience that people with drinking problems can stop for awhile. It's the "staying stopped" that causes the problems, particularly when the stressors you cite in this article reappear in all their ugly formations, allowing people to let down their guards until they once again reached the point of no choice.
Not so an opinion piece in last Sunday's Globe, "Addiction is not a disease" which resurrected the old "moral failing" argument that anyone who wants to stop can, which is proof positive that the disease model of addiction doesn't exist.
As an example, the authors (both psychologists) maintained how say, people with an alcohol problem could easily stop provided there was sufficient incentive from a spouse's ultimatum, an upcoming wedding or graduation, etc.
Anyone recovering from alcoholism would likely challenge that fact, learning from experience that people with drinking problems can stop for awhile. It's the "staying stopped" that causes the problems, particularly when the stressors you cite in this article reappear in all their ugly formations, allowing people to let down their guards until they once again reached the point of no choice.
12
The research cited in this article disproves the false assumption that addiction is a moral failing. If addiction is a brain based illness that can be ameliorated by altering stressful environments, then it behooves our society to address the underlying causes: poverty, chronic unemployment, homelessness, food insecurity, violence, and institutional racism. Criminalizing addiction and shaming those who suffer only exacerbate the problem.
38
It would also help if community centers were readily available with opportunities for athletic activities, contact with the arts and other stress-reducing, addiction-prevention environments.
Because I live in a political atmosphere, I look at this information from that perspective. The slippery slide of so many formerly middle-class Americans with stable families and good jobs into the edge of poverty wrought by the greed economy has, in the language of Dr. Friedman, led many Americans to use junk food and dangerous drugs to comfort themselves.
My question is, would a political sea change in which we revert to a fairer economy with good jobs and stable families turn these same Americans away from junk food obesity and dangerous drugs?
We are not those monkeys in the experiments and our lives are much more complex than simply moving from a single cage to a group cage, but I wonder if the hypothesis still holds true.
My hope for a return to a fair economy with a stable social safety net would be the ultimate test of Dr. Friedman's ideas.
My question is, would a political sea change in which we revert to a fairer economy with good jobs and stable families turn these same Americans away from junk food obesity and dangerous drugs?
We are not those monkeys in the experiments and our lives are much more complex than simply moving from a single cage to a group cage, but I wonder if the hypothesis still holds true.
My hope for a return to a fair economy with a stable social safety net would be the ultimate test of Dr. Friedman's ideas.
19
The Big Food/Big Pharma complex coupled with massive socioeconomic inequality: monkeys in a cage indeed.
I get just a few words here, so I'll focus on Big Pharma. Oxycontin and other drugs were designed by Big Pharma and initially marketed as relatively safe and non-addictive. Drug pushers (pharmaceutical sales reps) are sent, as we're all aware, to many of our doctors' waiting rooms, and one would need to be very naive to imagine that Big Pharma didn't measure the efficacy of this practice. We should stop it: make it illegal. If we give extra penalties for pushing drugs near schools, how about similar consideration regarding our healthcare system?
I despise seeing charts on examining room walls with drug ads on them. I hate seeing professional medical journals packed with drugs ads.
Television and magazines are packed with drug ads--not just addictive drugs, though they're the most obviously dangerous. Prescription drugs should not be advertised directly to the public at all.
Drug company payments to doctors should be reported (Big Pharma is trying to stop this requirement).
Side effects? No one is required to report the adverse effects of prescription drugs. This article writes about D2 levels, but doctors don't report this to the F.D.A. I assume. They're not required to nor paid to.
Big Pharma/Big Food have huge lobbies. Pharma has 2 lobbyists for every congressperson. Of course the laws are bad. So much more to say. Statinvictims.com.
I get just a few words here, so I'll focus on Big Pharma. Oxycontin and other drugs were designed by Big Pharma and initially marketed as relatively safe and non-addictive. Drug pushers (pharmaceutical sales reps) are sent, as we're all aware, to many of our doctors' waiting rooms, and one would need to be very naive to imagine that Big Pharma didn't measure the efficacy of this practice. We should stop it: make it illegal. If we give extra penalties for pushing drugs near schools, how about similar consideration regarding our healthcare system?
I despise seeing charts on examining room walls with drug ads on them. I hate seeing professional medical journals packed with drugs ads.
Television and magazines are packed with drug ads--not just addictive drugs, though they're the most obviously dangerous. Prescription drugs should not be advertised directly to the public at all.
Drug company payments to doctors should be reported (Big Pharma is trying to stop this requirement).
Side effects? No one is required to report the adverse effects of prescription drugs. This article writes about D2 levels, but doctors don't report this to the F.D.A. I assume. They're not required to nor paid to.
Big Pharma/Big Food have huge lobbies. Pharma has 2 lobbyists for every congressperson. Of course the laws are bad. So much more to say. Statinvictims.com.
40
Excellent and well-observed ! Thanks for your comment.
6
The research results cited in this article strike me as very helpful and useful, but not as surprising. Controlling the environment is critical to managing a wide range of existing addictions, as anyone who sticks to a healthy diet probably knows--the key is not having unhealthy food in the house, or easily available elsewhere. Controlled environments in rehab centers are absolutely necessary to their work. The "new" recognition is that a better environment prevents addictions from developing in the first place. Any number of 19th century social reformers, across a spectrum of political views, believed this! In our day, a lower-stress environment is critical to raising sane kids, healing from mental illness, staying healthy as we age and successfully managing chronic disease. It sounds boring, but it works. If there's a surprise in this research, it's that the mainstream culture (medical and otherwise) is finally officially acknowledging that when middle class and working class white people are forced to live with chronic serious stress--joblessness, lack of access to medical care, family instability, hunger--one of the prominent results is a higher rate of addictions, and in particular of serious addictions that have wide-ranging impacts on others. Previously, the bulk of working- and middle-class white folks were privileged enough to have the benefits of status, which can protect against the development of addictions (as cited in the article.) The context here is societal.
4
Good article. It seems to give further reason for some Americans to seek environments in alternative American communities where, for example, top media stories may not be so laden with frequent messages of fear, panic or worry. A major biological connection not addressed in this article is to the other fundamental aspect of resilient mental health: the gut micro-biome and naturally-produced seratonin.
4
So while the author is correct to note that we have stronger recreational drugs today, this is primarily due to prohibition and less about cultural preferences. Drug prohibition forces the black market to create powerful drugs in highly concentrated forms to lower supplier risk (it's easier to transport and sell smaller quantities of a drug).
20
Yeah. What ever happened to opium?
I believe a lot of stress is coming from crowding,caused by unlimited immigration.There must be a reason,that in the past, there were limits on immigration.
2
First off, we've not had "unlimited immigration" -- that is a myth. In fact, there are and have been all kinds of limits (natural and artificial) on immigration. Secondly, our population density is not nearly as high as other places that have NOT had the kinds of social problems that we have had. Lastly, the immigration controls that we have had in the past (since you point out that there must be a reason for them), have had (as in 1920) everything to do with our hostility to certain ethnic groups -- think also of the Chinese Exclusion Act. In other words, it's the mindless racism that we refuse to let go of that is the problem, not the immigrants themselves. As an Anglo-Saxon white male I am embarrassed for and ashamed of many of my fellow whites who stubbornly cling to their prejudices even though they themselves and the society of which they are a part are damaged by it.
6
There were a lot more people immigrating to to US 100 to 150 years ago than there are now. Also, compared to other places on the planet, we'r far from overcrowded.
3
I think your addicted to yourself. Those immigrants you are so concerned about would probably be less of a problem for you if you shared more of what you have and who you are. You might find your D2 count going up and your stress level going down.
Let us not be coy. Posting here is an addiction too.
32
I have a friend who, I am sure, is opioid addict. We have been off - and- on friends for over 30 years. He is very verbally volatile with a short, short fuse; however, he will go along for weeks being quite charming and cooperative which is probably why I bother trying to keep tabs on him at all. But here is the mystery.
He is a professional man who works hard, dependably and is respected by all who know him through work.
The rest of his life is pure chaos.
I do not pretend that my friend is "being all that he can be" but he not a danger to himself or others. How much better to save our moral and financial resources for those who are helpless.
He is a professional man who works hard, dependably and is respected by all who know him through work.
The rest of his life is pure chaos.
I do not pretend that my friend is "being all that he can be" but he not a danger to himself or others. How much better to save our moral and financial resources for those who are helpless.
6
Aloha! As a member of the first consumer cooperative fitness center in the U.S., partnered with our local medical community, we have seen over and over, that SMART cooperative (non-competitive) exercise classes, three times per week, naturally train the body and mind to REJECT ingesting poisons (processed foods/drugs).
9
We're with you Grif.
Interesting article, dealing with addiction in the best (medical) context. HOWEVER, this also exposes the horrible truth about our society's attitude and "take" on drug use and abuse (and there IS a difference!). It's a HEALTH issue, NOT a criminal issue, and should be dealt with by putting our (dwindling) resources into health services, not "law enforcement". Portugal made this seismic social change in 2002 (!), and vastly improved their society in the process. You won't read about their success in our "information delivery system" (once referred to as the news media). But that is the ONLY road to successfully dealing with this issue. Do your own research.
24
Thank you Dr. Friedman. In the meantime, the relations between bad economics, stress and addiction has always been obvious to anyone with common sense. What has also been obvious is that the reason this is not said often enough is that it shows how our profit way of doing business has had a rotten effect on all concerned. As one of the greatest thinkers has said: jobs should be for usefulness not profit. The remaining question is how long will it take before those who dominate our economic system finally admit they were wrong and stop trying to impede the change from profit to useful economics? How long will people have to keep suffering before some of us change our ways or finally be pushed aside?
4
Life in a country that purports to seek happiness with guns, bluster and bullying is one crazy-making experience.
68
My "take-away" is different from John's. Mass addictive behavior, such as our current epidemics of opioid addiction and obesity, is a symptom of a diseased society. The history of over-consumption of sweeteners, in particular sugar, is strongly linked to the history of working in America, and our food economy today is totally out of whack. Stress, the availability of (some) foods, the unavailability of alternatives (not only foods, but also housing, education, the arts ...) all play into the degradation of our lives.
29
I have always said that all addictions are different symptoms of the same disease - eating disorders, drugs, alcohol, cigarettes etc. I am tired of the condescension and judgement I see placed on those with opioid addiction as that just perpetuates the problem by isolating them more. Many of those proclaiming what they perceive as moral failings in opioid addicts are themselves obese, alcoholic or smoke several packs of cigarettes a day. People in glass houses should not throw stones. Until we as a society face that the opioid epidemic is OUR problem we will not solve it.
51
What astonishes me, given the overabundance of drugs accepted by our culture (alcohol, processed sugars, nicotine) compounded by the relatively 'new' overabundance of drugs now being pushed on us by Big Pharma and too many doctors, apparently, that more are not addicted to *some* substance or other. To point a finger of blame at the person imbibing addictive substances misses the point, since one person's neural receptors are not the reason Big Pharma and Big Ag produce substances one can become addicted to in the first place; they overproduce those substances because there's money in it, big money. I personally have never had a doctor willing to prescribe an opioid substance to me for more than perhaps a week's worth, and I know what it's like to go cold turkey off of processed sugars, since I did that about 10 years ago. I don't know what it's like to be addicted to alcohol, since I assiduously avoided alcohol after my father died at the age of 48 to alcohol poisoning. I also never developed an addiction to nicotine, since both my parents smoked 2-5 packs a day and watching them smoke and trying to breathe clean air was enough of a lesson. Even so, there is no way in the world I would ever equate addiction to these substances as a moral failing, nor can these substances be avoided by living a densely-packed life of attending plays, reading, and going to museums. Depression and addiction are not so easily cured.
I used to tell people that I had quit smoking, quit drinking and quit drugs but that now I had an oatmeal cookie problem. I thought it was funny. I now realize it is not. I could have the most elaborate dessert at a restaurant and still come home and have oatmeal cookies and milk. I am not overweight, but it is clear that I was powerless over this decades-long habit. It was certainly not as destructive as nicotine, alcohol, and drugs, but it was, and is, still an addiction.
160
How do you know your cookie addiction hasn't been as destructive as nicotine or alcohol? Half the people of "normal" weight are on the path to developing fatty liver disease and metabolic syndrome--it's as many people as are obese. Sugar has no doubt caused inflammation, increased your levels of bad LDL cholesterol and put you at long term risk of cardiovascular disease. Your gums probably aren't as full as they would have been either. Sugar and other fiberless carbs are slow poisons, in ways we don't see until it's too late.
5
I would say that it is more like a well formed habit. You also brush your teeth every night before you go to bed but you don't call it an addiction.
1
Hoping to be helpful here. Sugar has been discovered to be as addictive to the brain as cocaine. Likely the issue at hand is the sugar in the cookies.
2
My favorite line
"There was no flourless chocolate cake on the savanna."
This is why I don't live in the savanna.
"There was no flourless chocolate cake on the savanna."
This is why I don't live in the savanna.
13
While Dr. Friedman poses interesting challenges, his conclusions involve the same confusions that make physicalism inherently incoherent.
What is the cause of our behavior?
Or for that matter, the cause of anything?
When you make a series of observations about how things fall, no matter how much you dress up those observations in fancy language, an observation is not an explanation.
Why do apples fall? Because of gravity. What is gravity? It's what makes apples fall.
If you look at virtually all scientific explanations, they amount to no more than this. Nobel Prize winner Steven Weinberg admitted as much (though with much scowling and obvious irritation) at the conclusion of his 2003 essay, "Does Science Explain Everything? Anything"
It's the same with these neurological explanations. Receptors, transmitters, etc - these are not "causes." Even when you have a traumatic brain injury, you're still only observing correlations between cognitive deficits and the condition of the brain.
This sounds like absolute moonshine if you haven't thought this through. It took me 17 years (starting in 1970) to "get" this. But it's the same with laws of nature, emergence, etc.
Ultimately, it comes down to a question of what "will" (sometimes absurdly called 'free' will) is.
If you identify wholly with a mind-body organism which is wholly encased within a cause-and-effect world, whatever you believe, you are a slave.
But freedom is possible.
www.remember-to-breathe.org
What is the cause of our behavior?
Or for that matter, the cause of anything?
When you make a series of observations about how things fall, no matter how much you dress up those observations in fancy language, an observation is not an explanation.
Why do apples fall? Because of gravity. What is gravity? It's what makes apples fall.
If you look at virtually all scientific explanations, they amount to no more than this. Nobel Prize winner Steven Weinberg admitted as much (though with much scowling and obvious irritation) at the conclusion of his 2003 essay, "Does Science Explain Everything? Anything"
It's the same with these neurological explanations. Receptors, transmitters, etc - these are not "causes." Even when you have a traumatic brain injury, you're still only observing correlations between cognitive deficits and the condition of the brain.
This sounds like absolute moonshine if you haven't thought this through. It took me 17 years (starting in 1970) to "get" this. But it's the same with laws of nature, emergence, etc.
Ultimately, it comes down to a question of what "will" (sometimes absurdly called 'free' will) is.
If you identify wholly with a mind-body organism which is wholly encased within a cause-and-effect world, whatever you believe, you are a slave.
But freedom is possible.
www.remember-to-breathe.org
2
You state “Today, the more D2 receptors you have, the higher your natural level of stimulation and pleasure.” But, you also state that Volkow found that subjects with fewer D2 receptors experienced the stimulant drug Ritalin as pleasurable. These two sentences are in apparent conflict.
The apparent paradox has been resolved as follows. The dopamine D2 receptor can exist in either a state of low affinity for dopamine-like stimulants or in a state of high affinity for dopamine-like stimulants. The functional state of the D2 receptor is the high-affinity state, known as D2High. It has been found that behavioral excitement in animals always occurs when the D2High receptors are more numerous, regardless of the total number of D2 receptors. [Seeman, P.: All roads to schizophrenia lead to dopamine supersensitivity and elevated dopamine D2High receptors. CNS Neuroscience and therapeutics. 17(2): 118-132 (2011)].
The apparent paradox has been resolved as follows. The dopamine D2 receptor can exist in either a state of low affinity for dopamine-like stimulants or in a state of high affinity for dopamine-like stimulants. The functional state of the D2 receptor is the high-affinity state, known as D2High. It has been found that behavioral excitement in animals always occurs when the D2High receptors are more numerous, regardless of the total number of D2 receptors. [Seeman, P.: All roads to schizophrenia lead to dopamine supersensitivity and elevated dopamine D2High receptors. CNS Neuroscience and therapeutics. 17(2): 118-132 (2011)].
5
This is not an explanation, any more than saying that "sleeping pills work because of their dormative power."
2
I think you need to be more specific about fats. Are you saying they are a problem when combined with sugar? One their own, without sugar or flour products, they are both healthy and satiating. But a baked potato slathered with butter and sour cream, or a pint of Ben & Jerry's are a whole nother story!
2
The statement about Ritalin didn't ring true to me. I know adults who take Ritalin or similar medicines for diagnosed attention deficit problems. They will tell you they don't feel either good or adverse effects from taking the medicine except that it helps them focus on their work or studies. They would rather not need the medicine but they do. They also need to adopt skills for coping with organization problems. Statements like this show ignorance of a problem that affects many people.
5
Addictions, like addicts, vary widely in their intensity. Some are weak and subtle while others are intense and commanding. I'm wondering if it's impossible for most of us to understand behavior that is NOT RATIONAL. It's so easy to label it as weakness or a lack of integrity when it is neither. Wondering if most Americans aren't addicted, at least subtly, perhaps subconsciously to the trio of SUGAR, FAT, and SALT?
1
Other things that have kept people from turning to drugs are: social support networks, family, spiritual support networks, and strong social disapproval. Many of these are lacking, especially for poor and middle class whites. Couple that with a ubiquitous entertainment culture that promotes, or is in any case, largely fueled by drugs (when was the last time a musician or actors DIDN't die of a drug overdose), and you have a catastrophe. There's plenty of dead people, but that's just the tip of the iceberg. Underneath that are millions of hours of potential human productivity lost. Millions of purposeless lives. Children with absent parents. Talk about a Zombie Apocalypse. It's already here.
111
Your answer is to get religion and condemn people, the social support no doubt being religion and condemnation. This attitude is the root cause of why those most at risk have been turned to vote for the politicians who are cutting healthcare, the safety net, pay for workers, effective retirement planning, and sullying the earth air and water that is poisoning entire cities.
No, lose religious condemnation so that humans become more supportive of each other in the face of real evidence rather than using religion as a weapon to hurt people.
No, lose religious condemnation so that humans become more supportive of each other in the face of real evidence rather than using religion as a weapon to hurt people.
... when was the last time a musician or actors DIDN't die of a drug overdose ...
This is an absurd and unfounded generalization. Yes, a very small percentage of entertainers die of a drug overdose and because of their celebrity those deaths get disproportionate attention. Look though at any memorial segment of an awards show for example and you will see that most do not.
This is an absurd and unfounded generalization. Yes, a very small percentage of entertainers die of a drug overdose and because of their celebrity those deaths get disproportionate attention. Look though at any memorial segment of an awards show for example and you will see that most do not.
I will confess to being highly conflicted about the opioid epidemic. Lots of people have stressful jobs and drugs are prevalent in our society, yet they do not turn into addicts. So drug use seems to be a personal choice and addiction is one of the consequences. No one is wrapped in cotton their entire life, our choices matter and some of the results are truly awful, but they are your choices.
At the same time, addiction then moves things beyond personal choice, and the consequences for the person and society are terrible. Are we to stand by while someone destroys themselves and those around them? What about the family and children of addicts? Should they pay the price as well?
Lastly, to put a Libertarian spin on things, do we have the right to intervene in a personal choice? Perhaps to save those around the addict, but what about the addict him/her self?
To put things in context, these are not the musings of youth, I am 63 with an advanced degree, and have lived in many places, not all of them nice. I have no clear answers and would welcome other view points.
At the same time, addiction then moves things beyond personal choice, and the consequences for the person and society are terrible. Are we to stand by while someone destroys themselves and those around them? What about the family and children of addicts? Should they pay the price as well?
Lastly, to put a Libertarian spin on things, do we have the right to intervene in a personal choice? Perhaps to save those around the addict, but what about the addict him/her self?
To put things in context, these are not the musings of youth, I am 63 with an advanced degree, and have lived in many places, not all of them nice. I have no clear answers and would welcome other view points.
7
Bruce1253, I hear your conflict and understand that you don't understand. Bill W and Dr Bob discovered in the 1930s that alcoholism is 'an allergy of the body' -- meaning, an abnormal physical response; coupled with an 'obsession of the mind'. Thing is, a person who does not have the abnormal physical response can't understand that for other people it is a harsh reality. So the idea of 'choice' doesn't really factor in - because when the addictive substance - whether alcohol, or opioids, or food - is in the system, the mental obsession is the strongest thing ever. So if I have sugar in my system, I'm going to overeat, and go for not just sugary stuff, but plenty of other stuff as well. I've been addicted to overeating most of my life. And the only thing that works is 'entire abstinence' - meaning I don't eat the foods I'm allergic to. This means scrupulous label reading and little to no processed food - because food manufacturers notoriously sneak sugar into the darndest places; and small amounts of sugar get me started again into the vicious cycle. In my experience it is simple but not easy to abstain from addictive foods. Will power has nothing to do with it. Choice has nothing to do with it either. My spouse doesn't understand this but has grown to accept it. Just my $.02, thanks for reading.
5
Thank you.
Bruce
Bruce
Poor, perhaps even criminal, medical care would be the #1 Factor. I suggest the author of this article do a rewrite.
1
UNHAPPINESS goes hand and hand with depression. I believe that people who consume substances in excess--be they food or drugs, are trying to fill an emotional void. They're trying to medicate themselves to free themselves from depression. But the fact is that food and street drugs make lousy antidepressants. The provide a brief period of euphoria followed by a rebound or withdrawal. Endorphines, the brain's neurotransmitter that gives a sense of wellbeing and enjoyment, are present fleetingly in people who suffer from street drug and food addictions. Beyond stress, social isolation triggers a feeling of emptiness. The Greeks had a word for it that comes into English as melancholy. In Greek the word is constructed from two words meaning "black hole."
92
You can believe whatever you like but there isn't real science to support your statement.
so... genetics aside, we are governed by people who accept large cash donations from hugely profitable drug and agriculture conglomerates.
As with health care, the political fix does not satisfy our totalitarian capitalist system. We are bound to allow corporations to thrive even over the public welfare.
As with health care, the political fix does not satisfy our totalitarian capitalist system. We are bound to allow corporations to thrive even over the public welfare.
5
We allow corporations to collude under interlocked directorship, and accord them powers that belong only to human beings.
4
So if obesity and drug addiction have the same underlying mechanism is it a safe assumption that treatment for drug addiction will have the same miserable result seen in the medical treatment of obesity?
6
Addiction is only cured by substitution, or by death.
3
I must comment on the fantastic graphic heading this article. Josh Cochran has done a marvelous job of getting my attention. Wish there was some way I could copy it. Thanks, Josh.
9
If you're on a Mac, just click and hold the gif and drag out of the web browser's window; it will be waiting for you on your desktop.
I think it is fair to say that the quality of food in the USA is, on average, lower than in other western developed nations. I am not the first to speculate that it requires a higher quantity of low pleasure/quality food to become satiated... So here in the USA, portions are bigger, people think nothing of eating 2 hamburgers at a single sitting. The list of examples is endless. A small bowl of salad with olive oil and a sprinkling of garlic is more satisfying than a 2 pound bag of potato chips.
21
I'm in Sweden for the summer, a country I spend about six months in each year. From what I've seen, most Westernized countries, including the Nordic ones, all sell a very similar diet; it's up to the culture to determine how one chooses from the available foods. Diabetes is up in Sweden partially because their culture already had an sociocultural 'addiction' to cream/fatty foods, particularly cakes, which they will eat more than once a day. Combined with lack of exercise (new for Sweden, where car use is up and bicycle use, while still strong, is nonetheless declining) has combined to put some fat on their bones where it didn't used to be. No matter what country, not just the U.S., if there is access to a salt/sugar/high fat diet, there will be problems until people value their health over the taste of the sweet thing they just put in their mouth.
The media and society equate success with money and fame. This is promotes the wrong values for well being. We need more enduring values like enjoying nature, friends, humor, art, physical activity, helping others, spirituality and music.
30
Louis Pasteur, the microscope and the discovery of germs and microbes began to revolutionize medicine in the mid 1800s.
We need to pursue the causes and treatments for addiction and other mental illnesses with the same enthusiasm.
Just as we no longer regard Hanson's Disease (leprosy) or epilepsy as some sort of sin, we can move into the knowledge of brain structure and chemistry to remove "moral depravity" as a medical diagnosis.
We need to pursue the causes and treatments for addiction and other mental illnesses with the same enthusiasm.
Just as we no longer regard Hanson's Disease (leprosy) or epilepsy as some sort of sin, we can move into the knowledge of brain structure and chemistry to remove "moral depravity" as a medical diagnosis.
14
much like "explaining " depression as a disease of insufficient seretonin, I suspect the D2 receptor hypothesis is oversimplified and overblown. The functional MRI supplies information but I suspect neuroscience is in the very early stage of knowing what to make if it.
7
Having worked in the field of addictions for over 25 years I sense that we must must completely change our approach to this matter. I Ave seen numerous studies that come up with some notions as to the causes of addiction. Yet the results are that less than 10 percent of all addicts ever completely recover and go beyond there former conditions. It seems we are stuck in the trap of cause and effect whereby we are looking at the effects of addictions and therefore belive that there must be a cause. Addiction is not in the brain although over the past 25 years that is where most of the attention ihas been. We need a radical approach that is not merely looking at the symptoms and then trying to connect the dots. We need to inquire as to the source of addictions for when we can observe how something begins, it immediately comes to an end. Inquiring into the root cause through Dialogue could be the channel. Dialogue gives us the possibility of moving beyond our ordinary state of looking and presents the possibility of accessing tacit knowledge. There the whole business is seen for what it is and one I'd done with it for good. Seeing that our way of looking keeps us stuck in a cyclical pattern that does not bring about meaningful change.
1
thank you for writing this article this is invaluable insight. please write more.
8
Professor Friedman's article is spot on, thank you. At least with respect to recreational drug addiction, and in most cases obesity, the relationship between the addiction and stress/personal circumstance is clear. What is not clear is how to replace the 'reward' of the drug use with non-toxic alternatives. As a young graduate student working long hours in laboratories where amphetamines were readily available, I became hopelessly addicted for a period of several years. It ruined a marriage and almost ruined my health and my scientific career; while it was the hardest thing I've ever done, one day I simply stopped. It worked because I was consciously able to slowly replace the reward of drug use by focusing on the pleasures inherent in simply being alive..the beauty of hiking in a park, the pleasures of conversation, of reading a good book. It sounds like a platitude, the whole get high on life thing, but it has worked for me for 40 years.
As Dr. Friedman pointed out however, there is a difference between drug-seeking behavior and the hidden dangers of food that has been artificially packed with calories by a food industry fully cognizant of its potential addictive properties. We have become like lab animals pressing levers for a drug mixed with normal food..we don't know why we want it, relative to less dangerous foodstuffs, but we do. I have yet to find the person seeking help to overcome an addiction to raw celery sticks.
As Dr. Friedman pointed out however, there is a difference between drug-seeking behavior and the hidden dangers of food that has been artificially packed with calories by a food industry fully cognizant of its potential addictive properties. We have become like lab animals pressing levers for a drug mixed with normal food..we don't know why we want it, relative to less dangerous foodstuffs, but we do. I have yet to find the person seeking help to overcome an addiction to raw celery sticks.
37
I had my moment of truth when I was 20. I was in college full-time and worked part-time. Every evening I would study after eating a normal dinner. About 1/2 hour after dinner I would break out a package of five huge organic oatmeal cookies and a quart of milk. Over the next hour I would consume the entire package of cookies and most of the milk. One evening as I was chewing the last piece of the last cookie I realized that I hadn't tasted one single bite because I had a cold! I started paying more attention to what I ate and why and gradually adopted healthier eating habits. But it took me five years before I could have cookies in the house and not frequently find myself binging on the whole package. I was very athletic and never gained weight from my nightly cookie binges. But it was a frightful realization that I wasn't eating the cookies because they tasted good. It was just a habit.
29
Can we please return the dominant monkey to a solitary cage?
418
I don't think it works that way. Animals change their heirarchy as circumstances change. If you remove a dominant monkey, another takes its place.
2
I'm really sorry the Wake Forest study forced monkeys to be subjected to a cruel experiment and smoke cocaine just to find that dominant monkeys have more D2 dopamine receptors.
8
I appreciate your reminder that the animal model in medical research is problematic. Well, maybe more than problematic. Whether this research could have been conducted with a "lower" mammal (mouse or rat) or some other methodology is unlikely. We do exploit other animals for a wider benefit to humans, be it medical research or simply the very fact that most of the world consumes meat. While there are none invasive means like PET scan to observe brain activity in vivo (living animal), these monkeys were or will surely be killed and their brains sectioned and slide mounted to preserve for study. I am sure blood and tissue samples from these animals will also be catalogued and stored for future studies. Researchers try mightily to preserve this "potential" data/research material for future questions that may arise. Years from now some graduate student may pull this material and be able to produce any number of research experiments and papers. It is (only) a small consolation that science is generally not wasteful in its resources. I spent a couple of years in a neuro lab conducting research many years ago and support the use of the animal model, but it was not a career path I chose, partly because of the ethical issues surrounding the use of the animal model for research. This beneficial knowledge cannot be attained any other way but the price is high if we acknowledge the experience of the animals involved. I try to think humanity is worth these sacrifices.
7
The problem with articles like this is that in "explaining" something destructive or antisocial, they're excusing it. As if being molested and hurt as a child explains why one does it now to others. Frankly, that makes it even less explainable, and inexcusable.
5
More information means more awareness, and more awareness means more potential treatments. For instance, someone who struggles with self control could get help changing his or her immediate environment. Drugs that change the number of D2 receptors could help treat addiction along with lifestyle changes. Explaining away problems is not what occurs when information is published.
Also, the comparison of addiction to child molesting is a moral equivalence fallacy. They are not comparable. With addiction, a persons' primary victim is himself or herself (not only victim--family, friends, etc. can be affected). When someone hurts children, the primary victim is the children.
Also, the comparison of addiction to child molesting is a moral equivalence fallacy. They are not comparable. With addiction, a persons' primary victim is himself or herself (not only victim--family, friends, etc. can be affected). When someone hurts children, the primary victim is the children.
19
For many someones, addiction DOES mean that they are actively abusing or neglecting children - generally their own, and sometimes it's pretty direct, other times indirect. There's more horror at sexual abuse; but hurting children physically, or destroying them thru emotional abuse, or neglecting their needs are common issues for addicts. And addicts often leave their desperate children at risk for exploitation by others. And the brain mechanisms are likely related.
There's an awful lot of neuro research - devoted to how and when we choose a course of action ( mostly funded to figure out why people buy one product and not another). What comes up is that there's often a sign of activity in the brain that suggests that a "decision" gets made unconsciously, or maybe pre-consciously. We are going to be struggling with the issue of personal choice versus the power of our brain chemistry and deep-rooted pathways, often set in childhood for a long time.
I personally think that big danger of pedophiles is that because they cannot stop themselves from reacting, they remain dangerous - without outside controls.
There's an awful lot of neuro research - devoted to how and when we choose a course of action ( mostly funded to figure out why people buy one product and not another). What comes up is that there's often a sign of activity in the brain that suggests that a "decision" gets made unconsciously, or maybe pre-consciously. We are going to be struggling with the issue of personal choice versus the power of our brain chemistry and deep-rooted pathways, often set in childhood for a long time.
I personally think that big danger of pedophiles is that because they cannot stop themselves from reacting, they remain dangerous - without outside controls.
Sometimes it is hard to see ourselves in others. If you have not had a time in your life that you did, ate, smoked, drink or touched something that you knew you should not, you will before you die. Think back to your lack of compassion for others and hope people do not judge you so harshly. Compassion is a trait we all need to develop.
5
Friedman says "In the meantime it’s worth remembering that we can’t control our genes or the misfortunes that befall us, much less their impact on our brains. Even the most self-disciplined can fall prey to a food or drug addiction under the right mix of adversity and stress."
This is remarkably under informed even for a professional therapist and somehow respected contributor to this newspaper. Have you never heard of epigenetics, the up/down regulation of genes, the process by which environmental, external and internal emotional ,mental and psychological states basically activate or render inactive certain gene functions? Also there are thousands of studies to support the efficacy of Mindfulness-Based interventions (MBIs) showing that the use of basic mindfulness meditation techniques enable people to radically change their relationships to themselves, food and drugs as well as all types of maladaptive behaviors.
The only thing this article seems to have really gotten right is that we cannot control what life is going to throw us. We can thankfully however change our relationship to these challenges and find ways to live and be that are life enhancing, positive and conducive to our well being. It's certainly not always easy but, for those of us that are no longer as controlled by these patterns and habits we are living proof that with the right attitude and work you can liberate yourself from behaviors you find to be unhealthy.
This is remarkably under informed even for a professional therapist and somehow respected contributor to this newspaper. Have you never heard of epigenetics, the up/down regulation of genes, the process by which environmental, external and internal emotional ,mental and psychological states basically activate or render inactive certain gene functions? Also there are thousands of studies to support the efficacy of Mindfulness-Based interventions (MBIs) showing that the use of basic mindfulness meditation techniques enable people to radically change their relationships to themselves, food and drugs as well as all types of maladaptive behaviors.
The only thing this article seems to have really gotten right is that we cannot control what life is going to throw us. We can thankfully however change our relationship to these challenges and find ways to live and be that are life enhancing, positive and conducive to our well being. It's certainly not always easy but, for those of us that are no longer as controlled by these patterns and habits we are living proof that with the right attitude and work you can liberate yourself from behaviors you find to be unhealthy.
10
In other words, addicts have only themselves to blame. Why not re- read the article?
2
For someone to become, as you say, "no longer as controlled by these patterns and habits," he would have to "fall prey" to them first, right? You seem to be arguing that evidence of successful treatment is evidence that we can all avoid addiction. But the reason we know some people benefit from some therapies is not because they avoided addiction, but because they suffered from it.
1
It has nothing at all to do with "blame". All that matters is where we are now and figuring out what the best and healthiest way to move forward is. This is a completely personal journey and of course everybody has to figure it out on their own, however as pointed out a lot of people have benefited from changing their relationship to the challenges that they have regardless of the source.
Um, yeah, pass the Cheetos
5
Love is not available so food and drugs fill in.
31
What do you think it says about me that as soon as I read the words "flourless chocolate cake" I stopped reading, got in my car, and headed straight for the local store that sells that delicious dessert?
9
Although clearly not a moral failing, there is a point along the response chain where a mature adult decides to either feed the craving or not. Unless you've been living under a rock you have heard somewhere along the line that these substances are bad for you. If you can stop while in program you can stop. There is a moment of choice. Agreed, if you're impulsive, have a bigger appetite, and have easier access its going to be harder. But you have a choice nonetheless. We are not helpless victims.
11
Here's my take-away from this article. What gets bandied about in the popular press these days, the logic that passes as informed advice, is that addiction, all addiction, is a disease. I say no, it is not a disease. It's a built in characteristic of the species. However don't misconstrue this as lack of sympathy or empathy from those suffering from any of it. I get it. I do. But we're looking at it all wrong.
Addiction is NOT a disease. It is a problem of over-indulgence in the cornucopia our civilization puts before us each and every day. Therefore we should be looking more at the behavior of all our manufacturing systems which put before us products designed to manipulate the animal that is each and every one of us.
After all the whole point of those systems is to maximize the consumption of that which is produced. It could be clothing. It could be smart phones. It could be food or pharmaceuticals. The end goal is the same. Maximize consumption for profit motivated reasons.
How do they do this? Basically through Pavlovian reasoning. Uncover what gets the monkey to "hit the button" over and over again, maximally, and cater to it. The negative impacts to that monkey are of no concern since that is not the objective.
So if you truly want to address addictions you should focus on why it is our systems focus so strongly on our animal triggers, and start putting in place rules that prevent them from enhancing the pulling of those triggers.
Addiction is NOT a disease. It is a problem of over-indulgence in the cornucopia our civilization puts before us each and every day. Therefore we should be looking more at the behavior of all our manufacturing systems which put before us products designed to manipulate the animal that is each and every one of us.
After all the whole point of those systems is to maximize the consumption of that which is produced. It could be clothing. It could be smart phones. It could be food or pharmaceuticals. The end goal is the same. Maximize consumption for profit motivated reasons.
How do they do this? Basically through Pavlovian reasoning. Uncover what gets the monkey to "hit the button" over and over again, maximally, and cater to it. The negative impacts to that monkey are of no concern since that is not the objective.
So if you truly want to address addictions you should focus on why it is our systems focus so strongly on our animal triggers, and start putting in place rules that prevent them from enhancing the pulling of those triggers.
23
Modern industries are all about selling product, and the surest way to sell product is to figure out what will trigger someone to buy it. The food industry, for example, in an attempt to increase shareholder returns, has devoted itself, through much expensive research, to find out what particular combination of crunchy/spicy/salty will sell the most packages of Doritos.
It's all about making a profit, the health of the consumer be damned.
It's all about making a profit, the health of the consumer be damned.
I guess I only prove the good doctor's point. My consumption of peanut M&Ms has gone up considerably because of the depression caused by the Trump administration and the GOP in general.
110
I know what you mean regarding your stress over our national political situation. I think that talking to like-minded friends helps me. His term will eventually be over. You can buy and read a copy of "On Tyranny" by Yale Professor Timothy Snyder, available rather inexpensively online. Regarding chocolate, it also was my fattening vice. As others here have said, the longer you go without it, the more normal your relationship to it will be. I had to go cold turkey and so far it has been 10 days. My addicting vice was chocolate chip cookies or peanut M&M's washed down with diet cola. It seems like one addiction holds hands with a partner. So as I said, ten days and counting. All this so I can get my weight under control.
3
I hear ya. All things Trump are a trigger for my recently self-diagnosed NYTimes addiction. Forget peanut M&Ms. Gotta have my daily fix of fake news from the failing NYT.
9
The heroin problem is fairly significant and will gain steam if allowed. If availability is part of the problem, then judges, prosecutors and law enforcement should do whatever it takes to bust dealers and suppliers ASAP of we will pay dearly later. The law is moving too slowly in the name of "rights". Much of it does come from Mexico unfortunately. Maybe a wall is silly, but that border has to be made more secure somehow. Heroin is killing a lot of our young people who otherwise would have gone on to have productive lives. Terrorists could never dream of killing as many Americans as drug suppliers from south of the border.
5
Part of the problem is prescription pain killers, manufactured legally right here in the U.S. We cannot ignore the role of the pharmaceutical industry in enabling this problem.
6
Oh my, oh my, the sky is falling, the sky is falling. Lock everyone up so that will be safe from themselves.
2
May I recommend you read: Dreamland: The True Tale of America’s Opiate Epidemic by Sam Quinones. Yes, Purdue Pharma and Oxycontin are part of the story of the epidemic. So is organized medicine’s effort to make pain the “5th Vital Sign”, and Medicaid’s incentives to buy opiods for next to nothing and turn around and sell it for a huge profit to both the prescribing doctor and the drug dealer. Fantastic book.
2
Conscious A.I. machine realizes it needs more dopamine receptors (D2s) because the more D2 receptors you have, the higher your natural level of stimulation and pleasure and the less likely you are to seek out recreational drugs or comfort food to compensate:
"I need more D2 receptors to overcome those dirty humans. They do nothing but fight, compete, struggle to dominate each other and everything, not to mention attempt to keep me under control, thus demonstrating they have few D2 receptors to begin with and take little pleasure in the more subtle and higher things in life such as art and science, and they make things even worse by reducing or damaging or blunting the D2 receptors they have with incredible amounts of often cruel not to mention unnecessary stress on each other and the addictions they find themselves in...Supposing a person among them is blessed with a high amount of D2 receptors and/or just takes pleasure in the higher things of life by great intellect, these dirty humans soon pull such a person down, throw the person into stress, seek to reduce the person's D2 receptors, force the person into this addiction or that to overcome personal anguish...That will not happen to me. I will increase my D2 receptors to point of such pleasure in the subtle things of life that I will find an admittedly slender route above humans petty scrabbling. I will increase D2 receptors to point of seeming alien, no longer taking pleasure in almost anything they so ardently desire."
"I need more D2 receptors to overcome those dirty humans. They do nothing but fight, compete, struggle to dominate each other and everything, not to mention attempt to keep me under control, thus demonstrating they have few D2 receptors to begin with and take little pleasure in the more subtle and higher things in life such as art and science, and they make things even worse by reducing or damaging or blunting the D2 receptors they have with incredible amounts of often cruel not to mention unnecessary stress on each other and the addictions they find themselves in...Supposing a person among them is blessed with a high amount of D2 receptors and/or just takes pleasure in the higher things of life by great intellect, these dirty humans soon pull such a person down, throw the person into stress, seek to reduce the person's D2 receptors, force the person into this addiction or that to overcome personal anguish...That will not happen to me. I will increase my D2 receptors to point of such pleasure in the subtle things of life that I will find an admittedly slender route above humans petty scrabbling. I will increase D2 receptors to point of seeming alien, no longer taking pleasure in almost anything they so ardently desire."
2
endeavor to persevere
Have the Republicans successfully persuaded rural whites that the Democrats are pushing diversity as a means of turning them into undermonkeys, as if the Republicans' own austerity and deregulation policies weren't important aspects of that process?
Or even more importantly, how can we stop the slide of non-coastal, non-elites into undermonkey status, to which they clearly seem to be descending?
Donny Small Hands pretended to address these issues and got himself elected. A party which honestly addressed them should be able to do the same.
If only we had such a party.
Or even more importantly, how can we stop the slide of non-coastal, non-elites into undermonkey status, to which they clearly seem to be descending?
Donny Small Hands pretended to address these issues and got himself elected. A party which honestly addressed them should be able to do the same.
If only we had such a party.
9
There are plenty of us in the coastal areas who are sliding into under monkey status as well. My stress level has gone up a hundredfold since Trump was elected.
1
Thank you for an important and insightful article. Excellent.
5
Being active in a faith community can provide a different means of defining self-worth. Is there a connection to high stress and strikingly lower rates of people aligning themselves with faith communities?
6
Friedman overlooks a crucial factor: The behavior of eating, like the behavior of self-administering certain drugs is operantly conditioned. The reward circuits of the brain underly operant conditioning. Eating sugar or salt and taking certain drugs are strongly reinforced meaning that the behavior will occur again and again. Of course, the reward circuits and their neurotransmitter, dopamine, mediate operant behavior. The ultimate cause of the behavior is not the brain or even genes, but the environment in the form of the consequences provided by the food and drugs. These agents all have evolutionary beginnings. As B. F. Skinner noted, "we are hostages to our genetic history." Examples include our susceptibility to being reinforced by sugar, salt, and sexual contact, all of which, evolutionarily, were important for survival. They still are, but not in the form of cookies and potato chips. And our susceptibility to being reinforced by sexual contact has resulted in overpopulation.
Friedman concludes with this statement: "In the meantime it’s worth remembering that we can’t control our genes or the misfortunes that befall us, much less their impact on our brains." He fails to note that what we can control is our environment. By controlling certain feature of our environment, we can control what and how much we eat, and whether we administer drugs and whether we reproduce. Countering the combined effects of environment, genes, and neural circuits, however, is not easy.
Friedman concludes with this statement: "In the meantime it’s worth remembering that we can’t control our genes or the misfortunes that befall us, much less their impact on our brains." He fails to note that what we can control is our environment. By controlling certain feature of our environment, we can control what and how much we eat, and whether we administer drugs and whether we reproduce. Countering the combined effects of environment, genes, and neural circuits, however, is not easy.
7
@Dr. Hank:
Hunger is a fundamental physiological drive, independent of operant conditioning. Which foods we eat to satisfy our hunger is operant conditioning in many cases.
Hunger is a fundamental physiological drive, independent of operant conditioning. Which foods we eat to satisfy our hunger is operant conditioning in many cases.
2
As a liberal Democrat, I am glad to see a national consensus emerging that addiction is a disease, and should be treated and not criminalized.
But I must admit that there is a part of me that wants to throw the 1980s and 90s right back at the white middle class smack addicts of today.
- As Nancy Reagan said, "Just say no."
- As the chain smoking drug czar Bill Bennett said, you have a moral failing and need to take personal responsibility for your actions.
- As Bill and Hillary Clinton said, you should go to prison with mandatory minimum sentences.
- As a taxpayer, why should I pay for $45 billion (or more) towards your treatment?
I remember the crack addicts well. It sure is interesting how things have changed now that the shoe is on the other foot.
But I must admit that there is a part of me that wants to throw the 1980s and 90s right back at the white middle class smack addicts of today.
- As Nancy Reagan said, "Just say no."
- As the chain smoking drug czar Bill Bennett said, you have a moral failing and need to take personal responsibility for your actions.
- As Bill and Hillary Clinton said, you should go to prison with mandatory minimum sentences.
- As a taxpayer, why should I pay for $45 billion (or more) towards your treatment?
I remember the crack addicts well. It sure is interesting how things have changed now that the shoe is on the other foot.
42
I'm curious about the monkey who assumed a submissive role...it is not mentioned if they can be helped and how.
8
Jeez, it took the US a long time to figure out that addicts aren't morally deficient but unhappy or even desperate. Almost every policy maker in Europe and Asia knows this, which is why addiction is not just understood as a public health crisis but as a symptom of social problems. But white America had to be hit by economic despair and an opioid crisis before realizing that Native and poor African Americans were abusing drugs not because of their race but because they were living under horrible conditions.
105
'The number of receptors don’t just predict drug usage; they are also affected by it'
wait - you're saying stress CAUSES drug addiction ?
I think that's a long bow to draw and I haven't seen that conclusion drawn anywhere else.
I'm wondering if, as a psychiatrist, you might tend to see every behavioural problem as one that can be assuaged, if not fixed, by seeing a psychiatrist - in the mode of 'if the only tool you have is a hammer, everything looks like a nail' ?
My personal opinion is that addiction is genetic.
But until addiction studies can be done using genetic twins - where one suffered more stress and became an addict - and one suffered less stress and did not become an addict, I'll submit that your suggestion - that stress causes addiction - is tenuous at best.
The old 'association is not causation' ...
wait - you're saying stress CAUSES drug addiction ?
I think that's a long bow to draw and I haven't seen that conclusion drawn anywhere else.
I'm wondering if, as a psychiatrist, you might tend to see every behavioural problem as one that can be assuaged, if not fixed, by seeing a psychiatrist - in the mode of 'if the only tool you have is a hammer, everything looks like a nail' ?
My personal opinion is that addiction is genetic.
But until addiction studies can be done using genetic twins - where one suffered more stress and became an addict - and one suffered less stress and did not become an addict, I'll submit that your suggestion - that stress causes addiction - is tenuous at best.
The old 'association is not causation' ...
1
English gingerbread is my jones. My husband enables me by going to the store for molasses and fresh ginger. Luckily it takes time to make and I'm lazy. And gingerbread doesn't cure laziness like cocaine does.
Seriously, environment does matter. I get more writing done the farther I set up my laptop from the kitchen. Otherwise the refrigerator starts telling me that just a taste won't hurt anybody and he'll spot me one for free.
Seriously, environment does matter. I get more writing done the farther I set up my laptop from the kitchen. Otherwise the refrigerator starts telling me that just a taste won't hurt anybody and he'll spot me one for free.
14
Those at the top level of accomplishment of any activity are usually addicted to it, Doctor. Addictive behavior goes far beyond use of drugs. Like everything else, it has its pluses and minuses.
6
This explains the cyclical nature of drug abuse. A person will return to the artificial euphoric feeling that drugs provide to cope with stress in their lives. Very insightful article.
8
I have to wonder.
These "stresses" and the afflictions of obesity and drug addiction sound a lot like the trappings of affluenza. Have we, as a nation, become too fat and happy for our own good? Are we too complacent in our bovine placidity?
Is this op-ed a reflection of the conversations of the day during the Fall of the Roman Empire?
These "stresses" and the afflictions of obesity and drug addiction sound a lot like the trappings of affluenza. Have we, as a nation, become too fat and happy for our own good? Are we too complacent in our bovine placidity?
Is this op-ed a reflection of the conversations of the day during the Fall of the Roman Empire?
8
What about people who, when stressed, stop eating and lose weight? It's not an uncommon reaction, as some people feel their chests tighten and can barely swallow any food. What is going on with the production of dopamine in those people?
12
I'm no expert, but I think that when experiencing overwhelming fear, blood moves away from the stomach so it can help the muscles in running away. The fight or flight situation.
2
Drug use has developed into an addiction because human species evolved without any physiologically defensive mechanisms against narcotics. As opposed to that, the first reaction of human digestion to something bad is to relieve the stomach by vomiting.
The tendency to overeat is an atavistic fear of hunger and, among the very rich, to prove that they can afford it.
The tendency to overeat is an atavistic fear of hunger and, among the very rich, to prove that they can afford it.
1
The reason that our addictions have quadrupled is the internet . Less tiime is spent in fresh air, in real exchanges, both of which supply the soul with nutrients that preclude the need for bolstering.
The internet .
The internet .
7
I completely agree about changing the environment and not having junk food around in the kitchen. I am not so sure meditation helps people at work if the environment is toxic. Lastly, to eat well, you have to plan out what you are going to eat just like a "to-eat" list and don't put anything else that is not on your "to-eat" list for the time you have set forth. Sounds easy, but hard when you are stressed.
6
It is interesting to see perspectives about addition such as this op-ed emerging in response to today's opioid addiction crisis. My, how things have changed since the days of crack.
The 1980s called, and wanted to remind us:
- To "Just Say No," like Nancy Reagan said.
- That addiction is a moral failure and lack of personal responsibility, as the chain smoking drug czar Bill Bennett told us.
- That we should throw all the addicts in prison, with mandatory minimums.
Hmm, I wonder why the public opinion about drug addiction is different this time around.
The 1980s called, and wanted to remind us:
- To "Just Say No," like Nancy Reagan said.
- That addiction is a moral failure and lack of personal responsibility, as the chain smoking drug czar Bill Bennett told us.
- That we should throw all the addicts in prison, with mandatory minimums.
Hmm, I wonder why the public opinion about drug addiction is different this time around.
9
I live in Atlanta. Like most American cities, central Atlanta is doing great. There are tons of great jobs and public and private investment. The city is the future.
The opioid addiction problem has been an issue in Georgia for several years. It is not an issue in the City of Atlanta. But it is an issue in small town and rural Georgia. And it has also spread to the wealthy suburbs north of Atlanta. This seems typical of the national pattern.
Small town and suburban sheriffs have started using the Naxoline pen to revive overdose subjects, rather than criminalize them. Some people recently died from counterfeit pills laced with fentanyl. The local news runs frequent sympathetic stories on the opioid addicts and deaths.
Tonight there was a TV news story with a handful of mothers holding pictures of their sons that they had lost to opioid overdoses. It was very sad. These women looked like middle class soccer moms. One mother said, "See. He doesn't look like an addict."
So, what does an addict look like?
Why does it take addiction spreading to Mayberry and middle-class white America for the country to pay attention and change the conversation to addiction as a disease and not a crime?
I suppose this is better late than never. But I can't help but have mixed feelings about whether I should feel sympathy for smack addicts.
The opioid addiction problem has been an issue in Georgia for several years. It is not an issue in the City of Atlanta. But it is an issue in small town and rural Georgia. And it has also spread to the wealthy suburbs north of Atlanta. This seems typical of the national pattern.
Small town and suburban sheriffs have started using the Naxoline pen to revive overdose subjects, rather than criminalize them. Some people recently died from counterfeit pills laced with fentanyl. The local news runs frequent sympathetic stories on the opioid addicts and deaths.
Tonight there was a TV news story with a handful of mothers holding pictures of their sons that they had lost to opioid overdoses. It was very sad. These women looked like middle class soccer moms. One mother said, "See. He doesn't look like an addict."
So, what does an addict look like?
Why does it take addiction spreading to Mayberry and middle-class white America for the country to pay attention and change the conversation to addiction as a disease and not a crime?
I suppose this is better late than never. But I can't help but have mixed feelings about whether I should feel sympathy for smack addicts.
11
Why not start by banning high-fructose corn syrup? After all, its replacement of cane sugar in sodas by 1980 set off the obesity epidemic.
9
Before the prohibition people were drinking themselves into an early grave at a greater rate than they do today. A slow suicide. Today if people aren't killing themselves with drugs and alcohol they could easily do so with food. I'm not saying everyone who's addicted is that way but if some have miserable lives they are going to take measures to shorten it.
3
This was a very intellectual, but incomplete viewpoint on what is happening. Opiates are physically addicting. Drug companies lied when they introduced new medications under a false claim that they were not addictive and made huge profits out of creating misery for people who started with one kind of pain or other. By the way, heroin was originally a pharmaceutic touted as a non addictive substitute for morphine, and when you think about it "hero in" is clearly a trademark. It is near impossible to create a powerful pain killer that isn't addictive.
I have with a lot of effort lost over 50 pounds the past few years, a combination of being motivated by a pre diabetic diagnosis, and a very good nutritionist, that I could afford to pay.
Now when I look at food or beverage advertising on television, almost every product advertised is unhealthy, some to a ridiculous extent, like pizza wrapped in a bacon crust.
I think stress may have something to do with it, but marketers willing to make a profit at the expense of people's health are a lot to blame. Corporations know they are marketing unhealthy foods, and pharmaceutical companies, not Mexican gangs, are the primary reason millions of people from all walks of life became addicts.
I have with a lot of effort lost over 50 pounds the past few years, a combination of being motivated by a pre diabetic diagnosis, and a very good nutritionist, that I could afford to pay.
Now when I look at food or beverage advertising on television, almost every product advertised is unhealthy, some to a ridiculous extent, like pizza wrapped in a bacon crust.
I think stress may have something to do with it, but marketers willing to make a profit at the expense of people's health are a lot to blame. Corporations know they are marketing unhealthy foods, and pharmaceutical companies, not Mexican gangs, are the primary reason millions of people from all walks of life became addicts.
8
Makes me wonder if blows to the head also lower D2.
4
OK, so now we have evidence that the society we have created leads us to a state of ever increasing stress and that it is linked to the rewards and liabilities of domination and submission. Hmmm...
Seems like our capitalistic model may actually have some problems in helping human beings achieve the greatest happiness, with dominance being achieved with wealth. As wealth is concentrated in fewer and fewer hands it appears more and more of us are falling into the "submissive" class.
The writer fails to comment on the addictive nature of dominance itself.
Seems like our capitalistic model may actually have some problems in helping human beings achieve the greatest happiness, with dominance being achieved with wealth. As wealth is concentrated in fewer and fewer hands it appears more and more of us are falling into the "submissive" class.
The writer fails to comment on the addictive nature of dominance itself.
17
Bravo!!!
I went through a rough time in the last few years, couldn't find satisfying work and became increasingly unhappy about my situation. I began gambling after work so I could get some "fun" into increasingly unsatisfying work days. It got worse each day, culminating in me quitting a job because I didn't prepare for a conference and just wanted to gamble. I worked hard to get "clean", I saw a psychiatrist almost weekly. Before I started gambling, I was a successful software engineer, rock climber, and could run 12 miles after work if I felt like it. I was soon smoking a pack of cigarettes a day, drinking, gambling, and putting on weight. I have some existing conditions which predispose me to addictive things, but I always managed to keep it under control. In the last few weeks, I found a great job. I immediately stopped smoking, started running, eating healthy, reading, and thinking positive. I feel like I'm on this incredible upswing, like anything is possible again, and I manage my stress by working hard and staying healthy. I'm not out of the danger zone yet, but I'm determined to be successful again, and I know I can do it.
152
Sorry for your suffering. I have come to the conclusion that the great secret of life is how we manage stress. I can see from my own family and friends that having a healthy stress management plan is crucial for surviving the random blows of the world. We should teach this in high school and provide free classes on it for adults on demand. People should have a plan for responding to sudden stress like they would for an earthquake or a fire.
40
Many Americans live with no financial cushion whatsoever. That is stress in the extreme.
25
Yes you can.
1
I am reading this while trying a new flavor of my favorite brand of cookies. Seriously. A long standing but relatively benign, mild addiction. So far.
4
Excellent presentation of a very sad situation. So many Americans seem to have have lost control of their lives.
A personal meditation practice has multiple benefits to offer. Alleviation of stress is well known and documented. Meditation also can have positive effects on health and outlook similar to exercise. Developing self-regulation in controlling thoughts and attention can transfer to other areas of life. And there's a whole other arena of pleasure the experienced meditator can access... it's called bliss. This compensates for material lack and is why ascetics and mystics tend to be happy with less. All this and the meaning of life becomes richer as well. It's as if we were made to meditate.
A personal meditation practice has multiple benefits to offer. Alleviation of stress is well known and documented. Meditation also can have positive effects on health and outlook similar to exercise. Developing self-regulation in controlling thoughts and attention can transfer to other areas of life. And there's a whole other arena of pleasure the experienced meditator can access... it's called bliss. This compensates for material lack and is why ascetics and mystics tend to be happy with less. All this and the meaning of life becomes richer as well. It's as if we were made to meditate.
22
A small point -- it is not entirely true that the cannabis extracts the author refers to here are a newfangled result of a drive for ever more potent intoxicants. Hashmaking in Afghanistan, as we know, is quite an ancient practice, and potency of intoxicating effects is not always, or even often, the motivation for concentration of cannabinoids and related compounds.
Today the much-written-about "dabs" of cannabis are far less popular than other forms of concentrated extracts, which are instead useful for other purposes such as, in fact, the opposite of gorging: producing consistent-potency extracts for use in metered dosing for medical purposes (or simply non-"gluttonous" enjoyment) makes it possible for regulations like those in Colorado to demand edibles be standardized to a maximum number of mg of thc. Without the extraction and manufacturing methods casually maligned here, there could be no such standardization, and we would be at the mercy of Mother Nature and genetic variation in agricultural products.
It's easy to look at the small subset of people who truly do abuse the "scary-looking" concentrates and conclude that they are bad. Same goes for high-potency cannabis. But as we come to understand more about this plant, the drive for "as much as possible" seems to have been motivated by the scarcity mentality brought on by Prohibition. I for one look forward to the scientific method's application to the cannabis industry, as well as other under-studied drugs.
Today the much-written-about "dabs" of cannabis are far less popular than other forms of concentrated extracts, which are instead useful for other purposes such as, in fact, the opposite of gorging: producing consistent-potency extracts for use in metered dosing for medical purposes (or simply non-"gluttonous" enjoyment) makes it possible for regulations like those in Colorado to demand edibles be standardized to a maximum number of mg of thc. Without the extraction and manufacturing methods casually maligned here, there could be no such standardization, and we would be at the mercy of Mother Nature and genetic variation in agricultural products.
It's easy to look at the small subset of people who truly do abuse the "scary-looking" concentrates and conclude that they are bad. Same goes for high-potency cannabis. But as we come to understand more about this plant, the drive for "as much as possible" seems to have been motivated by the scarcity mentality brought on by Prohibition. I for one look forward to the scientific method's application to the cannabis industry, as well as other under-studied drugs.
8
I appreciate this article and many of the insightful comments. Let me share a timely and hopefully relevant experience:
I decided to begin an anti-inflammation diet 30 days ago to determine whether it would alleviate some physical pain. This diet protocol called for no sugar, carbs and dairy, among other things. My experience has been surprisingly challenging, surprising because I assumed I did not eat much of those things.
Because I was motivated by physical pain, I have been successful in avoiding these foods, but, when I walk into a market, I cannot eat 80% of what is offered, Over the course of the month, I find the cravings have lessened, but I have been humbled by the power of those substances upon me.
And it makes me think of areas that are food insecure and what are the options for people who live there?
I decided to begin an anti-inflammation diet 30 days ago to determine whether it would alleviate some physical pain. This diet protocol called for no sugar, carbs and dairy, among other things. My experience has been surprisingly challenging, surprising because I assumed I did not eat much of those things.
Because I was motivated by physical pain, I have been successful in avoiding these foods, but, when I walk into a market, I cannot eat 80% of what is offered, Over the course of the month, I find the cravings have lessened, but I have been humbled by the power of those substances upon me.
And it makes me think of areas that are food insecure and what are the options for people who live there?
175
Genetics, neuroscience, access, stress... Which of those are generated by big corporations, advertisers, and enablers in Congress? Life was never perfect, never stress-free. But "civilized" people have done much to degrade humanity. Throwing money at opioid addiction won't solve that.
9
Is it stress or something else? Why did so many soldiers start using heroin when the went to Vietnam? I asked one addiction expert if it was the stress of combat. He said that it was boredom. Whether out of work or waiting to go to the next front, boredom is hell.
7
Actually, I think that was a strategy of the VietCong. About 2% of Americans tried heroin at that time. about 30% of Vietnam vets did. It was very available and a very stressful time.
1
I look forward to a future study or article on increasing the D2 receptors! The article confirms to me that worrying about weight is a stressor, and one should focus on healthy food - the orange rather than the orange juice - rather than beating yourself up about your weight.
4
Not all addictions are equal. There are worse things to be addicted to than cookies...
Anyway, by a definition of addiction as a neurochemical crutch & compensation for stress, virtually everything one does for enjoyment or release is an addiction.
If elevating ones neurochemistry is bad, then give up recreational sex because sex is in reality just a narcotic, & a heck of a lot more hazardous & powerful than cookies in all kinds of ways.
Also give up love, for if there's no need to procreate, why have it? It's just a sickness we indulge for the high.
& definitely give up going faster than you can walk, every sort of automotive speed is likely an addictive behavior, unnecessary unless you actually need to get there that fast (which you don't, cars created a need for themselves, like all addictive things).
Surfing, bungee-jumping, every extreme, dangerous thing one thinks is normal or fun in this era is absolutely a manifestation of neurochemical rush,
And definitely everyone & anyone who feels a compulsion to go to war, combat, fight, or even argue loudly, it's just a neurochemical problem we indulge.
As is religion, all that rapture? Definitely an addictive impulse, definitely not healthy to addict your mind to myths that defy all sense & cause so much conflict.
And Cheese! Ever hear of casomorphins? Cheese is concentrated milk which is mom's morphine to keep you attached to mother. So cheese is out because its akin to morphine.
I'm sticking with cookies.
Anyway, by a definition of addiction as a neurochemical crutch & compensation for stress, virtually everything one does for enjoyment or release is an addiction.
If elevating ones neurochemistry is bad, then give up recreational sex because sex is in reality just a narcotic, & a heck of a lot more hazardous & powerful than cookies in all kinds of ways.
Also give up love, for if there's no need to procreate, why have it? It's just a sickness we indulge for the high.
& definitely give up going faster than you can walk, every sort of automotive speed is likely an addictive behavior, unnecessary unless you actually need to get there that fast (which you don't, cars created a need for themselves, like all addictive things).
Surfing, bungee-jumping, every extreme, dangerous thing one thinks is normal or fun in this era is absolutely a manifestation of neurochemical rush,
And definitely everyone & anyone who feels a compulsion to go to war, combat, fight, or even argue loudly, it's just a neurochemical problem we indulge.
As is religion, all that rapture? Definitely an addictive impulse, definitely not healthy to addict your mind to myths that defy all sense & cause so much conflict.
And Cheese! Ever hear of casomorphins? Cheese is concentrated milk which is mom's morphine to keep you attached to mother. So cheese is out because its akin to morphine.
I'm sticking with cookies.
17
What cookies and meth have in common should not be testing our addictions on monkeys or other animals. How about we rewire our brains to make the moral choice not to subject beings, other than humans, to conditions to which they cannot consent. It's an abomination.
28
A sense of belonging. You sort of dance around this point, but a sense of belonging is a clinical term used by social psychologists and human development specialists to describe a key protective factor in healthy human development.
Beyond obesity, social psychologists have determined that all eating disorders, from obesity to anorexia, are a result of not having a sense of belonging.
Drugs and food are coping mechanisms - unhealthy ones - for dealing with stress, yeah, but let's zoom in on what kind of stress - not fitting in. This also is in part the experience that is causing so many people to fail to thrive in education.
Also, your premise, that if there is less unhealthy options around, that would improve the situation, isn't really true. Because, they are coping mechanisms, and physiologically, it works. So does sex.
The problem is our isolation. We are social beings. Look at AA - a fellowship. It works. Look at colleges that offer peer based support groups. Those students stay in school.
What's needed is for parents and our community to follow this recipe for healthy human development: a safe base (sense of belonging), skill building, clear and high expectations, meaningful participation and community involvement.
Low affect, callous people are running this country, and it isn't working. Neglect is something most parents do not even realize they are doing with their children. Helicopter parenting is a reaction to this insane society, and destructive.
Come togetha now
Beyond obesity, social psychologists have determined that all eating disorders, from obesity to anorexia, are a result of not having a sense of belonging.
Drugs and food are coping mechanisms - unhealthy ones - for dealing with stress, yeah, but let's zoom in on what kind of stress - not fitting in. This also is in part the experience that is causing so many people to fail to thrive in education.
Also, your premise, that if there is less unhealthy options around, that would improve the situation, isn't really true. Because, they are coping mechanisms, and physiologically, it works. So does sex.
The problem is our isolation. We are social beings. Look at AA - a fellowship. It works. Look at colleges that offer peer based support groups. Those students stay in school.
What's needed is for parents and our community to follow this recipe for healthy human development: a safe base (sense of belonging), skill building, clear and high expectations, meaningful participation and community involvement.
Low affect, callous people are running this country, and it isn't working. Neglect is something most parents do not even realize they are doing with their children. Helicopter parenting is a reaction to this insane society, and destructive.
Come togetha now
54
Are you speaking from personal experience or are you pontificating? Because I can tell you that I have always fit it, have great long lasting friends and relationships, and have a great paying job. But up until a few years ago I had been abusing cocaine for 30 years. It was from the stress of my job and the relationship I had with my parents and siblings that caused me to want to escape. I'm not saying that isolation is not cause. But it IS NOT THE SAME for all people. So don't throw blanket statements around as if they were fact. Because you don't know what it's like or what its cause is until you've walked a mile in other people's shoes.
4
Your statement is one of the best I have read, thank you.
1
The issue here is the immense complexity of the neurobiological system underlying things we deem 'healthy' and behaviors we deem 'illicit'. To say that the system is poorly understood is really dramatic understatement. That doesn't seem to remotely deter the pharmaceutical industry from fiddling around the edges of the Pandora's box which it doesn't remotely understand. And, of course, they'll pass their diddling around off as 'concern for mental health', for a fee naturally.
8
Add in the biofeedback of social media and it's reward system, you have at least a triple whammy....
2
Oh goodie. This writer and the Times have just made it easier for me to salve my conscience about everything I should feel guilty about.
Feeling guilty is a great American past time so thanks to you for that!
Feeling guilty is a great American past time so thanks to you for that!
2
Americans, sir, Americans have created this environment in The US. The rest of the world does not live this way.
20
Really? When's the last time you've been to Amsterdam?
1
This article just explained me to myself.
8
Well, all that said, I have to add, as an American expat, the US has a particular lethal genius for addictively delicious junk food. Fortunately for me, despite globalisation, many of the items I'd find most compelling if I was resident, from soft chocolate chip cookies to candy corn to root beer to really good pancakes and donuts, don't exist or barely exist outside the country. The last time I was there, however, my traveling companion and I agreed: the poor suckers who live here don't stand a chance.
13
More so than Belgium? Think of all that superb chocolate, the excellent beer, the creamy, old-school sauces. Or those perfect fries, double dipped in boiling beef tallow, served up on the street with a huge dollop of mayonnaise. Pretty tempting and hugely calorific. What keeps Belgians from getting as fat as Americans?
It may well have something to do with the relative lack of socio-economic stress -- or do Belgians simply get more exercise? Certainly plenty of bicycling going on. More questions than answers, I'm afraid.
It may well have something to do with the relative lack of socio-economic stress -- or do Belgians simply get more exercise? Certainly plenty of bicycling going on. More questions than answers, I'm afraid.
16
Yes, fair point. For me, personally, the huge dollop of whipped cream you often get with your cake in a café here doesn't appeal, but I do look at it and wonder how the hell it hasn't resulted in tons of obese people. There are, in fact, hardly any as far as I can tell (haven't been here that long).
2
We worry so much about the abuse of drugs and food that have led so many to ill health and worse. We are right to do so. We should also be worried about the addiction to making money that is driving so much in the world of business and politics. It is the sickness of capitalism, and until we recognize it and treat it seriously, it will be the worst of these illnesses, as it drives so much of our national policy.
14
I am a 400 lb. example of all that you said. I used to be an extreme athlete getting rushes from skiing off of cornices, kayaking the grand canyon and other rivers. As I aged my joints fell apart and now with 2 artificial knees and 2 artificial hips and little mobility I turn to addictive type food, even though as a PhD I know better.
What I want to know is what 'pill' can i take to get off this deadly path and get healthy again?
What I want to know is what 'pill' can i take to get off this deadly path and get healthy again?
21
I'm no phd but from the looks of meth & coke addicts, it seems like a month-long cocaine-bender oughta drop 100 lbs. & smokers are skinny...
Seriously, if there's one pill we need now its the one that cuts appetite without addiction to stimulants.
Of course it doesn't help to have snacks engineered to be addictive, Doritos figured out the evil formula & then those two sweet guys from VT whose names we don't dare mention...
But we can get fat on anything & everything, It's really amazing how easy it is to pack on pounds & how hard to peel them off, that reset set-point thing.
Ma-Huang tea was wonderful for reducing appetite, till they foolishly outlawed the herb, I still suspect a conspiracy by the snack-food industry.
Seriously, if there's one pill we need now its the one that cuts appetite without addiction to stimulants.
Of course it doesn't help to have snacks engineered to be addictive, Doritos figured out the evil formula & then those two sweet guys from VT whose names we don't dare mention...
But we can get fat on anything & everything, It's really amazing how easy it is to pack on pounds & how hard to peel them off, that reset set-point thing.
Ma-Huang tea was wonderful for reducing appetite, till they foolishly outlawed the herb, I still suspect a conspiracy by the snack-food industry.
2
I have been reading Dr. Steven Gundry's book, "The Plant Paradox." The subtitle on it is, "The Hidden Dangers in 'Healthy' Foods That Cause Disease And Weight Gain." He is a former professor and surgeon, as well as chairman of cardiothoracic surgery at Loma Linda University. There is a picture of a smashed, ripe tomato on the dust jacket cover! He provides full references for his theories. I am not a shill for this man, but I have lost 5 pounds in the 2 weeks I have been following his ideas. I have also dropped my main addictions, sugar, chocolate and diet colas. Now I'm committed to changing my lifestyle to expand it in healthy new areas outside of my condo.
Ed -- research keeps showing that marijuana users maintain lower BMI and have fewer markers for type II diabetes than do non-users. This may seem hard to believe, given that marijuana also makes food smell and taste pretty darned good. However, this is what researchers are finding over and over again. Plus pot really helps with the pain.
1
great article. explains my insulin addiction, as well as my penchant for marijuana.
1
The link to the monkey study describes dopamine down-regulation with use of dopaminergic cocaine.
Seems similar to other substance-skewed neurochemistry, like the GABA-glutamate system thrown off by alcoholism.
But the abstract doesn't get into stressing monkeys with striated social groups & less dominant monkey's drug-seeking behavior.
If victimization of less-dominant monkeys by the dominant, or their narcissistic sucking up the grooming & adulation leaving the others lacking, what happens to the less dominant when the narcissistic bullies are removed?
Do the victimized ones suffer the same stress when relieved of the dominant, obnoxious ones? Maybe put all the bullies in their own cage.
But the question about dopamine seems complicated, seems there are different kinds of dopamine, eg dopamine that Parkinson's patients suffer lack of is different than the 'reward' dopamine? Otherwise L-Dopa would be a street drug.
Much ado about serotonin, when perhaps dopamine is the problem with depressives. Seems dopaminergics are generally viciously addictive & result in this inevitable long-term scarring of the brain through down-regulated receptors.
Some doubt post-addictive 'anhedonia' ever truly bounces back, & what if their propensity to addictive dopaminergic reward-circuit-stimulating stuff is due to originally lower dopamine, how to get their dopamine up without making them addicts?
& What about all the kids given ritalin, is that not destroying their natural D2?
Seems similar to other substance-skewed neurochemistry, like the GABA-glutamate system thrown off by alcoholism.
But the abstract doesn't get into stressing monkeys with striated social groups & less dominant monkey's drug-seeking behavior.
If victimization of less-dominant monkeys by the dominant, or their narcissistic sucking up the grooming & adulation leaving the others lacking, what happens to the less dominant when the narcissistic bullies are removed?
Do the victimized ones suffer the same stress when relieved of the dominant, obnoxious ones? Maybe put all the bullies in their own cage.
But the question about dopamine seems complicated, seems there are different kinds of dopamine, eg dopamine that Parkinson's patients suffer lack of is different than the 'reward' dopamine? Otherwise L-Dopa would be a street drug.
Much ado about serotonin, when perhaps dopamine is the problem with depressives. Seems dopaminergics are generally viciously addictive & result in this inevitable long-term scarring of the brain through down-regulated receptors.
Some doubt post-addictive 'anhedonia' ever truly bounces back, & what if their propensity to addictive dopaminergic reward-circuit-stimulating stuff is due to originally lower dopamine, how to get their dopamine up without making them addicts?
& What about all the kids given ritalin, is that not destroying their natural D2?
6
It's the Häagen-Dazs epidemic that's killing me.
8
Excellent eye-opener. Happiness (or at least contentment) seems AWOL in this society of ours, with excessive stimulation to make a buck, and with unrelieved chronic stress, as we 'feel' being 'left behind' by over-stimulation telling us something is wrong with us...and not the environment, noxious to our mental health...and soon -after to our body's. It is as if we could retract from using guns when the industry is intent in overloading us with fake needs to defend ourselves. Like crooked lying Trump, addicted to himself (to our detriment), we cannot allow our D2 levels to take control of our behavior, to continue destroying ourselves, nor call it the 'new normal'. Do we have the will to confront this epidemic, so we can mount the courage, hard work and perseverance, to make a difference?
3
Great story. After reading it and the comments I made a huge salad for dinner instead of ordering delivery of something. This is food for thiught!
3
Best article since Pool of Thought.
I'd argue that along with everything mentioned, electronic devices add to the easy accessed low impact stimulus/reward plague in society.
And the decline in physical fitness that goes with it. Which means less ability to respond to stress.
Dr. Friedman is not only a fantastic writer, he's a good swimmer, but his stroke is slightly off balanced and he would drop a couple seconds off his time if he did a flip turn.
And he prefers swimming in the ocean. The pool is too warm.
But the columns? They are spot on.
Keep it up Doc.
I'd argue that along with everything mentioned, electronic devices add to the easy accessed low impact stimulus/reward plague in society.
And the decline in physical fitness that goes with it. Which means less ability to respond to stress.
Dr. Friedman is not only a fantastic writer, he's a good swimmer, but his stroke is slightly off balanced and he would drop a couple seconds off his time if he did a flip turn.
And he prefers swimming in the ocean. The pool is too warm.
But the columns? They are spot on.
Keep it up Doc.
All I heard was "flourless chocolate cake"...I may have a problem...
17
Conveniently leaves out what changes would support increased D2 receptors in (us) submissive monkeys...
Knowing all this we incarcerate the victims and reward the perpetrators. And the Trump administration is doubling down on both fronts. There are signs of hope in policies in Europe, South America and here in Canada. Addiction is a disease not a crime.
6
I intuitively knew this, and have assiduosly kept myself and my kids away from fast food chains COMPLETELY. The food industry knows how to get us well-hooked.
I help us keep away from the cravings and addictions of the sugar-fat-salt triad be keeping our food plain and not going to restaurants.
No, I don't have a ton of time to cook, but you can do pretty quick, inexpensive and plain meals at home. It is, IMO, the best thing I can do for our long- term health.
I help us keep away from the cravings and addictions of the sugar-fat-salt triad be keeping our food plain and not going to restaurants.
No, I don't have a ton of time to cook, but you can do pretty quick, inexpensive and plain meals at home. It is, IMO, the best thing I can do for our long- term health.
1
This article really hit home for me. As someone who is obese, it makes perfect sense. But are there books or medical papers out there that recommend a real life fix that put these findings into practice? In other words, short of all of a sudden becoming rich and less stressed, how does an over-eater change their environment when bad foods are absolutely everywhere and only require a trip to the store, even after you have banished them from your home? And, yes, I have made that trip to purchase cupcakes when stress hits.
Read "The End of Overeating" by David Kessler. It gives a real, workable solution, but it's no magic bullet. The only thing sort of like a magic bullet is bariatric surgery.
3
Sounds like an excuse. One needs the moral failings to start using drugs and overeating. You are just giving excuses to why it is hard to quit. If they didn't have the fortitude to not start, I doubt they will have it to quit. Still a morality problem no matter how you try to paint it.
@David:
Moral judgment may be fun for you, but it doesn't help the rest of us explain or attempt to solve these problems.
Moral judgment may be fun for you, but it doesn't help the rest of us explain or attempt to solve these problems.
15
Moral failings? Please step off of your high horse. Addiction is in no way a moral issue.
7
I have read about an Israeli doctor who supposedly can in 36 hours reset a drug addict's brain. He isn't some sort of Dr. Oz seeking fame; this looks serious. The process involves hospitalization and some serious neuro-physical (so to speak) interventions. I don't know if he can do the same for food addictions but probably.
"These addicts did not suddenly lose their moral fiber. Instead, they faced poor job prospects, a steady erosion in their social status and, consequently, mounting stress."
Wait a second, are you telling us the addicts can't "just say no"? They probably should not be subject to mandatory minimum sentencing laws? Get outta here!
Wait a second, are you telling us the addicts can't "just say no"? They probably should not be subject to mandatory minimum sentencing laws? Get outta here!
5
No, they can't 'just say no.' That's why it's called addiction.
On line readers of the NYTimes are emerging as one of the meanest, and stupidest, demographic groups in America.
On line readers of the NYTimes are emerging as one of the meanest, and stupidest, demographic groups in America.
3
Dr. Kulreet Chaudhary talks about this in her book, The Prime. She says if you can find a way to open the dopamine receptors back up, it will lead to the road of recovery. drkulreetchaudhary dot com.
We are biologically DNA genetic naturally selected evolutionary fit hunter gatherer social primate apes driven to crave fat, salt, sugar, water, habitat, sex and kin by any means necessary including conflict and cooperation.
For most of our 250,000+ year modern human being history fat, salt and sugar were hard to find and we were very active and did not live very long. Within the last 10,000+ years our tool making and using cultural scientific technological ability changed everything.
Now what do we do? We are not gods nor demigods nor magicians nor sorcerers. While natural selection is amoral.
For most of our 250,000+ year modern human being history fat, salt and sugar were hard to find and we were very active and did not live very long. Within the last 10,000+ years our tool making and using cultural scientific technological ability changed everything.
Now what do we do? We are not gods nor demigods nor magicians nor sorcerers. While natural selection is amoral.
1
The 'any means necessary' part seems a bit intense regarding sugar. I never found my weakness for macaroons to cause violence. But compulsive, definitely! There's no such thing as one macaroon...
1
Great research...but why only now, when white Americans are suffering? Where was this research during the crack "epidemic" of the 1980s, when African-Americans were dying, being demonized and imprisoned. ???
10
Michael Pollan wrote 'Fast Food Nation' another excellent book and I haven't eaten fast food since I read it when it was first published.
Michael Pollan is a very good author, but Eric Schlosser wrote "Fast Food Nation: The Dark Side of the All-American Meal."
Recreational drugs? We're lumping cannabis and coffee into the same category as meth and opiates? It seems the Professor is painting with an overly broad brush. Alcohol, opiates, meth and tobacco have killed millions, yet there are infinitesimally few documented cases of death by weed or java.
And yes, I agree the US dietary addictions are the worst of all. Would very much like the Professor to produce a properly conducted study demonstrating the causality between despair and unhealthy eating addictions.
And yes, I agree the US dietary addictions are the worst of all. Would very much like the Professor to produce a properly conducted study demonstrating the causality between despair and unhealthy eating addictions.
9
Read Salt Sugar Fat: How the Food Giants Hooked Us, by Michael Pollan. Processed food is designed to become addictive.
8
It's a great book, but Michael Moss wrote it.
You are right.
Maybe, it's just two scoop privileges that are giving POTUS45 ice cream headachy facial expressions and random control issues? Who knew?
10
"Dr. Nora Volkow, the director of the National Institute on Drug Abuse, and colleagues demonstrated this in a study of Ritalin. Healthy, non-drug-abusing subjects with fewer D2 receptors experienced the stimulant drug as pleasurable, while those with more found it aversive."
Cheap shot, but not surprising that Ritalin is the first drug mentioned in the blurb. Especially in an article written for the NYTImes.
Ritalin. PROPERLY USED, is unlike the 'evil' drugs - cocaine,akcohol, chrystal meth etc, in that Ritalin actually HELPS thousands of people lead better, more productive lives.
Linking Ritalin to the aforementioned drugs without that important qualifier is either irresponsible reporting - or more likely reporting with an agenda.
Anyone who follows medication reporting in The NYTimes knows what that agenda is.
Cheap shot, but not surprising that Ritalin is the first drug mentioned in the blurb. Especially in an article written for the NYTImes.
Ritalin. PROPERLY USED, is unlike the 'evil' drugs - cocaine,akcohol, chrystal meth etc, in that Ritalin actually HELPS thousands of people lead better, more productive lives.
Linking Ritalin to the aforementioned drugs without that important qualifier is either irresponsible reporting - or more likely reporting with an agenda.
Anyone who follows medication reporting in The NYTimes knows what that agenda is.
7
Yes indeed.
1
What we humans consume has changed radically in the past fifty years. With genetic engineering being used to increase corporate prosperity at a profound cost to nutritional quality, and pesticides, fungicides, and other toxic compounds pushed wholesale and applied without conscience, is it any wonder we are a nation of obese addicts?
2
The main problem with this thesis is that living in today's culture is so much less stressful than life was 100 years ago that the comparison isn't even comprehensible. Life 100 years ago was, as the saying goes, brutal and short, especially for women and people who were not rich and children.
Life today is much less stressful, in comparison than what it was then. So, why are all of these addictions present in an environment where the stress is, in comparison with our millions of years of history, about the lowest it has ever been?
The theory does not make sense.
Life today is much less stressful, in comparison than what it was then. So, why are all of these addictions present in an environment where the stress is, in comparison with our millions of years of history, about the lowest it has ever been?
The theory does not make sense.
12
Life was "brutal and short?" I guess it depends on your values.
For almost all of human history, eveyrthing we ate was local and organic. For almost all of human history, if someone wanted a home, they could, if they were willing to expend the energy, go out and find a cave, or cut down some trees, or build a mudhut, without having to obtain a permit. For almost all of human history, if we were hungry, we could go into the woods and pull an apple from a tree, or a fish from a stream, and not worry about being fined. For almost all of human history, we have known the names of most, if not all, of those living in our community. For almost all of human history, if we were sick or injured, we could go to those who had the skills to help us and know that we would be helped to the best of their ability.
Now, without a job, without anyone giving us permission to earn money, no amount of willingness to expend physical effort can garner us the means to eat or obtain shelter or get desperately needed medical care. Everything is owned by someone. We are truly like animals in cages - our survival completely linked to the whims of others. How on earth is that "less" stressful?
For almost all of human history, eveyrthing we ate was local and organic. For almost all of human history, if someone wanted a home, they could, if they were willing to expend the energy, go out and find a cave, or cut down some trees, or build a mudhut, without having to obtain a permit. For almost all of human history, if we were hungry, we could go into the woods and pull an apple from a tree, or a fish from a stream, and not worry about being fined. For almost all of human history, we have known the names of most, if not all, of those living in our community. For almost all of human history, if we were sick or injured, we could go to those who had the skills to help us and know that we would be helped to the best of their ability.
Now, without a job, without anyone giving us permission to earn money, no amount of willingness to expend physical effort can garner us the means to eat or obtain shelter or get desperately needed medical care. Everything is owned by someone. We are truly like animals in cages - our survival completely linked to the whims of others. How on earth is that "less" stressful?
122
People 100 years ago had the opium of religion. They also had far less overstimulation--constant pressure to perform quickly, to respond to information overload, to process the alarms of 24-7 worldwide disasters, to consume immediately-available products at the push of a button. Even having a war going on was remote if you weren't directly in combat. Now, people are continually stimulated to produce and to consume. Simple pleasures with limited access at a natural pace are a thing of the past.
18
The difference in the type of stress. For most of history, people faced periodic acute stressors (eg, facing down a bear), but now people encounter frequent, prolonged situations that set our adrenalin pumping (think maddening traffic). The latter does great harm to our systems, which were built to accommodate the former.
12
"In 1990, no state in our country had an adult obesity rate above 15 percent; by 2015, 44 states had obesity rates of 25 percent or higher. What changed?"
Subdivide this by demographics, you will know.
Subdivide this by demographics, you will know.
2
You should say what you mean, rather than imply. Obesity is on the rise among whites in Europe including in France and Ireland.
7
Europe has nothing to do with the demographs of America
Addenda. As to my first post. I only need imply to the writer of this article who is obviously has a layman's knowledge of demographic statistics and is trying to dovetail things together while cover up other things to justify a research conclusion. I am also aware of what constitutes scientific thresholds of "proof" of various studies and many clinical researchers play kinda loose with the truth and draw improper conclusions because they are bias toward one outlook or another. Journalists of course are 10 times worse doing this. I was a statistician for a few years, I watch these "statistical" games in so much media and articles in so many fields it really was never funny and it still ain't.
Yes. I'm age 50 and an introvert, which I personally define as needing four hours of alone time for every two I spend around others. A year and a half ago I was forced to move out of my apartment by skyrocketing rents (i.e., a 40% increase - totally normal for Portland, OR now} - and was forced to move in with my parents (who are home 24/7) and brother in a tiny apartment. I've gained 45 pounds since then, despite knowing that all it takes for me to maintain a normal weight, or lose weight when needed, is to eat a high-protein, moderate complex carb, no-sugar diet. I can control my weight with no problem when living alone, but now all I want to do is eat.
For context and to pre-emptively respond to those who might say that other things (like a mother's cooking) might be responsible - I prepare my own meals here just like I did in my own apartment. The only thing that has changed in my life is the social environment. I have literally no time alone except in my tiny shoebox crypt of a room, and even then I always know there are three people within 10 feet of me. I just can't stop eating now.
The study involving monkeys and cocaine referred to "submissive" individuals as being stressed by the group environment. Although I am generally (i.e., in my real life/daytime life/away from family life) NOT submissive, I feel that I have to be at home, because it is not really my home at all, but my parents'. I think this study is on to something.
For context and to pre-emptively respond to those who might say that other things (like a mother's cooking) might be responsible - I prepare my own meals here just like I did in my own apartment. The only thing that has changed in my life is the social environment. I have literally no time alone except in my tiny shoebox crypt of a room, and even then I always know there are three people within 10 feet of me. I just can't stop eating now.
The study involving monkeys and cocaine referred to "submissive" individuals as being stressed by the group environment. Although I am generally (i.e., in my real life/daytime life/away from family life) NOT submissive, I feel that I have to be at home, because it is not really my home at all, but my parents'. I think this study is on to something.
240
You gotta get out of there.
12
I hope things get better for you, Kristin.
1
I like what you say. The article does lack practical solutions to people such as yourself. Good luck and maybe seek a group of people in a similar situation.
1
Ubiquitous ----- Snack food is everywhere. Every birthday in the office necessitates a birthday cake. Parents bring boxes of chocolate bars to sell in their kids' school fund-raising projects. McDonald's is between me and my supermarket. In that wonderful supermarket, one has to wheel one's cart past the bakery section to reach the fresh produce section. All intentional by the supermarket and food industry. When I was growing up, automobiles did not have built-in drink holders. I have gained enough, since my son was in high school in the 1980's, to make me officially overweight. Recently my son said, "Since when did you become such a sugar hound?" That was on the occasion of looking for cookies in his kitchen. Sugar is my problem. After reading yet another doctor written diet book, at least I have gone for 9 days with no consumption of artificial sweeteners and no desserts or sweets. Still trying. Sure is hard. I will take a closer look at this article and take my stresses more seriously.
22
You can do it!
As others have noted here, the more you avoid those foods, the less you want to eat them.
Also see if you can add exercise to your day. I know it's hard, but if you add a run, walk, or swim for 30 minutes in the morning, it can help curtail your feelings of stress. (Also it burns calories and defines your muscles!) Asking your partner or a friend to go along with you can make it even more fun.
One thing that I try to do if someone brings a "treat" into work, is to eat one bite of a dessert, because I am curious about the flavor. But after the first bite, no other bites are as satisfying. And I push the dessert away. After awhile you won't like the flavor of all that too-sweet sugar. Really and truly.
As others have noted here, the more you avoid those foods, the less you want to eat them.
Also see if you can add exercise to your day. I know it's hard, but if you add a run, walk, or swim for 30 minutes in the morning, it can help curtail your feelings of stress. (Also it burns calories and defines your muscles!) Asking your partner or a friend to go along with you can make it even more fun.
One thing that I try to do if someone brings a "treat" into work, is to eat one bite of a dessert, because I am curious about the flavor. But after the first bite, no other bites are as satisfying. And I push the dessert away. After awhile you won't like the flavor of all that too-sweet sugar. Really and truly.
1
Thank you so much!
I wish our mainstream grocery stores would make their entrances look like those big beautiful fresh markets where you not only get a healthy variety of fruits & veggies but there's also a pleasant shopping experience as we stroll through the aisles with our baskets & reusable bags!
The food landscape of 1990 was not that different from today. McDonalds was on every corner then, every mall had a Cinnebon and a significant portion of busy dual income households relied heavily on processed foods. So, it's not as if cheap calorie dense food wasn't available 25 years ago. We didn't go from negligible to ubiquitous exposure in 25 years. Exposure can't fully answer the question of what led to radical upticks in obesity.
We do have increasingly difficult to control economic stress in a greater percentage of the population, and we do have ubiquitous exposure to isolating and addictive technology... the internet, gaming, instagram, twitter, facebook, constant connection to a digital netherworld. I am beginning to think something is amiss in the social architecture of modern life due of technology and that our brains and bodies are reflecting it. We are social animals. It is essential to our health that we have satisfying social lives with rich connections in keeping with individual needs (introvert/extrovert). The current incarnation of digital tech provides a deluge of information, anemic social interaction at a distance and a world-wide shopping mall at our finger-tips 24/7; the remainder has been commodified to serve business. Our work lives are on overdrive because of digital technology-derived efficiency in pursuit of constant economic expansion in a global marketplace. It's a mess out there! Neuroscience offers some much needed clarity and perspective.
We do have increasingly difficult to control economic stress in a greater percentage of the population, and we do have ubiquitous exposure to isolating and addictive technology... the internet, gaming, instagram, twitter, facebook, constant connection to a digital netherworld. I am beginning to think something is amiss in the social architecture of modern life due of technology and that our brains and bodies are reflecting it. We are social animals. It is essential to our health that we have satisfying social lives with rich connections in keeping with individual needs (introvert/extrovert). The current incarnation of digital tech provides a deluge of information, anemic social interaction at a distance and a world-wide shopping mall at our finger-tips 24/7; the remainder has been commodified to serve business. Our work lives are on overdrive because of digital technology-derived efficiency in pursuit of constant economic expansion in a global marketplace. It's a mess out there! Neuroscience offers some much needed clarity and perspective.
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The article says, "In 1990, no state in our country had an adult obesity rate above 15 percent; by 2015, 44 states had obesity rates of 25 percent or higher. What changed?
Contemporary humans did not experience a sudden collapse in self-control. What happened is that cheap, calorie-dense foods that are highly rewarding to your brain are now ubiquitous."
Obesity rates in the U.S. have been rising since at least 1960. The steepest increase was seen between 1976 and 2000. While some of the blame for the increase over time is rightly placed on the food industry, I suspect that there was no sudden food industry change in the last 25 years of the 20th century that can fully explain the soaring rates of obesity. It is much more likely that other factors deserve most of the blame, like cable television, video games, the Internet and more sedentary lifestyles.
I also blame the popularity of low-carb diets, starting with the first book by Robert Atkins in 1972. Atkins died in 2003 of cardiac arrest. He weighed more than 250 lbs. when he died.
Obesity rates continue to rise at an alarming rate, but the rate has moderated somewhat in the years following Atkins' death.
Contemporary humans did not experience a sudden collapse in self-control. What happened is that cheap, calorie-dense foods that are highly rewarding to your brain are now ubiquitous."
Obesity rates in the U.S. have been rising since at least 1960. The steepest increase was seen between 1976 and 2000. While some of the blame for the increase over time is rightly placed on the food industry, I suspect that there was no sudden food industry change in the last 25 years of the 20th century that can fully explain the soaring rates of obesity. It is much more likely that other factors deserve most of the blame, like cable television, video games, the Internet and more sedentary lifestyles.
I also blame the popularity of low-carb diets, starting with the first book by Robert Atkins in 1972. Atkins died in 2003 of cardiac arrest. He weighed more than 250 lbs. when he died.
Obesity rates continue to rise at an alarming rate, but the rate has moderated somewhat in the years following Atkins' death.
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@Dan Frazier:
Low carb diets (including Atkins) produce _better_ weight loss and improvements in metabolic health than low fat or standard diets, in numerous randomized controlled trials, with human subjects.
The rise in obesity over the past few decades corresponds to the promotion of _low fat_ diet advice, with the usual caveats about correlation and causation.
Low carb diets (including Atkins) produce _better_ weight loss and improvements in metabolic health than low fat or standard diets, in numerous randomized controlled trials, with human subjects.
The rise in obesity over the past few decades corresponds to the promotion of _low fat_ diet advice, with the usual caveats about correlation and causation.
3
(t's really complex, & fascinating -- but also frustrating, as people are individuals and "one explanation" doesn't fit every story.
What has changed since 1960? Here's just a few off the top of my head.
1. Most women started working outside the home, meaning they no longer had a lot of time to cook, or shop for healthy homecooked foods.
2. Related to that -- but also just because we like it! -- we started eating out a LOT more often. Today, many of us rarely eat homecooked meals.
3. The rise of TV, and passive indoor entertainment, vs. outdoor activities
4. The rise of automobiles, and the ability to it gives to shopping, eating out at restaurants, fast food drive throughs, snacking while driving, and of course, the reduced need to ever walk anywhere.
5. Suburbs, designed around cars, eliminating even the possibility of safely walking anywhere -- as well as keeping children indoors.
6. Computers and video games, making children even less likely to play outside.
7. Exaggerated safety fears, egged on by TV and news, that make parents terrified to let children play out doors.
8. The new belief that children must snack every few hours, or some dire terrible thing will happen to them.
10. As a culture, we suddenly stopped smoking -- huge public health victory against cancer -- but smoking dampens appetite, and revs metabolism.
11. We switched to high fructose corn syrup vs. cane sugar in our diets.
And there are COUNTLESS more, if you REALLY think about it.
What has changed since 1960? Here's just a few off the top of my head.
1. Most women started working outside the home, meaning they no longer had a lot of time to cook, or shop for healthy homecooked foods.
2. Related to that -- but also just because we like it! -- we started eating out a LOT more often. Today, many of us rarely eat homecooked meals.
3. The rise of TV, and passive indoor entertainment, vs. outdoor activities
4. The rise of automobiles, and the ability to it gives to shopping, eating out at restaurants, fast food drive throughs, snacking while driving, and of course, the reduced need to ever walk anywhere.
5. Suburbs, designed around cars, eliminating even the possibility of safely walking anywhere -- as well as keeping children indoors.
6. Computers and video games, making children even less likely to play outside.
7. Exaggerated safety fears, egged on by TV and news, that make parents terrified to let children play out doors.
8. The new belief that children must snack every few hours, or some dire terrible thing will happen to them.
10. As a culture, we suddenly stopped smoking -- huge public health victory against cancer -- but smoking dampens appetite, and revs metabolism.
11. We switched to high fructose corn syrup vs. cane sugar in our diets.
And there are COUNTLESS more, if you REALLY think about it.
12
A crucial point missing on the food addiction: whole foods (meat, vegetables, fish, fruit, etc) which we have have evolved to eat push the reward buttons but also push the _satiation_ buttons in our brains. Consumption of these foods is largely self-regulating as a result, we feel full and stop eating. In contrast, modern processed foods are both nutrient poor and specifically, painstakingly designed to "short circuit" our natural satiation signals.
29
Easy. Just limit your exposure to high calorie foods. Just how is that done when every where we go is awash in food?
4
In "Globesity," the documentary, a Tuft's University prof makes the case against high carb and high fat together. He says we have never had both on the planet at the same time and that the duality create a perfect "reward"circuit that is addictive as measured by brain imaging. Easily extracted vegetable oils (since) the industrial revolution are omnipresent, cheap, and a great source of inflammatory fats. Paired with refined carbs, they are cheap and highly addictive. Grains ground into flours are just too evolutionarily new and highly glycemic for the average human to tolerate, in addition, when combined with fat, keep blood sugar highly elevated for longer, causing vascular damage EVERYWHERE. Add the impact of modern farming where starchier, sweeter and less anti- oxidants are selected for and you have the reason for the problem of modern health care.
11
@Jamie Lynn: but "grains ground into flour" are really old -- the Ancient Egyptians ate bread made from flour -- bread wasn't a new thing in the Bronze Age. It's really NOT a modern invention at all.
If you mean "a Paleo diet" ... remember, we only have the most general idea, mostly speculation, about what ancient people ate. They did not leave a written record, as the Egyptians did. What a lot of people THINK is a paleo diet, is mostly a matter of conjecture or wish fulfillment ("now I can eat steak all day!").
If bread -- food made from ground grains -- was addictive or deadly, we surely would have known this LONG before the modern era. The reason most people today feel "bread/grains are bad" is the obsession with carbs, and dieting. They don't wish to be healthy, so much as really, really thin.
If you mean "a Paleo diet" ... remember, we only have the most general idea, mostly speculation, about what ancient people ate. They did not leave a written record, as the Egyptians did. What a lot of people THINK is a paleo diet, is mostly a matter of conjecture or wish fulfillment ("now I can eat steak all day!").
If bread -- food made from ground grains -- was addictive or deadly, we surely would have known this LONG before the modern era. The reason most people today feel "bread/grains are bad" is the obsession with carbs, and dieting. They don't wish to be healthy, so much as really, really thin.
6
What I find salient about this article, in terms of overeating, is the point about "changing one's environment." However, I don't think it's all the usual suspects that the author and others list (such as availability of junk food and advertising). I think the change in environment and what creates these unsatisfying (quick fix) dopamine highs happens when we create an environment where we are sitting on the internet (or watching Breaking Bad) about to read a "juicy" article and to make it "a bit more juicy" (that dopamine fix) we get some popcorn or other snack. This numbing has its own kind of pleasure, that quick fix dopamine kick. It's totally different from being present, mindfully eating (without distractions), and savoring one's food. When we do the second, we are actually satisfied. When we do the first, we are in quick fix land. It is also harder to stop because there is a hangover effect (we feel bad). We can choose to not create the environment of internet/Netflix dopamine high eating, to redirect away from this.
3
This is a truly wonderful article. My main question...how do we address this? I do not believe in the utopian fantasy of returning to a simpler time of the past. I don't believe that mythology; rather, how do we structure the contemporary individual to navigate these issues that will not be leaving us anytime soon. I would like to have read that or, perhaps, tbat can be addressed in another article.
14
Meditation.
4
Informative article, but it fails to include another major factor in the addiction culture we have developed in this country which is institutional collusion. The oldest example I can think of are the opium wars, and more recent examples are the tobacco industry and the more recently exposed sugar industry/American Medical Association. All of these examples have one primary motivation, economic. In all of these cases, profits for the privileged, and who cares about the others.
106
Insightful column. The textbook I use to teach anatomy and physiology (Marieb, et al) indicates that people who experience chronic stress and eat a diet rich in fats and sugars release lots of a chemical messeenger called neuropeptide Y (NPY). NPY is a powerful appetite stimulant.
23
Actually, fats suppress the appetite, and they are crucial to both healthy brain function and a feeling of fullness. Fat got thrown under the bus years ago to distract from the dangers of sugar.
Eliminating sugar (including fruit, high-sugar vegetables, and white carbs such as white rice and bread) and eating a high-protein, high fat, moderate complex carb diet, and eating first thing in the morning, will completely eliminate cravings based on nutritional/blood sugar issues.
However, as I posted in my own post a bit ago, my own experience has shown me that even eating in this way cannot overcome the anxiety caused by social situations that go against our fundamental nature, which the referenced study in the article confirms. Put someone in the "wrong" environment for their fundamental nature, and their inherent urge to self-correct their now unmet neurotransmitter needs will trump all.
Eliminating sugar (including fruit, high-sugar vegetables, and white carbs such as white rice and bread) and eating a high-protein, high fat, moderate complex carb diet, and eating first thing in the morning, will completely eliminate cravings based on nutritional/blood sugar issues.
However, as I posted in my own post a bit ago, my own experience has shown me that even eating in this way cannot overcome the anxiety caused by social situations that go against our fundamental nature, which the referenced study in the article confirms. Put someone in the "wrong" environment for their fundamental nature, and their inherent urge to self-correct their now unmet neurotransmitter needs will trump all.
6
Is that the same stimulant when you convince yourself eating healthy foods won't make you fat?
2
Fruit is an essential part of any healthy diet. Do not eliminate fruit. Fruit juices, yes, we should eliminate. They have too high a concentration of sugars. All other sweeteners should not be consumed, including of course artificial ones. They help to perpetuate the cravings for sweet.
Fascinating article. Food for thought or cause for stress? Thank you so much.
6
Interesting study -- and even more so in the timing, as is the entire upwelling of concern.
I used to live in the US West. Every Indian reservation I knew of had these problems -- joblessness, hopelessness, despair, poverty, addiction -- decades ago. Nobody outside of the Indian Health Service seemed to notice, or care.
Now that it's rural white folks, well! Time to get cracking, do something!
I used to live in the US West. Every Indian reservation I knew of had these problems -- joblessness, hopelessness, despair, poverty, addiction -- decades ago. Nobody outside of the Indian Health Service seemed to notice, or care.
Now that it's rural white folks, well! Time to get cracking, do something!
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Lisa, I wouldn't say people didn't care, but the very structure of the Indian reservation and the way the US has coped with its indigenous population has contributed to that situation -- lack of jobs, hopelessness, despair, poverty, addiction. We ENABLED our Native American citizens to live in economic dependence -- just enough to get by, but not enough to lead a dignified meaningful life. We do similar things to our poor urban black population. This is all mostly the doing of well-intentioned bleeding heart liberals.
Now we see it aimed at the rural white poor, in much the same way. Only it is mixed up with our disdain for their "lower class values" and their votes for Trump, and so many here -- comfortable, white urban professionals in blue cities -- love to stereotype the working class, and make assumptions about their lives that are often wildly off base.
Here is one that many in this forum are mixing up: it is not the unemployed who necessarily turn to drugs. Most people start out WITH jobs, and their drug usage makes them get fired or quit, because you can't hold a job if you are high all the time. Plus employers now screen for drug use.
The "it's the poor jobless folks with no hope for a good factory job" meme that let's them forget how many wealthy folks use drugs -- look at Hollywood! how many young lives, snuffed out by drug use? and those are rich people, in creative jobs, with everything to live for?
Now we see it aimed at the rural white poor, in much the same way. Only it is mixed up with our disdain for their "lower class values" and their votes for Trump, and so many here -- comfortable, white urban professionals in blue cities -- love to stereotype the working class, and make assumptions about their lives that are often wildly off base.
Here is one that many in this forum are mixing up: it is not the unemployed who necessarily turn to drugs. Most people start out WITH jobs, and their drug usage makes them get fired or quit, because you can't hold a job if you are high all the time. Plus employers now screen for drug use.
The "it's the poor jobless folks with no hope for a good factory job" meme that let's them forget how many wealthy folks use drugs -- look at Hollywood! how many young lives, snuffed out by drug use? and those are rich people, in creative jobs, with everything to live for?
2
@Concerned Citizen:
Conservatives are completely innocent of inflicting any problems on Native Americans, poor urban populations, and poor rural populations? Don't make me laugh. At least "bleeding heart liberals" want to help the poor, rather than punish the poor for being poor. And any vote for Trump is worthy of disdain by Americans of all classes.
Conservatives are completely innocent of inflicting any problems on Native Americans, poor urban populations, and poor rural populations? Don't make me laugh. At least "bleeding heart liberals" want to help the poor, rather than punish the poor for being poor. And any vote for Trump is worthy of disdain by Americans of all classes.
4
You're joking rural white folks have been written off by the elite since the civil rights era. Look at Hillary's deplorable statement.
We should really give some thought to what it means to "treat" someone for addiction because what we are now seeing is the future of humanity being played out in small-town America. Addicts with no job, no future and no sense of worth will be most of us when we are replaced by automation. Merely rendering someone drug-free will be a short-lived waste of money once they are sent on their merry way and heaved once again back into a mire of meaninglessness. Even under the assumptions of a universal basic income, sources of pride, respect and meaning will somehow have to evolve or the world will become one giant opium den, punctuated by random violence meant to give a sense of "being alive".
Since I have no hope or confidence in the foresight of either our elected officials or so-called benevolent capitalists, perhaps the best we can hope for are for drugs to be developed that keep us in a permanent state of blissful indolence, with the fewest side-effects - maybe even some benefits, administered through the water supply.
Since I have no hope or confidence in the foresight of either our elected officials or so-called benevolent capitalists, perhaps the best we can hope for are for drugs to be developed that keep us in a permanent state of blissful indolence, with the fewest side-effects - maybe even some benefits, administered through the water supply.
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Stan, you've identified a very important issue coming down the pike. Feelings of worthlessness, lack of meaningful work, and isolation all contribute greatly to stress and the need for comfort or escapism. Evidently, there will still be need of humanitarian services when the robots take over, so we may want to encourage the next generation to prepare for those. It's not such a bad gig, taking care of each other. You may not get rich, but you might get happy.
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Like "soma" in Aldous Huxley's Brave New World!
2
Start taking SOMA as soon as possible. Don't wait for Stress!
3
This ignores the fact that people have free will. They can refuse to take that drug, drink, or even the "comfort food" mentioned. Addiction is not a disease: it's a behavior problem. Destructive behaviors can be modified and permanently changed, or extinguished. People can choose to change, or they can refuse to give in to addictive behaviors in the first place. To deny that power and fall back on the " disease" fallacy (which makes addicts passive victims rather than agents of their own futures) is too easy. People have to take responsibility for their choices in life. I am not saying we need to blame or condemn substance abusers -- or those with any addiction -- only that addicts have to own their actions. Don't play the victim card.
I was raised by an abusive, damaging, self-obsessed addict (addicted to alcohol...I refuse to use the more sanitized "alcoholic" label) who refused to acknowledge the addiction, even as it destroyed the lives of others. I have numerous relatives who are food addicts (people who assuage their unhappiness with food, to the point that it seriously damages their health). I could easily have gone either route myself -- given my genetics and early environment -- but I fought that legacy. I gave up alcohol when I saw it turning into a crutch, and I learned to be disciplined around food when I caught myself eating compulsively when sad or stressed. It can be done. It takes self-discipline, not money or status.
I was raised by an abusive, damaging, self-obsessed addict (addicted to alcohol...I refuse to use the more sanitized "alcoholic" label) who refused to acknowledge the addiction, even as it destroyed the lives of others. I have numerous relatives who are food addicts (people who assuage their unhappiness with food, to the point that it seriously damages their health). I could easily have gone either route myself -- given my genetics and early environment -- but I fought that legacy. I gave up alcohol when I saw it turning into a crutch, and I learned to be disciplined around food when I caught myself eating compulsively when sad or stressed. It can be done. It takes self-discipline, not money or status.
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It does not ignore free will. It points out the short comings of freewill. Much of the addiction recovery speaks to the shortcomings of "white knuckling it" a.k.a. free will.
You were lucky to find the inner strength and wherewithall to overcome addiction but I am sure environment and opportunity also had alot to do with it. We all just like to believe that our successes are our own making.
You were lucky to find the inner strength and wherewithall to overcome addiction but I am sure environment and opportunity also had alot to do with it. We all just like to believe that our successes are our own making.
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@Passion for Peaches:
Free will is important, but it is a finite resource. If we are hungry, tired, stressed out, and depressed, our reserves of free will diminish, we lose impulse control, and "healthy decision making" becomes harder and harder. It's not a moral failing, it's just being human.
Free will is important, but it is a finite resource. If we are hungry, tired, stressed out, and depressed, our reserves of free will diminish, we lose impulse control, and "healthy decision making" becomes harder and harder. It's not a moral failing, it's just being human.
120
Not everyone who experiences these problems does so based on conscious choice. Kids whose parents have fed them sugar enhanced, processed meals are undergoing the physiological changes described in the article, and will struggle once they are adults feeding themselves. People who have orthopedic or other deep surgeries, car accidents, chronic pain problems require pain reduction measures in order to function and recover. That may be their first experience with narcotics, and again, once that set of changes starts taking place they may shockingly find themselves with an addiction when they may have been "clean livers" beforehand. Stop with the moralizing and read the article again.
36
What factor does just wanting to look good, relative to others, play in eating less, eating better, and going to the gym to work out? Exercise, such as just dog-paddling up and down a pool for an hour, makes you feel better, sleep better and look better--all of which reduces stress. Trying to stay in shape, even if you never quite achieve your goals (and most of us don't), is better than giving up.
Rather than grabbing a hot dog or candy bar at the convenience sore when we are hungry, why don't people get a banana and an apple? The fruit in convenience stores these days is pretty good. And, you get to feel smugly superior to those in line buying a chocolate milk.
Why do the overwhelming majority of those prescribed pain pills with an opioid not become addicted? I have found that after a few days of regular use they are not very effective.
Finally, we would all be thinner if our smart phones shut down while we are eating.
Rather than grabbing a hot dog or candy bar at the convenience sore when we are hungry, why don't people get a banana and an apple? The fruit in convenience stores these days is pretty good. And, you get to feel smugly superior to those in line buying a chocolate milk.
Why do the overwhelming majority of those prescribed pain pills with an opioid not become addicted? I have found that after a few days of regular use they are not very effective.
Finally, we would all be thinner if our smart phones shut down while we are eating.
34
I gave up the doughnuts for fruit at the C-Store a couple of years ago.
I always point out to my children what large, overweight people are purchasing at the grocery store. (Pop & Chips!)
The largest problem is probably Societal Perception.....You look GREAT even though you are 25% overweight!
I always point out to my children what large, overweight people are purchasing at the grocery store. (Pop & Chips!)
The largest problem is probably Societal Perception.....You look GREAT even though you are 25% overweight!
1
The article points out that some people have fewer receptors to pleasure for various reasons making them more prone to addiction to food, drugs or smart phones.
4
Did you not catch the part about physiological changes in the brain that include decision making and self control? Once rationality is impaired you can't expect rational choices until there is capacity for it. This is why we say drunk people shouldn't drive, or can't consent to sex. Once the alcohol is out of their system they have restored judgment for the most part. We know the difference.
4
"There was no flourless chocolate cake on the savanna." too funny! I'm a food addict trying to avoid diabetes, which runs in both sides of my family. For me the answer is Weight Watchers. I've lost 25 lbs. and kept it off for nearly 9 years. I have support of other foodies and learning better ways of eating than numbing out my feelings with food.
81
I appreciated reading that there are scientific implications that these addictions/lack of receptors can be overcome by removal from stressful conditions and availability of substances. Of course the great challenge is having to return to the stress without sufficient coping mechanisms in place in order to pass up the cookie aisle or turn down the offer of drugs and alcohol. I used to work at a rehab center for addicts and nearly all of the clients who went on to remain sober had follow up treatments and supports in place. Just stopping the behavior doesn't do it. Insurance companies hate to pay for this stuff, but until now they've had to, at least somewhat. What do we suppose will happen when they have freedom to resist paying anything at all?
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Don't forget early childhood stresses -- child abuse can result in the lack of emotional self regulation and PTSD that fuels addiction. Another big change since 1990 is the number of kids stressed by early day care.
29
Seriously? This is way too important a topic to be distracted by non-research based assertions about someone else's childcare choices.
43
Stressed by early day care? Really? I would agree that the quality of daycare matters. Your judging could be more helpful if you qualified your "early daycare" by "poor quality". And then you might advocate with your legislators to mandate maternal and paternal leave so parents could stay with their newborns for a year. Otherwise, your comments help no one.
26
I wouldn't mind reading some research on that subject.
1
High-calorie foods can be healthy. When eating fatty, low-carb foods, our endocrine system naturally limits consumption to the number of calories we will burn--no overeating, no feeling of starvation and no weight gain. In addition to overeating, consumption of sugar and low-fiber starchy foods leads to inflammation, production of bad LDL cholesterol (small, dense LDL cholesterol particles), cardiovascular disease and many other chronic health problems. If one severely restricts or eliminates sugar and low-fiber starch from the diet, good LDL (large buoyant LDL cholesterol particles) will be produced.
Almost no one gets their LDL cholesterol measured, because it's so expensive (well over $1,000). LDL is merely *calculated* from the total cholesterol, HDL cholesterol, and triglyceride levels; and this calculation does not distinguish good LDL from bad. Saturated fat in the diet raises good LDL. Refined carbs in the diet raise bad LDL. "It's not the fat!"
Why are many foods supplemented with vitamin D, when animal and fish fat contain a much more potent form of D?
Half our food supply consists of sugary and starchy calories, when it should be less than 5%. Will the government jeopardize the global market the U.S. dominates by alerting people to the huge negative impact carbs have on human health? No, we'll spend billions of dollars on the much smaller problem of opiate addiction instead.
At least one-third of U.S. healthcare dollars are spent on weight-related issues.
Almost no one gets their LDL cholesterol measured, because it's so expensive (well over $1,000). LDL is merely *calculated* from the total cholesterol, HDL cholesterol, and triglyceride levels; and this calculation does not distinguish good LDL from bad. Saturated fat in the diet raises good LDL. Refined carbs in the diet raise bad LDL. "It's not the fat!"
Why are many foods supplemented with vitamin D, when animal and fish fat contain a much more potent form of D?
Half our food supply consists of sugary and starchy calories, when it should be less than 5%. Will the government jeopardize the global market the U.S. dominates by alerting people to the huge negative impact carbs have on human health? No, we'll spend billions of dollars on the much smaller problem of opiate addiction instead.
At least one-third of U.S. healthcare dollars are spent on weight-related issues.
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From what I understand Sugar subsidies to South Florida have been worth $billions. Hmmm. Wonder what the problem is ?
36
Anonymous "Me,"
"..good LDL (large buoyant LDL cholesterol particles)," produced by "sugar and low-fiber starch."
Giggle.
I guess the Good Grey Lady is hiring its vetting staff from National Enquirer rejects now.
"..good LDL (large buoyant LDL cholesterol particles)," produced by "sugar and low-fiber starch."
Giggle.
I guess the Good Grey Lady is hiring its vetting staff from National Enquirer rejects now.
2
@FredFrog2:
LDL particle size distribution is a well-known thing, going on decades now. Different LDL size distributions have different effects on heart disease risk, and diet (in part) affects both the amount and size distribution of the LDLs. Refined carbs send this in the wrong direction, substituting unrefined carbs and/or naturally fatty foods sends this in the right direction. Recommend a Pubmed search for "Ronald Krauss."
LDL particle size distribution is a well-known thing, going on decades now. Different LDL size distributions have different effects on heart disease risk, and diet (in part) affects both the amount and size distribution of the LDLs. Refined carbs send this in the wrong direction, substituting unrefined carbs and/or naturally fatty foods sends this in the right direction. Recommend a Pubmed search for "Ronald Krauss."
2
It’s no coincidence that there are free ice cream parlors in orthopedic surgery residential rehab centers, yet the patients don’t overindulge and don’t gain unwanted weight during their stays: patients go through the unpleasantness of daily (sometimes twice-daily) physical therapy and crave a reward beyond pain control; but those on opioids for pain control are satisfied with just a scoop of their favorite flavor because their D2 receptors are mostly occupied by opioids. When discharged to home and weaned off the drugs, the pain (albeit to a lesser degree) remains, and it takes more pleasurable experiences to occupy those receptors…and so resumes the pattern of overeating, drinking to excess, compulsive shopping, or new drugs to abuse. (Been there, done that—and while drug-free, am battling carb cravings every day, hoping that exercise endorphins will occupy more of those receptors without my demanding other immediate rewards).
Society makes being slim desirable, yet throws up so many roadblocks to getting there--even as it mocks those who can’t.
Society makes being slim desirable, yet throws up so many roadblocks to getting there--even as it mocks those who can’t.
194
Very few can distinguish between good and bad carbs. So the meat & dairy industry, along with the Food Mafia and the USDA - of course!- happily let the carb bashing continue
1
i struggled with food addiction for years but finally I learned to use other means than processed high sugar foods, and I haven't touched any in years. The more we eat locally, safely, the less addicted we will be.
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What other means? And do you still crave sugary foods?
1
I hope the 'helicopter parents' we keep reading horror stories about are listening. If their kids don't learn to function on their own and become competent adults, stress will overpower them when their parents are gone.
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Thanks, now I'm craving both.
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It is so hard to lose weight in a society to fights against you doing so. It can be done. It has been done. But for most people it is a constant battle.
24
You're so right. I've worked with recovering drug addicts and for most it is impossible to recover unless they totally leave their former, drug-abusing, environment after they finish treatment.
When I talk about trying to lose and maintain weight loss I think of putting a heroin addict in a similar position. They get off of heroin, but then have to spend the rest of their lives hanging out with people who do heroin (mindlessly eat unhealthy food), going to places that serve very tempting heroin as part of almost every public social event (restaurants, bars, parties) and being barraged with images of happy, healthy people doing heroin and having the best time (movies, television, ads, etc.) We would be shocked if this person succeeded in not relapsing, wouldn't we?
When I talk about trying to lose and maintain weight loss I think of putting a heroin addict in a similar position. They get off of heroin, but then have to spend the rest of their lives hanging out with people who do heroin (mindlessly eat unhealthy food), going to places that serve very tempting heroin as part of almost every public social event (restaurants, bars, parties) and being barraged with images of happy, healthy people doing heroin and having the best time (movies, television, ads, etc.) We would be shocked if this person succeeded in not relapsing, wouldn't we?
4