When Cathryn Kemp suddenly developed chronic pancreatitis at age 33, literally overnight, the pain was, she recalls, "the sensation of a million red-hot maggots eating away at my insides." It came in excruciating bouts on and off for four years, as the award-winning travel writer with an exciting career and social life was suddenly forced to live with her parents between extended hospital stays on a morphine drip.
A London-based specialist eventually diagnosed her with pancreatic dysfunction, and she had surgery that mitigated her condition.
But by then she had just as big a problem: she was hooked on painkilling drugs.
Kemp was given a prescription for breakthrough pain and told to take a maximum of eight lozenges containing the drug fentanyl, 100 times stronger than heroin, each day. A few months into the routine, however, during a gut-wrenching end to a relationship, she popped an extra one.
It was a fateful decision. The need for ever-increasing amounts of the drug to produce the same cozy, numbing effect increased until she was taking a potentially fatal dose of nearly 60 strawberry cheesecake-flavored fentanyl lozenges every single day.
"I used to think a drug addict was someone who lived on the far edges of society. Wild-eyed, shaved head and living in a filthy squat. That was until I became one," writes the petite blonde, now married and a mother, in the book about her journey into and out of drugs, Coming Clean: Diary of a Painkiller Addict (Piatkus, 2017).
Kemp's story illustrates how vulnerable ordinary humans are to having our brains hijacked by addiction. America's colossal and expanding opioid addiction crisis is an obvious case in point. It dwarfs the situation in other Western countries, and it got out of hand very quickly. The rate of drug overdose in the United States quintupled in just the seven-year period between 2009 and 2016. It now holds first place as the leading cause of accidental death, responsible for 63,600 American fatalities in 2016—and the rate is rising.
The gateway for a large number of these tragedies is the widespread use of prescription drugs—painkillers given for such things as back pain or after childhood surgeries.1 Each year, American doctors write a staggering 259 million prescriptions for addictive opioid painkiller medications alone—nearly a bottle for each citizen. The Centers for Disease Control and Prevention estimates that more than two million people are addicted to prescription painkillers and street drugs.2
The opioid crisis is just one particularly destructive tentacle of a gigantic hydra of addiction that is looming over society in what seems like unprecedented levels. If you are not an addict yourself, you know someone who is.
By 2020, the number of American adults age 50 and older with a substance abuse disorder is expected to double from 2002-2006 levels.3
And the World Health Organization (WHO)'s latest update on the age-old scourge of alcohol addiction is as bleak as ever: alcohol abuse is epidemic in most parts of the globe, claiming 3.3 million lives per year.4 If the drugs and alcohol haven't got us, there are other tentacles to avoid, such as gambling, shopping, food, internet, sugar and smartphones.
Not so sweet
There is heated debate among researchers about whether or not sugar is actually 'addictive' in the medical sense of the word. A recently published review paper by cardiovascular research scientist James J. DiNicolantonio and cardiologist James H. O'Keefe, both from Saint Luke's Mid America Heart Institute in Kansas, and William Wilson, a doctor with the non-profit US group practice Lahey Health, concludes that it is: "In both animals and humans, the evidence in the literature shows substantial parallels and overlap between drugs of abuse and sugar, from the standpoint of brain neurochemistry as well as behavior."5
The researchers cite studies showing that rodents prefer sweet water to injected cocaine. One by a team at the University of Guelph, Canada, for example, found that rats responded similarly to Oreo cookies and cocaine in an experiment using either as a reward.6
Sugar causes the release of feel-good chemicals in the brain—the neurotransmitters dopamine and serotonin and endorphin hormones, the natural opiates that are the brain's reward system.
Eating a lot of sweets and foods with a high glycemic index may eventually change your brain chemistry, reducing the number of receptors for dopamine so that more and more sugar is needed to produce the same effect. The more we use it, the bigger the 'hit' we need to produce the same dopamine surge.
As with other addictions, our bodies and brains can become rewired to use that sugar to temporarily alleviate anxiety, depression and other mood swings.
Excess sugar consumption reduces dopamine receptors in the brain and triggers other neurobiological changes similar to those induced by addictive drugs, indicating that it over-activates the brain's reward system.7 Their conclusion? Sugar fulfills many of the descriptive features of addiction: bingeing, craving, tolerance and dependence marked by withdrawal symptoms.
"Nowadays, sugar has been refined to the state of a chemical-like substance," they note—pure white crystals like cocaine or opium.
Others maintain that, while habit forming, sugar is not capable of hijacking the neurochemistry of the brain in the manner that drugs do. University of Cambridge psychiatrists reject the theory that sugar is addictive in the strict sense used in their review of the scientific literature.8
Maybe it's not as powerful as heroin, but research strongly supports the view that a growing compulsion to eat the sweet stuff has serious health ramifications. Sugar consumption has grown from a mere two pounds a year 200 years ago to a whopping 150 to 170 pounds per year today.9
Most of the world's population live in countries where obesity kills more people than malnourishment, and the WHO blames this fact in part on massive sugar consumption, which is linked to obesity, type 2 diabetes and cardiovascular disease.
Not so smart
You don't have to go further than your local coffee shop to see that people don't like to be without their mobile devices. Checking social media, email and texts is highly addictive behavior because, like a lottery or a slot machine, you never know when you are going to get the reward of something exciting.
A 2016 survey found that half of teenagers polled feel they are addicted to their smartphone. Even more parents (59 percent) feel their teens are addicted to their mobile devices, and more than a quarter (27 percent) feel they are addicted themselves.10
In a Vodafone survey of 2,000 British adults, one-third of them said they would check their smartphone during sex. More than half (51 percent) said they would use it while attending a wedding ceremony, and 54 percent said they would think it was fine to pick up while out to dinner. About 57 percent said they would pick up a call while going to the bathroom.11
A recent study by venture capital firm Accel and data analytics company Qualtrics found that millennials check their smartphones an average of 150 times per day. Seventy-nine percent sleep with their phones near their beds, and half check their phone in the middle of the night.12
Some of us just can't stop taking selfies. Junaid Ahmed, 22, who has 50,000 followers on Instagram, admits he takes about 200 snaps of himself a day and gets a rush when the flood of likes comes in. "When I post a picture, in the first minute or two I'll probably get 100 likes, and I love it, my phone goes crazy, it's just amazing," he told the BBC recently.13
In 2014, scientists staged a hoax, coining the term 'selfitis' to describe a new mental illness involving selfie obsession, but in December 2017, researchers at Nottingham Trent University and Thiagarajar School of Management in India reported that the phenomenon is indeed a reality and described a 'Selfitis Behavior Scale' they developed to assess its severity.14
While digital obsession may be giving millennials a rush, it is not necessarily increasing their performance in reality. In another 2017 study, researchers published their findings from two experiments they conducted relating to "smartphone-induced brain drain" and reported that just the presence of a smartphone on the table during tests reduces one's cognitive scores.15
"Your conscious mind isn't thinking about your smartphone, but that process—the process of requiring yourself to not think about something—uses up some of your limited cognitive resources," said lead researcher Adrian Ward, a professor at the University of Texas. "It's a brain drain."
Canadian physician Gabor Maté, an addiction specialist, offers a sweeping definition of addiction: any behavior or substance that gives temporary relief or pleasure but in the long term causes harm, and which is craved but can't be given up without relapse. This captures many of the obsessive behaviors of modern culture, from checking email 11 times every hour,16 to running 17 miles a day on a treadmill17 to pathological gambling.18
In his TedX talk on addiction, Maté admitted he knows the subject personally—he used to be addicted to buying classical music CDs. One week he spent $8,000 on them. "Once I left a woman in the hospital in labor to get a classical piece of music," he said. Worse than that, he got so absorbed in the music store that he didn't return to the hospital in time. "I missed the delivery of that baby." Like most addicts, Maté lied to his wife and himself about his obsession as it staked greater and greater claim on his life.
Maté refers to the Buddhist idea of "hungry ghosts"—"creatures with large empty bellies, small scrawny necks and tiny little mouths so they can never get enough. They can never fill this emptiness on the inside." Addiction is frequently related to childhood trauma like abuse or abandonment, he says in his book, In the Realm of Hungry Ghosts (Knopf, 2008). "We are all hungry ghosts in this society. . . Addiction is all about trying to fill the emptiness from the outside."
Rat Park vs. demon drug
Maté and others cite an old 1970s rat study by Bruce Alexander and colleagues at Simon Fraser University in Canada, who built something known as Rat Park, a rodent facility 200 times larger than a standard laboratory cage. In it, 16-20 rats of mixed sexes had access to plenty of food, entertainment (balls and wheels) and a choice of morphine water or plain water.
The researchers found that the rodents living in exciting Rat Park avoided the drugged water significantly more than those that were isolated in their cages. They concluded that drug addiction was more about lack of stimulus and less about the chemical hooks of a "demon drug" or being "born addicted" with drug-user's genes.
Still, some substances clearly have potent addictive chemical hooks—some more than others. Recent studies have shown there is more than social environment or drug hooks at play in addiction, however. In 2011, Lir-Wan Fan of the University of Mississippi Medical Center and her colleagues reported that rats, particularly males, that have an early episode of brain inflammation—which could be caused by an infection or brain trauma—are more likely to become addicted to drugs as adults.
"Our findings suggest that early-life brain inflammation leads to long-lasting damage of the brain's reward system," Fan told reporters. "But this damage may not become apparent unless later unmasked by exposure to an addictive drug, like methamphetamine."19
In fact, such an immunological predisposition seems to underlie many more cases of addiction if you count obsessive compulsive disorder (OCD), which is known to overlap with drug and alcohol abuse. A 2017 study that compared brain images between OCD sufferers and healthy people found the "strongest evidence to date for inflammation in the brain in OCD."20
Find a substitute
As dismal as all of this addiction research may sound, Rat Park does present novel ways to beat habits—of both substance abuse and compulsive behavior. The reason rats—and most people—don't do drugs or use their smartphones all the time is because they find better things to do.
In her book All That Glitters: A Climber's Journey Through Addiction and Depression (Conexion Books, 2016), Margot Talbot describes how she was able to rescue herself from years of drug addiction and crime when she discovered the replacement thrill of climbing ice waterfalls. It's very common for addicts to replace one addiction with another; they just have to use that capacity to become addicted to something fulfilling.
There are many stories of people who 'find God,' and this experience is dramatic enough to replace their identity as an addict with a new spiritual identity.
Cathryn Kemp, the woman who was addicted to fentanyl lozenges, was able to come off of high-dose fentanyl when she found the love of her life. She needed rehab to help, but something entered her life that was more valuable than fentanyl.
You can't wait for love to walk in, but you can decide what things you want in your life—career goals, marriage, children, fortune, adventure, whatever—and then weigh your addiction in light of how it will serve those goals. Will time spent twittered away on social media help you accomplish what you are trying to achieve?
"Miracles happen every day to recovering addicts," Kemp wrote five years after she came clean. "It's remarkable what happens when the drugs or the alcohol, the food, relationships or gambling, are put down, and real life is given a chance to uncurl."
Letting your brain take control again
Our ability to control unprofitable behaviors is at the heart of what psychologists call 'executive function'—an umbrella term that refers to a collection of neurological skills based on a network in the frontal lobe of the brain that controls self-regulation, organization, planning, short-term or 'working' memory, strategizing and inhibition of impulses. Poor impulse control is a weakness in executive control, and these networks have been found to be damaged in substance abusers.
Fortunately, it is possible to 'exercise' a weakened frontal lobe to strengthen it, as Katrijn Houben and her colleagues at Maastricht University in the Netherlands demonstrated in a recent study.
They divided people who consumed more than 30 drinks per week into two groups—one in which participants completed a month of online training sessions designed to activate parts of the executive network, and one that replaced these training sessions with sham exercises.
The training program involved a variety of verbal and spatial tasks specifically targeted to improve working (short-term) memory, such as recalling numbers in reverse order after seeing them appear one by one on a computer screen. Not surprisingly, as they practiced these tasks, the participants in the treatment group became better at them. For example, they could recall more numbers in reverse.
But what was somewhat surprising was that at the end of the one-month study, the people in the treatment group had cut their drinking by about 10 glasses a week, and those who drank the most cut the most alcohol.
By contrast, the placebo group, in which participants performed untargeted tasks, saw no change in drinking habit. And both the improvements that the researchers observed—in working memory and in reduced alcohol intake—remained when the participants were re-examined one month after the study had ended.1
You can find exercises to boost your brain's executive function in free apps, including one called CogMed, which can be found at www.neurodevelop.com.
Another free way to boost executive control is by doing aerobic exercise. According to a 2013 review, "ample evidence indicates that regular engagement in aerobic exercise can provide a simple means for healthy people to optimize a range of executive functions."
One study cited in the review showed that older adults who went to three one-hour sessions of aerobic exercise a week for six months had "significant increases in gray and white matter volumes" on brain scans in areas of the brain associated with executive control compared to those who did "flexibility" exercises, who showed no improvements.2
Get smart with your phone
Besides using smartphone apps like Forest (where you can grow a virtual tree if you don't fiddle with your phone) to cure smartphone use, try the following:
Go to grayscale. Tristen Harris, a former design ethicist at Google and founder of the non-profit Time Well Spent, now openly compares smartphones to slot machines. Harris recommends turning your smartphone color setting to grayscale to make it less inviting than a Technicolor Vegas casino.
Different models of Android phones have different ways to enable grayscale, which can be found online. For Apple devices, go to Settings > General > Accessibility >Display Accommodations > Color Filters. Switch Color Filters on and select Grayscale.
Turn off the vibrations. A 2012 study found that 89 percent of Indiana University undergraduates polled had experienced 'phantom vibration syndrome'—thinking their phone was receiving a message when it wasn't.1 This may be contributing to smartphone brain drain by distracting your attention. You don't need a message every time someone likes your post. Most messages can wait.
Expand your rules. You already have some rules about where your phone will be off—at a funeral or wedding service, or in the movie theatre, for example. Look for face-to-face situations that you value and extend those boundaries. If you are going out for dinner with your friends or to the park with your kids, for example, leave your phone in the car, or turn it off. Insist on no phones at the dinner table and keeping it off—and out of sight—at night.
Supplements to fight addiction
Many therapies help addiction, from mindfulness and meditation to hypnotherapy, but giving the body physical, nutritional support may help too.
Theanine, an amino acid found in tea, increases the production of both GABA and dopamine, relaxes the mind without inducing drowsiness, and promotes alpha brain waves, which boost creativity and reduce stress.1 Theanine may reduce nicotine dependence by inhibiting the dopamine reward pathway in the brain2 and reducing opioid withdrawal symptoms.3
Suggested daily dosage: Theanine is found in green and black teas. Supplement at a dose of 200 mg/day.
Magnesium can decrease dependence on opiates, nicotine, cocaine, amphetamine and alcohol, as well as weaken withdrawal symptoms from these substances and reduce relapse, especially among cocaine and amphetamine users.4
Magnesium deficiency also favors the development of tobacco addiction; smokers supplementing with magnesium reduce their smoking, as magnesium supplements boost the stimulation of the reward system and thus reduce its need for stimulation by nicotine or other addictive substances.5
Alcoholics usually have low levels of magnesium. Supplementing with magnesium can diminish withdrawal symptoms from alcohol and reduce anxiety and complications.6
How to take: Magnesium-rich foods include dark leafy greens like spinach and chard, pumpkin seeds, almonds, avocado, dark chocolate and bananas. Or take baths with Epsom salts.
Suggested daily dosage: Neurosurgeon Russell Blaylock recommends consuming 1,000 mg/day of magnesium as magnesium citrate, malate or both.
Lithium. This naturally occurring silvery-white metal is used in massive doses by mainstream doctors to treat bipolar disorder—not always successfully. Many alternative practitioners prefer to use smaller doses of more absorbable lithium orotate to treat mental illnesses, improve mood and lower stress. Those effects are well-documented, but a number of studies also suggest that it reduces alcohol addiction.7
Suggested daily dosage: Natural medicine practitioner Dr Jonathan Wright of the Tahoma Clinic recommends that recovering alcoholics try 5 mg of lithium orotate three times daily. "Practicing" alcoholics should try taking 10 mg three times daily. "The majority of these patients report improved mood and decreased desire for alcohol after about six weeks using lithium therapy," he says.
N-Acetylcysteine (NAC). This precursor to the essential amino acid cysteine can penetrate the blood-brain barrier and increase blood and brain levels of cysteine. Also a precursor to glutathione, a potent antioxidant and anti-inflammatory agent, NAC has shown potential for treating addictions, bipolar disorder, schizophrenia and obsessive-compulsive behavior, including nail biting and skin picking.8
Suggested daily dosage: A study of 27 pathological gamblers found that those who supplemented with an average of 1,470 mg/day of NAC for just six weeks scored 60 percent lower on a psychological test to assess their level of gambling addiction, leading the researchers to conclude that NAC "might target core symptoms of reward-seeking addictive behaviors."9