What do addicts really want?

This article, written with Jaak Panksepp and Eleni Pantelis seeks to understand what addicts really want.

Substance abuse

Generally speaking consciousness – especially feelings of pleasure and unpleasure – guide us toward biologically useful activities. Substance abuse appears to employ brain mechanisms designed to reward these activities that promote survival and reproduction.

Clearly, substance abuse is a biological dead end. While it appears to employ these same brain mechanisms, it does not actually enhance our chances of survival and reproductive success, in fact, it likely does the opposite. So why do addicts continue to abuse their drug of choice?

Substance abuse represents a failure to transition successfully from self-soothing, or from seeking substitutes for need fulfilment, to actually meeting needs in the real world, which is often not easy. So how do we normally negotiate this transition?

Meeting needs in the outside world

It will come as no surprise that the mechanism responsible for meeting needs in the outside world is the SEEKING system. It is the SEEKING system, in conjunction with the pleasure-LUST system and learning that usually enables us to negotiate these transitions smoothly.

But if individuals come to learn that substances that artificially activate the SEEKING system through substance abuse enable them to gain access to pleasurable experiences in the outside world that would be otherwise inaccessible to them, they may fall into the trap of addiction.

The PANIC/GRIEF system

In addition, the PANIC/GRIEF system that causes us to instinctually form attachments has an uncanny resemblance to addiction – love is of course the ultimate drug! We could infer that it is perhaps the very same brain mechanisms that are employed in forming loving attachments that are manipulated by the process of addiction.

Addiction can therefore be seen not only as a substitute for mastering the outside world but also for the attainment of a loving social relationship that is evidently lacking.

With permission of UCT Press. This article ‘Neuropsychoanalytic notes on addiction’ was published in G. Ellis, D. Stein, E. Meintjies & K. Thomas (eds.). Substance Use and Abuse in South Africa: Brain behaviour and other perspectives (UCT Press, 2012).