The science of addiction

Addiction is commonly associated with substance abuse such as alcohol, tobacco and drugs. National Institute on Drug Abuse has listed different reasons (as below) for why people take drugs.

lTo feel good: Feeling of pleasure, “high”

lTo feel better: To relieve stress

lTo do better: Improve performance

lCuriosity

lPeer pressure

Not just drugs, some behaviors too can be categorized as addictive. Addiction to video games is one such addictive behavior. Mounting evidence shows that the effects of video games simulate those of drugs of substance abuse and that video game addictions also alter the brain neurochemistry unlike the previously held belief that a person addicted to games lacked willpower.

The limbic system of the brain also known as the “brain reward system” is the part involved in addiction. When activated it releases neurochemicals such as dopamine, “the feel good” neurotransmitter.

Unlike activities like food, drinking, reading, music, which produce the optimum levels of dopamine, addictive substances or behaviors can release up to 10 times more dopamine leading to the “high” associated with use of drugs.Recurring activation of the “reward system” due to repeated use of addictive drugs leads to addiction.

“Dopamine surges in the reward circuit cause the reinforcement of pleasurable but unhealthy activities, leading people to repeat the behavior again and again. Over time, the brain adjusts to the excess dopamine, which reduces the high that theperson feels compared to the high they felt when first taking the drug—an effect known as tolerance. Theymight take more of the drug, trying to achieve the same dopamine high” (National Institute on Drug Abuse).

Recent studies also implicate serotonin, besides dopamine, in the development of addiction. Serotonin is responsible for feelings of well-being and contentment. Low serotonin levels can also increase the risk of drug addiction.

A study from the Victoria University of Wellington showed that serotonin levels during initial drug use affect the chances of a person becoming drug dependent. Higher the serotonin levels, lesser are the chances of somebody becoming addicted. The study suggests that “once drug use escalates and becomes frequent, the anti-addiction effect of serotonin is decreased. Another brain chemical, dopamine, seems to be the critical determinant of drug addiction during this phase”.

Drugs that modify dopamine affect motivation, motor functioning, sense of pleasure and important events a person experiences. While, drugs that affect serotonin affect the ways how a person learns, remembers, sleeps and feels emotions.

A person addicted to gaming can spend anywhere between 10 and 14 hours a day playing. Most of these people have some underlying social and psychological conditions as well. They are either suppressed, depressed, need appreciation or need compliments.

Addiction may worsen an underlying mental disorder or trigger a mental disorder such as attention-deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anxiety, depression etc. Such persons are more at risk of addictions.

The World Health Organization (WHO) has now included video game addictions as “Internet Gaming Disorder” in its latest revision of the International Classification of Diseases (ICD-11). It described the addiction as a ‘pattern of persistent or recurrent gaming behavior’ that becomes so extensive it ‘takes precedence over other life interests’.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA