Addictions hijack the brain, subduing it until it makes it give up on the most basic needs. Even eating and drinking, essential for life, are no longer a priority. But that substance or behavior that generates such brain dysfunction is usually just the symptom of a deeper phenomenon. The tip of the iceberg of a complex network of vulnerability and poor mental health, agrees Rubén Baler, a scientist who is an expert in public health and addiction neuroscience at the United States National Institute on Drug Abuse (NIDA): “We have to worry about important, not just urgent,” warns the neuroscientist.
Baler (Buenos Aires, 64 years old) knows first-hand the dimensions of the health crisis. He works on it. And perhaps precisely for that reason, he raises the focus of attention beyond the grotesque figures. It is not the substance, but the phenomenon behind it. The key, he assures, are the more or less hidden hands and interests that pull the strings of the dynamics harmful to public health. From alcohol and tobacco to junk food or digital content on social networks, “there are increasingly powerful forces that have an interest in these products becoming more and more addictive and popular,” warns the neuroscientist, who last week visited Palma de Mallorca to participate in the joint congress held by the Spanish Society of Dual Pathology and the World Association of Dual Pathology.
Ask. What happens to an addicted brain?
Answer. Actually it is very simple. The brain is designed to learn what gives it a natural and healthy reward. When there is something that increases our chance of survival, a little dopamine is released, we learn from the experience and are better equipped for the next time. It is a very delicate mechanism, which works like any thermostat, between minimum and maximum values. It is what evolution designed: that thermostat regulated by dopamine, which is what regulates reward learning. Now, in the modern world, there are things that can skew the thermostat and push those reward dopamine release values to levels it’s not designed for. Say, if sex takes your dopamine from 1 to 10, methamphetamine takes it to a thousand. But the brain is not designed for that and if you give meth 10 times, the thermostat can break and the only thing that gives reward in that case would be the meth. The brain adapts to that and that artificial learning is addiction.
P. Why do some brains become addicted and others do not, when faced with the same behaviors?
R. Each individual is a universe and this variation also manifests itself in different vulnerabilities and robustness. The interindividual difference is enormous due to genes and experience. It is not the substance, but the phenomenon behind it. The key, he assures, is the more or less hidden hands and interests that pull the strings of the dynamics harmful to public health.
P. What are the differences when you expose the brain of an adult or a teenager to these harmful substances?
R. The adolescent brain is being programmed, it is changing in a very plastic, rapid and dynamic way. All these changes program the circuits to prepare them for life. That programming is like running; and any little push can make us fall, distort the quality of that programming and take it down an unhealthy, harmful path. Drugs can very effectively corrupt the quality of programming.
There are increasingly powerful forces that have an interest in making these products more and more addictive.”
P. And what does that mean? What are the biggest risks?
R. One of the most obvious examples is the issue of bizarre or strange pornography. In adults, their brain is developed and has the ability to understand that, although the images are strange, they are not normal or normative and that they hardly lead to a healthy or lasting reward. A 12, 13 or 14 year old boy who is exposed to the same type of pornography could end up with sexual dysfunction because the brain is programming the circuits that will serve sexual function, and if that is absorbed at that critical moment, that could become normative, making normal sex unable to trigger the response it should because it has already been programmed and adapted to bizarre and strange things. That is why we are starting to see sexual dysfunctions in younger and younger people.
P. How have screens and new technologies impacted addictions?
R. It is very difficult to say because science is very careful, very rigorous, it has its methods and its rhythm. And that pace has nothing to do with the technologies that we are trying to prevent or regulate or understand. There is a gap between what we can study and what is relevant from a public health perspective. And that gap creates the potential for an experiment on biblical scales. The possibility of an adverse relationship between some aspects of social media and mental health is so potentially harmful, that we have to be much more cautious and cautious about what we are doing. At the very least, postpone exposure to screens until age 16.
P. When you talk about potentially harmful, are you referring to the risk of addiction to screens?
R. Yes, because algorithms are addictive. Who invented that scrolling from the screen? That’s addictive. The algorithms are a dopamine laboratory of the platforms, which studied how to make these platforms more addictive. Especially for kids who gravitate so much towards social comparison, who depend so much on feedback of the community. All of this is extremely addictive and creates habits, in many cases, pathological.
P. What can be done?
R. We cannot depend on politicians nor can we wait for scientists to save us. I think the solution is at the local level, in the schools. Parents can, for now, stop the use of screens in bed because it affects their sleep and that is a vicious circle that leads them to get into risky situations and the lack of sleep changes their brain itself. I don’t understand why kids are allowed to bring devices to class because that interferes with learning, class dynamics, and attention. It makes no sense. The first thing is to educate yourself about how the brain works and that we are being taken advantage of: we are guinea pigs, a profitable commodity. Our attention has become a profitable commodity.
P. For the industry?
R. Yes. We are paying a price voluntarily and the decision is up to each one: or we are zombies and sleepwalk or take control of our own lives. Right now, we are selling our souls to the devil, both our privacy and our brains, each other’s decisions. I understand how difficult it is because this little device [señala al móvil] It is everywhere and we depend on it, but we should make an effort to see the good and the evil, try to take advantage of what it offers us for our well-being and discard the harmful effects of these technologies.
P. At NIDA they focus on drug abuse. What is the substance that worries you the most?
R. In adolescents, the prevalence of alcohol is very problematic, especially in cultures in which it is normative. It is a problem, not only because it is addictive, but because alcohol has neurodegenerative properties, producing holes in the brain the longer the period of use. The problem is that alcohol is combined with the perception of low risk, everyone makes it normative and nothing happens. But it does happen.
We are guinea pigs, our attention has become a profitable commodity”
P. And in adults? In the United States they have a major opioid crisis on the table.
R. Yes, but what the crisis teaches us is that it is not a drug, it is a phenomenon. Those are all symptoms: this epidemic started with prescription drugs (OxyContin, Vicodin…). When we tightened the valve on doctors overprescribing these things, the curve of those prescriptions went down and the curve of heroin began. When heroin started to rise, traffickers realized they could cut it with something much more powerful, they started creating fentanyl, and synthetic opioids came along. Now, the fourth wave has to do with amphetamine that is cut with heroin and that appears mixed with fentanyl and a new drug, xylazine, which prolongs the psychoactive effects of fentanyl. But these are all symptoms. What we have to worry about is not what is urgent, but what is important: why do people use drugs? What leads them to it? The misery? Hopelessness? Boredom? That is what needs to be attacked. You have to look for the deep roots.
P. And which are they?
R. There is a financialization of the economy. There are groups that are very interested in the profitability of businesses: if we talk about junk food, they are industries that produce an incredible amount of profit, but these foods are addictive, they do not help public health. The platforms [de contenidos digitales] They are addictive. The tobacco, cannabis or alcohol industries produce enormous amounts of profits. And to the owners, those who sit at shareholder meetings, the only thing that matters to them is the company’s profits, public health is not a priority. And in that equation, the population will always lose. There are increasingly powerful forces that have an interest in making these products increasingly addictive and popular.
P. Is capitalism the problem?
R. No, I think capitalism is the only system that works. I am not against capitalism, but I am against this form of overflowing capitalism that apparently has no type of responsibility towards the citizen.
P. Can brains sickened by addiction be cured? Can you go back to the beginning?
R. No brain, healthy or sick, goes back to the beginning. If brains are characterized by something, it is constant change. Learning changes the architecture of the brain, but it can be good or bad learning. And addictions are based on learning through reward. It’s like riding a bike: can you imagine a situation where you unlearn to ride a bike? No. Because what was learned that way, with that intensity, in those learning trenches in the brain, cannot be unlearned. Addiction is the same; It will never heal, it will not go away. The learning trenches are going to remain there. They can be covered with new, better, more passionate, more natural, more evolutionarily appropriate learning, but the trenches are going to remain there and that is why there is always the risk of relapse.