Shortly after my November series about “changing the face” of men’s health, a good friend reminded me that addictions also need our attention. As such, my next couple of posts will explain the brian chemistry of addictive behaviors, followed by the types of stimuli that often turn into an addiction, especially for men.
My goal for these posts is to help you understand how these addictions develop and see how addiction impacts your relationships with friends and family.
NOTE: Most of this information is based on The Addictive Brain, a book and Great Course class by Thad A. Polk, professor of psychology with the University of Michigan. Polk has done significant research on how brain chemistry impacts addiction.
Addiction is a modern-day epidemic. By some estimates, roughly one in four Americans may be considered an addict. More than 500 people die every hour as a result of addiction-related disease or overdose. The disease costs the United States more than $600 billion every year in healthcare costs, lost productivity, and crime. Untreated addictive behaviors destroy families, ends careers, and waste lives.
And the problem is only getting worse!
Currently, the coronavirus (COVID-19) pandemic is causing an increase in fear, uncertainty, and anxiety. Social distancing/isolation, loneliness, and economic repercussions are impacting the marginalized who tend to struggle with substance use disorders and social burdens most. However, these factors also impact many people these days, regardless of economic class, ethnicity, and gender.
According to a study from the Well Being Trust, the high levels of stress, isolation, and unemployment from the pandemic could cause up to 75,000 “deaths of despair” related to drug or alcohol abuse and suicide. This is especially among men, who will die nearly 2-1/2 times more often than females (82.6 per 100,000 men vs 29.3 for women in the chart below).
Most people with a high risk of despair already have a mental illness or are part of the vulnerable categories like the elderly, children/adolescents, individuals from deprived areas, and minorities. Healthcare workers are also experiencing an emotional overload due to the shortage of suitable personal protective equipment, relentless work shifts, the burden of becoming infected and infecting relatives, high mortality rates, grieving the loss of patients and colleagues, and long separation from families.
The stress of life in COVID-times has led to a surge in drug use, a shift to other substances, and other addictive behaviors that minimize the pain. Patients with relapses are also showing up frequently at treatment centers.
The Addicted Brain
Thad Polk’s research helps us understand the neurological aspects of addiction that hijack the brain’s natural reward system. Many addictive behaviors cause an almost-irresistible urge for the rush of dopamine, the so-called addiction molecule that comes from the nucleus accumbens, the pleasure center of the brain.
The nucleus accumbens regulates the exchange of two essential neurotransmitters: serotonin and dopamine. Dopamine motivates us to do what is necessary to meet our needs. The release of serotonin once the needs are met, leads to feeling satisfied and contributes to our happiness and well-being. When the levels are too low, the effects lead to addictive behaviors that try to regain that rush.
According to Professor Polk, the repeated overstimulation from addictive behavior begins to numb the nucleus accumbens. This eventually weakens the prefrontal cortex, which is the area that helps our self-control and motivation for many behaviors. It determines future consequences and actions needed to stop and/or continue the behavior, albeit good or bad.
Every major drug of abuse (cocaine, nicotine, alcohol, heroin, etc.) causes an increase in the neuron activity of the nucleus accumbens.
The firing of these neurons also increases for natural stimuli such as food and sex; two other areas of addiction for some people.
Addiction in Men and Women
Did you know that there are differences between men’s and women’s brains that make each respond differently to addictions?
For men, addiction is related to the spike in dopamine that comes from overuse of alcohol or drugs, behaviors such as gambling, pornography, and even physical sex.
Men tend to start using drugs at an earlier age. We also abuse drugs more often than women, mostly alcohol, heroin, and marijuana.
Conversely, women tend to produce less of the mood stabilizer serotonin than men which requires less dopamine. They also process the chemicals at slower rates.
So even though women consume fewer drugs and alcohol than men, they become addicted at much faster rates. This is partly because women are generally smaller physically than men so their bodies feel the effects much faster.
Women primarily abuse prescription pills, are less likely to be referred to treatment by a doctor, and are more likely to relapse than men. A woman’s opioid misuse is typically related to emotional issues, whereas men misused opioids because of legal and behavioral problems.
DNA studies on addicts also show that certain people are innately more susceptible than others. However, it does not mean you will become on yourself just because you have a family history of addiction.
Of course, our culturally defined roles also play into addiction.
Treatment is Different for Men
Men tend to delay seeking treatment due to work obligations. We are more likely to enter treatment when mandated by the court, an employer, or a family member. We’re also less likely to admit to mental health problems.
Women, on the other hand, delay seeking treatment for fear of being seen as an unfit wife/mother. They are less likely to invest time in treatment due to family obligations. However, they are more likely to enter treatment after serious complications, such as an overdose.
Since men often have difficulty expressing their emotions and showing any sign of vulnerability, experts suggest male-only support groups or meeting with a male doctor. This helps make men feel comfortable, establish a sense of trust, and encourage them to let their guards down.
Of course, I also suggest having some close friends, some God Buddies per se, at least be aware of your struggles. They add extra support and accountability, both of which are important to a man’s emotional well-being, health, and overall happiness.
In my next post, I will describe the various stimuli that lead to addictions in men.