Trying to figure out the puzzle that is addiction for at least a century now, scientists have since realized that the problem is far more complex than just being the bane of the weak-willed.

by DANILOVA MOLINTAS

THE CARD games last from early afternoon to late evenings, but they are never really relaxing. They are held mostly in tense silence, broken only by an occasional wisecrack, or the scrape of the screen door opening, then the brisk footfalls of a young girl bringing food or drinks. The piles of money in the middle of the table — the "pot" — and on each player's side come to a small fortune, but no one looks happy. No one, though, is eager to leave.

One game fades into another — pusoy, tong-its, bridge — in a tense and compelling way, yet L---, 45, an official in this small city, finds that just shuffling and dealing the cards is powerful release from his anxieties. He has been a regular at these card games for so many years now, he can't recall when he first sent his secretary to withdraw cash from his office account. He has been juggling office and personal funds for so long, the distinction between the two is no longer clear.

Several hours away, R---- is ranting over how his partner made wrong deals and lost contracts, but the anger is really because he has finally run out of shabu. For two days he had gone without sleep and without working, spending the time instead smoking the white crystals off sheets of tinfoil stripped from cigarette packs. As the flushes of synthetic energy recede, the realization that business is bad emerges in his consciousness, and 47-year-old R---- is crashing hard.

Across the metropolis is G---, who has taken to hiding her regular bottle of vodka under her bed. It's tequila that she really likes, but vodka does not foul up her breath the way other drinks do — and a foul breath is a reminder that she needs to stop drinking. It's a reminder she thinks she really doesn't need, because she plans to quit drinking. Just not right now. Maybe after she closes the sale at the real estate office where she works, and gets her commission. Then she'd have more money. Then maybe she can take her young son to the mall to make up for last night, Halloween, when in a drunken rage, she smashed the glass pumpkin she bought and flushed all the candies down the toilet, enraged that her sister found the vodka hidden in her closet.

I know all of these people, but they have never met each other. Other than knowing me, they have nothing in common. Except, that is, for the fact that they are all held captive by powerful addictions, which they know are wreaking havoc on their lives. The scenes I described happened years ago, but save for that involving G---, who seems to have found another substance to abuse, they are still being repeated with just minute changes in detail. My friends cannot escape from whatever has them in its grip, and I have a sinking feeling they really have no desire to do so.

I am no stranger to substance abuse myself, having gotten hooked on amphetamines when I was 16. I managed to wean away from those pills, but then I turned to alcohol. I sobered up quickly, though, when a drunken fit saw me being hauled off to jail where I had to spend a few hours cooling off. But sometimes I wonder if I am just seconds away from popping pills in quick succession or tipping a bottle and emptying it into my mouth. While there are still some things in my memory that I will not touch with a 10-foot pole, I can still put myself back into that night, and feel the same fear, pain, and betrayal engulfing me then, and which had led me to seek comfort in whisky.

Following most modern definitions, addictions are compulsive physical and psychological needs for habit-forming substances like nicotine, alcohol, and drugs. They are also the condition of being habitually and compulsively occupied with, or involved in, an activity such as gambling, or even a seemingly innocuous pursuit such as shopping or playing computer games.

For at least a century now, scientists have tried to figure out the puzzle that is addiction. During the 1800s, addictions were thought to occur only to those who were weak-willed. But researchers have since realized that the problem is far more complex than that, and factors leading to addiction include genetics, which make some people more prone to become dependent on a substance, as well as trauma or pain, which lead individuals to seek ways in which to alleviate this or escape from it, even for a moment.

ADDICTION, like all behaviors, is "the business of the brain," says Avram Goldstein, Professor Emeritus of Pharmacology at Stanford University, and a leading researcher into drug addiction. In 1979, Goldstein made the claim that heroin and all other narcotics worked on a bundle of neurons deep in the brain called the mesolimbic dopaminergic pathway. This is the brain's reward pathway that regulates how a person feels or does not feel pleasure. Here, addictive drugs cause dopamine neurons to release dopamine, the pleasure hormone. The narcotics disable the inhibitory neurons that would have normally kept the dopamine neurons in check. These then become overstimulated. Hence, the rush after a hit.

The brain, however, protects itself from this abnormal surge of pleasure by becoming less sensitive to the drug. In the long run, the user needs more of the drug to reach the same high. The reward pathways also become less sensitive to the effects of endorphins, which act primarily as some sort of pain reliever. Thus, without the drug, the user now survives with a persistent feeling of sickness.

Following this "brain-based" view, a person who uses a drug again and again becomes tolerant and dependent, and undergoes withdrawal symptoms when he or she stops taking the drug. The user loses control and becomes an addict.

As for other types of addiction that involve activities like gambling and shopping, some doctors explain that the brain could be creating peptides that equal the effect of drugs when these activities take place. Thus, when an addicted gambler or shopper is satisfying his or her craving, endorphins are produced and released within the brain, creating a high and reinforcing the individual's positive associations with the activity. As with drugs, consistently engaging in these addictive activities is also believed to cause excessive stimulation, and lead eventually to tolerance and dependence.

For decades, the scientific community seemed so taken with this framework that placed the blame for the addiction on the substance or activity and not on the user. In the early 1960s, University of Michigan researchers fashioned devices that allowed rats to inject themselves with drugs by simply pressing a lever. By the end of the 1970s, there were hundreds of experiments of this sort — and they all showed rats, mice, monkeys, and other captive mammals self-injecting large doses of heroin, cocaine, amphetamines, and a number of other drugs.

But imagine being implanted with a needle in one vein connected to a pump that is connected to a tube. Could it be that the lab animals were turning into drug addicts to ease the pain of their captivity, or to cope with the stress of being isolated from other animals and from other stimuli? Were they reacting to being imprisoned in the complex self-administration apparatus?