A spark was lit

Addiction neuroscience, in its quest to find out why a human would choose heroin to the point of his or her own death, bumped into social neuroscience, which was trying to figure out how the brain processes empathy and morality to the point that a person would sacrifice themselves for others or for something bigger than themselves.

It turns out that the exact same chemical pathways and circuits that are hijacked by addiction were evolved in mammals for a very different purpose: to make social interactions feel good. We don’t just need social interaction because it gives us economic advantages, like a better ability to find food or build shelters by working together. In humans, meaningful social connection is so important that babies will literally die without touch, even if all other biological needs are satisfied.

What does this have to do with addiction? Meaningful social interactions and connectedness with others release powerful hormones that can in turn modify activity in every brain system that sustains life, from metabolic circuits that also control “fight or flight” responses to executive control circuits that give us the ability to switch activities when we choose or override automatic behaviors, like habits. Hormones like oxytocin and neurotransmitters like dopamine do different things in different brain species’ systems, and in humans, these systems are arranged so that empathy feels good, like the things we get compulsive about feel good, like the best ice cream, new love, and, yes, like being high. But there’s more. These brain systems are arranged so they make social disconnection feel bad, just like withdrawal feels bad, as it turns out. It is not an accident that grief and withdrawal have cause some of the same physical symptoms.

Programs that most successfully and lastingly transform addicts’ lives may borrow medical language and metaphors, but they don’t work by providing a cure. Instead, what they do is provide a context full of opportunities for social connection, where the mechanism for healing is in the interactions between peers, some of whom might be further along their own journey of healing. The emphasis is on outward-focused living, and on taking practical steps to mitigate disconnection between addicted people and their families and social contacts, by repairing relationships and reclaiming personal responsibility.

But importantly, the healing can’t be administered like medicine, it must be sought, and then it must be lived.