Misunderstanding dopamine: Why the language of addiction matters | Cyrus McCandless | TEDxPortsmouth

so I'm a neuroscientist I've spent the last 11 years studying normal consumer behavior and decision-making but before that I spent even more years studying motivation and addiction in the lab and I believe that if we have any chance of solving our current drug crisis the marketers app developers and most of all journalists need to stop using the word addiction when they're talking about iPhones candy crush saga or cheeseburgers if our only problems were too much junk food or apps that took up too much of our attention then our misunderstanding of addiction wouldn't be a big deal but we've got a really serious problem to deal with right now and I worry that by misunderstanding addiction or loosing our chance to have productive conversations and to find solutions that really work we've lost tens of thousands of lives to drug addiction last year and it's getting worse but we continue to take the same aggressively punitive approach to drug enforcement under the presumption that if we're just hard enough on addicts they'll stop and we've severely limited the kinds of treatments that are available and the availability of those treatments and we've been very slow to adopt new approaches from the science of addiction where we've made huge progress over the last thirty years if our current approach worked don't you think things would be getting better and stead of worse marketers and journalists have perpetuated a key misunderstanding that what feels like your addiction to your phone is the same thing as addiction as real addiction to addictive drugs and while it may feel like a compulsion to check your phone every couple of minutes you're still very much in control over that relationship and I hope that if we all understand a little better the difference between these two kinds of relationships with substances it will be in a better position to make some progress on this crisis and this misunderstanding is related to a long-standing misunderstanding about dopamine so McDonald's is probably where you learned about cheeseburgers for the first time as a child right that's where you learned that you like them where you learned that you wanted them and it's how you figured out how to get them how many people in the audience liked cheeseburgers how many people want a cheeseburger right now and you might really want a cheeseburger right now but are you motivated enough to stand up right now and go get one anybody leave the theater no okay well you're experiencing it's called competitive reinforcement some goals are more important than others we may like cheeseburgers and we may even want cheeseburgers but it's not important enough to you to get up right now and abandon what you're doing to go get one but we need to breathe and most of us feel like we need to find our kids if we don't know where they are so we have priorities we all tend to think that we want things because we like them but if you really think about that for a minute you'll find a lot of situations where that doesn't strictly apply so you might want a cheeseburger right now and you might think that you want a cheeseburger because you like cheeseburgers and it's mostly harmless to think that you want cheeseburgers just because you like cheeseburgers scientists also used to think that we like things because we want them or we want things because we like them it seemed obvious but recently we figured out that the brain process is liking things and wanting things in different ways they're not equal and I want to focus on motivation so it turns out that dopamine is not the feel-good chemical that we thought it was dopamine does not make us feel good and it doesn't tell us how much we like things don't mean teaches us how and where to get the things that we need or just the things that we like and it does this in a deceptively simple way dopamine makes us pay attention to things that are important put our energy into the things that are most important and let less important things wait and to do this it depends on a nice clear signal from dopamine neurons in the brain it's delivered with precise timing first we're surprised the first time we get a cheeseburger right someone hands us a cheeseburger out of the blue and dopamine says hey something good just happened something I didn't expect but what it's really doing is it's telling us to remember all the things that happened before we got that cheeseburger and try to figure out which of those things are actually related to it actually predict the fact that we're gonna get a cheeseburger so after you've had that first cheeseburger the next time you get a cheeseburger don't mean does something very different now dopamine response the signs that it has learned predicts the appearance of cheeseburgers so now you're driving down the road and you see those signs they say I'm thinking of a burgers coming right burgers ahead and what happens now when you get that cheeseburger nothing don't mean doesn't care how much you like that cheeseburger it only cares about the things that predict that cheeseburger that it was surprised by once in the past so what's the other thing that can happen here what happens if you see the prediction that a cheeseburger is coming and then cheeseburger doesn't come dopamine actually stops and that teaches the brain then maybe these weren't such great predictors after all when something more important than something else is going to happen dopamine responds more strongly to things that are more highly valued but addictive drugs don't affect dopamine the same way that cheeseburgers and iPhones do addictive drugs go directly into the brain and effect the release of dopamine directly you take the drug and after you take the drug if you take a sufficient dose of it you're releasing a whole lot of dopamine so what does that look like it looks like that surprise success signal right so what you're seeing here for all of these drugs are getting this huge release of dopamine and what it's saying is surprise this is a success this is way more than it may way more of a success than I thought it would be because normally when you predict that something good is gonna happen to you dopamine doesn't respond at all right now but dopamine in there artificially and it's acting as though this drug has presented you with this huge surprise success so here I'm surprised when it starts out now I'm more surprised as time goes on and I get even more surprised as time goes on and that signal goes on for hours this means that you're getting way more reward than you thought you would so you need to upgrade your prediction of how much your reward you're gonna get when you take this drug next time just to kind of keep your dopamine stable now I want to show this to you in one other way that this comes from a paper from 1988 and I just want you to get a feel for how dramatic the differences are between you know that little blip of dopamine that you get for eating a cheeseburger for the first time or predicting a cheeseburger versus taking one of these drugs now this isn't dopamine this is dopamine recorded in rats who are taking very high doses of drugs right so the highest dose of alcohol that you see there that peak of that chart is the equivalent of taking about 17 shots in about five minutes which would kill anyone here is not an alcoholic but that's what it that's what's happening right every time you take a big dose of an opioid if you're tolerant to them and you can tolerate those big doses you get this huge surprise success signal right this overwhelming dopamine response happens every single time you take a big dose of these drugs the drug is telling the brain whatever just happened was surprisingly good you've succeeded you've succeeded way more than you ever expected to whether you enjoyed it or not this huge success signal always takes your brain by surprise because you're directly creating this big surprise success signal it's bigger than any other reinforcement signal that you get and it keeps going for much longer in a lot of cases hours this dopamine signal tells all of your competing motivations to leave you alone you've got more important things to do and they tell you to focus on this one thing above all else this place this situation this little baggie of drugs is the place to be anything to do getting more of this drug is the most important thing that you can do right now and your brain knows exactly how to get that big reward that big surprise success signal and it'll climb over all of your other motivations to get it now sure those times that somebody took heroin or meth before they were addicted those were probably bad choices to make but the amount of reward that your brain gets from those drugs is always much bigger than you expected to be you can never accurately predict how much reward you're going to get your brains always getting this huge surprise success signal that says you should really focus your energy on this and do more of it because it was surprisingly good and it's no matter how much you think you know or how much experience you have and if you don't understand that liking and wanting are really two different things then you're vulnerable to this this is not a moral failing it's a biological one and the same biological vulnerability exists in all of our brains addicts want their drugs far more than you could ever even conceive of wanting your iPhone or Facebook or anything else it's not because they like the drugs it's because when they take these big doses of drugs those doses of drugs are teaching their brain to seek out more and more drugs no matter the cost addiction demands a sophisticated response one that recognizes what we know about motivation and the progress that we've made in drug based research over the last three decades we the health addicts regain control of their own behavior and not punish them for a loss of control that in a very real sense they couldn't possibly have seen coming when we understand that addiction isn't anything like our normal likes and wants I think we stand a much better chance of addressing this problem effectively let me say that again addiction is not a moral crisis but a biological one and that's something we'll never change as long as we're human thank you [Applause]

Channel: TEDx Talks

Views: 308,420

Keywords: TEDxTalks, English, Science (hard), Brain, Drugs, Language, Motivation, Neurology, Neuroscience, Policy, Public health, Public Policy, Science

Id: aqXmOb_fuN4

Length: 10min 45sec (645 seconds)

Published: Tue Sep 25 2018