Apr 14, 2016 | By Tim Powers

Should Drug Addiction Be Viewed as a Learning Disorder?

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In the current political and societal landscape, the issue of drug addiction is a topic in which people from many walks of life can find common ground. The issue of addiction has been front and center in the national consciousness due in large part to the prescription pill and heroin epidemic that has its vice grips on all corners of the United States.

While lawmakers on all levels have been working feverish to institute new legislation in an attempt to stop the current addiction crisis, a larger debate is looming on the horizon–and it focuses on how we view the complex nature of drug addiction as a whole. According to reporter and author Maia Svalavitz, the debate on defining addiction should also include it as being a learning disorder.

Do We Learn To Be Addicted?

In an article published yesterday in The Guardian, Szalavitz talks about her own struggles with heroin and cocaine addiction in her 20’s and reflects on how the current model of tough drug sentences and harsh consequences have further fueled America’s drug abuse issues. In Svalavitz’s estimation, the way we as Americans truly address the current opioid epidemic (and other substance abuse issues by proxy), we as a society need to recognize addiction as a learning disorder–and especially one that is characterized by failing to learn our lesson from punitive measures.

Szalavitz states that learning is important in addiction because simply addiction can’t occur without it. When someone is in active addiction, they learn to associate that taking a substance makes them feel better at first and they will continue to take their substance of choice even though it eventually produces negative consequences. Secondly, Szalavitz states that substance abuse unfolds as the brain undergoes the maturation process and people respond to formative experiences.

Additionally, Szalavitz states in the article that ninety percent of all addictions begin during the teens and 20s, and this period of development is marked by dramatic evolution of an individual’s brain structures and functioning. If young people experience the trauma, mental illness or other factors that can lead to substance abuse, these patterns of behavior become deeply ingrained.

The Basis of Understanding Drug Addiction As A Learning Disorder

The concept of addiction as a learning disorder is not new, and one of the prime examples of explaining the role of the formation of addiction is the social learning theory. This theory states that behavior is learned from the environment through the process of observational learning. Within social learning theory there are two fundamental ways in which we learn behavior: classical conditioning and operant conditioning.

In an substance use scenario, classical conditioning occurs with the pairing of the pleasure that is felt when substances are taken to the cues present in the environment. Another way to look at it is through the set and setting principle. The set refers to the psychological mindset or frame of mind of an individual when they use a substance and the setting refers to the physical and social setting in which substance use is taking place. The repeated exposure of the mindset and setting with the drug can become powerfully reinforcing and can lead to the development of an addiction.

Operant conditioning is based on a system of rewards and punishments. For example, if an individual uses a substance for the first time and it is a rewarding experience with no association with unpleasant consequences, the more likely people are to continue their drug. If we look at how we can increase chances of recovery, we can see operant conditioning come into play. If family members and friends discontinue enabling the addict and allow them to face the consequences, the wheels can be set into motion for the addict to address their addictive patterns of behavior and seek help.

Additionally, we can also take a look the concept of addiction as a learned behavior through the rational choice theory. According to this theory, decision making and learning is based on framing the problem or situation, assigning values to the various options or outcomes and then choosing the best option. When we are rational, we will evaluate each of our options and evaluate each option’s risk versus its rewards before we make the best decision.

When it concerns the process in which we evaluate situations, our dopamine systems play a large part in that process. As we already know, dopamine is the “feel good” neurotransmitter that is produced in the brain and the dopamine centers respond to rewards, whether they are primary rewards such as food, water and sex or abstract rewards such as money.

When dopamine is released, the amount that is released will be dependent on the experienced or anticipated expectation that occurs with rewards. In healthy individuals, if we know we are going to get a reward the release of dopamine may not be as large.  Learning takes place only when something unexpected occurs, and our reward system will get the message that the old rules don’t apply and it may be time to learn a new association.

When we take drugs and alcohol, our evaluation systems become skewed, and we can over evaluate those cues that surround the experience of taking drugs. In a blog written for the Psychology Today website, Dr. Shahram Heshmat explains the relationship between the formation of addiction, learning and the dopamine system as follows:

With repeated drug use, dopamine systems assign excessive value to the cues and the contexts associated with drug taking. When dopamine continues to be released beyond the normal period, the brain is thrown into a perpetual state of “wanting,” which is the essence of addiction. That is, addictive substances, by artificially boosting dopamine levels in the brain, can lead to a desire for the substance that is way out of proportion with the pleasure it brings.  In short, thanks to the distortions in the valuing system of addicted individuals, addiction seems to increase desire or want without increasing the enjoyment of the drugs.

Because of the artificial boosting of dopamine in the brain due to substance use, we “learn” to desire the drug to a level that is grossly disproportionate to the pleasure it brings to us. This distortion  in our valuing and learning system in active addiction seems to increase our desire to continue using while the enjoyment of using drugs exponentially decreases over time.

Delving further into the concept of addiction as a learning disorder can definitely have the potential of allowing our current drug policy to evolve. In 2014, over 50 percent of the United States prison population were jailed for drug offenses, and nearly 30 percent of that population where there for offenses related to marijuana possession. In order to put a sustained and significant dent into the country’s drug problem, purusing treatment and prevention programs that place more focus on the learning aspects of addiction may be a wise choice.