The Impossibility of “Just Say No”

Question: What makes somebody become addicted to a drug?

Nora Volkow: Many surprising findings have come across the studies that have completely destroyed all of the hypotheses that we initiated with. For example, when we first started doing these studies, one of the things that I had postulated, not because it was my great idea, but because a lot of people had been postulating it and in animal models, there was evidence that that could be the case, that people that were addicted because drugs were more rewarding, more pleasurable. And thus, their brain will have a much greater release of dopamine in these limbic areas when they took it. And so, that was the idea. But we did the studies and consistently now in three independent investigations that we've done in our laboratory, and similar findings have been reported by others at Columbia University, we've shown exactly the opposite. Which is fascinating! What we're observing is that in cocaine addicted individuals, and individuals addicted to alcohol, that in these subjects, the ability of drugs to increase dopamine is actually markedly decreased and their subjective experience of the drug is also decreased. But what's fascinating is that this fact, almost in contradiction, in contrast to these decreased responses, when they take the drug, they immediately, it's almost like triggers the desire of more, of more, of more. Like, almost like you open the faucet and there's this intense drive to want more drug and this inability to get satiated.

And I always try to understand when someone is telling me this experiences, have I ever felt that way? And I've never been addicted to anything, but I am a very compulsive person, and I can get into stages, certainly for example, with food, certain foods, I generate, and you eat a chocolate chip cookie and it tastes so good that you immediately know that you want more and you do another bite, and you already in your brain are saying, "I'm going to want more." So when I think about it, this is the closest it gets. Or when you've been incredibly, incredibly thirsty. I actually, I just start to drink water, it seems like you need more and more and more water, right? Eventually, of course, you just get bloated and that's the end of the water. But in the person that's addicted, that's what seems to happen.

So the reward center itself is decreased, but it triggers a response that is abnormal, that you don't see in people that are not addicted. And our imaging studies, of course, we've been trying to understand then, what is driving this different response, even though you have less reward, why are they generating this response? And what we have shown and certainly other investigators have looked at that is, that you've shifted the response to the drug to add stimuli that is associated with the drug and this is done through memory and learning, condition. We all know about conditioning, because Pavlov taught us that if you show a dog, taught him hear a sound when they get meat, and you do that repeatedly and repeatedly and then one day you bring the dog and you just show the sound, that animal will salivate with the sound. There's no meat, they salivate. That's a transfer of the physiological response that initially was triggered by the meat into the sound. And that's what we call conditioning.

Now, you can look inside the brain and try to understand what happens, why is this dog salivating with the sound? It just makes no sense. Well, the learning, the brain has automatically linked the meat with the sound so in the moment that the brain inside listens to the sound, it's predicting that the pleasure will come, it's predicting the meat. So just automatic they've learned. The brain needs to learn in order to be prepared and that's exactly what happens when people become addicted to drugs, they get conditioned to a wide variety of stimuli.

So, for example, a person that is snorting cocaine with a $20 bill, when they see that $20 bill will do the equivalent of salivation, except inside their brain, and what's going on is, their brain, in expectation of getting cocaine, is releasing dopamine. So they've transferred what was a pharmacological response, a response to cocaine, an action of the drug affecting specific areas in the brain, is now triggered by observing a $20 bill. Now what happens when dopamine goes up, because they see that $20 bill, is that that activates the motivational circuit that drives you into action. So, the brain is saying, this is motivational salient, this is relevant, remember? All of the circuits were generated for us to survive, to do behavior crucial for survival, it, sex for procreation.

So these are hard wired across evolution. So your brain is immediately, automatically responding and it becomes an automatic response. So in that moment, the person desires and takes action to take the drug. They have all of these learning responses and memory that actually just automatically triggers a behavior that becomes compulsive and repetitive.

And they cannot stop it. It's basically, when the brain engages in such a state, and the normal mechanisms by which we sort of control our desires and our behaviors, all of us, all of us. I think that if we are honest, on a daily basis have things that tell us, "I want that! But I shouldn't do it, it's a bad idea. I just can think of a million reasons why it's a bad idea." And so we have to relinquish things that we want on a daily basis. How can we do that? Well, we judge, we analyze, and it's always a balance about how much we want this and how bad it is to go and do this.

So dopamine actually there plays a very important role because it regulates the brain areas that are making the analysis, that are judging. Is this worth the effort? Is this worth the punishment? And in base of that, that judgment, you then stop. Stop the behavior. No matter how much you want it, if your judgment is not worth the risk, you'll stop it. And that's also regulated by the pathways. So when you've been taking the drug repeatedly, you basically disrupted all of these normal mechanisms that allow you to exert judgment and to decide, no, it's not worth the risks. Or basically you decide, "No, I don't think it's a good idea. If I take cocaine, I'll end up, my probation officer will put me in jail." You cannot stop it.

Recorded on November 6, 2009

Nora Volkow, Director of the National Institute on Drug Abuse, separates the drug addicts from drug users.

Politics & Current Affairs

Political division is nothing new. Throughout American history there have been numerous flare ups in which the political arena was more than just tense but incideniary. In a letter addressed to William Hamilton in 1800, Thomas Jefferson once lamented about how an emotional fervor had swept over the populace in regards to a certain political issue at the time. It disturbed him greatly to see how these political issues seemed to seep into every area of life and even affect people's interpersonal relationships. At one point in the letter he states:

"I never considered a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend."

Today, we Americans find ourselves in a similar situation, with our political environment even more splintered due to a number of factors. The advent of mass digital media, siloed identity-driven political groups, and a societal lack of understanding of basic discursive fundamentals all contribute to the problem.

Civil discourse has fallen to an all time low.

The question that the American populace needs to ask itself now is: how do we fix it?


Discursive fundamentals need to be taught to preserve free expression

In a 2017 Free Speech and Tolerance Survey by Cato, it was found that 71% of Americans believe that political correctness had silenced important discussions necessary to our society. Many have pointed to draconian university policies regarding political correctness as a contributing factor to this phenomenon.

It's a great irony that, colleges, once true bastions of free-speech, counterculture and progressiveness, have now devolved into reactionary tribal politics.

Many years ago, one could count on the fact that universities would be the first places where you could espouse and debate any controversial idea without consequence. The decline of staple subjects that deal with the wisdom of the ancients, historical reference points, and civic discourse could be to blame for this exaggerated partisanship boiling on campuses.

Young people seeking an education are given a disservice when fed biased ideology, even if such ideology is presented with the best of intentions. Politics are but one small sliver for society and the human condition at large. Universities would do well to instead teach the principles of healthy discourse and engagement across the ideological spectrum.

The fundamentals of logic, debate and the rich artistic heritage of western civilization need to be the central focus of an education. They help to create a well-rounded citizen that can deal with controversial political issues.

It has been found that in the abstract, college students generally support and endorse the first amendment, but there's a catch when it comes to actually practicing it. This was explored in a Gallup survey titled: Free Expression on Campus: What college students think about First amendment issues.

In their findings the authors state:

"The vast majority say free speech is important to democracy and favor an open learning environment that promotes the airing of a wide variety of ideas. However, the actions of some students in recent years — from milder actions such as claiming to be threatened by messages written in chalk promoting Trump's candidacy to the most extreme acts of engaging in violence
to stop attempted speeches — raise issues of just how committed college students are to
upholding First Amendment ideals.


Most college students do not condone more aggressive actions to squelch speech, like
violence and shouting down speakers, although there are some who do. However, students
do support many policies or actions that place limits on speech, including free speech zones,
speech codes and campus prohibitions on hate speech, suggesting that their commitment
to free speech has limits. As one example, barely a majority think handing out literature on
controversial issues is "always acceptable."

With this in mind, the problems seen on college campuses are also being seen on a whole through other pockets of society and regular everyday civic discourse. Look no further than the dreaded and cliche prospect of political discussion at Thanksgiving dinner.

Talking politics at Thanksgiving dinner

As a result of this increased tribalization of views, it's becoming increasingly more difficult to engage in polite conversation with people possessing opposing viewpoints. The authors of a recent Hidden Tribes study broke down the political "tribes" in which many find themselves in:

  • Progressive Activists: younger, highly engaged, secular, cosmopolitan, angry.
  • Traditional Liberals: older, retired, open to compromise, rational, cautious.
  • Passive Liberals: unhappy, insecure, distrustful, disillusioned.
  • Politically Disengaged: young, low income, distrustful, detached, patriotic, conspiratorial
  • Moderates: engaged, civic-minded, middle-of-the-road, pessimistic, Protestant.
  • Traditional Conservatives: religious, middle class, patriotic, moralistic.
  • Devoted Conservatives: white, retired, highly engaged, uncompromising,
    Patriotic.

Understanding these different viewpoints and the hidden tribes we may belong to will be essential in having conversations with those we disagree with. This might just come to a head when it's Thanksgiving and you have a mix of many different personalities, ages, and viewpoints.

It's interesting to note the authors found that:

"Tribe membership shows strong reliability in predicting views across different political topics."

You'll find that depending on what group you identify with, that nearly 100 percent of the time you'll believe in the same way the rest of your group constituents do.

Here are some statistics on differing viewpoints according to political party:

  • 51% of staunch liberals say it's "morally acceptable" to punch Nazis.
  • 53% of Republicans favor stripping U.S. citizenship from people who burn the American flag.
  • 51% of Democrats support a law that requires Americans use transgender people's preferred gender pronouns.
  • 65% of Republicans say NFL players should be fired if they refuse to stand for the anthem.
  • 58% of Democrats say employers should punish employees for offensive Facebook posts.
  • 47% of Republicans favor bans on building new mosques.

Understanding the fact that tribal membership indicates what you believe, can help you return to the fundamentals for proper political engagement

Here are some guidelines for civic discourse that might come in handy:

  • Avoid logical fallacies. Essentially at the core, a logical fallacy is anything that detracts from the debate and seeks to attack the person rather than the idea and stray from the topic at hand.
  • Practice inclusion and listen to who you're speaking to.
  • Have the idea that there is nothing out of bounds for inquiry or conversation once you get down to an even stronger or new perspective of whatever you were discussing.
  • Keep in mind the maxim of : Do not listen with the intent to reply. But with the intent to understand.
  • We're not trying to proselytize nor shout others down with our rhetoric, but come to understand one another again.
  • If we're tied too closely to some in-group we no longer become an individual but a clone of someone else's ideology.

Civic discourse in the divisive age

Debate and civic discourse is inherently messy. Add into the mix an ignorance of history, rabid politicization and debased political discourse, you can see that it will be very difficult in mending this discursive staple of a functional civilization.

There is still hope that this great divide can be mended, because it has to be. The Hidden Tribes authors at one point state:

"In the era of social media and partisan news outlets, America's differences have become
dangerously tribal, fueled by a culture of outrage and taking offense. For the combatants,
the other side can no longer be tolerated, and no price is too high to defeat them.
These tensions are poisoning personal relationships, consuming our politics and
putting our democracy in peril.


Once a country has become tribalized, debates about contested issues from
immigration and trade to economic management, climate change and national security,
become shaped by larger tribal identities. Policy debate gives way to tribal conflicts.
Polarization and tribalism are self-reinforcing and will likely continue to accelerate.
The work of rebuilding our fragmented society needs to start now. It extends from
re-connecting people across the lines of division in local communities all the way to
building a renewed sense of national identity: a bigger story of us."

We need to start teaching people how to approach subjects from less of an emotional or baseless educational bias or identity, especially in the event that the subject matter could be construed to be controversial or uncomfortable.

This will be the beginning of a new era of understanding, inclusion and the defeat of regressive philosophies that threaten the core of our nation and civilization.

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