6/30/00

Compare these two quotes from Dr. Leshner. The first is from an article he published in the JAMA, Oct. 13, 1999 (an equivalent statement is in his Science article, Addiction is a Brain Disease, and it Matters, Science, vol. 278, pages 45-70, 10/3/97), and the second from his current web page at NIDA (http://www.nida.nih.gov/NIDA_Notes/NNVol14N1/DirRepVol14N1.html). These are from his discussion of his Hijacked Brain Hypothesis of addictions, his theory of addictions.

"Although the onset of addiction begins with the voluntary act of taking drugs, the continued repetition of voluntary drug taking begins to change into involuntary drug taking, ultimately to the point that the behavior is driven by a compulsive craving for the drug,"

and,

"We now know that while initial experimentation with drugs may be voluntary, continuing drug abuse changes the brain in fundamental and long-lasting ways. These brain changes trigger the compulsive drug-seeking and drug-taking behaviors that are the hallmarks of drug addiction."

You'll notice the change from "begins with the voluntary act," to "may be voluntary." This change seems small but is actually galactic. It is the first recognition that even the first use of a drug, leading to addiction, is (may be) involuntary. On the other hand, the change to "may be voluntary" may just be a figure of speech and not signify any change in his concept of the volitional nature of the first drug use. Being an optimist, that there is intelligent life in the universe, I will assume the former explanation and move on while waiting for a response from my e-mail to him (below).

What does this differentiation mean? It means that there are people whose drug use is inexorable and involuntary from the start. The implication of this is staggering and is actually one of the tenets of the Hypoism paradigm, although Leshner doesn't know about Hypoism because he has ignored all my attempts to inform him about it. The distinction between is and may be voluntary is a recognition that choice and control are impossible, just as Hypoism states. The whole issue of free will, for that matter, is up in the air when it comes to addictions and use of addictors for hypoics. I think there is no free will in addiction etiology. Hypoics are born, not made. The new take on the involuntary nature of the first use makes it clear that the drug war, prevention efforts, and criminalization and punishment of addicts is not only useless but inappropriate. It changes the emphasis onto the addict's brain before the first use rather than on his brain after the first use, an enormous change of emphasis. It also de-emphasizes the importance of the drugs and other addictors (prohibition and drug war) as is demanded in the Hypoism paradigm and places the emphasis correctly on early diagnosis of Hypoism followed by early recovery, as in any genetic and involuntary disease, the only effective means of prevention of a disease's symptoms, in this case, addictions.

Moreover, and equally as important, this distinction means there is something behind addictions, even the first use of the addictor: a mechanism in the brain that makes certain people, use addictors against their will and get addicted. This idea, of course, changes responsibility for having the disease of addiction and getting addicted from personal to neurobiological. Not only is this change important for relief of guilt and remorse from the victim, but also is helpful to destigmatize, remove denial, and to allow the person to get into recovery at the earliest possible time.

Something behind addictions? Yes, a neurobiological mechanism that drives people with the correct pathophysiology to seek out addictors unconsciously, use them to change how they feel, and get addicted per force.

This discussion continues in the article on this web site called The Third Millennium N4A Conference Keynote Address on Hypoism. A similar discussion of the Hijacked Brain Hypothesis is in the Hypoism Magazine section of this page called #8 Critique of Alan Leshner's (NIH) Hijacked Brain Hypothesis. Please read them if you haven't yet. Both were written before he made the above change in his statement on the voluntary nature of the first use of the drug. I have e-mailed him today about my congratulations on his change of orientation:

Dr. Leshner:

I was heartened and excited to see that you changed the statement of initial drug use by addicts from "is" to "may be" voluntary in your home page discussion of addiction. Could you please tell me how and why you made that change? It may be the beginning of the most important realization about the role of free will (or lack thereof) and volition in the field of addictions. As you will learn, if you choose to read about my Hypoism addiction paradigm, inexorability from the getgo is a key and essential element in the genesis of addiction in those who are the real addicts. My neurobiological paradigm categorically clarifies the essentially unconscious nature and brain location of the mechanism that is etiologically responsible for all addictions: to substances, behaviors, and beliefs. One of the basic reasons why addiction is so confusing is due to this unconscious as opposed to conscious mechanism. The implications of this differentiation are clearly discussed in my book, Hypoic's Handbook, that discusses all aspects of the Hypoism paradigm from the neurobiology, physiology, genetics, animal addictions, etiology, natural history, course, recovery, to policy for addictions. I have attempted to inform the addictionology community for many years about Hypoism, but have been ignored. My paradigm is, I believe, as close to the neurobiological reality of addictions as is possible today. Until the paradigm is changed to one that comprehends the "involuntary" nature of addictions based on the physical location of the brain mechanism responsible for both the initiation and maintenance of addiction, we will make no headway into improving recovery and policy, and even more so for prevention. I would ask you to read three articles on my web page whose url's I include. If these interest you, maybe you'll read the book. I hope so. I'd be happy to discuss all this with you at any time. I believe there really is a solution to addictions, but one that is not based on the current paradigm. In fact, it's diametrically opposite to the current paradigm. Much of its difference is the realization of the difference between "is voluntary," and "may be voluntary." My paradigm, when accepted and taught to the country, will do for addictions what the discovery of microorganisms did for infectious diseases. I hope you have an open mind.

The URL's:

http://www.nvo.com/hypoism/whatsup/

http://www.nvo.com/hypoism/thehypoismaddictionhypothesis/

http://www.nvo.com/hypoism/thirdmilleniumn4aconferencekeynoteaddressonhypoism/