Author: neuroscientistinrecovery

I quit drinking a year and 3 months ago, but since then had 4-5 relapses. However, I have been completely free of mind-altering substances now for a full 6 months (exactly 6 months today, Huzzah!). The thought of having a drink seems foreign to me now, and despite having some heavy stress at work, I haven’t once thought of drinking to get through it. Rather it surprises me that I ever used this as a coping tool. I have been in some incredibly awkward and difficult situations, but ones that came about because I confronted issues that were necessary to work through, and it occurred to me that if I were still drinking I would have taken a lot longer to confront them. Rather I would have hidden behind my drinking, escaping into my world where memories are lost instead of made, and thought I was ‘coping’ because at least I have a few hours each night where I didn’t think about the stress. This way is so much better. Having said that, I have randomly had the thought of drinking pop into my head a few times out of the blue – all the terrible things it brings with it are forgotten for a brief moment in which the urge just comes on strong and fast. But I either distract myself or talk myself out of it, and then it is gone almost as fast as it comes on, and I am left wondering how it could have ever entered my mind.

Another strange thing has been happening lately. My senses have seemed to be heightened. In particular, I will be walking along the street and seem more acutely aware of the sounds around me, things happening in my peripheral vision, smells seem stronger, and the ‘atmosphere’ appears to be more present. Then at home I noticed that I keep telling my husband and daughter to turn things down, and that I don’t ask people to repeat themselves as much when I am talking to them. It occurred to me… does drinking affect your hearing? Your sight? Since alcohol is a GABA-A agonist, and GABA-A receptors are found throughout the entire brain (rather than being localised to more specific areas such as, say, dopamine neurons and receptors are) we could assume that alcohol does indeed affect the visual and auditory cortices, as much as any other brain region I have talked about on this blog. So I did some digging.

Alcohol affects hearing and vision and olfaction (smell)

Lo and behold, alcohol DOES affect your hearing, vision and olfaction! Whhhaaaaat???

I mean, it is fairly obvious that your senses are impaired when you are drunk (especially if the room is spinning, or you can’t keep your balance – something that relies heavily on hearing), and scientific studies back this up. In one study, cats were given different doses of ethanol, and the amplitude of electrical activity in the auditory cortex in responses to sound were measured. After consumption of the 10% solution amplitudes increased, but after 20 and 30% solutions they decreased. Similar results were recorded in humans (10 white males) who were measured using EEGs. But these are acute effects. In other words, these are the effects of one-off consumptions of alcohol, not long-term effects resulting from its long-term consumption.

It is important to know that how the brain co-ordinates vision and audition is a much more complex process than often realise, because we take so many of the underlying processes for granted. For example, our brains are constantly working out whether what we observe matches our experiences, whether to pay attention to something and what to pay attention to, and what information is irrelevant and should be filtered out. In order to achieve these processes and stitch them together to form the unified, uninterrupted representation of our environment that we experience as consciousness, various underlying cognitive processes are also necessary. Indeed, to determine if current experiences matches things we have observed in the past or are novel, we must retrieve past experiences from memory. Memory is therefore involved in perception. Moreover, to determine what is important and should be attended to, emotions are often relied upon. Therefore, emotions must be integrated with sensory information to determine attention, and attention, in turn, of course informs what is sensed and what is ignored (i.e. you can’t see something if you’re not looking at it). When these processes come naturally we barely notice the array of complex computations that underlie them, but when they go awry, they can result in a number of different neuropsychological deficits, with schizophrenia known as one of the most common.

Prefrontal cortex (mild sciencey bit)

It turns out that the prefrontal cortex (among others), which is a region of the brain heavily affected in alcoholics, is also heavily implicated in many of the cognitive processes underlying sensory integration, and as a result, over-consumption of alcohol over a long period of time can affect these underlying processes. The result of this is a dulled experience of perception that can last for several months into early recovery. However, they do seem to abate after several months (although perhaps not as drastically if you have drunk so much as to have caused Korsakoff’s syndrome, a type of dementia caused by over-consumption of alcohol and under-consumption of thiamine), which I believe is the reason why the world seems to be a brighter, smellier, and noisier place to me now. It isn’t a huge shift, but it is noticeable, and it is wonderful, and it is something I don’t want to lose again. I should also note that alcohol can damage the sense organs themselves, such as the retina, damage which may also not be reversible.

Emerging from the fog

I have heard many people describe early recovery as ‘emerging from the fog of addiction’ and it certainly felt that way to me. However, I have been pleasantly surprised to find out that this emergence only gets better and more intense over time – months even. I know, of course, that some of this fog was caused by dulling of cognitive capacities that had nothing to do with perception, but I am surprised to find out that some of it did. I hope it keeps getting better.

Perfectionism Fucks You Up

I’ve been fucked up in various ways throughout my life, and most of these ways have been linked to my perfect storm of perfectionism, extreme discipline, and low self-esteem. I had an eating disorder for many years when I was younger, because I just couldn’t lose weight fast enough so I almost stopped eating altogether. Ignoring the growling stomach and the obsessional thoughts about food, I saw the weight drop off, listened to the compliments I received, and felt validated in my choices. Although this was many years ago, the after-effects lasted a long, long time, and it was only when I got pregnant that I decided to eat normally, because I didn’t want to starve my baby. At that point I realised that actually eating when you are hungry makes life soooooooo much more enjoyable, and leaves cognitive capacity free to think about things other than food. How on earth I earned a PhD whilst being so damn hungry I’ll never know, but then I was also a burgeoning alcoholic back then, so I guess it simply speaks to my other kind of ‘addictive’ behaviour: working too hard.

I have had plenty of opportunities to work myself ragged, starting in school during adolescence, and lasting right up until the present moment. I have studied away, getting great grades, qualifications, and more recently, publications in great journals. The phasic burst of dopamine that no-doubt accompanied each accolade (as well as each compliment when I was losing weight back in the day) did more than just make me feel good, it motivated me to work harder/eat less, and so forth. Only when those things didn’t come so easily anymore – when suddenly everyone I’m competing with had a PhD and was super-smart, or when I had a baby to look after and don’t want to starve myself – that phasic burst was harder to come by. This was when I really doubled-down on my drinking.

As I’ve mentioned previously, drinking is primarily a GABA-A agonist, which means it increases the actions of the major inhibitory neurotransmitter in the brain which can quiet all those pesky thoughts of not being good enough. However, it also increases dopamine (as I have also written about before). So when ‘life’ stopped producing those phasic bursts of dopamine, and reinforcing those adaptive and not-quite-so-adaptive actions of starving and working hard, I replaced them with a quick, easy, and artificial way in which to produce that same dopamine burst. This time, however, because the effects of alcohol are more complex than simply increasing dopamine in the brain, and because when the alcohol wears off the brain is trying to reach equilibrium again and dopamine levels are low, over the long term the drinking just made me extremely unmotivated.

There were hungover days when I didn’t get out of bed, and many, many more day when I did get out of bed, but not because I wanted to. Rather, what got me out of bed was because a sense of duty to my job, my husband, and my daughter. I remember the first time I took my daughter to the park after I stopped drinking, and I remember feeling bloody marvellous but also deeply ashamed that this was the first time in years I had taken her to the park without a hangover. I also remember when I first got into recovery, that feeling of having energy again. Suddenly it wasn’t too hard to do my laundry, clean the house, and sort out my clothes I don’t wear anymore and put them in the clothing bin. Suddenly I had the energy to do all the things I couldn’t be bothered doing before.

When Perfectionism Takes Over in Recovery

For all the wisdom and fabulous advice I have heard people give in recovery groups and have read in books, there is one piece of advice I think has been fundamentally missing. That is, you MUST find a balance in life. It can feel so great when you get into recovery and you suddenly have energy again, you feel motivated again, and you participate in life again. However, I do worry that some people take this too far.

Time and time again I have heard of people in recovery and their behaviour seems just as extreme as it was when they were still drinking/drugging, only it is being channelled into what is seen as ‘healthy’ behaviours and therefore is encouraged rather than discouraged. For example, people become vegan, or give up all sugar, or exercise three hours a day, or work themselves to the bone. I’m not saying that just because people do any of these things that they have a problem, they might not! But they might. And look – there are times (during grant applications for example) when I also don’t eat a lot and work pretty much 24/7. But the important thing that I have learned over the years, is that I can only do this temporarily if I want to stay sane. I am generally only writing grants for a certain part of the year, and I know that in that time, I will be working like crazy. But I also know that when those couple of months end, I’m gonna watch some real good Netflix, have some great picnics with my family, and have some loooooong baths. Even in those months I am writing grants I try very hard to take at least one whole day off a week.

It is common wisdom throughout the recovery community that ex-addicts make fantastic workers, at least once they have been sober long enough to become stable. I wholeheartedly agree with this, and no doubt our ability to work hard and do what it takes to get the job done feeds into this, not to mention the motivation and desire to be successful (once levels of dopamine are more or less restored and working as evolution intended – not induced artificially by a drug). These are all great things. However, I can’t help wondering sometimes whether the ex-addict who is running ultra-marathons and refusing to eat all sugar, dairy, and meat, is really doing so from a healthy mind-space (and all power to them if so), or is doing so in a desperate ‘addict’ kind of a way.

One of the men in one of my recovery groups died of his addiction recently after many years sober. In recovery, this man dieted and exercised to the extreme, worked hard, wrote a book, and so on. And who knows? Maybe those things had nothing to do with his death. I know he had other personal things going on. But I can’t help but wonder – when your mindset is so ‘All or nothing”, if you let go of the ”all” for a moment and let yourself eat a sausage, or sit on the couch instead of going for a run one morning, maybe it’s easier to lapse into the ‘nothing’ and get on that train straight back to addiction. I know that it would be for me.

So for that reason, I really try and watch myself, and all facets of my addict behaviour. I actually don’t diet at all anymore, although I do try and eat healthily (minus the two brioche buns I ate whilst writing this, but shhhhh). As I mentioned before I love to exercise – but to be strong and fit, not to win competitions or to be skinny. At work I also try to have a balance, although it works better at some times than others. But I have learned to say no a little bit more than I used to, and it feels good.

There isn’t much science out there that speaks to this that I know of, although please send some my way if you do. I do know, however, that addicts tend to be less sensitive to punishment, and I wonder if that applies to all of these other kinds of ‘addict’ behaviours as well as drinking/drugging. For example, if a ‘normal’ person stops eating sugar, but finds it really hard to the point of being aversive to refrain from eating cake, they will probably just crack and eat the cake. An addict, on the other hand, might just handle that aversion and manage to not eat the cake. This really is just speculation on my part, but it would be quite interesting if I were right. Indeed, it would imply that addicts actually have increased will-power relative to ‘normies’, contrary to common wisdom, and as counter-intuitive as that may sound.

In any case, I guess that is a question for future research. But for now, my suggestion to those in recovery is try and kerb all aspects of your ‘addict’ self, even those unrelated to your drug of choice. Because if you don’t, your ‘all or nothing’ attitude could lead you back down the path of addiction, and you KNOW that is not a place you want to be.

Yes. Now we can all stop reading. Thanks very much, please read again.

OK fine I will go into more detail, but seriously? Why is this even a question?

The definition of a disease according to Wikipedia: “A disease is a particular abnormal condition that negatively affects the structure or function of part or all of an organism, and that is not due to any external injury” well yep, I’d say that covers addiction wouldn’t you? Wikipedia goes on “In humans, disease is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, or death to the person afflicted, or similar problems for those in contact with the person”, wow it’s almost as if the person who wrote this broader definition did so with addiction in mind!

Still doubtful? OK what does the National Institute of Health say? “Recent scientific advances have revolutionised our understanding of addiction as a chronic, relapsing disease and not a moral failure”. That really gets to the crux of it, don’t you think? Because what people are really saying, when they say that addiction is not a disease, is that it is a choice, a moral failing. They see it as the individual’s choice to pick up a drug or a drink, that they could stop at any time if they wanted to. OK so let’s unpack that a little. Is addiction really a choice? Luckily, my research speaks directly to this question.

It is well established, and without dispute, that addiction is accompanied by particular chances in the brain. Some of these I have talked about on this blog already: the alteration in phasic dopaminergic firing from responding to the drug itself to the stimuli that predict it, and the long-term plastic changes in glutamatergic receptors in the nucleus accumbens to name but two examples. There are many more.

However, it is also true that all learning and memory changes the brain, and some have used this as their reasoning to say that addiction is not a disease after all. In particular, that other ‘neuroscientist in recovery’ Marc Lewis is a strong proponent of the idea that addiction is a memory disorder that is formed by repeated experience. I don’t dispute this, but I would argue that it does not mean that it is not a disease.

*Sciencey bit*

In addition to the changes I have already described on this blog, there are alterations in the striatal “action-selection” centres of the brain during addiction. To be specific, there are two parts of our dorsal striatum that control action selection the middle ‘caudate’ and the more lateral ‘putamen’. When we are in control of our actions, or our actions are voluntary and conscious, there’s a lot of evidence from animal studies, neuroimaging studies in humans, and more, that it is the caudate that regulates action selection.

On the other hand, when actions are repeated over and over, in the presence of the same stimuli, they no longer become consciously controlled, but are instead involuntary, automatic, and habitual. At this point action control is transferred to the putamen.

*End science bit*

There are a number of consequences of this switch in control from what we call ‘goal-directed’ to ‘habitual’ processes. One of the main ones is that actions will be elicited in the presence of particular stimuli much faster than they would if they were voluntary, and under normal circumstances this is efficient. For example, right now I am touch-typing this blog post without any thought as to where the letter ‘A’ actually is, and if I start to try and think about where the letters are, it slows me down. This habit is adaptive.

However, in the case of addiction, habits can be maladaptive. This is because another consequence of action selection becoming habitual is the fact that, once habitual, the ‘goal’ or the ‘outcome’ of the action itself becomes somewhat irrelevant to whether the action will be produced or not. So when you hear someone say that they went to X place and ended up drinking/drugging, without even really knowing why or how they ended up there, chances are that it was a simple reflex, a habitual response elicited in the presence of particular stimuli without any thought for the consequences. This often happens outside of addiction too: when we automatically take a wrong turn because we are so used to turning left at a particular intersection, for example. At these moments, it is our putamen and not our caudate that is in control.

There is lots and lots of evidence that, in addiction, goal-directed control is impaired. What this means is that addicts have less voluntary control over their actions, and are more reliant on habits. When those habits are tuned towards drinking and taking drugs, well you can imagine the consequences: more drinking/drug-taking. So no, sorry, addiction is not a choice. Absolutely not.

The other thing I’d like to point out, is there are plenty of brain disorders that involve an interaction between a genetic predisposition to a particular disorder and environmental circumstances, that no-one would question the nature of whether they are legitimately a ‘disease’ or ‘disorder’. Individuals with a genetic predisposition to schizophrenia, for example, who smoke a lot of weed in adolescence, might end up schizophrenic. If either of those components had been missing: the predisposition OR the smoking weed, the individual might not develop schizophrenia. Does that mean schizophrenia is not a disease? Of course not! To take a different disease: there is evidence that individuals who do not look after their health generally, do not exercise, and do not perform cognitively demanding tasks are at more risk of Alzheimer’s. So again, there is often an interaction between a genetic predisposition and environment for an individual to end up with Alzheimer’s. Do we then say it’s not a disease because there’s often (although not always) an environmental component? Of course not.

The truth is, addiction is just like these disorders in the sense that individuals who have a genetic predisposition to addiction who are exposed to alcohol or drugs will often become addicts. Again, if either of these elements are missing: the exposure or the predisposition, an individual will not become addicted. Indeed, most people who drink alcohol do not have a genetic predisposition, and therefore do not become problem drinkers. Yet they still make the same choices addicts do initially: to have a couple of drinks. No-one sets out to become an addict. Therefore, to characterise addiction as a disorder of low will-power is simply ludicrous.

To those who prefer not call addiction a disease because they find it empowering and believe that it gives them a choice not to drink in recovery, that’s fine by me. Do whatever you need to do for your recovery. But I choose to exercise a lot, partly because I know it is neuroprotective against Alzheimer’s -that’s my choice, but it doesn’t mean Alzheimer’s is not a disease.

Having said all of that however, whether you call addiction a disease or not, the really, really important thing to remember is that addiction is not a moral failing, it is not a choice, and most importantly of all: you can make choices every day that will help you recover.

This morning briefly reminded me of those mornings I used to start dreaming about drinking Sauvingnon Blanc around breakfast time. First of all my daughter wasn’t sure if it was fancy dress day at school today, and couldn’t decide whether to go in normal clothes or fancy dress: cue gigantic meltdown. Then my computer-illiterate husband starts swearing and getting frustrated at the computer when it turned off in the middle of his paperwork, losing what he was working on. Right in the middle of it all the chaos the dog starts to barking to be let out so he can pee and poo in his favourite spot up the street where I have to go and pick up after him, and I was running late. It made me think: life isn’t easy! No wonder people look to alcohol or other crutches to get them through! I am just so happy that I had been to the gym before all of this craziness descended, and that put me in a good enough mood to get through the morning without having a meltdown myself and, for the most part, with a smile on my face. I am so grateful that I have begun to learn the coping skills in sobriety that mean I don’t turn to meltdown in stressful situations.

Hello Again

So I’ve been gone a little while. Last time I left you guys I promised to try and get a bit more raw and vulnerable on the blog. I can’t say I’ve had any epiphanies or deep amazing thoughts about where to go with this blog or how to reveal myself in a vulnerable manner. One thing I have decided, however, is that instead of aiming for weekly blog posts I need to aim for monthly posts instead. This is the only way it is going to be manageable for me as I just have too much work to do in my day job. As for my personal journey I do feel like I am still learning and progressing every day, although rather than it being epiphanies hitting me all the time, the progress is a little more incremental now. But that’s fine too. Slowly, slowly in sobriety I am starting to build self-esteem, starting to believe in myself more, and starting to get over my imposter syndrome, all of which is a welcome change from the stuck record that was previously in my head for so long, telling me I’m not good enough.

Online Commenters (Trolls)

Yesterday one of my more controversial blog posts was shared around a few places online, getting a bit of attention. Now I have been trolled a fair bit in my life prior to writing this blog whilst trying to advocate for science online (some of those anti-vaxxers can be cray cray!), so I can handle a bit of criticism and don’t tend to take most of it on board. Generally I don’t bother giving trolls oxygen, or only engage with them in a way that amuses me, but as a ‘once only deal, I will reply to a couple of the comments I received here. The ones I will reply to were those saying that I am in love with my intellect, or that I have a huge ego. I can have a huge ego it’s true – the kind of ego that a person with low self-esteem has, where they are going to solve the world’s problems alone on the one hand, and are deserving of nothing on the other. An ‘insecure egomaniac’ as my recovery coach calls it. Nothing special or different about that, and I’m trying to become more balanced.

Am I in love with my intellect? Well at this point in my recovery, I look at it this way: I have battled with low self-esteem and imposter syndrome for many years, and this was one driving force behind my drinking. In sobriety I have begun to piece together some self-esteem and some belief in myself so that now I think I’m in a position to say “Fuck yeah I’m in love with my intellect”. It’s pretty good. It’s helped me get pretty far in life, so I’m not going to sit here and tell you that I’m stupid when I’m not. Sorry (#notsorry) if that pisses you off, but it’s the truth and I have finally reached a place where I am comfortable enough within myself not to apologise for that. It doesn’t mean I know everything about everything, and it doesn’t mean I’m never wrong. I have changed things on this blog when inaccuracies have been pointed out to me for example, but I  only engage in this manner with commenters who are respectful.

Overall, I guess what I’d like to say to those people who feel negatively about the things that I write in the blog is that all I am doing here is trying to help people. When I got into recovery I couldn’t find many voices like mine – atheist with a strong adherence to science and evidence – so I thought why not put my voice out there for the others in recovery who feel like me? You don’t have to like it and you don’t have to agree.

I would also like to address some of the comments on my atheism for a second, as people seem to have plenty of thoughts about that. To the trolls on this issue: I am not you, and my reasons for my atheism are not necessarily the same as yours were before you got into recovery etc. Mine have a lot to do with believing in the big bang, evolution, the vastness of the universe (and if there’s an omnipotent power ruling over such vastness then what is the meaning of their life?), the fact that coincidences are statistically more likely to happen than not, and the fact that our brains are wired to detect patterns when they are not present (hence inferring the hand of God).

Working through Trauma

Finally, something I share in common with so many of you who are in recovery is some of the traumatic events I have been through in my past that had led me to drink. I talked about many of these today for the first time in a very long time to my wonderful recovery coach and this has left me feeling very emotional. But for the first time in recent memory, not only have I been able to ‘sit’ in my emotions, but I have actually wanted to. I haven’t wanted to run away and escape from them, but rather have just let them wash over me in a way that wasn’t necessarily effortful or effortless. Mainly I have known that I am just processing them in both a conscious and unconscious manner. Most importantly, until writing this blog right now, the thought of drinking didn’t even enter my mind, and this is real progress.

So overall, between the crazy morning, the trolls, and the trauma, I experienced a lot of triggers today. But I didn’t drink, and I didn’t even want to drink. This is real progress, and I think I might finally be growing up – not actually to the point of being a proper adult yet, but maybe 15 or 16 instead of 13 😀

I watched ‘Nanette’ by Hannah Gadbsy on Netflix last night, and WOW WOW WOW! What a show (if you haven’t seen it I have tried to keep spoilers out of this post). I have to be honest, I was a little apprehensive about watching it beforehand, based on a couple of reviews I had read. I mean, I like to think I’m pretty ‘woke’ an all, but sometimes I’m just… tired (ironically so it turns out, so is Hannah). I had heard that Nanette was bang on message for many current ‘woke’ issues, and sometimes I just get a bit of fatigue with it all (‘woke fatigue’?). I know that it is part of my privilege that I am able to get fatigue about these issues, and as a middle class white woman I’ve certainly had my fair share of privilege. Nevertheless, I just wasn’t sure if that’s how I wanted to entertain myself after a long, hard day at work then being a mum etc. But damnnnnn, Nanette was worth it.

One area in which the odds have been stacked against me somewhat, and I can relate to being an underrepresented minority, is in my career. Neuroscience, and behavioural neuroscience in particular, is very top heavy with white men. That is, although most of the graduate students and people in the early phases of their career are female (I’m not sure of the exact numbers, but I’d estimate at around 70-80% female), the further you get up the career ladder, the more those numbers switch around completely. By the time you reach Professor level, the numbers are approximately 80%+ male. Representation of other minority groups is even worse, and those of us working in science have a lot to do to make things fairer and more equal.

What does this all have to do with drinking or addiction I hear you ask? Well a number of things. Before we go on, I would like to say that I know these are first world problems, but they are still problems, and did feed into my addiction nevertheless. One of the reasons I drank was because I think that as a female striving to make it in this field, I felt highly visible in the sense that each time I go to give a talk, I feel the weight of various expectations on me based on how I look (i.e. that I won’t be that smart). I have also experienced things like giving a talk and having all questions about my research being directed to my (white male) supervisor. I have been overlooked a number of times in favour of males when trying to ask questions at conferences, something I see happen to other females all the time. I have been told that people think I don’t understand my own research. I have had grant reviewers pull me up on ‘gaps’ in my track record, that they extended to 3 x as long as they actually were and having completely overlooked the fact that I had given birth to a WHOLE FRIGGING HUMAN BEING the year before and had been on maternity leave. I have had other grant reviewers question the contributions I made to my first author publications relative to my (white male) senior author. I have been told that I need to have a thicker skin and get over all of this. Put the pressure of dealing with all of this on top of all the other immense pressures brought on by such an intensely competitive career choice and it’s a potent mix, ripe for self-esteem issues and you guessed it… drinking.

As I said, I know these are first world problems. They are far from the worst problems I have ever had to deal with in my life, but that doesn’t mean that they don’t matter and that they are not important. They do and they are.

Well I am emboldened by Hannah Gadbsy, and I am sober now, and I’m not gonna take this shit any more.  Because I have advanced in my career somewhat now, I don’t tend to get overlooked when trying to ask questions at conferences so much anymore, and I don’t get people making as many inaccurate comments on my grant reviews. But that doesn’t mean the unfairness isn’t there any more for other, younger females. I also really hope that I can help the young female scientists navigate their way through it the way that some of the badass female neuroscientists I know have helped me. I know there are also some fantastic men in my field who are also well aware of these issues and are fighting to make things fairer and more equal, and I totally support that too. And if someone tells me to grow a thicker skin then they might be told which improvements society could make to be more supportive of female scientists.

I am so glad I sobered up at this point in my career. I think I had a lot of shame, I certainly had low self-esteem, and I took these negative things people said and did personally or thought that I had done something wrong. But my head is clear now, and I can see clearly.

What does this have to do with Nanette? Well the reason I found this show to be SO incredible, was not anything to do with it being so zeitgeisty, but rather because it was so raw and honest and vulnerable. Damn Hannah, your emotions were real and you made me feel. I didn’t agree with everything she said, but that’s OK. We’re adults and we can still be friends (can we Hannah? Please?).

It also made me think about this blog and what I am doing here. I wanted to start this blog so that I could start a dialogue with the recovery community, and I sat back and thought for a moment about how well I have been doing at that. I start thinking about whether I was really connecting. Have I been my most vulnerable and honest self? I certainly haven’t been dishonest, and the topics that I have covered have been interesting and important to me, but something was niggling at me.

Then I came across a podcast interview with Prof. Alan Jasanoff, author of the “The Biological Mind: How Brain, Body, and Environment Collaborate to Make Us Who We Are”. Very interesting interview, give it a listen if you have time. Again I didn’t agree with everything he said (I guess I can be quite disagreeable sometimes!) but one point that he did make got to the core of something that was niggling at me. It was this concept of ‘cerebral mystique’. This is the idea that the brain is not some distinct, unknowable entity, but although complex, is essentially a part of the body it is attached to as well as the environment it experiences.

It was exactly this mystique that I wanted to tackle in my blog. I wanted people to realise that the brain can be knowable and although it is unimaginably complex, we also do know a lot about how it works. I wanted people to know that it is not just drugs that change the brain, but our experiences, learning and memories all change the brain as well. I wanted people to know that even though the names of particular parts of the brain sound big and scary, in the end they are just names – names like ‘arm’ or ‘leg’ or any other part of the body. When you know the names of the brain parts this mystique recedes a little bit. And if we realise that experiences can change the brain, just as drugs can, then I think this can feel very empowering.

Other than that, I also want to figure out how to be vulnerable and how to put the ‘real me’ on the page. I really struggle with this, as I know many other people do, but, as the famous Australian saying goes “I ain’t here to fuck spiders”. In other words, I’m not writing this to half-ass it, I want to be vulnerable and I want to give you all of me. But I need to figure out how to do that, so after this post I’m gonna take a little break and re-assess. Thank you all for reading so far.

Using Marijuana in Recovery

I don’t really like smoking weed. Those who know me might be surprised to hear that, because I have given it a really good nudge in the past. I think sometimes I would smoke it just to feel something other than sober, or because I was hungover, but I never really like the high. I certainly never liked it as much as alcohol.

In my younger days I would smoke weed in cars or parks and stuff, and I would always have to be the last person out of my friends to smoke because as soon as I did I was immediately convinced the police were going to come and arrest us – much to the amusement of my friends. As I got older my paranoia would move on to believing that people were talking about me, or laughing at me, or other paranoid thoughts. One time I may or may not have even been a little bit scared that aliens were coming to get me from outer space (sadly not even joking). I have smoked weed a couple of times since I quit drinking, just to make sure that I reeeeaaalllly don’t like it. However, I finally admitted to myself that I don’t like it several months ago and stopped for good.

But other people do like it. It doesn’t make them feel paranoid, it makes them feel relaxed. Some people believe that it is not as addictive as alcohol and other drugs, and not as damaging, so some people substitute it for their drug of choice. Well I have no judgement on people who choose to do that – I can’t tell you what’s right for you. But I can tell you the facts, and they do seem to suggest that it isn’t quite as harmless as many would like to believe.

Cannabis and the Brain

*Warning sciencey bit*
There’s actually still a lot we don’t know about the effects of cannabis on the brain. This is one of the reasons I tend to be sceptical when I hear claims that it is ‘harmless’ and not linked to mental health disorders etc. The latter claim in particular, is demonstrably untrue, because cannabis use is strongly linked to schizophrenia, as well as several other mental health disorders, particularly amongst those who smoke heavily during adolescence. However, it’s not entirely clear if the evidence is causal or correlational (in other words, does smoking weed cause schizophrenia, or does schizophrenia cause smoking weed? Perhaps those affected are more likely to smoke to get relief from their symptoms. I don’t think science has answered this – but happy to hear about it if I am wrong). One thing that is pretty clear, however, is that smoking weed is not good for the developing/adolescent brain. So if you’re a teenager, then you probably just shouldn’t smoke weed.

As for what we do know about marijuana’s effects on the brain; well the active ingredient in cannabis is THC, and it is this that binds to cannabinoid receptors (specifically CB1 receptors). This has been linked to increasing ‘magical thinking’ and ‘imagination’, but I think at a fundamental level it really just magnifies your thoughts. So whatever the basis is there for already gets exaggerated. It also releases dopamine and norepinephrine, which can lead make you feel good or anxious, depending on several factors.

At a circuit level, marijuana can affect CB1 receptors in your hypothalamus, messing with satiety signals and hence giving you the munchies. It can affect your amygdala that regulates emotions and basal ganglia linked to decision-making. We’re not really sure why it has different effects on different people, but my assumption is that it builds upon the foundation that is already there. For me, because I am already quite prone to anxiety, smoking weed can amplify these thoughts and feelings and lead to paranoid thoughts. Of course it also affects your cerebellum which regulates movement and coordination.

Smoking marijuana also affects the hippocampus, although this possibly occurs primarily through neurotransmitters other than cannabinoids. This brain region is central to learning and memory. In particular, it is important for those memories of the things that you experience, rather than memories that have to do with learning facts about the world or learning skills. This is why if you smoke weed often, your memory can tend to be quite hazy (alcohol also affects this part of the brain, so if you drink and smoke, you might be particularly forgetful!).
*End Sciencey bit*

Should I Stay Away from Marijuana in Recovery?

I just don’t think that there is a ‘one fits all’ answer to that question. If you smoking weed sparingly (not every day), whereas you used to shoot dope every day, and your life is all the better for smoking, then I don’t think I should be the one to tell you to stop. Especially if you do stop and your life goes to shit again, that’s not going to do anyone any good.

I should also make it clear that I am not referring to medicinal marijuana for anything other than addiction here. The science is really very preliminary with regards to medicinal marijuana, despite what a few loud voices over the internet might have you believe. Therefore it is totally possible that smoking weed might be helpful in overcoming nausea for cancer patients undergoing chemotherapy, for example. There’s also cannabidiol that does not contain THC, which might be particularly helpful in treating a range of conditions. I am not speaking to those uses of marijuana here, I believe with regards to those we should go with what the science says. I am only speaking to the addict in recovery who is thinking about substituting their drug of choice for marijuana.

In these instances, my worry is that the person who substitutes one drug for another will not adequately address the underlying issues that led to their addiction in the first place, and then end up addicted to a whole new drug all over again. I have heard of this happening to a number of people in recovery. And yes I do think marijuana is addictive, psychologically at least. It might not induce tolerance and physical dependence in the same way as alcohol and heroin etc, but it certainly contains perceived value that can be imbued in its use and everything associated with it. That alone can produce a physical reaction in the brain and, over many learning episodes, a psychological need for the drug. It’s also a little worrying that if you are smoking weed you are still partaking in a mind-altering drug that could lead back to your drug of choice. Also if we take what we know about marijuana’s effects on the brain into account, then it just doesn’t seem to be as harmless as advocates would have you believe. Several lines of evidence now suggest that the damage from smoking heavilly over a long period of time can be long term.

So in short, my answer is that you probably shouldn’t smoke weed whilst recovering from other addictions. But as I said, I never liked it much anyway so the decision may have been easier to make for me than for others.

I’m sure there are bound to be those who disagree with me on this one, so feel free to let me know what you think. I am here as much to learn as I am to impart the knowledge that I have.

Oh Frigging hell.

A $100 million study titled “The Moderate Alcohol and Cardiovascular Health Trial” was recently pulled because of corruption and credibility issues, resulting from collusion between Alcohol industry executives, scientists, and government officials.

Frigging hell.

But before I get to that…

Big Pharma Tangent and Sticking up for Scientists

I started this blog for many reasons, one of which was to try and give a different perspective to the way that scientists and scientific research is portrayed on social media and certain other circles on the internet. What I mean is that there is a general distrust of big corporations, of ‘Big Pharma’ and so on and so forth, and sometimes scientists get lumped in with that. We can be seen as pawns working for pharmaceutical companies, exploiting people for profit, or altering findings in order to earn money for shareholders.

I get it! I really do. I look upon the role of drug companies in the US in the current opiate crisis with as much horror and disgust as anyone else. It is awful that people are dying and lives are being ruined every day, all because of greed.

But to speak for myself for a second, and for my colleagues, and for the vast, vast majority of scientists I know, I would like to say that most scientists I know are good people, who got into this biz because they want to help others. I know I did. Like myself, most of the scientists I know don’t work for pharmaceutical companies (although plenty of good scientists do), they work for Universities and Institutes. Most scientists I know work on their own ideas funded by competitive grants with no vested interest in particular outcomes. We are just trying to find out what the brain does, and we don’t argue with the data. Most scientists I know have never had anyone tell them what to study, ever, or had anyone put pressure on them to produce results in a certain direction. Most scientists I know have never knowingly been compromised or misrepresented data. I certainly haven’t.

A Lack of Trust

Despite all of that, however, there is still a general distrust of the scientific community, and the recovery community is particularly vulnerable to this. Although this makes me a little sad, it makes sense. Those in recovery are those who have lost so much because of drugs and alcohol, and their addictions may have started with a prescription, or succumbing to societal and advertising pressures to drink, and when these things are seen as being linked to scientists, it is understandable that we would be looked upon with distrust.

But scientists and industry/big Pharma are not one and the same, and they’re not all bad. There are so many of us out there, working hard to try and make things better for people.

A Setback (back to Frigging hell)

With all of that in mind then, it was more than disappointing to read about a recent $100 million study involving over 7,000 participants examining the possible health benefits of drinking alcohol being shut down because of corrupted interactions between individuals in the alcohol industry, scientists, and government officials. Disappointing on so many levels. It is events like this that make it difficult for the general public to trust scientists, and make it tempting for people to tarnish us all with the same brush.

I must be clear for a minute, however, that when it comes to science and the study of the effects of alcohol or drugs, scientists MUST approach that the data for what it is. As much as my life has unimaginably changed for the better since I have quit drinking, that doesn’t mean that this is the same for everyone, and it doesn’t mean that moderate drinking is bad. If the data shows that moderate drinking is healthy, then we have to go with what the data says, whatever our personal feelings are on the matter. We have to be unbiased.

Of course, as it turns out, there are plenty of studies showing that even moderate drinking can actually be bad for us, especially in terms of raising the risk of cancer (alcohol is a group 1 carcinogen), and more recently dementia for example. This information was produced from good studies conducted by good, uncorrupted scientists, in the aim of trying to help us become a healthier society.

Therefore, I am as disgusted and as horrified as anyone else that this large study has been corrupted, that people’s trust has been betrayed, and so many people’s time and money has been wasted. I can’t imagine how it must feel for the scientists involved with the study who were innocent – and there were many because they were the ones who worked diligently to expose those that were colluding with industry. I would also like to note was scientists at the National Institute of Health and the National Institute of Alcohol Abuse and Alcoholism that shut down enrolments into the study and eventually investigated and exposed the corruption.

So we’re clearly not all bad.

But we have to do better.

Scientists Have to do Better

As scientists we are privy to a certain way of thinking. For example, if we see reports in the media of a study showing that ‘drinking red wine is as good as going to the gym’, for example, we would usually know to take this with a large grain of salt. Specifically, because of our extensive years of training in how to critically evaluate information, we know that things like a) the findings of the study are likely to be much more nuanced and complicated than have been reported (in the linked study, for example, participants were fed resveratol, an ingredient in red wine, not red wine itself), b) one study alone generally doesn’t prove very much, rather what is important is the convergence of evidence from many studies, and c) we can make informed assessments about the likely quality of the study based on the journal it is in, and how likely it was to have involved conflicts of interest (such as industry funding from a partner that has an interest in seeing certain results). We can know all this information quite quickly upon reading an article. But the general public don’t study science for around a decade like we do, and then go on to live and breathe science every day in their jobs like we to. So we have to do better.

As scientists, we need to ensure our results are being reported accurately, and to ensure that hyped up results are put into their correct context in a way that is jargon free, and easily accessible. Hopefully this way, we can start to install trust in our profession again. We also need to talk to people, to start a dialogue. Not to sit in our labs and talk to other scientists all day, but talk to the real people that are living the issues (e.g. addiction, dementia, mental health disorders) that we are studying. I should note that there are plenty of scientists already doing this – the conversation is a good example. But there’s always room for improvement, and in the words of the great Michael Jackson “I’m starting with the (wo)man in the mirror“, starting with this blog. Even in the short time I have been writing here I have learned so much about the opinions of non-scientists, how to communicate my ideas more effectively, and so on. But I still have much to learn.

Progress not perfection eh?