During the years I’ve spent in the field of addiction medicine, I’ve heard a lot of non-medical explanations for the symptoms and behaviors of people who suffer from addiction. One explanation that keeps recurring in different forms is the idea that all human beings are somehow born with a capacity for “something higher”. This is often described as “enlightenment” or a “higher plane of consciousness”; one Internet commenter recently described it to me as “sparkles and comfort”. The idea is that a normal, healthy human being is somehow lacking in some mysterious key to happiness, and it is this being destined for “more” that drives addicts to their substance of choice to try and find it.
We can also describe this idea using the more scientific concept of hedonic tone. The hedonic tone is a way of measuring the happiness or contentment a person feels or is capable of feeling. Each person has a unique base hedonic tone — that is, each person has a baseline level of happiness that they return to when their lives are free from great stress or achievement. Anhedonia is a condition in which someone’s hedonic tone is unusually low, so they are incapable of feeling pleasure.
People who argue for the “destined for more” model of addiction seem to be saying that we are all born with a certain hedonic tone — let’s say 50% — which is much lower than our maximum, and that this is something wrong with us. They see this unnaturally low hedonic tone as the real problem, while addiction is just a misguided attempt to self-medicate for the real problem. They therefore suggest that by fixing the real problem, you fix the addiction, which is only a symptom. The same commenter I mentioned earlier insisted that if patients could get their “sparkles and comfort” elsewhere, like from a spiritual or religion, their addiction would no longer be a problem.
The fact is that while we do naturally have a hedonic tone that is less than our maximum, this is normal. By having a hedonic tone lower than the maximum, the brain leaves itself room to increase it in order to reward us for doing things that help us survive. If we were born with a maximum hedonic tone, we wouldn’t respond to any rewards, and we would have no motivation for even keeping ourselves alive.
We can physically see this in action when we study happiness and how the brain responds to it. The brain wants to stay at that ideal 50% hedonic sweet spot over the long run, so while it will reward you with endorphins that raise your hedonic tone, it will eventually return to baseline when they wear off. We see this in people who have achieved some goal that makes them happy, say by buying a new car they really wanted. At first, their hedonic tone is higher, but after some time the brain adjusts the baseline upwards, so that what was once 75% becomes 50% again. This is a way of preventing us from stagnating, and keeping us moving on to the next goal.
We see the same pattern when we look at chemical receptors in the brains of people who suffer from addiction. Normally receptors are active at a baseline level — again, say 50%. Drugs raise the saturation and the hedonic tone, mimicking the feeling of the brain’s reward; it feels good, so the addict continues to do it. The brain wants to be at 50%, so it will eventually adjust the receptor levels, producing more, until what used to stimulate 100% now only stimulates 50%, and to get to 100% requires a greater amount of drugs. This is called “tolerance”, and it’s a phenomenon that many addicts are intimately familiar with. If escalated too long, it can lead to severe brain malfunction, and eventual overdose from the ever-increasing amount of substance needed to reach that 100%.
We can see from this that the “destined for more” model is actually a very distorted way of interpreting real data. It’s true that doing drugs raises the hedonic tone towards the maximum, and that this is the reason addicts first seek it out. Where the “destined for more” model goes wrong is in thinking that humans are supposed to be at 100%, that we are meant to be there, and that being at our natural state of 50% means we are somehow “broken”. It puts a mystical and philosophical distortion over a very real biochemical phenomenon.
Addiction has been around for a very long time, and like any scientifically classifiable disease, it often follows predictable patterns. People with ulterior motives or a lack of medical training have come up with all sorts of theories that claim to explain the nature of addiction, but ultimately fail to hold up under the evidence. It is imperative that all research and treatment of addiction be based on sound science, instead of mysticism, if we are ever to make progress against this disease.