/ 21 February 2011

Profile of an addict

Profile Of An Addict

There’s a lot of debate about the nature of addiction, but researchers have only recently agreed that people can become addicted to gambling, according to Professor Don Ross, the research director at the National Responsible Gambling Programme (NRGP).

But they don’t know if problem gambling is part of a spectrum in which addiction is the extreme form or if gambling addicts are a distinct group whose condition has particular causes.

Ross and his research team’s evidence points to the latter. Addiction has a biological basis, and 65% to 80% can be ascribed to genetic factors, according to Ross.

Increasingly, research is looking at the brain mechanisms involved in the addictive response. Ross says addiction seems to be linked to the failure of regulatory mechanisms primarily in the prefrontal cortex.

“Addictive behaviour falls within the brain region that houses the dopamine reward system, an engine of behaviour that compares values of different courses of action. When an action is chosen and brings a better outcome than expected, the result is more dopamine,” says Ross.

Gamblers are addicted to surprises that reward the brain with dopamine.

“Surprising things are a basis for learning. It’s why gambling is addictive. The action of using the slot machine or rolling the dice creates a surprise and the result is a dopamine spike. The addict’s brain has learned that gambling actions are rewarded.”

The area of the brain involved interacts directly with the body’s motor control system, which causes craving in the addict.

“If the addict receives an email from a regular gambling friend, there is an association and the brain’s pre-frontal inhibiting mechanism fails to work or doesn’t work well. The dopamine signal thus cues the motor system. The body is primed to gamble and, if [he or] she can’t gamble right then the addict will feel physically uncomfortable. The addict’s brain has learned a gigantic network of cues which result in craving.”

Ross describes gambling as one of the purest forms of addiction as it doesn’t include external chemicals that cause changes in other parts of the brain.

Dr Adele Pretorius, the treatment director of the programme and a clinical psychologist, says that “addicts have established defence mechanisms, which include denial, minimising the problem, rationalising or blaming others for their behaviour. This is partly why it’s so difficult to treat.”

She says that any addiction is a relapsing illness and, with most addicts, the path to recovery involves relapsing. The biggest determinant of success is motivation.

“But readiness for change is sadly often brought about by severe consequences before they are ready to deal with the addiction.”