Conference 2012: Paul Fletcher – From intoxication to addiction: Neurobiological substrates for hubris?

“The transition from intoxication to addiction is associated with a preoccupation with the negative effects of withdrawal from the source of addiction (as opposed to the satisfaction of a perceived need that it was originally felt to provide).

Professor Paul Fletcher
Bernard Wolfe Professor of Health Neuroscience, University of Cambridge

Download notes of Professor Fletcher’s address here: Neurological substrates

Download the Powerpoint here: From Intoxication to addiction

Professor Fletcher indicated that Owen and Davidson’s paper, together with Russell’s thoughtful response to it, had led him to view some of the issues associated with intoxication from a phenomenological perspective that was new to him. He was glad that the papers had avoided falling into the error of pseudo-science in raising issues of impaired risk appraisal and of a developing inability to foresee undesirable outcomes. But he also considered it highly unlikely that it would prove possible to link phenomena associated with such issues to specific areas of the brain or to particular neurotransmitters.

He referred to the work of Volkow et al in describing addiction in terms of:

• A compulsion to seek specific sources of gratification
• A loss of personal control [choice]
• An associated emergence of feelings of guilt

The transition from intoxication to addiction is associated with a preoccupation with the negative effects of withdrawal from the source of addiction (as opposed to the satisfaction of a perceived need that it was originally felt to provide). This transition involves a move from impulsivity to compulsivity which is, in turn, associated with anxiety and stress; from positive to negative reinforcement and from goal-directed to habitual behaviours.

Such developing patterns of behaviour suggest that, “under the right conditions a human being may be as sophisticated as a rat”. Stages in progression from, say, binge, through intoxication, to addiction follow familiar patterns of neurotransmission and neuroplasticity.

Professor Fletcher proposed that consideration might be given to two, separate syndromes – hubris and addiction – which in some circumstances might share some of Owen and Davidson’s key indicators of a possible liability to hubris syndrome.