Howell Foundation luncheon in La Jolla looks at addiction, a ‘brain disease’


Addiction specialist, author and integrative medicine practitioner Carolyn Coker Ross, MD, MPH, is looking to change the conversation when it comes to addiction. The keynote speaker at the Howell Foundation’s health lecture series Aug. 17 at La Jolla Country Club, she spoke about how addiction expands beyond drugs and alcohol, and is less about what we are putting in our bodies, and more about what is happening between our ears.

She focused her talk on the bio-mechanical aspects of addiction that take place in the brain and how addiction may be rooted in our past experiences.

“I like to say we are all addicted to something,” she told those gathered. “Many people are talking about sugar addiction, food addiction, shopping addiction, tobacco addiction, video game addiction ... but I’m here today to suggest that food addiction is not about food. Drug addiction is not about drugs. It’s important to recognize (addiction) as a brain disease. It’s not a disease of willpower. When people with addiction make bad choices, it’s due to what’s going on with their brain.”

Anecdotally, she said when a lot of her patients overcome one addiction, another tends to creep in. For example, those who quit drugs and alcohol can take up smoking. Those who overcome over-eating turn to excessive shopping.

Addressing the opioid epidemic, which Coker Ross said, “we are all hearing a lot about,” she pointed out there is a historic precedent being set: “For the first time ever in America, 50 percent of Americans have a close friend or loved one with an (opioid) addiction … that has never happened before. This affects men and women, different racial groups, all age ranges, it’s across education levels and the political spectrum.”

As to how this can be, she said it’s all about how the brain reacts to the stimuli.

“Part of the brain’s job is to release dopamine when we experience pleasure,” she explained. “This lovely meal today will give us a spike in dopamine of about 150 percent. If you use cocaine, dopamine spikes 300 percent. If you use heroin or a prescription pain killer, it goes up 250 percent.”

When addiction is in motion, she added: “When you start using a drug, you do it because you like the way it makes you feel. Then, later in the addiction, you stay on it to avoid the pain of withdrawal. People think their loved ones are just getting high, but their loved ones are really afraid of not feeling good or feeling withdrawal. We’ve said people with addiction are weak or are morally bankrupt. We might not say it out loud anymore, but it is an underlying belief for some: that addicts can just stop using.”

Coker Ross theorizes that addiction has its roots in childhood trauma. “The more traumatic experiences you have, the higher your risk for addiction,” she said.

She cited the Adverse Childhood Experiences (ACE) study that started in San Diego more than 20 years ago, which looks at the correlation between negative experiences and one’s likelihood to develop an addiction.

“Adverse childhood experiences lead to social, emotional and cognitive impairment and then adoption of health-risk behaviors,” she said. “These are not uncommon experiences, but I still think it’s important that there are these associations.” Examples include physical abuse, incarceration, sexual abuse and lack of emotional support, from or by an adult before one’s 18th birthday.

She concluded: “Addicts are no different than you or I. They want the same things we want; they want to love and be loved, and they want to fulfill their own unique purpose. So, instead of saying ‘What’s wrong with you?’ we should be saying ‘What happened to you?’ and ‘How can I help?’ ”

Howell Foundation scholarships

The August luncheon doubled as an opportunity to dole out thousands of dollars in scholarships to Ph.D. candidates at the Hahn School of Nursing at the University of San Diego.

Ellen Fleischman, who is looking into how the stigma of prenatal mood and anxiety disorders (such as postpartum depression) affects the frequency with which women seek treatment; and Michelle Lee, who is conducting the first study of galactogues (pills, teas or tinctures that promote breast milk production) and their efficacy, received a total of $7,000 from the Cheryl Wilson Nursing Scholarship fund.

Further, the Dr. Skai Krisan Memorial Scholarship was awarded to Sara Torres Robles, who hopes to advance research in the biochemistry field. She studied in China and Japan, where she worked in a lab exploring plasma membrane and nuclear signaling.

The Doris A. Howell Foundation for Women’s Health Research is dedicated to making a positive impact on female health, and raises funds through luncheons and events throughout the year.