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Feeling Trapped and Fearing Abandonment

Feeling Trapped and Fearing Abandonment
Posted by James Browning on October 23, 2012

If you think your wife is codependent, there’s a good chance you are, too. Often codependent men are attracted to women who are needy, demanding, jealous, or critical. Men become dependent on their wives’ approval, and then feel trapped by their manipulation, demands, or expectations. They’re unable to set boundaries and fear emotional retaliation and/or rejection, including withholding of sex. Their wives may be very emotional, providing a sense of aliveness to the relationship and compensating for the numbness many codependent men feel inside. In the beginning, a man can feel powerful, helping a needy girlfriend or wife and giving her attention or gifts. He conforms to her expectations, while being assured that she won’t abandon him, but eventually discovers that it’s never enough to satisfy her. . Fear of rejection and abandonment are powerful motivators for codependency, usually because of early emotional abandonment by a parent. Consequently, the men never leave – physically – but withdraw to the safety of a self-made emotional prison. After a while, they feel trapped, controlled, and resentful. They may use drugs or addictive behavior to manage anxiety and depression, while some look outside the marriage for validation. However, it’s not their wives that are the cause of their problem, it’s their codependency. Darlene Lancer, M.A., MFT, J.D.

“More people would learn from their mistakes if they weren’t so busy denying them.” –   Harold J. Smith

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Multiple Pornstars Speak Out About The Reality of The Pornography Industry!

The next few posts on Castimonia.org will focus on former female pornstars that have come forward to burst the fantasy bubble and expose the harsh reality of the pornography industry.  I urge everyone who reads this NOT to go searching on the internet for more information on these women as it would most likely bring up old ponographic content and constitute acting out.  Be satisfied about what you read here and praise God for the courage these women have to speak the TRUTH about the porn industry.  A special thank you to Shelley Lubben for her hard work with the Pink Cross Foundation. 

L**** L*******

L**** L******* has much to say about her pornographer:

“When in response to his suggestions I let him know I would not become involved in prostitution in any way and told him I intended to leave, [T******] beat me up physically and the constant mental abuse began. I literally became a prisoner, I was not allowed out of his sight, not even to use the bathroom, where he watched me through a hole in… the door. He slept on top of me at night, he listened to my telephone calls with a .45 automatic eight shot pointed at me. I was beaten physically and suffered mental abuse each and every day thereafter. He undermined my ties with other people and forced me to marry him on advice from his lawyer.”

“My initiation into prostitution was a gang rape by five men, arranged by Mr. T******. It was the turning point in my life. He threatened to shoot me with the pistol if I didn’t go through with it. I had never experienced anal sex before and it ripped me apart. They treated me like [triggering language removed] I have never been so frightened and disgraced and humiliated in my life. I felt like garbage. I engaged in sex acts for pornography against my will to avoid being killed.The lives of my family were threatened.”

J**** J******

“Most girls get their first experience in gonzo films – in which they’re taken to  a crappy studio apartment in Mission Hills and penetrated in every hole possible  by some abusive a****** who thinks her name is Bitch. And these girls, some of  whom have the potential to become major stars in the industry, go home afterward  and pledge never to do it again because it was such a terrible experience.”

A**** C*******

“I have been a performer now for 14 years in the adult film industry in many countries, states . . . all over the place. I have worked for most of these companies, and I was around for the once-a-month HIV-positive outbreak in ’98. Yes, I was, and I got to see those performers that nobody knows about—that nobody claims that got HIV, that are not a part of the statistics—walk out the door as non-performers, not to be counted.”

“Yeah, there are a lot of cover-ups going on. There is a lot of tragedy. There are a lot of horrible things.”

S******** S****

“I was sexually abused the first time by my step grandfather on my dad’s side and the second time by my actual stepdad so my sexuality was messed up from the beginning. I created another personality that was in complete control and didn’t have those things happen and didn’t have to deal with the pain. The industry is not a real accomplishment.  It’s just a false sense of accomplishment.  It covers everything up for what it is.”

B*********

“I like to hide — hide everything, you know?… And I’m not happy… I don’t like myself at all… My whole entire body feels it when I’m doing it and… I feel so — so gross.”

A*** A*******

“After a year or so of that so-called “glamorous” life, I sadly discovered that drugs and drinking were a part of the lifestyle. I began to drink and party out of control! Cocaine, alcohol and ecstasy were my favorites. Before long, I turned into a person I did not want to be. After doing so many hardcore scenes I couldn’t do it anymore. I just remember being in horrible situations and experiencing extreme depression and being alone and sad.” – A*** A*******

A****** B*****

“I honestly felt that if I had to have another strange man in my face, his hands (God knows where they’ve been) all over me, him calling me his “baby”, and having to exude some sort of forged passion for the world to see, I probably would’ve exploded. And what would’ve been stuck to the walls would’ve probably been nothing. Just pieces of skin, bone, the brain of a robot, and what would have been left of a once huge and warm heart.”

T**** T****

“As for myself, I ended up paying the price from working in the porn industry. In 2006, not even 9 months in, I caught a moderate form of dysplasia of the cervix(which is a form of HPV, a sexually transmitted disease) and later that day, I also found out I was pregnant. I had only 1 choice which was to abort the baby during my first month. It was extremely painful emotionally and physically. When it was all over, I cried my eyes out.”- T**** T****

L*** R***

“We should think about these issues right now, to change stuff around to make this a safer f**kin’ business. It isn’t a safe business, and I thought it was, and I would have not did that scene with no condom with Darren James if it would have crossed my mind that those tests weren’t good and that I couldn’t trust him or the people he’s been with. I thought porn people were the cleanest people in the world, is what I thought.” – L*** R***, diagnosed with HIV in April, 2004 along with four other porn stars.

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The Story of Former Porn Star Shelley Lubben

The next few posts on Castimonia.org will focus on former female pornstars that have come forward to burst the fantasy bubble and expose the harsh reality of the pornography industry.  I urge everyone who reads this NOT to go searching on the internet for more information on these women as it would most likely bring up old ponographic content and constitute acting out.  Be satisfied about what you read here and praise God for delivering these women from the bondage of the pornography industry. 

The Story of Former Porn Star Shelley Lubben
by shelleylubben| Sun, 09/18/2011 – 1:09pm

The Story of Former Porn Star Shelley Lubben
by Judith Reisman

I first watched Shelley Lubben on YouTube in early 2009. An “ex-porn star,” she has created the Pink Cross (www.thepinkcross.org) as a public charity to reach out to “adult industry workers, offering emotional, financial and transitional support.” In the YouTube segment, filmed before a church audience, Shelley describes her past life and her current work. A tall, stately woman, she treads the boards, moving her hands to emphasize her words, looking directly and earnestly at her listeners.

As a veteran student of pornography and prostitution, I did not expect to learn anything new from watching Shelley Lubben’s public testimony. I was wrong. Shelley’s description of the sexual violence and degradation of modern pornography was a shock, even to me. It made me think that it made perfect sense to hear that she had left her economically rewarding “star” roles to return to a safer life doing “straight” prostitution. The “glamour” of porn is only a mask:

You have to do what they want on the sets. . . . Girls . . . feel like stars. They get attention. . . . They don’t realize the degradation. . . . Raised on porn, [they] don’t even ask if it’s wrong. . . . They get into drugs to numb themselves. They get their [bodies] ripped. . . . They get HPV and herpes, and they turn themselves off emotionally and die.

Shelley says such women totally lose their identity and live on drugs and alcohol. They cannot plan, save their money, or eat properly. The survivors commonly have only sexual diseases and “fake boobs” to show for their lives in porn. She used to be one of them.

The Back Story

Shelley, born in 1968, notes that she attended “a good church” with her family and that, “as a little girl, I knew and loved Jesus very much.” Unfortunately, her stable if unaffectionate family moved to another location and stopped going to church. Television became the basis of their family life. A creative child, Shelley put on her own plays at her elementary school, with the approval of her amazed first-grade teacher.

Then, at age nine, a classmate and the girl’s teenage brother sexually molested Shelley. With no one to turn to or redress her abuse, Shelley defused her anxiety via autoeroticism and furtive sexual forays with both girls and boys. “It felt good to be wanted by someone and to receive attention, but at the same time I felt dirty. I didn’t recognize until much later that my entire childhood had been sexually hijacked.”

She carried shame and self-blame into her teen years. “It must be something evil in me,” she thought. She “started having sex at age 16” and became a “rebellious resentful teenager who acted out to get attention.” Hoping to keep peace in the home, her parents let Shelley dress up as a Playboy bunny and date strange boys, who led her into drug and alcohol abuse. The family tried counseling to no avail. Unable to understand what to do, her parents “told me to leave home at age 18.”

She landed in the San Fernando valley with no food and no money. “A ‘nice’ man saw I was upset and told me how sorry he was.” Still shocked and angry about being kicked out the house, so “that I didn’t care any more . . . I sold myself for $35.”

Thus Shelley entered the “glamorous” life of prostitution, but the money, jewelry, and gifts soon included bizarre sex with strangers who stalked her, slashed her tires, and threatened to kill her if she demurred from performing certain sex acts. One man tried to kill her with his truck, and she often had to lie her way out of frightening situations. During her eight years as a prostitute and exotic dancer, she had two miscarriages and one birth. Little Tiffany grew up living “with a lewd wild woman.”

Now a single mom, “Jesus kept tugging at my heart,” Shelley writes, “but I ignored him. I figured, God wasn’t taking care of me, so I had to do whatever I could to survive.”

Most of her prostitution money went for drugs and alcohol to blot out the trauma of her life. To avoid the rapes and arrests for prostitution, she turned to pornography because “it seemed safer and more legal.” However, even prostitution did not involve the brutal kinds of rape and degradation that she endured while “starring” in pornography. Soon she was required to do very hardcore scenes.

[O]nly more drugs and alcohol could get me through them. . . . I sold what was left of my heart, mind and femininity to the porn industry and the woman and person in me died completely on the porn set.” After becoming infected with herpes, I quietly left the porn industry but went back to prostitution to survive.

The Rescue

In 1994 Shelley met her husband Garrett at a bar. At first she refused his requests for a date, but when she finally accepted and the two went out, they became instant friends. Garret was raised in a Christian home and had attended a Christian school. He wanted to rescue Shelley. She says, “He was a friend to a prostitute, just like Jesus. We knew God was working in our lives, so we turned back to Jesus and got married on February 14, 1995.”

It was a rough marriage, but Shelley says God sent them to a church called Champions Centre in Tacoma, Washington, where they learned “to live a champion life.”

With God, I had true forgiveness from all my sins and a chance to grow into a whole new person without being perfect first. That was a relief! I learned that God loved me unconditionally, regardless of my past, and even had a plan for my future. God had a plan for my life? It was like someone turned the light on for me.

Shelley says she “practiced God’s principles in everything I did.” She learned web design and operated her own web design business for four years. She also attended college and got a bachelor’s degree in theology and counseling. She had walked into Champions Centre “broken and shattered,” she says. Eight years later, she was a

Champion woman healed and excited to live life! God restored me from drugs, alcohol addiction, painful memories, mental illness, sexual addiction, sexual trauma, and the guilt and shame from my past. . . . He also restored my femininity and healed my sexuality, which is a major miracle for me.

Shelley reports herself cured not only of herpes but also of cervical cancer. In addition, she says, “God also healed our marriage in a remarkable way. Garrett and I have a beautiful and loving relationship and are best friends!” Their “three beautiful daughters are being raised as Champions,” and, says Shelley, her daughter Tiffany has forgiven her and “allows me to be a mother to her.”

The Ministry

As a child, Shelley had dreamed of being a preacher. Having received her bachelor’s of theology degree, she is indeed a preacher now, sharing her testimony of transformation and rescue out of drugs, porn, and prostitution “by the power of Jesus Christ.” Her website says:

Now happily married to Garrett, her husband, and the mother of three daughters, Shelley takes a message of transformation against-all-odds to prisons, TV, radio, film, conferences and rescue missions. She has been a guest on talk shows such as Dr. Phil, Michael Reagan and most recently, FOXNews. Her message is one of exposing the $57 billion porn industry for what it is—full of lies and deceit, addiction and broken lives. Shelley maintains that women who turn to the industry to make money “probably didn’t grow up in healthy childhoods.

“Almost all pornography performers were sexually assaulted as children,” she says, but hide their broken hearts. “That would kill the fantasy, now wouldn’t it?” She told Chris Hedges:

Porn is like any other addiction. . . . First, you are curious. Then you need harder and harder drugs to get off. You need gang bangs and bestiality and child porn. Porn gets grosser and grosser. . . . And meanwhile the addicts make their wives feel like they can’t live up to the illusion of the porn star. . . . He wants what isn’t real. Porn destroys intimacy.

She says, “God now sends me out to proclaim to the world the reality of his awesome love. I also want everyone to know that whatever God did for me, he will do for you. He’ll do this because he loves you and sent his Son Jesus in order to give you a whole new life.”

Shelley tells the women she rescues that God has a plan for their lives and that they “were made for greater things.” Her website offers the real stories of these women, and includes a tragic Dead Porn Stars Memorial.

Shelley’s story is indeed inspirational. “All I wanted was a normal life. Then I discovered the truth. Sure enough, I finally found the life I always wanted.”

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Ex Porn Star C***** T*****’s Story

The next few posts on Castimonia.org will focus on former female pornstars that have come forward to burst the fantasy bubble and expose the harsh reality of the pornography industry.  I urge everyone who reads this NOT to go searching on the internet for more information on these women as it would most likely bring up old ponographic content and constitute acting out.  Be satisfied about what you read here and praise God for delivering these women from the bondage of the pornography industry. 

Ex Porn Star C***** T***** Story
by shelleylubben| Mon, 10/10/2011 – 3:51pm

Former porn star V******* speaks out on her career in porn and the permanent damage it has caused her. V******* was active in the porn industry from 2003-2004 and did about 60 hardcore films. She is now on a mission to speak out about the harms of pornography.

SL: How were you first introduced to the sex industry?

V:  Through a girlfriend I had who stripped.

SL: What did you think the sex industry could offer you?

V:  Glamour and a sense of purpose with men. I wanted attention like my girlfriends received in high school. I was looked over for most of the part. I wasn’t the homecoming queen.

SL: Tell us about your first experience with the porn world.

V:  I won a contest in a Hustler magazine that I entered almost as a joke and suddenly I was off to LA. Someone who worked with Hustler set me up with Derrick Hey with LA Direct Models and I moved into his house along with other porn stars. His house was so full that he moved one of the girls into a closet. Every porn star had to pay $700 a month to stay with him.

SL: Did you feel pressured by pornographers to do sex acts you wouldn’t have done before porn?

V:  Yes. I swore I would never do anal and or interracial porn. I am not a racist but I don’t sleep with black men in my personal life and I don’t do anal. Just stomach turning…

SL: Which sex acts were you coerced into doing?

V:  I finally broken down after being pressured and did anal and a scene with a black guy.

SL: Who was your agent? Were you pressured to do sex acts you didn’t agree to?

V: D****** H** with LA Direct Models was my agent and he pressured me to do anal. He even booked me to do an anal with him so I packed up my bags and left his house.

SL: What was your worst experience in porn?

V:  When I did a scene for Red Light District, V**** V**** gave me a ride to the set and he asked me for “(triggering sexual reference removed)”. He called me a whore and told me I had to do it. So I did. When I arrived to the set I expected to do a vaginal girl boy scene. But during the scene with male porn star E*** E*******, he forced himself anally into me and would not stop. I yelled at him to stop and screamed no over and over but he would not stop. The pain became too much and I was in shock and my body went limp. I couldn’t fight him off anymore. After the scene, they wouldn’t give me a ride home. I called a taxi and went to a medical clinic to check me out due to the severe pain I was in. A day later I received a phone call from V**** to keep my mouth shut about the rape. He threatened me that I didn’t know who I was messing with and that his edited footage of what happened would prove me a liar. When I went to Red Light District to get my check, I was only paid for vaginal, not the anal rape. The anal scene was so traumatizing that I hid out for six weeks.

SL: Were you offered drugs and alcohol?

V:  I did not do any drugs… I don’t use alcohol. I performed sober. I was never around drugs and only around alcohol at parties. I rarely attended those. I didn’t do any of it before getting into the industry and I never had a desire to use drugs and alcohol regardless. Thank God. He watched over me in that respect.

SL: Did you feel pressured to change your looks?

V:  Yes… incredibly. And it became an obsession to always measure up and now I am lost in myself trying to measure up to who I think I could have been. Very emotionally disturbing actually.

SL:  Describe any abuse you saw going on during a porn production.

V: I can only say that a lot of men in that industry don’t like women to begin with. I am not saying all of them don’t but a lot don’t and they could care less about the level of degradation they place on women.

SL: What is your experience with STDs?

V:  By the grace of God I didn’t catch an STD… I tested regularly through AIM, however, when a performer I worked with caught an STD, I was given a pill to prevent me from getting sick.

SL:  Do you feel you were educated by the porn industry about STDs?

V: I feel that they have a way of making you feel like a sex soldier and that you are exempt of the true risk that exists of contracting HIV. It was the last thought that crossed my mind when I worked. I know of someone who contracted it during the last outbreak. It is heartbreaking. I would love to see nothing more than the industry protecting the performers’ lives and mandating condoms. They can use clear ones and protect lives. The pornographers aren’t the victims when it comes to the STDS. The performers are.

SL:   Were you educated about your rights as an employee to a safe and healthful workplace?

V:  Absolutely not.

SL:  Describe your work environment. Did you feel it was a safe and healthful workplace?

V:  I was under the illusion that porn was safe until someone I met contracted HIV and it hit me that it could have been me at any given time and that we are not sex soldiers and not exempt from the perils and pitfalls that could happen as a result of unprotected sex.

SL:  Were you afraid you would catch STDS or HIV?

V: Not at the time because I was told I would be kept safe. I actually thought Sharon Mitchell was doing the best she could to protect performers. But at the same time there are NO guarantees that you will be spared from STDs or contracting HIV and that it can be you getting the positive test result at any time in an industry that allows for unprotected sex.

SL: V*******, did you ever enjoy making porn?

V: I only enjoyed the opportunities that arose such as appearing on the Howard Stern show. I never had an orgasm. I only acted. It was a big act. And the act got uglier with being raped by Red Light district. I don’t even like sex anymore because I can’t find someone that doesn’t abuse me on one level or another and they think it’s ok because I was a porn star and that their abuse is justified. No abuse is justified.

SL:   How did you get out of porn?

V: The very last scene I shot with Evil Angel and it was an interracial scene. I didn’t want to do it but after the anal scene, I was told I wouldn’t work again after V****’s threats and lies so I really had no choice. I did the scene with the black male porn star on a Thursday and the director tried to book me again on Monday with the same performer. I ended up getting on a plane going back home because I had enough. It was truly God watching over me because I learned that the male performer worked with someone who was on the first generation watch list for the HIV outbreak that occurred the day before that scene was booked. That’s how close I was to HIV. I cried my eyes out.

SL:  How are you treated now that you are out of porn?

V: I am treated absolutely horrific!!! Porn has left a permanent stain on my life. I have been harassed by boyfriends because of my porn past. I am discriminated against in my community when applying for jobs and sometimes on levels that are illegal. I deserve to be happy in life and not harassed by people who are threatened by my past. I also don’t deserve to be slandered, I don’t slander others, I don’t deserve it.

SL:  What message would you give to other aspiring porn stars?

V: I would say that it isn’t all glamour and there may be times that you could find yourself being coerced or violated and that you could contract HIV and you can wind up empty and soul less and alone in life…like me. And that the stigma and finger waving will follow you for the rest of your life. You could spend your life being harassed like I am. It isn’t fun by any means. It’s only made me hateful where I never used to be hateful. I am a product of what can happen to girls. I go to bed alone at night. I don’t have many friends. I never once thought people would act so incredibly sick in the head over my porn past.

SL: What message would you give to men viewing porn?

V: That women are NOT objects and we don’t want to have our insides pounded out and we don’t want to be degraded and that we are real people with real hearts and real personalities. It’s sick that porn viewers want to watch women being violated. The people I know who are obsessed with sex and porn and orgies are Lawyers Doctors Dentists and Judges, the people in position who society thinks so much of while they secretly get off to violent and degrading porn. These are the people who need to seek treatment and the ones that society are programmed to think so highly of. I know a dentist who has a porn collection and him and his wife take their office staff to Mexico and they have orgies. They tried to brand me a prostitute because I made porn when they are the hypocrites with the sexual addiction and even bully their office staff into sexual acts because of their sexual and porn addiction. This is the kind of thing that happens in the real world. Porn addiction is real and it damages lives.

SL: Thank you V******* for being honest and so courageous to share your story and experience in porn. I know it wasn’t easy but I am sure you will help many people learn the truth about porn and the damage it forever causes in the lives of women who work in porn. We are blessed to have you join with Pink Cross Foundation in the war against porn. May God continue to watch over you and bless you for standing for truth.

Call to Action to the readers: Please stop viewing porn and stop contributing to damaging women’s lives. Please instead pray fervently for the women who are abused in porn that God would heal their lives and do above and beyond all they could ask or think (Ephesians 3:20).

By

Addiction

Originally posted by Brain for Business

Addiction: a life long illness not lifestyle choice

Addiction is a major health problem that costs as much as all other mental illnesses combined (about £40 billion per year) and about as much as cancer and cardiovascular disorders also.

At its core addiction is a state of altered brain function that leads to fundamental changes in behavior that are manifest by repeated use of alcohol or other drugs or engaging in activities such as gambling. These are usually resisted, albeit unsuccessfully, by the addict. The key features of addiction is therefore a state of habitual behaviour such as drug taking or gambling that is initially enjoyable but which eventually becomes self-sustaining or habitual. The urge to engage in the behaviour becomes so powerful that it interferes with normal life often to the point of overtaking work, personal relationships and family activities. At this point the person can be said to be addicted: the addict’s every thought and action is directed to their addiction and everything else suffers.

If the addictive behaviour is not possible e.g. because they don’t have enough money then feelings of intense distress emerge. These can lead to dangerously impulsive and sometimes aggressive actions. In the case of drug/alcohol addiction the situation is compounded by the occurrence of withdrawal reactions which cause further distress and motivate desperate attempts to find more of the addictive agent. This urge to get the drug may be so overpowering that addicts will commit seemingly random crimes to get the resources to buy more drug. It has been estimated that about 70% of all acquisitive crime is associated with drug and alcohol use.

Addiction is driven by a complex set of internal and external factors. The external factors are well understood: the more access to the desired drug or behaviour e.g. gambling the more addiction there is.

The internal factors are less clear. Although most addiction is to alcohol and other drugs, addiction to gambling and other behaviours such as sex or shopping can occur. These tell us that the brain can develop hard-to-control urges independent of changing its chemistry with drugs. All addictions share a common thread in that they are initially pleasurable activities, often extremely enjoyable. This results in these behaviours hijacking the brain’s normal pleasure systems so that naturally enjoyable activities such as family life, work, exercise become devalued and the more excessive addiction behaviours take over.

However, not everyone who engages in drug use or gambling becomes addicted to them so clearly other factors are important. These are not yet understood but are now being actively studied. Some people may be particularly sensitive to the pleasurable effects of alcohol, drugs or gambling, perhaps because of coming from deprived backgrounds. In others, addiction may occur because of an inability to adopt coping strategies. Others may have an underlying predisposition to develop compulsive behaviour patterns. Some unfortunate people may have several of these vulnerability factors and there are also genetic predispositions to some of them.

Also a significant amount of drug use is for self-medication, examples include cannabis for insomnia, alcohol to reduce anxiety, opioids for pain control etc. This therapeutic use can escalate into addiction in some people though by no means all. Not all drugs which are used for recreational purposes are addictive. LSD and magic mushrooms seem not addictive at all, and some have a low risk of addiction (MDMA/ecstasy; cannabis). The most addictive drugs are nicotine, heroin and crack cocaine plus metamfetamine (crystal meth) although this is not much used in the UK.

Just because some people – including leading politicians – have used drugs but stopped before they became addicted does not mean that anyone can stop that easily. Starting to use drugs may be a lifestyle choice but once addiction sets in, choosing to stop is very much more difficult if not impossible.

We are beginning to understand how addictions start in the brain. The pleasurable or rewarding effects of addictions are mediated in the brain through the release of chemicals such as dopamine [by cocaine, amphetamines, nicotine] or endorphins [heroin] or both [alcohol]. The pleasures are then laid down as deep-seated memories, probably through changes in other neurotransmitters such as glutamate and GABA that make memories. These memories link the location, persons and experiences of the addiction with the emotional effects. These memories are often the most powerfully positive ones the person may ever experience, which explains why addicts put so much effort into getting them again. When the memories re-occur, which is common when people are still using drugs or gambling, as well as when in recovery/abstinence, they are experienced as cravings. These can be so strong and urgent that they lead to relapse.

A great deal of research has been conducted into the role of dopamine in addiction and we now know that the number of dopamine receptors seems to predispose to excessive pleasure responses from stimulant use. This excessive response is thought to initially occur in the reward centre of the brain – [the nucleus accumbens] – but then move into other areas where habits are laid down. This shift from voluntary (choice use) to involuntary (habit-use) explains a common complaint of addicts that they don’t want to continue with their addictions, and even that they don’t enjoy them anymore, but cant stop themselves. In this sense addiction can be seen as a loss-of-control over what starts out as a voluntary behavior. Thus addiction is not, as some like to suggest, simply a “lifestyle” choice. It is a serious, often lethal, disease caused by an enduring (probably permanent) change in brain function.

We know that personality traits especially impulsivity, predict excess stimulant use and in animals this can be shown to correlate with low dopamine and high opioid receptor levels. Similarly in humans low dopamine and high opioid receptor levels in brain predict drug use and craving. These observations give new approaches to treatment, both psychological interventions such as behavioural control, and anti-impulse drugs such as those used for ADHD e.g. atomoxetine and modafinil, are being tested.

For some addictions, especially heroin, the risk to the addict (life expectancy less than that from many cancers) and to society (from crime and infections), is so high that the prescription of substitute opioid drugs or even heroin itself saves lives and reduces crime. These substitute drugs are methadone and buprenorphine [Subutex]. As well as reducing crime and social costs by removing the need for addicts to commit offences to feed their habit, they also protect from accidental overdose and reduce risk of infections such as HIV and hepatitis. Similar substitute pharmacological approaches exist for other addictions e.g. gammahydroxybutyrate (Alcover) and baclofen for alcohol addiction, and varenicline (Champix) for nicotine dependence.

Another major reason for relapse in addiction is stress. This may work through increasing dopamine release in brain so priming this addiction pathway or by interactions with other neurotransmitters such as the peptide substance P. As antagonists of these neurotransmitters are now available they are being tested in human addictions and may offer an alternative to substitution treatments.