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Tuesday, January 3, 2012

Violence and Addiction -- Cocked and Loaded?

As we all suspect, people who are responsible for a disproportionate amount of crime are both violent and overwhelmingly addicted to alcohol and other drugs. Most agencies report  that drug use and addiction is linked to at least half of the major crimes in this country, as at least half of the suspects arrested for violent crimes, such as homicide and assault, were under the influence of drugs when they were arrested.

In fact, in a study released in February, 2010 by The National Center on Addiction and Substance Abuse (CASA) at Columbia University, researchers concluded that alcohol and drugs were involved in 78% of all violent crimes. The study also found that alcohol by itself is connected to the crimes of more than half of all inmates incarcerated in America. 

So, naturally, these alarming statistics, which show a strong relationship between drugs and violence, lead many Americans to see all addicts as dirty, violent psychotics. But, is this a true depiction? If it were, incarceration, not treatment, might seem to be the best answer to dealing with addiction. The old "lock them up and throw away the key" mentality of strict incarceration seems more justified for addicts who are chronic violent offenders, perverted criminals without empathy or remorse. Have drugs fried the brains of those who have become dependent and have these drugs turned them into incorrigible, violent criminals?

Brain Study

Brain imaging studies of violent criminals are difficult to interpret for a a very apparent reason: it is difficult to find exactly which brain changes are associated with addiction (which may not involve violence) and which brain changes are connected with brutal and violent behavior.

A new study published in the Archives of General Psychiatry has been completed that attempts to delineate the differences by comparing four groups of volunteers:

a. Violent offenders who were addicted to drugs,
b. The rare violent offenders who were not addicted to drugs,
c. Nonviolent people with alcohol or other drug problems, and
d. Those who were neither violent nor addicted.

"Brain scans suggest that drug misuse is linked with reduced brain volume in areas of the cortex that are involved with self-control, not violence or psychopathy as has been previously suggested,” says Boris Schiffer, lead author of the study and a forensic psychiatrist at the University of Duisburg-Essen in Germany.

On the other hand, violence, aggression and higher scores on measures of psychopathy were shown to be connected with greater volume in midbrain regions involved with desire, craving, pleasure and motivation.

"In other words, violent brains may be characterized 
by a more powerful 'engine' driving them to act impulsively, 
while the addicted brain is typified by weaker 'brakes' on such drives. 
In violent offenders who are also addicted to drugs, 
the combination of a more powerful engine and weaker brakes 
may leave them with both greater desire to seek pleasure 
(whether that’s drugs, violence or other activities) 
and a reduced ability to just say no.'”

(Maia Szalavitz, "The Criminal Mind: How Drugs and Violence May Affect the Brain,", June 10 2011)

James Blair, chief of affective cognitive neuroscience at the National Institute on Mental Health states, “[The research] does suggest that these problems may be exacerbated as children become more exposed to drugs and that makes treatment progressively more difficult.”

In the current study, 75% of the violent offenders met criteria for antisocial personality disorder (ASPD), a condition involving callous disregard for others, ongoing criminal behavior and self-centeredness.

But none of the 51 men who were studied met the full criteria for psychopathy, 
the extreme form of ASPD characterized by chronic cruel and violent behavior
with complete disregard for the law and the feelings of others. 
The implication is that psychopathy and ASPD may turn out to have different underlying pathology.

Blair believes larger midbrain regions found in the violent group in the new study may be more characteristic of hot-headed criminals, people who may be driven to violence by anger and frustration rather than a lack of ability to care for others.

Schiffer’s study did find that violence — but not drug use — was associated with reduced volume in the left insula, an area involved with disgust, anticipation of negative consequences and understanding the feelings of others. This is in line with previous research suggesting that callous behavior may involve both reduced empathy and less fear of punishment.

Which Came First -- Fried Brains or Drug Use?

This brain imaging study cannot determine cause and effect, so they shed no light on whether the brain differences lead to addiction and violence or whether drug use and violence preceded the changes. But other research does suggest these factors contribute to both addiction and antisocial disorders:

1. Genetic influences,
2. Certain environmental factors: child abuse, neglect and other trauma for addiction and antisocial disorders while childhood exposure to violence at home or in the community is a particular risk factor for adult violence.

What Can We Learn?

The CASA report says that the substance abuse statistics in today’s prison population point to the need for a different strategy. Treating addicts as criminals who need to be punished instead of recognizing that addicts are people with a disease that needs to be treated is to perpetuate a cycle of repeat offending that is “inane and inhuman” according to Joseph Califano, Jr., CASA’s chairman and president.

Ex-con Richard Broom agrees that the need for recovery programs in prison is vital. In his book Cocked and Loaded, Broom tells the story of his 24 years of substance abuse that led up to the night when he ended a man’s life in an alcoholic stupor. Broom had experienced three to four blackouts a week for the eighteen months prior to the shooting incident. Alcohol blackouts were a normal part of his every day life. (B. Farfan, "Alcohol and Drug Blackouts In True Crime Stories -- New Addition Statistics Show Need for Rehab Treatment In Prison,"

While in prison, Broom finally acknowledged his drinking problem--and his anger problem, took responsibility for his past crimes and sins, and worked to redeem himself and make amends. Rather than blaming his parents, his lawyer, or the system for the 11 years he spent behind bars, he now blames only himself. And he credits prison and Alcoholics Anonymous with saving his life.

Broom was released from prison in 1993, and because of the alcohol addiction rehab work he had been able to do in prison, he has been a sober and productive member of society ever since. “While I can say that prison saved my life, the Twelve-Step program saved my soul,” Broom says in his book. “Before I got sober, I didn’t want to live but was afraid to die. Today I want to live, but I’m not afraid to die.”

Ironically, Broom is now an addiction therapist who specializes in the treatment of police, corrections, parole and probation officers. From a clean and sober perspective, Broom sees his work today as more than just poetic justice. He sees his ability to help others because of where he’s been in his life as just part of the plan of “the big boss of the universe.”

I believe genes do not necessary determine a person's destiny. Yet, one study looked at 231 people who were diagnosed with drug or alcohol addiction, and compared them to 61 people who did not have an addiction. Then it looked at the first-degree relatives (parents, siblings, or children) of those people. It discovered that if a parent has a drug or alcohol addiction, the child had an 8 times greater chance of developing an addiction. (A. Lowenfels  and T. Miller, "Alcohol and Trauma," Annals of Emergency Medicine, 1984 13:1056-1060)

But, what if a child has a low genetic predisposition for addiction? He/She will be free of fear of addiction, right? Wrong -- repeatedly abusing drugs or alcohol will permanently rewire that person's brain. Poor coping skills can cause disasters.The person very well may become an addict (50/50 chance in some estimates).

No matter the reason for becoming dependent, the dependent person becomes ill with a disease. Yes, addiction is a disease. As a result of scientific research, the National Institute of Drug Abuse concludes that addiction is a disease that affects both brain and behavior. They have identified many of the biological and environmental factors and are beginning to search for any and all of the genetic variations that contribute to the development and progression of this disease. Can will-power and intelligent coping skills positively affect or even prevent a disease? I believe so -- ask anyone who has contracted an STD after drinking one too many.

“Almost any of us can become 
behavioral addicts, 
given the right exposure, 
the right timing 
and so on,
But there are multiple causes: 
our personalities, genetics – 
it’s not simple.”  

-Jim Orford, author, University of Birmingham, UK, 
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