Why do we still drink and smoke?

Why do we still drink and smoke?
Why do we still drink and smoke?

‘Food, drink and drugs have traditionally been substances that we use because they are rewarding,’ says VU professor Taco de Vries. ‘They make us feel good. And we want to continue doing everything that makes us feel good. Even if we know this is bad for us.’ Because our brain is focused on reward, says the addiction expert. Addictive substances such as alcohol, smoking and sugary food affect our reward system much more strongly than natural rewards, such as taking a walk, having sex or doing fun things with friends. And with that strong craving for substances that are not good for us, addiction lurks. “That makes them dangerous,” says de Vries.

What doesn’t help, according to the neurobiologist, is that addictive substances are everywhere available and visible. ‘You only have to walk through the city and you see unhealthy food or advertisements for beer brands everywhere. And with the rise of vapes, there are also plenty of incentives for smokers.’

Hooked in no time

The facts don’t lie. If you start smoking, you will become addicted in no time, according to professor Taco de Vries. “Nicotine is the most addictive substance we know,” he says. ‘The chance of addiction after you start smoking is one in three. That makes the substance more addictive than heroin.’ A smoke-free generation still seems far away. A quarter of young people and a fifth of adult Dutch people still smoke. And although the bright colors and apparently ‘clean’ smoke of the vape make you think otherwise, according to De Vries we should not see this drug as an alternative to cigarettes. ‘Vaping is also extremely addictive because it contains nicotine. And everything you put into your lungs is unhealthy’.

Addiction rates are lower for alcohol use, but no less than ten percent of the Dutch population still drinks alcohol excessively (figures: Trimbos). ‘We associate alcohol with fun moments, such as celebrations and social occasions, but alcohol also has major harmful effects,’ says de Vries. That knowledge does not seem to be that widespread yet. ‘People don’t know – or don’t want to know – that alcohol can also give you cancer. And we know that there is evidence that alcohol consumption can cause dementia and Alzheimer’s.’

Loss of control

There is no doubt that substances such as alcohol and smoking are dangerous. But even with a damaged liver and black lungs, we continue to use these drugs. “It all has to do with losing control over your own behavior,” says de Vries, “and that is an important symptom of addiction.” The stimuli from the environment and the withdrawal symptoms make it difficult for addicted people to stop their use. According to de Vries, something else also happens in the brain. ‘If you stop, you remain sensitive to everything associated with substance use. That craving does not stop, but only gets worse – especially in the first year. We know that 90% of people who quit relapse within a year.’ Taco de Vries is currently conducting research to dampen this ‘addiction memory’. ‘We are experimenting with therapies that manipulate this memory through EMDR interventions and stimulating or inhibiting the activity of certain brain areas. We already know this can be effective.”

Government is not doing enough

Taco de Vries sees that the government is mainly focusing on prevention. Rolling out information campaigns, reducing sales points, introducing smoke-free zones and imposing increased excise duties are all included. ‘These are relatively easy measures that do not cost much money. But that won’t reach the two million people who are already addicted. You should not assume that these people will or can stop on their own, because that is not going to happen,” says the addiction expert. He states that the government must be able to offer them a decent trajectory. This comes with a price tag, but the addiction itself also costs our society billions. ‘Addiction is the most expensive brain-related disorder. The social costs associated with smoking already amount to more than 30 billion euros. For alcohol this is two and a half billion euros. Together they account for almost ten percent of the total disease burden in the Netherlands.’

Yet the government does not release enough money to tackle addiction, even though, according to De Vries, much more knowledge is needed to do this effectively. ‘More knowledge is needed in almost all areas of addiction. In the field of prevention, but also about how you can reach vulnerable groups and develop more effective treatments.’

Addiction scientists like Taco de Vries are completely dependent on the government for their research. There are almost no alternative cash flows. ‘People prefer not to donate money to addiction. There are no collection box funds and there are hardly any patient associations. People who are addicted prefer not to show it off.’ De Vries advocates structural financing for addiction research, as is already happening in other countries. ‘In France, a national addiction fund is financed from excise duties. You would like that to happen in the Netherlands too.’

Professor Taco de Vries and other scientists recently wrote a report in which they argue for structural financing for addiction research. A letter to Parliament has been written about this, which is expected to be discussed this summer.

The article is in Dutch

Tags: drink smoke


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