Addiction Research and Articles About Research

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DSM manualsUnderstanding Internet porn addiction means understanding addiction mechanisms. All addictions hijack the same core neurocircuitry, which runs on the same neurochemicals (even though each addiction also involves additional neural circuits and neurochemicals that differ between addictions).

A basic physiological principle is that drugs do not create anything new or different; they simply increase or decrease normal brain functions. In essence, we already possess the machinery for addiction (mammalian mating/bonding/love circuitry), and for binging (storing calories, mating season).

At this time, only one valid study has examined the brains of porn addicts: Cambridge University: Brain scans find porn addiction. As we expected, it found the same brain response as seen in drug addicts and alcoholics. However, dozens of studies have examined the brains of internet addicts and internet videogame addicts and found those same responses.

Here's an excellent peer-reviewed journal article, with a current review of where addiction neuroscience is with respect to porn addiction: Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity (2013). A 2006 Dutch study found that erotica had the highest addictive potential of all Internet applications. No wonder. Internet erotica is an extreme version of natural rewards that we're all wired to pursue: sexual arousal and apparent mating opportunities.

More and more research is revealing the brain changes behind behavioral addictions. Consider the flood of recent Internet Addiction studies, including dozens of brain studies, which confirm that "Internet addicts" develop the same major addiction-related brain changes that occur in all addictions. (See: Recent Internet Addiction Brain Studies Include Porn). A new European Journal of Behavioral Addictions started in 2012. There is also a yearly conference, and cybersex addiction is becoming a more frequent topic.

In 2011, 3000 doctors of the American Society for Addiction Medicine (ASAM) came out with a public statement clarifying that behavioral addictions (sexual, food, gambling) are fundamentally like substance addictions in terms of brain changes.  Said ASAM:

We all have the brain reward circuitry that makes food and sex rewarding. In fact, this is a survival mechanism. In a healthy brain, these rewards have feedback mechanisms for satiety or ‘enough.’ In someone with addiction, the circuitry becomes dysfunctional such that the message to the individual becomes ‘more’, which leads to the pathological pursuit of rewards and/or relief through the use of substances and behaviors.— The American Society of Addiction Medicine (ASAM)

The head of the National Institute on Drug Abuse (NIDA) Doctor Nora Volkow, has suggested the agency's name be changed to the "National Institute for Diseases of Addiction," to address behavioral addictions such as pathological gambling, overeating and compulsive pornography use (More Addictions, Less Stigma).

Another famous addiction researcher, Eric Nestler, has this Q & A on his website, Nestler Labs.

QUESTION: Do these changes occur naturally in your brain without the influence of a drug of abuse?

ANSWER: “It is likely that similar brain changes occur in other pathological conditions which involve the excessive consumption of natural rewards, conditions such as pathological over-eating, pathological gambling, sex addictions, and so on.”

By creating a new behavioral addiction category, even the DSM-V finally acknowledged that these addictions appear to involve shared mechanism and brain changes.

“The idea of a non-substance-related addiction may be new to some people, but those of us who are studying the mechanisms of addiction find strong evidence from animal and human research that addiction is a disorder of the brain reward system, and it doesn’t matter whether the system is repeatedly activated by gambling or alcohol or another substance,” said Charles O’Brien, M.D., chair of the DSM-5 Work Group on Substance-Related and Addictive Disorders. “In functional brain imaging—whether with gamblers or drug addicts—when they are showed video or photograph cues associated with their addiction, the same brain areas are activated,” he explained.

Another DSM-5  work-group member (Sexual and Gender Identity Disorders) commenting in this article about Internet porn: Will quitting porn improve your life?

But the kind of definitive research that could explain what happens to the brain while watching porn simply hasn’t been done, says Dr. Richard Krueger, associate clinical professor of psychiatry at Columbia University’s college of physicians and surgeons. Kruger helped revise the sexual disorders section of the latest edition of the psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders, which doesn’t include sex or porn addiction due to lack of academic evidence that they exist. “The whole notion of what goes on in someone’s brain when they’re sexually excited is just starting to be evaluated,” he says.

He has little doubt porn addiction is real and will eventually garner enough attention to be recognized as a mental illness. But he’s skeptical it has the kind of universal neurological effects that some suggest. Other behaviours such as drinking alcohol or gambling are addictive to only a small minority of the people who engage in them—between one and 10 per cent, Krueger says. “I would argue for the same sort of hit rate with exposure to Internet pornography, that most people would do it and it won’t become a problem.”

Recent research on brain changes in response to "highly palatable foods" is revealing evidence of an addiction process. So is Internet addiction. If gambling, gaming, Internet use and food can alter the brain in this way, it would be amazing if Internet porn alone did not. See this review - Natural Rewards, Neuroplasticity, and Non-Drug Addictions (2011)

Today's extreme porn is as unnatural a "natural reinforcer" as today's junk food is. (See Porn Then and Now: Welcome to Brain Training by us, The End of the Porn Debate? by us, and Can Pornography Use Become An Actual Brain Addiction? by Donald Hilton MD.) The challenge now is that control groups of young male non-porn users cannot be found. And who wants to ask non-users to use it in a trial, given the apparent risk of addiction?

Some brains are certainly more sensitive than others to the potentially addictive effects of extreme stimuli. However, it's likely that the more intense our culture's sexual stimuli become, the greater the percentage of users who will show signs of imbalance—even those with fundamentally healthy brains. Also each generation uses more extreme synthetic stimulation than the previous one, and starts earlier with highspeed Internet porn. (Think smartphones.) Alas, adolescent brains are more vulnerable to addiction.

We often see healthy guys who develop porn-related erectile dysfunction return to good health simply by avoiding internet porn. This suggests they didn't have other issues that would have accounted for their vulnerability. Not only do those with healthy brains benefit from rebooting and thereafter avoiding extreme stimuli, it's also likely that users with especially sensitive brains, the "canaries in the coal mine," can also ease some of their symptoms by consciously moving toward normal brain sensitivity.