Can you force yourself to crave lettuce and running? Nora Volkow, Director of the National Institute on Drug Abuse, examines the science of compulsion.

Question: Can drugs change someone’s personality?

Nora Volkow: Yes, indeed. Unfortunately, drugs—again, it depends on the drug, obviously. Not all of the drugs are the same. In terms of how addictive they are, some drugs are more addictive than others. For example, methamphetamine is considered among the most addictive drugs of abuse. Not all of the drugs are the same in terms of their damaging certain circuits of the brain. Some drugs are more harmful. And for example, some interfere with cognitive processes more than others. One of the drugs that has been shown to be particularly damaging for cognitive processes for regulating mood, for example, is ecstasy. On the other hand, you have, for example, like nicotine, that does not damage cognitive processes. So when you are, again, addressing the extent to which a drug is going to produce changes in personality, you have to consider the type of drug.

So nicotine addiction does not, per se, change your personality. On the other hand, if you have drugs like alcohol that will change your personality and will trigger these cyclical shifts in the pattern of a person's behavior that are driven in part by the shifts between intoxication, withdrawal, and recovery. And the same thing happens with opiates. If you maintain someone on, a heroin abuser, when they are taking heroin, their personality may be very expansive. But when the heroin is leaving their body, they can become very irritable and aggressive. So you'll see that.

With repeated use, these drugs can, in some individuals, produce decreasing function of frontal cortex. And frontal cortex is what enables you to really understand a wide variety of environmental stimuli, including social, social communications, which are very, very important. Very important, on a one to one basis, but also in group, in group dynamics. And these can interfere with an ability of a person to properly engage on behaviors and social systems and this could explain why, also a person that has become addicted become more and more and more alienated with their own social networks. Which again, puts them at greater and greater risk of relying more and more on drugs as a means to try to get some sort of reinforcer, because they no longer get even the reinforces that we get with social interaction, which are very powerful.

So yes, indeed, and this is in fact one of the issues that when we are helping someone in a therapeutic set up recover and get back into their social system, recover from drug addiction, we need to very much help them into that transition, so that they regain the knowledge about how to navigate the social systems and they also regain the sensitivity to the social stimuli as enforcers. So that they can also be driven by them.

Question: Can we trick our brains to crave healthy things?

Nora Volkow: I actually am addicted to exercise. I am a compulsive person and again, I think that when one addresses the issue of vulnerabilities, we know that there's an important genetic component into addictions. And so if these genes have survived all these hundreds of years of evolution, an addiction still prevails, does it have, is there something positive about these genetics that make you vulnerable to addiction?

I think one of the things is that may, first of all, facilitate these compulsive behaviors. And compulsive behaviors are not necessarily bad at all, in fact, if you want to excel professionally, I mean, you really do require to do sometimes very compulsive work, just to maintain on task, no matter what, no matter when, you just actually, and that's a way, certainly, for example, I get with data. I stop, I basically filter everything out and I become compulsive until I understand it. And I cannot stop it. When I go running, I'm a compulsive person and I run, and I run, and I run, and I run, and I run and I have to sort of say, "Stop it, this is pathological."

Now, whether it's pathological or not, I do not know, it makes me feel good, and it doesn't have any adverse consequences. Not now, I mean, maybe when my joints start to hurt me, but not now. So my view on these things is that actually as a strategy for therapeutics so people that are addicted to drugs and have a propensity for these compulsive patterns of behavior, a healthy behavior that is compulsive, can actually substitute for a compulsive behavior that is pathological. And indeed, is one of the strategies that works in some people, not on all people that are addicted, this would work. Or on some people that are compulsive eaters, if you can get them to get compulsive about exercising, then you may have solved their problem. And there's two groups of individuals that are addicted that get into this marathon, ultra marathon behavior. And they actually stop the drug and just become compulsive exercisers.

So the answer is yes. Can you get compulsive about eating salads without dressing? Just a piece of lettuce? I have never seen that. But I have seen getting compulsive about eating a salad that has very nice things in it that go beyond just a piece of lettuce.

Recorded on November 6, 2009