Tiffany Cruz The most important question about addiction is, is it really a disease? The choice argument says that addiction is not a disease because addiction is a behavior and all behaviors are choices. The choice argument says that addicts, with a strong enough threat, can stop using; where with other diseases, you cannot do that. However, the choice argument does not take into account our brain. Addiction is a disorder in the very part of the brain we need to make proper choices. Disease is hard to define. Because of this, doctors and researchers developed what is called the “Disease Model.” The disease model says in order for something to be a disease, there must be an organ, that has a defect, and these defects must produce symptoms. Doctors could not fit addiction into this disease model, and therefore would not treat addiction as a disease. But now, neuroscientists can trace exactly where disease happens in the brain. The two areas of the brain that are important to addiction are the midbrain, and the frontal cortex. The frontal cortex controls thinks such as memories, morality, judgment, personality, rationality. It weighs options, and understands consequences. The frontal cortex is where we make attachments. According to this information, addiction must defect the frontal cortex. This is not true, however. Addiction affects much deeper than that; addiction affects the midbrain. The midbrain cares about the next 15 seconds. The midbrain tells us to eat, to defend, to kill, to survive. In addiction, the midbrain overpowers the frontal cortex and therefore makes the substance or behavior more important than morality, ration, and consequences. To an addict drugs or behaviors equal survival. Addiction involves genes, reward, memory, stress, and choice. 40% to 60% addicts have addiction in their genes. Something in the environment has to “turn on” the genes. Our experiences shape our genes. The midbrain releases a chemical called dopamine when it experiences something pleasurable, and makes the brain remember that thing that was pleasurable; rewards. Drugs released huge spikes of dopamine in our brains. When normal experiences give us pleasure our brain creates a certain “cap” that dopamine has to reach to make us feel pleasure; this is called our hedonic capacity. With constant, unusually high spikes of dopamine, our hedonic capacity is heightened so much that the only thing that feels pleasurable is the drug; this is called allostasis. Glutamate is what strives our memory formation and what reacts to dopamine. When drugs release such high levels of dopamine, glutamate reacts to this and tells our bodies to especially remember that drug. The relationship between dopamine and glutamate in an addict is defected and glutamate creates “hyper memories.” These hyper memories are what cause addicts to relapse after years and years of sobriety. Hyper memories that our brain makes in connection to drugs make addicts revert back to drugs every time it feels stressed. In addiction the “top-down” control of the frontal cortex over the midbrain, fails and therefore destroying choice and free will for the addict. This is called hypofrontality. Hypofrontality is what creates “craving”. The addict can choose in one moment to not use, but the addict cannot control the craving. The choice argument fails here, because it focuses on the behavior and not on cravings which are involuntary. With these new discoveries, addiction now fits into the disease model. The organ is the midbrain, the defect is a high hedonic capacity, and the symptoms include loss of control, craving, and persistent use despite the consequences. The brain can heal, though. Recovering is possible. Recovering not recovery, because addiction is locked into memory, and the minute stress enters our brain, we remember the things that used to make it feel better. Addicts have to stop the high release of dopamine, and have to develop stress coping skills. Normal pleasures can then start to become normally pleasurable.