'Food, drink and drugs are traditionally substances we use because they are rewarding,' says Professor Taco de Vries. 'They make us feel good. And anything that makes us feel good, we want to keep doing. Even if we know it's bad for us.' Because our brain is focused on reward, he argues. Addictive substances such as alcohol, smoking and sugary foods hit our reward system much harder than natural rewards, such as going for 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," de Vries said.
Another thing that doesn't help, according to the neurobiologist, is that addictive substances are available and visible everywhere. 'You only have to walk through town and you see unhealthy food or ads for beer brands everywhere. And with the rise of vapes, there are plenty of incentives for smokers, too.'
Addicted in no time
The facts don't lie. If you start smoking, you'll be hooked in no time, according to De Vries. 'Nicotine is the most addictive substance we know,' he says. 'The chance of becoming addicted after you start smoking is one in three. That makes that substance more addictive than heroin.' A smoke-free generation still seems a long way off. Still a quarter of young people and a fifth of Dutch adults smoke. And although the bright colors and apparently 'clean' smoke of the vape make you think otherwise, according to de Vries we should not start seeing this drug as an alternative to cigarettes. 'Vaping is also hugely addictive because it contains nicotine. And anything you put in your lungs is unhealthy'.
With alcohol use, addiction rates are lower, yet as much as 10 percent of the Dutch population drinks alcohol excessively (figures: Trimbos). 'We associate alcohol with fun times, such as celebrations and social occasions, but alcohol also has major harmful effects,' says de Vries. That knowledge does not yet seem to be so widespread. 'People don't know - or don't want to know - that you can also get cancer from alcohol. And we know that there are indications that alcohol consumption can cause dementia and Alzheimer's.'
Loss of control
That substances such as alcohol and smoking are dangerous is beyond question. But even with a busted liver and black lungs, we continue to use those substances. "It all has to do with losing control of your own behavior," de Vries argues, "and that is a major symptom of addiction. Environmental stimuli and withdrawal symptoms make it difficult for addicted people to come off their use. According to de Vries, something else also happens in the brain. 'When you stop, you remain sensitive to everything associated with substance use. That craving doesn't stop, but - especially in the first year - only gets worse. We know that 90 percent of people who quit relapse within a year.'
Government not doing enough
De Vries notices that the government's main focus is on prevention. Rolling out information campaigns, reducing points of sale, introducing smoke-free zones and instituting increased excise taxes all fall under this. 'Those are relatively easy measures that don't cost a lot of money. But they won't reach the two million people who are already addicted. You shouldn't assume that those people will or can quit on their own, because that's not going to happen,' the addiction expert said. He argues that the government should be able to offer them a decent pathway. That comes at a price, but addiction itself also costs our society billions, De Vries continued. 'The social costs associated with smoking and drinking amount to over 30 billion euros. Together they account for almost ten percent of the total disease burden in the Netherlands.'
Taco de Vries and other scientists therefore recently wrote a report in which they argue for structural funding for addiction research. A parliamentary letter has been written about this, which is expected to be debated this summer.
