>>[Person #1] I don't think addiction is a disease.
>>[Person #2] I think addiction can be overcome.
>>[Person #3] You have choices, and you can choose to stop.
>>[Person #4] It's not a disease.
>>[Person #5] It is a disease, but it doesn't need medication to be treated.
>>[Person #6] Of course it is a disease.
>>[Person #7] I just experienced working in a professional capacity with addicts--
I think it's a disease.
>>[Bill Nye] Have you ever heard that people say addiction is a disease?
>>[Person #7] I've heard a few people say it, but it isn't,
because you can stop whenever you want.
>>[Bill Nye] So, who's right?
Is an addiction a disease?
Or isomething you overcome with your force of will?
♪ [Singing the show's title: "The Eyes of Nye"] ♪
♪ [fast-paced digital music] ♪
♪ ♪
♪ [singing continues] Nye... Nye... ♪
♪ The Eyes of Nye! ♪
>>[Adam Carolla] Hey, everybody. It's Love Line.
I'm Adam Carolla. That is Dr. Drew.
Phone number: 1-800-LOVE-191. Bill Nye, the Science Guy in here.
Jamison? [button beeps]
>>[Jamison]Yes. >>[Adam] You're 16?
>>[Jamison] Yes. >>[Adam] What's up?
>>[Jamison] Lately I've been having these dreams of, like, me smoking pot,
and I've been clean for 3 months now.
>>[Dr. Drew] Well, "using dreams" are absolutely routine.
Anyone who's been addicted to a drug and stops, will have "using dreams."
It's your brain really craving the drug. That's the feeling you have.
You want to be using. You want it so badly.
It doesn't sound like you're in a program, because if you were,
people would tell you that everyone has that.
>>[Jamison] Well, I was in the program, and I didn't really bring it up.
It just started recently...
>>[Dr. Drew] Okay, well, tell your sponsor about it then.
>>[Jamison] Um...I don't have a sponsor.
>>[Dr. Drew] Alright, like I said, you're not in the program.
>>[Adam] We'll take ourselves a little break. We'll be back.
♪ [music starts] ♪
>>[Bill Nye] So, Drew, you do this radio show, Love Line, every night?
It takes you just a few moments to analyze people's problems, and you seem to be dead on.
What is it about addicts, what is it about addiction, that you pick up on?
>>[Dr. Drew] How do I know it's addiction? It's just...I, I...it's almost like a smell.
>>[Bill Nye] You're on the radio!
>>[Dr. Drew] I know! And I'll go to Adam: "I smell it. I just know it's here."
♪ [music like from old TV shows] ♪
♪ ♪
>>[narrator of the video] Youth is a happy time and a carefree time.
A time of auto rides and double dates.
It's a time of fun, pranks, and jokes.
Youth is a time for finding one's place in the world.
But, sometimes in these troubled days, the very thoughtlessness of youth
♪ [music changes to ominous] ♪ has led to a living nightmare:
addiction to drugs, too often acquired with tragic carelessness.
To these addicts, life's only work is to find money for drugs.
In their desperation, no means is too foul.
Their only goal in life is to keep the deadening chemicals forever in their heart's blood.
[sound of old film reel ending]
>>[Dr. Drew] It is important for me to-- for people, in this country in particular,
to understand this disease of addiction,
because the perception is so far from the reality.
It breaks my heart, the amount of suffering
and the amount of loss that goes on because of this disease.
>>[Bill Nye, narrating] When Dr. Drew's not working the phones on Love Line,
he's the director of chemical dependency services at Los Encinas Hospital,
where he works with hundreds of addicts.
>>[Dr. Drew, addressing an audience] ...and I want to hear how, again,
it was or was not relatable to your stories.
>>[audience member #1] I smoked pot with thousands of kids in my high school.
I ended up homeless and toothless on heroin.
>>[audience member #2] Through this drug that I got introduced to--
it was like cocaine, and couldn't get the cocaine, and moved on to speed--
I became this, like, superwoman and I was just, like, everything and anything.
>>[audience member #3] And every time I got pregnant,
like that [snaps her fingers], I stopped taking drugs,
I stopped doing alcohol, I stopped everything.
Then after your child is a year or two old, just naturally, you start using again.
>>[audience member #4] Since I accepted that idea that addiction was a disease,
it's been relatively easier for me to deal with my addiction.
>>[Bill Nye] Drew, in your opinion, addiction is a disease, right?
>>[Dr. Drew] Addiction is a disease, but really to answer that question accurately,
you've got to be able to understand what a disease is.
The definition of disease, for me, would be an abnormal physiological process
brought on by a relationship between the genetics of the individual and the environment.
That pathophysiology will create a set of signs and symptoms
that progress in a predictable way, we call it a "natural history,"
and by affecting the natural history,
we can create a predictable response to treatment.
>>[Bill Nye] Mm-hmm. >>[Dr. Drew] That's it. That's disease.
And addiction does fit that,
but people get hung up on where the physiology goes wrong,
and they don't understand that it's a brain disease.
>>[Bill Nye, narrating] Now, Dr. Drew went through that pretty fast.
Let's go over it again. So, what is a disease?
Well, it's an abnormal physiological process.
Something is going wrong inside you: a virus is replicating, a tumor is growing,
or your brain is being altered by steady drug use.
Now, diseases are brought on by the combination of the environment and genetics.
So, [for example] you've inhaled a flu virus and you've gotten infected, that's the environment.
You're color-blind? Well, that's genetics.
Diseases all have signs and symptoms, they all have natural histories,
and they all respond to treatments in predictable ways.
So, to see why we often think of addiction as a disease,
we have to take a look at how our brains work.
Like everything else inside you, your brain is made of cells, billions of them.
We call them neurons.
Messages are carried from neuron to neuron with tiny chemical signals,
across gaps we call synapses.
Now, at this chemical level, everything we find pleasurable
amounts to nothing more than a microscopic flood
of the neurotransmitter called dopamine.
So, we call this the "reward pathway."
We like the pleasurable feeling, so we do it again and again,
do it again and again.
Things like eating, drinking, and having sex are pleasurable
because they're required for our survival.
But, it turns out, there's a connection between drugs and dopamine.
[cavemen eating loudly]
>>[caveman #1] Wow, these cocoa leaves are really raising the level of dopamine
at the synapses in my brain!
>>[caveman #2] Yeah, you know, it's like...
it's, uh, almost mimicking the neurotransmitter's structure
by tying up to binding sites the molecules that transport dopamine.
>>[caveman #1] I've heard that to get high, they have to occupy at least 47% of those sites.
>>[caveman #2] Really? You know, I heard it was 60 to 80%.
>>[caveman #1] Well, sure, 60 to 80% for MAXIMUM effect, but 47% at the minimum.
>>[caveman #2] Well, I don't want to get high;
I just want to get through the cold temperatures at night.
>>[caveman #1] The cold doesn't bother me.
>>[caveman #2] Really? So, um...why are you chewing on these?
>>[caveman #1] Because my dad never played catch with me.
I think I'm gonna need a hug here.
>>[caveman #1] No, dude.
>>[Dr. Drew, to an audience] Down in here, down in the sort of reptilian part of your brain,
we share that with mice and rats and other, certainly, lower mammals.
And it's why addiction is so easily studied in rodents and lower mammalian life forms,
because this is a disease of this part of the brain,
of an area called the mesolimbic reward system.
And it's a part of the brain that does not have language,
does not have logic... [trails off]
[to Bill Nye] It's basically what drives us--
it's the survival center of your brain.
Addiction is basically a hijacking of the survival system.
>>[Bill Nye] To show the powerful effect that drugs can have on the survival system,
an experiment was done with laboratory mice.
Now, these were special mice, they were already alcoholic mice.
They were given access to all the cocaine they wanted every time they pressed a lever.
So, the mice would maintain a precise concentration of cocaine in their bodies,
pressing a lever every 12 minutes exactly.
After 14 days, the mice died. Powerful stuff.
>>[Dr. London] I'm a brain researcher.
Here at the Brain Mapping Center at UCLA,
we have this wonderful opportunity to look inside a human brain.
>>[Bill Nye] So, doctor, let's say I were gonna get a PET scan (positron emission tomography).
First, I got the sunglasses because it's bright, right?
But, then what happens?
>>[Dr. London] If you were going to get a PET scan, we would... [dialogue trails off]
>>[Bill Nye, narrating] Now there are exciting breakthroughs
using magnetic resonance imaging (MRIs) and positron emission tomography (PET scans).
We can get to the next level of addiction research.
We can see exactly what drugs do to the human brain.
>>[Dr. London] Here, we're looking at
the comparison of a group of methamphetamine abusers
and a group of non–drug-using volunteers.
The blue areas are areas where the methamphetamine abusers are not working.
If you have a look at the pre-frontal lobe,
the central area that's so important for being able to make a decision
that involves balancing reward against knowing that there's a negative consequence.
You can see that that area is just turned off.
But these other areas that are part of that executive center
that are important in the emotional state of craving are really hot.
>>[Bill Nye] You've lost your ability to make decisions;
at the same time, you've lit up your need, your craving.
So let me ask you this:
Is it possible that the methamphetamine abuser
cannot decide NOT to take the drug that's related to addiction?
>>[Dr. London] In fact, the very nature of addiction
has to do with the inability to make proper decisions.
>>[Bill Nye] This pattern where the decision-making part is sorta turned off--
Is this what happens to an addict? "I can't decide-- Like, this is gonna kill me,
this is gonna kill me, but I gotta have it, I gotta have it, I gotta have it"
and there's no-- They can't think about the future?
>>[Dr. London] Well, you know, for many years,
we were thinking that the best way to treat addiction
was to come up with a blocker to block the high, but that didn't really work.
And then the next wave of work in coming up with treatment
was to reduce craving, but in fact,
I think the biggest problem in drug abuse is the decision making that you just talked about.
Sure, craving occurs, but then what is someone going to DO with it?
>>[Bill Nye] Because they're not thinking.
>>[Dr. London] The part of the brain that's really critical for decision making
is just not functioning properly in the methamphetamine abuser
(and in drug abusers in general).
One of the things that my colleagues who are treatment providers have told me
is that it's very useful to take pictures like this to show people that are in treatment
and it allows the person not to feel guilty about not being able to do the right thing.
It allows the person to see that there is some chemical problem that needs to recover
before they get back to a state where they can make all the right decisions.
>>[Bill Nye] So, Doctor, you look at these images all day, right?
You analyze these things.
If you had one thing to tell the world about your research, what would it be?
>>[Dr. London] Addiction is a brain disease; no matter how the addict got there,
at this point, he has a problem making decisions.
The whole executive center of the brain is involved.
The central area that's really needed for him to be able to make a choice
when he's got to balance between a quick fix,
knowing that there's a negative consequence is something that's not happening properly.
>>[Bill Nye] Addiction is a brain disease. >>[Dr. London] It is.
>>[Bill Nye] There it is, in black and white...
>>[Dr. London] ...and color. >>[Bill Nye] ...and blue and orange.
So how do drugs affect your brain?
Different drugs affect the brain in different ways.
[narrating] For example, cocaine molecules resemble dopamine molecules,
so cocaine molecules end up binding to the receptors of the cells in such a way
that prevents the cells from removing or pumping the dopamine out of the synapses.
And so the brains end up with more dopamine and more pleasure.
It may be that the neurons in addicts' brains receive such high levels of dopamine
that the cells try to adapt by reducing the number of sites to which dopamine can bind.
Well, then, between hits, or during withdrawal, when the addict isn't taking the drug,
their brains end up having not enough dopamine after all of that.
So they start out taking cocaine in order to feel high,
and they end up taking it in order not to feel low.
>>[Dr. Drew] Every addict has experience with being able to start and stop it
earlier in their disease;
that's what makes it so difficult for them to accept that they can't, later on.
♪ [music like from old TV shows] ♪
>>[Mr. Sanders] Children, what do you think causes addiction to drugs in humans?
>>[Mary] The neurons in the brain adapt and respond to excessive stimulation from the drugs,
causing molecular changes that lead to cravings when the drug is not present.
>>[Mr. Sanders] That is one possibility, Mary.
Tommy, what do you think?
>>[Tommy] I've read that addiction can also be traced to genetics,
which (when combined with trauma) can lead the addict to seek relief from reality.
>>[Mr. Sanders] Perhaps, Tommy.
But I believe addiction occurs when someone you love
suddenly decides you're too needy and throws your clothes out on the lawn.
>>[Tommy] Gee, Mr. Sanders, I sure hope science finds a cure for that
by the time I'm older.
>>[Mr. Sanders] I wouldn't count on it, Tommy.
[sound of old film reel ending]
>>[Dr. Drew] You've got a family history of addiction there,
you see a genetic predisposition,
there's some sort of environmental trigger -- oftentimes, it's trauma -- set up...
>>[Bill Nye] What's a trauma?
>>[Dr. Drew] Trauma would be-- usually a childhood trauma is what we're talking about
and it's an experience of powerlessness in childhood;
a feeling that they're threatened with not being able to survive, quite literally.
And you're 15 and you feel out of control and life sort of sucks,
and you can't figure out what's going on,
you can't feel good about yourself or what you're feeling.
You look for solutions and somebody hands you a joint
and oh, things are okay now!
>>[Bill Nye] We're gonna run a little test here, right?
We're gonna have these people drink what they think is beer...
but there's no alcohol.
>>[Dr. George] Correct.
>>[Dr. Marlatt] Some people think it's just a biological disease, period.
But we're saying that's PART of it, but the psychological factors
and the social factors and the cultural factors play also a big role.
>>[Bill Nye] So what do we expect to happen?
>>[Dr. Marlatt] Well, we're gonna see if we get a sort of placebo effect
in the sense that people, if they think they're drinking alcohol
and they're in a bar setting and they're with other people,
how much of the effects are due to alcohol
and how much are due to the setting and the expectancy and they contact high?
>>[Bill Nye, narrating] Dr. George and I are now observing behind a mirror
while Dr. Marlatt plays bartender.
>>[Man] Here's to science. [Glasses clink together.]
>>[Dr. George] I'm looking for the usual types
of changes that you see in people after they have a drink,
which are feeling a little bit more relaxed, being a little more sociable,
perhaps a little giggly, being a little looser.
[Cheering, glasses clinking]
>>[Man, unclear]
[overlapping chatter]
>>[Dr. George] Those are the typical types of things that happen
when folks normally drink alcohol,
and so, as a consequence, those are their expectations.
And that belief is so strong
that just believing that they've been drinking can stir up those effects.
>>[Dr. Marlatt] I'm gonna tell you something now about what you've been drinking.
Somebody asked about what brands.
These were the beers; they're alcohol-free.
[various reactions]
>>[Bill Nye] Ladies and gentlemen...
It's really cool. You guys were carrying on
like you were just drinking, you know, a lot of beer.
Not that I've ever done that.
>>[Some participants laugh.]
>>[Bill Nye] So let me ask you this:
Do you think it would change the way you drink in the future?
>>[Participant] We could still have fun without getting drunk?
>>[Bill Nye] That might be one conclusion.
>>[laughter from participants]
>>[Bill Nye] So I just noticed,
as soon as you guys found out, nobody's drinking anything.
>>[laughter from participants]
>>[Man] Ray! Big meeting in 15 minutes. C'mon! Put your game face on. Let's go!
>>[Ray] Uh, okay, um...
♪ [jazzy elevator music] ♪
♪ ♪
>>[Man] Hey, Ray. What's up?
>>[Ray] Oh, we got a big meeting in 15 minutes and I thought I'd have a quick smoke.
[sighs] Oh, geez, I guess I left them on my desk.
>>[Man] Oh. That was my last one.
>>[Dr. Drew, to an audience] So let's talk about cocaine.
So you're using cocaine, you get going with crack.
What does that look like when you start? Are you with friends? Are you by yourself?
>>[Woman] In the beginning, you're with friends.
>>[Dr. Drew] You're with friends, you're hanging out,
[unclear] you're at a party, you start smoking crack...
♪ [sirens] ♪
The first time you take a hit, the first hit of that [unclear].
How does that feel? >>[Man] Awesome.
>>[Dr. Drew] How about the second? How about the second hit?
[distorted speech] How does that feel?
>>[Man] Not quite as good. >>[Dr. Drew] Not quite as good.
How about the 100th hit?
>>[Woman] You're just kinda like, "Why am I even doing this?'
[distorted speech] That's the insanity.
>>[Dr. Drew] Let's say now, we're about 36 hours into this. Where are you?
>>[Woman] Underneath the tables. >>[Another woman] In the closet.
>>[Dr. Drew] Under the table, closet... >[Woman] Locked in a motel room.
>>[Dr. Drew] Locked in a motel room;
brightly lit with the curtains open?
>>[several] No.
>>[Dr. Drew] Who's with you? >>[several] Nobody.
>>[Dr. Drew] Nobody. You're by yourself. Who do you see outside?
>>[various responses] Everyone, police, the CIA.
>>[Dr. Drew] Police, CIA, who else? Who else? FBI. Uniformed officers.
You look out the window. Where do you see them?
>>[Someone] The trees. >>[Dr. Drew] The trees! The palm trees!
>>[several laugh]
>>[Dr. Drew] You're in a dark room with a single light bulb.
Your fingers are burned, you're under the table, you're looking out at the LAPD in the palm trees.
Why don't you stop smoking crack?
You know, you KNOW, not only are you NOT going to get what you got that first hit;
with each subsequent hit, you're gonna feel crappier and crappier and crappier.
So you just stop, right? No, when do you stop?
>>[Man] You can't. >>[Dr. Drew] You can't.
>>[Someone] When you run out of money.
>>[Dr. Drew] When you can't get it anymore. [He chuckles.] That's when they stop.
They know hit #2, that they're heading down this path to just misery and can't stop.
>>[Man] There's nothing that anyone can do, say, or-- No way can they really help you stop
until you decide inside for yourself: "I've had it."
>>[Another man] One has to be sick and tired of being sick and tired.
When you get tired of just getting ran over by a truck everyday...
>>[Woman] It doesn't matter the level of losses, the level of death, the level of financial --
How many times people have been to prison. When is it enough? You just have to be done.
>>[Dr. Drew] If all I had to do was convince addicts they needed to stop,
my job would be very easy.
The problem is, I get them on their knees, begging for some help with stopping.
>>[Someone] Mm-hmm.
>>[Dr. Drew] Their lives are being destroyed.
They want to stop in the most sincere way they know; they can't do it.
Addicts have a misconception
that they can just get off the drugs, get through the withdrawal, and that's it.
But no, the hardest part is staying off the drug,
and some of that is the result of the chronic changes the brain is in.
But the real significant changes --
the the feeling of loss, irritability, mood lability -- goes about a year.
Pinsky's Rule is one year.
>>[Bill Nye] Pinsky's Rule. >>[Dr. Drew] Pinsky's Rule.
It takes one year to get the brain back to normal after addiction,
and by "normal," it's still never really normal
because they always have drives
that are activated by cues or exposure to these chemicals.
>>[Bill Nye] Mm-hmm.
>>[Woman] I have a drug counselor in an outpatient program who always says to me,
"Your addiction is sitting in that corner over there doing one-armed pushups.
He's just waiting, waiting, waiting, waiting."
>>[Man off-screen] Yeah, that's what I'm saying.
>>[Bill Nye] It the costs of addiction are so high
and the substances that get you addicted are so common in nature,
then how can these genes for addiction have persisted?
Why weren't these people selected out by evolution?
Nobody knows for sure but there must be a reason,
and there are some pretty interesting theories.
>>[The addicts I know were rich, phenomenal, intelligent, interesting human beings.
>>[Bill Nye. off screen ] Bright. >>[Dr. Drew] Bright! Brighter than average.
This cannot be all bad. There must be something here that has caused this gene to be perpetuated.
It should have burned out centuries ago if it really were just all about a disease.
Then i saw the movie "Braveheart," and I watched 10,000 guys go into battle.
Three guys survived, the three remaining were alcoholics,
and I thought, "Of course. Of course."
They are so activated by thrill
that these incredibly overwhelming situations for a normal person, they're somehow--
Time slows down, they're focused, they're into it.
If you look at populations of humans that have [withstood] repeated military genocidal assaults,
you find a refinement of the gene for alcohol.
>>[Bill Nye] Give me an example.]
>>[Dr. Drew] Scottish. Irish. North American Indian,
Central Europeans --
populations that have just withstood incredible atrocities.
So I started going back to my patient group.
I give lectures every week, and I say, "Guys, what would happen..."
(150 patients in the room)
"What would happen if Attila the Hun and a thousand hordes came over the hill.
What would you guys do?"
Almost to a person, they'd say, "I'd pick something up and I'd run at them."
I'm thinking, "Are you guys high right now?" [chuckling] "Are you using drugs today?"
>>[Bill Nye, off screen] You wouldn't run away, you'd run toward them.``
>>[Dr. Drew] They'd run towards the action.
I said, "Well, how about if a bomb blew up in the parking lot?"
[They'd say] "Oh, I'd go over there and check it out."
They go TOWARDS the action,
and I guess, in military circumstances, being able to go at the action
and keep your wits about you makes you survive, and that's evolution.
>>[Bill Nye] When you first start using drugs, there's a time when you have a choice.
You really could quit if you wanted. It's a window of opportunity.
But how long that window stays open depends on the person, the drug, and the circumstances;
because sooner or later, that window is gonna close.
And when it does, you no longer have a choice.
Now, you have a disease.
>>[Announcer] We've covered a lot of ground, but it's just the tip of the iceberg.
Check out EyesOfNye.org for more cool science.
♪ [Fast-paced digital music plays during ending credits.] ♪
♪ ♪
>>[singers] ♪The eyes of Nye! ♪
♪ ♪
♪ Nye... Nye... Nye... ♪
♪ The Eyes of Nye ♪
♪ ♪
[END]