Morvwen Duncan & Shehnaz Bham
Addiction refers to a pathological and compulsive set of drug-seeking and drug-taking behaviours that persist despite adverse health, social and occupational consequences. Addiction involves a process of learned associations between drug-associated environmental cues and drug effects. Consequently, treatment procedures have focused on manipulating the memory processes involved in the learning of these associations.
The concept of manipulating memories is something we often come across in books and films. When you think of the memory charm obliviate, in Harry Potter or the hijacking technique used to implant false memories in The Hunger Games trilogy, using psychological treatments to alter the learned associations formed in drug addiction seems mundane in comparison to this fictitious presentation. Recent articles and research papers have been focused on the effectiveness of memory techniques as a treatment for drug addiction. Our article looks at the topic from an ethical perspective. Does the benefit of the treatment for sufferers of drug addiction outweigh the issue of altering a memory system that we do not yet have a complete understanding of?
22% of all male deaths and 11% of all female deaths in the UK are due to smoking. Around 95% of alcoholics die from their disease approximately 26 years earlier than their normal life expectancy. There were 2652 drug poisoning deaths registered in 2011. Addiction is one of the biggest preventable killers in the UK. It destroys lives, breaks up families and has a damaging impact on society as a whole. Worryingly, children of addicted parents are the highest risk group to become alcohol or drug abusers due to both genetic and family environment factors, a horrifying cycle. Therefore, it is vital that any development of a treatment method is explored fully.
A revolutionary psychological treatment involves breaking the link between drug stimuli and environmental cues by a brief reactivation of the drug taking memory, followed by an ‘extinction session’ of repeated exposure to the same memory cues. To put it simply, an addict is asked to recall the drug stimuli, then later they are repeatedly presented with images of the drug in the absence of the drug and the associated positive effects. This procedure involves no pharmacological side effects and has been successfully demonstrated by Xue et al. (2012). They showed heroin addicts a 5-minute video of images of heroin use and related scenes, 10 minutes before an hour-long extinction session, in which they were repeatedly exposed to the same images. Addicts who were shown the video 10 minutes before the extinction session had significantly decreased drug cravings both during the session and up to six months later.
This simple, non-invasive method has the ability to prevent the suffering caused by addiction. The sufferer is in no way harmed, and no other memories are ‘destroyed’ or picked out, it is simply learning a new way to think about the addictive substance. Addiction destroys the lives of so many, in some way it affects us all. Therefore, a simple memory recall experiment is a small ethical price to pay. It is time to see this as a revolutionary scientific finding to fight addiction rather than a scary procedure out of fictitious films.
Is it just a simple recall experiment or the changing of a person’s entire identity? Dr. William B. Hurlbut, from the Stanford University Neuroscience Institute and member of the President’s Council on Bioethics, argued that “There’s a continuity to self, a sense that who we are is based upon solid, reliable experience. We build our whole interpretation and understanding of our world based upon that experience or on the accuracy of our memories. If you disrupt those memories, remove continuity, what you have is an erosion of personhood” (LaFee, 2004, p. 5). If we lose our memories, we lose an intrinsic part of ourselves.
Individuals suffering from drug addiction may want to lose that part of their memory and personality, as it gives them a chance to start over and move on from their addiction. However, the first step towards overcoming an addiction is thought to be acceptance. If the original memories of the drug and associated environmental cues are altered using extinction and reconsolidation techniques, are individuals really accepting and moving on from their addiction or simply trying to forget about it?
Ho and Shah (2010) suggest that experiencing negative events is an important part of life and overcoming these events enables us to grow and develop. For instance, many recovering addicts choose to become drug addiction treatment counsellors. They are utilising their first-hand experience of drug addiction to benefit others.
Ho and Shah compare the psychological techniques used to alter memories to the film ‘Eternal Sunshine of the Spotless Mind’, where Jim Carrey and Kate Winslet portray a couple who erase their memories of one another. This has the opposite effect of making them realise how much they love one another. In reality, memory loss or memory alteration is an irreversible process and may not result in the happy ending found in Hollywood movies.
The use of extinction and reconsolidation techniques to alter memories may have emerged as a therapy for drug addiction, but what if it used by the wrong people for the wrong reasons? Memory is a delicate system that should not be tampered with.
Ho, J., & Shah, A. (2009). The Ethics of a Spotless Mind: A Discourse on Tampering with Memory. Editorial Board Editors-in-Chief, 16.
LaFee, S. (2004, February 11). Blanks for the memories: some day you may be able to take a pill to forget painful recollections. San Diego Union Tribune, p. 5.
Xue, Y. X., Luo, Y. X., Wu, P., Shi, H. S., Xue, L. F., Chen, C., & Lu, L. (2012). A memory retrieval-extinction procedure to prevent drug craving and relapse. Science, 336(6078), 241-245.