Dr. Luke Clark

RTAD: Addiction, in general, is a complex and deeply personal subject. Today there seems to be a divide within professional circles between those who believe that solely genetics cause the disease and those who believe that it's only caused by the social environment. What is your take? 

Dr. Clark: It's a curious movement. We talk about it a lot in the lab and try to get our heads around it. Anyone who works on brain systems of reward or [looks into] what dopamine does--well, to me, it seems really obvious that the brain system is going to be affected by social context. There are social and environmental risk factors for all sorts of problems and certainly for addictions. But you see this in other areas of mental health research as well, where a lot of people assume that you either have a neurobiological model of what's going on, or you have a psycho-social model of what's going on. You've either got brain factors, or you've got environmental factors. To most of the psychologists that I speak to, [they] view these things as being completely complementary and not at all at odds with each other.

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Dr. Alexander Goumeniouk: Addiction, Trauma, Salience, and Recovery

The interesting observation I've made about addiction is that while the popular data says that 80% of people who end up in rehab centres have trauma from childhood or otherwise, my experience is that 100% of our patients do. Sometimes it stares you in the face like PTSD, and sometimes it doesn't. But there is always an adverse childhood event. A brilliant neuroscientist, Helen Mayberg, can look at a PET scan of a 45-year-old woman and tell you whether she's had sexual abuse as a child or not, and I think that's just remarkable. Charlie Nemeroff, who's the head of the University of Miami's Behavioural Science and Psychiatry, has done a lot of work on looking at the input of adverse early childhood events on outcome, and it's clearly there.

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In Conversation with Poverty & Addiction Reporter, Photographer Chris Arnade

The Guardian columnist, photographer, and former physicist-turned-Wall Street trader, Chris Arnade speaks on the friendships he's made during his 6-year long Faces of Addiction project. Touching on the flaws within the criminal justice system and the alienation of many Americans by 'civil society', he details the reasons behind the revolving doors of Rikers Correctional and Hunts Point in The Bronx, NYC.

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