A drink of alcohol, any kind; "rails" of white powder; a pill prescribed by a pediatrician to assist with attention deficit disorder. Whatever the poison, addiction can take a powerful toll. Nor is it limited to drugs—food, sex and even death-defying stunts can exert the same pull.



But it seems to be a particular breed of person who succumbs to addiction, most recently exemplified by the late singer Amy Winehouse. She joins the "27 Club" of rock stars who died, via addictive behavior, too young—Kurt Cobain, Jimi Hendrix, Janis Joplin and Jim Morrison. Nor is it limited to the rock-and-roll lifestyle—Thomas de Quincey invented the modern addiction memoir with his Confessions of an English Opium-Eater in 1821. In fact, the list of addicts often overlaps with the giants of culture.



So is there a link between creativity and addiction? To find out, Scientific American spoke with neuroscientist David Linden of Johns Hopkins University School of Medicine and author of The Compass of Pleasure: How Our Brains Make Fatty Foods, Orgasm, Exercise, Marijuana, Generosity, Vodka, Learning and Gambling Feel So Good.



[An edited transcript of the interview follows.]



Is there a link between creativity and addiction?

No. I think the link is not between creativity and addiction per se. There is a link between addiction and things which are a prerequisite for creativity…. We know that 40 percent of a predisposition to addiction is genetically determined, via studies on heritability in families and twins. There's no single addiction gene. We don't even know all the genes involved in conferring addiction risk. But the ones we do know have to do with the signaling of the neurotransmitter dopamine for pleasure and reward.



You don't become addicted because you feel pleasure strongly. On the contrary, addicts seem to want it more but like it less. They feel pleasures more weakly and are more likely to try more to achieve more. This blunted dopamine hypothesis is supported by brain-imaging studies and biochemistry tests in rats and monkeys. It also holds for addictions to food, sex and gambling.



Genetic variants make for a low-functioning dopamine system, specifically D2 receptors. If you carry those variants, you are more likely to be more risk-taking, novelty-seeking and compulsive. None of which are explicitly creative, but they are things that get to creativity. So novelty-seeking might be a spur to creativity. Risk-taking might lead you to go more out on a limb. If you're compulsive, you might be more motivated to get your art, science idea or novel out into the world. These traits that come from having low dopamine function have an upside. These traits can contribute to people having great success in the world, like business leaders.



Genetics is 40 percent, it's not 100 percent—it's not the whole show. It's possible to carry the variants and not be an addict, and it's possible to not carry the variants and still be an addict.



Is there a link between addiction and other human attributes we might value?

There have been some studies in Scandinavia associating personality traits with the genetics of D2 receptors. If you carry these variants that turn down dopamine, you become more socially desirable. There is something charismatic about risk-takers.



Does curing the addiction eliminate the creativity?

Usually not. When you cure the addiction, you're not changing your genes. People are in recovery for life…. There is always a tremendous risk of relapse. Successful recovering addicts adopt behavioral strategies that allow you to resist or reduce cravings.



If you develop a full-blown addiction to a drug, the indications in rats are that it changes the brain forever. You can get it back a little but never entirely.



Is there a specific time that is more vulnerable?

There is nothing magic about that age [27]. Brain maturation ends at about age 20. In the early 20s, you have your adult brain. In the late 20s, it's the same.



Generally speaking, 27 is an age where you can have achieved a lot and be at a place that is very enabling. The one thing that we really know about relapse and addiction is that it is stress-triggered. Anyone dealing with an addict knows that relapse doesn't happen when things are going great.



Stress is a biological phenomenon. We know the intermediate steps. You argue or you're fighting off an infection and your body releases stress hormones, which bind to receptors in the brain pleasure circuitry that ultimately result in cravings. We know how stress causes craving…. The two biggest factors are genetics and stress.