Doctor explains to public attorneys the 'rat-brain' urges behind addiction

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As drugs continue to fuel crime in Carson City, the two justice court judges coordinated with Partnership Carson City to bring in an addiction specialists to explain to other court workers the differences between an addict's brain and non-addicts'.

Dr. Mel Pohl, a Las Vegas-based Fellow of the American Society of Addiction Medicine who is certified by the American Board of Addiction Medicine, explained it simply Tuesday: An addict's brain is struggling against animalistic urges to use its drug of choice that's on par with the need to eat and sleep.

It's a disease that doesn't rest in the more reason-based frontal lobe, he said, but in the dopamine-dominated and rewired "rat-brain that says get me that drug now!"

He shared a story of one of his clients, a young woman identified as Cindy, who suffered from heroin addiction. She had already been arrested and admitted into drug court and faced its rigid schedule of drug testing.

"Cindy knew she would be going to jail if she tested positive with (a urinalysis), and she use heroin that morning," Pohl said.

"'I felt inhuman, I felt I couldn't function without that drug,'" Pohl recalled her saying. "So that's what we're dealing and it's pretty powerful stuff."

She's been clean for nine months now, he said.

Carson City Justice of the Peace Thomas Armstrong told the 30 people at the event - a mix of public defenders, lawyers with the district attorney's office, and officers with alternative sentencing - that about 90 percent of all criminal cases that come before him are in some way related to addiction.

Armstrong said it may not be immediately apparent but is often a factor.

He asked Pohl how to differentiate between people he sees who are criminals who use drugs versus addicts who commit crimes, so as to sentence people appropriately.

Pohl suggested being equitable.

"I'd hate to throw people away because of some instinctual feeling," Pohl said, adding that criminals can be addicts also.

"I've had people in my office that I thought were complete criminals that completely turned their lives around once they get clean."

Diane Crow, with the Nevada State Public Defender's Office and a defense attorney on drug court, said the two-hour session validated Carson City's approach to treating addicts with a carrot-and-a-stick approach - coerced treatment that involves avoiding jail time, and punishment for lapses.

Pohl noted that treatment can often seem like leading a horse to water without being able to make it drink, "but as both you and I know, if you hold its head above water long enough, it will eventually get thirsty. And that's the theory behind coerced treatment."d

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