Excerpt from Crave: The Hidden Biology of Addiction and Cancer

Excerpt from Crave: The hidden biology of addiction and cancer
by Dr. Raphael E. Cuomo

“If there’s a single idea that shapes a way to think about addiction, illness, prevention, it’s this: biology is not fixed. It changes: environment, behavior, and experience.

This adaptability explains how craving develops. But it also explains how craving can be interrupted. The same nervous system that learns coercion can learn regulation. The same tissue that preserves inflammation may begin to release it. It can be supported to repair the same cells conditioned to survive under stress. None of these changes happen anytime soon. But they happen. And understanding how they happen gives us a blueprint for healing.

At the brain level, plasticity is constant. The neurons fire together and wire together. The more the action is repeated, the more efficient the brain will be to carry it out. This principle allows someone to develop habits, whether good or bad, and that also makes change difficult at first. The old path is still strong. They automatically respond to the cue and provide impulses before consciousness intervenes. However, due to its consistency with time, new patterns begin to form. They start to be weak and often require effort, but each iteration strengthens the signal and weakens it with every interruption of the old loop.

This is why food, alcohol, technology and more, recovery from addiction can be intense first. The brain is not broken. It’s simply trained. We still hope that the queue will produce action, but we still hope that the action will produce remedies. And when the remedies don’t reach them even in familiar ways, they cause discomfort. That discomfort is readjusting the nervous system. It’s the space between what’s going on and what’s going on.

Neuroplasticity is often the strongest in young people, but it remains for life. Adults can change. They learn new skills, form new relationships, respond differently to stress, and recover from trauma. These changes are not merely mental. They are mobile phones. Brain-derived neurotrophic factors, or BDNF, increase with moments of exercise, sleep, learning, and even quieter reflexes. BDNF supports the growth of new neurons, repair of existing neurons, and the formation of new circuits. It is one of the molecular drivers of resilience.

However, the brain does not act alone. All the systems in our body are shaped by repeated actions. Hormones respond to patterns. When the body is ingested irregularly, insulin and leptin become sensitive. If it is overflowing with caffeine or alcohol, cortisol becomes dysregulated. When sleep is interrupted every night, melatonin release slows and changes the overall circadian rhythm. These changes can last for years, but they are not permanent. They reflect the input and change the input slowly, consistently, and compassionately, and balance begins to regain. ”

About the author
Dr. Raphael E. Cuomo is one of the leading scientific voices at the intersection of addiction, cancer and public health. Dr. Cuomo, an associate professor at UC San Diego School of Medicine, has published extensively on the biological mechanisms that link obsessive-compulsive behavior to chronic disease. His research integrates neuroscience, epidemiology, and systems biology to reveal how modern environments shape the body’s craving pathways, often with life-changing results. As a senior investigator at multiple large studies, his research informs clinical practice, public policy and global conversations regarding habits, healing, and the biology of human vulnerability. Crave: The hidden biology of addiction and cancer His definitive quest for the science behind what drives us, and how we can change.

Crave: The hidden biology of addiction and cancer Available on June 10th Amazon E-book, paperback, hardcover format.