DOWNEY'S DOWNFALL

The Actor's Latest Arrest Supports The Idea That Drugs Rewire The Brain

If anyone ever had good reason to say no to drugs, it was surely Robert
Downey Jr. The actor, 35, had already seen a promising career held back by
substance abuse. He had been separated from his wife and son and lost his
freedom--twice. But since his release from prison last August, Downey
seemed to be turning his life around. He was in the middle of a
ratings-boosting guest run as Calista Flockhart's romantic interest on Ally
McBeal. He was set to star in a film with Julia Roberts and Billy Crystal
and to take a turn onstage in Mel Gibson's production of Hamlet. He had
proclaimed in one interview after another that he was ready to put drugs
behind him.

Not ready enough, evidently. On Nov. 25, Downey was arrested at a luxury
resort in Palm Springs, Calif., charged with possession of cocaine and
speed and with violating the terms of his August parole. Against all logic
and common sense, he had played with the same fire that had repeatedly
burned him in the past--and this time his career could be put on hold
indefinitely.

Yet crazy as Downey's latest bout of self-destructive behavior seemed, it
was pretty typical for someone who is addicted to drugs or alcohol. Experts
and addicts alike have long understood that willpower alone is helpless in
the face of addiction, and in recent years science has started to figure
out why. "The brain of a drug user," explains Dr. Alan Leshner, director of
the National Institute on Drug Abuse, "is physically altered in ways that
make it difficult to resist further use."

For public figures like Downey, the danger is especially great. "When
you're famous," says Niki Moyer, a psychologist and clinical specialist at
the Hazelden Foundation in Center City, Minn., "people respond to your
public image, not to you as an individual. But direct human connection is
an important key to healthy recovery." Going public with declarations that
you're on the wagon, as Downey did in Vanity Fair and other publications,
doesn't help. The feeling that your struggle is on full public view adds
stress that can help trigger a relapse. That's one reason, says Moyer, that
the Alcoholics Anonymous 12-step program and others like it counsel against
self-disclosure to the media.

But ultimately, addiction is a physical disease of the brain caused by
exposure to drugs. It starts, many neuroscientists believe, when alcohol,
cocaine, amphetamines or other drugs boost the activity of a brain chemical
called dopamine, which generates the sensation of pleasure. Flip the
pleasure switch often enough, and nerve cells in many parts of the
brain--especially in a tiny region known as the nucleus accumbens--become
accustomed to the rush. When the switch is left in the off position too
long, nerve cells feel deprived, a sensation the addict experiences as a
nearly irresistible craving.

That craving can be staved off by substitute drugs--methadone for heroin,
for example. But while doctors have found substitutes for nicotine and
alcohol, there's nothing yet for cocaine and amphetamines. The craving can
also be diverted through behavior-modification therapy and by regular
participation in self-help groups like Narcotics Anonymous.

But even when an addict has been clean for a long time, says Leshner, the
addictive brain has been permanently primed for relapse. One common trigger
for returning to drugs is stress, which can send the recovering addict back
to a proven stress reliever. Another is contact with people, places and
things associated with drugs--cues that bring up dormant memory circuits
laid down during active addiction and thus reawaken craving.

Since addiction is caused by drug exposure, Leshner believes, anyone who
takes drugs long enough will become an addict. But "long enough" can vary
dramatically from one person to the next. In Downey's case, it can't have
helped that when he was six, he was given a joint by his filmmaker father
(Downey Sr. has since expressed regret for that action). But without an
understanding of individual biological differences, which scientists have
yet to unravel, nobody can say whether those experiences turned Downey into
an addict right from the start or whether repeated drug use over many years
finally etched the circuits of self-destruction into his brain.

The good news, say experts, is that recovery is still possible after
multiple relapses, although whether or not serving jail time has a
beneficial effect is hotly contested. "Addiction," says Leshner, "is a
chronic illness, just like high blood pressure. We can't cure it, but we're
getting better at managing it all the time." So while Downey's situation
looks very bad at the moment and for the immediate future, it may not be
entirely hopeless.