Changing the Stamp of Nature: Pornography Addiction, Neuroplasticity, and the ASAM and DSM Perspectives. (2012)

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podiumThis talk was delivered recently at SASH (The Society for the Advancement of Sexual Health) by neurosurgeon Donald L. Hilton, Jr., MD, FACS. It is entitled, "Changing the Stamp of Nature: Pornography Addiction , Neuroplasticity, and the ASAM and DSM Perspectives."

The author also co-authored this journal article on the reality of porn addiction.

Here's an excerpt from this talk:

There are currently no prospective peer-reviewed studies on pornography or sexual addiction, for that matter, in the context of neuroscience.  Truly unbiased research on human sexuality is probably not possible in today’s cultural environment, particularly given the financials.  At 100 billion dollars a year porn is big business, to say the least. Pro-porn activism has ensured that any true research regarding unrestricted sexuality will take place in a scientific vacuum.  Any attempt to present unlimited sex as harmful is immediately scripted as Victorian moralistic prudishness, an infringement on First Amendment rights. That the discussion might venture into biological and /or demographic effects therefore never becomes an issue.  As long as condoms are secure and viruses are contained, any sexual activity is thereafter ‘safe’ with no possible emotional, behavioral, or especially, addictive effects.

The porn industry ‘s 100 billion dollar reason to fight the addiction label is obvious, and is given voice by one industry representative:

While much has been written and said about pornography being addictive, on par with drugs, booze and cigarettes, it's important to consider that this misinformation has been based upon questionable "science" and the opinions of anti-porn activists -- not upon any legitimate, unbiased research. Consider also the fact that "drugs, booze and cigarettes" are all physical, chemical agents that are ingested and can indeed have measurable, harmful, addictive effects. The mere viewing of any type of subject matter hardly falls into this category and, in fact, belittles the very real battles that addicts face over drugs, booze and cigarettes -- all of which can be lethal. No one ever died from looking at porn. While some compulsive types can be "addicted" to anything, such as watching a favorite television show, eating ice cream or going to the gym, nobody suggests that ice cream is akin to crack cocaine and should be regulated to protect…people from themselves -- instead, these compulsive actions are rightfully viewed by society as personality defects in the individual…[1]

An example of this same perspective manifest as academic apologism with regard to human sexuality is seen in a recent article in Salon.  The author of the article trumpets a succession of psychologists who support some variant of the same statement “There is no specific study on pornography showing any effects on the brain.”  For instance, one said, “Not even a smidgen of such evidence exists...,”[2]

Understand that by “evidence” they mean a prospective double blinded control where, as one Salon article source said, we would have to take two cohorts of children, expose one to porn and protect the other to prove causation.  Obviously this won’t happen given the ethical issues with such a study. Yet I would presume that these same psychologists would accept the premise that tobacco is addictive without demanding the same prospective, child-based study.  In other words, where is the comparative prospective study with tobacco in children? The one that divides the kids, gives half cigarettes, protects the others, and follows them?  It doesn’t exist, of course, and never will, and therefore those so biased will still say that smoking is not addictive, even now.  So said the seven tobacco executives in front of Henry Waxman’s subcommittee on Health and the Environment.  In succession, each said “No” when asked if smoking was addictive.

Yet based on a tapestry of research over the decades virtually everyone but these tobacco executives believes evidence exists that tobacco is indeed addictive.  The main difference is that we now understand receptors, including nicotinic acetylcholine and dopamine receptors, much better that we did in the past.  We now see addiction, whether to smoking, cocaine, or sex through the lens of the neuronal receptor.

Is there evidence supporting the existence of pornography addiction?  It depends on what one accepts, or can understand, as evidence, and this is a function of perspective and education. ...


[1] Interview with Stephen Yagielowicz, senior editor of XBIZ,

[2] Santorum’s Bad Porn Science,  Salon, March 20, 2012