It’s impossible to talk about addiction and recovery without considering the effect that substance abuse has on the brain, and how brain changes wrought by addiction can affect a person’s ability to get and stay sober.
“The brain is the main player in addiction, and countless areas of the brain are affected. Addiction is a disease of the brain,” said Beth Wright, a therapist intern at MFI Recovery Center, which provides affordable rehab for people with substance use disorder in California. “When we are using substances we are tampering with our brains and all the amazing natural chemicals in it.”
Understanding how addiction affects our brains and the chemical communications that take place within them can help people understand the process of addiction and recovery.
How Does the Brain Become Addicted?
Although there is still an idea that substance use is a choice, science is making it clear that addictive substances change the make-up of our brains, making it more likely that people will continue to use substances even if it does them harm.
“While addiction professionals and addicts understand that addiction is a chronic disease, often an individual who has never struggled with addiction will frustratingly argue that addiction is a matter of willpower,” Wright said. “Addiction occurs in incredibly intelligent, high-functioning individuals and does not discriminate. It is not a matter of sheer willpower.”
This is because addiction affects two important systems in the brain: the amygdala, which controls conditioned learning and affects our feeling or rewards, and the frontal cortex, which affects decision making, judgement and much more.
“Brain structure and function are both altered by addiction. An addict becomes trapped in the endless cycle of craving, intoxication, and withdrawal, which leads to cravings, intoxication and withdrawal – the endless cycle,” Wright said. This becomes worse over time.
“The more the individual uses a substance, the greater the damage done to the brain,” Wright said. Rather than thinking rationally, a person’s decision making becomes dominated by their need to get the next dose of their drug of choice.
“The individual in the simplest terms becomes motivated by the reward system, and all rational thinking becomes secondary,” Wright said. “Motivation for all behavior begins coming from the addict believing the drug is needed to survive, which is the mid-brain running the show and overriding any rational thinking our frontal cortex would normally suggest, such as not selling all of our family’s jewelry for meth, or spending our last dime on a gram of heroin when we are late on our rent.”
In addition, facing life without the drug becomes unbearable. The person who is addicted believes that they need their drug of choice to survive, and that becomes the primary driving force in their day to day lives.
“The desire for the drug will override the need for food, shelter, sex, our basic human needs,” Wright said.
Repairing the Dopamine System
Dopamine is a brain chemical that is naturally released when we experience pleasure. However, drugs flood the dopamine system. To attempt to regulate this, the brains of people using drugs will stop producing dopamine and eliminate dopamine receptors, Wright said.
This can make it tough when people with substance use disorder enter a drug treatment program and get sober, since they don’t feel the same dopamine hit from regular activities like music or physical touch.
“If and when an addict decides to enter recovery and stop substance use, the brain needs time to begin producing its own natural dopamine and begin repairing receptors. We have to patiently wait as our brain heals itself and we have usually by this point depleted our natural ‘feel good’ chemicals in our brains,” Wright said. “This takes time, where with addiction, the dopamine surge is immediate. Instant gratification is what every addict becomes accustomed to, hence the horrible relapse statistics.”
People in recovery also need to retrain their brains to remember not just the euphoric high of their drug of choice, but also the real negative consequences.
“Recovery will involve uncovering and challenging the addict to face memories or ‘triggers’ such as seeing a needle or a bottle of alcohol, and with time the implementing of new behaviors and creating coping skills in order to rewire the brain,” Wright said.
The Unknowns About Addiction and the Brain
How exactly drugs affect the brain depends on many factors, including what type of drug a person uses.
“This is the absolute simplest way of describing the brain. So many fascinating and terrifying changes can occur in the brain during substance abuse depending on numerous factors – age of onset, mental health disorders, substance being abused, etc.,” Wright said.
Methamphetamine use can cause psychosis in an individual who previously has not had mental health issues. Alcoholics can drink themselves to the point of Wernicke-Korsakoff syndrome, which causes dementia-like symptoms. Memory loss can be permanent, and psychosis may occur for several days or several months.
Although the specifics may vary, it is clear that drugs can have lasting and dangerous effects on brain health.
MFI provides affordable substance abuse and addiction treatment based on scientific methods and the 12-steps. They have a network of inpatient, outpatient, intensive outpatient and detox facilities throughout the state of California. Connect on Twitter, Facebook or LinkedIn