“Through scientific advances, we know more about how drugs work in the brain than ever, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and lead productive lives,” according to The National Institute On Drug Abuse (NIDA). But despite the great strides we’ve made in understanding addiction and educating the public to lessen the stigma, there are still those who don’t comprehend that substance abuse is not a character failing or a lack of willpower but a legitimate disease.
In a 2012 report by The National Center On Addiction and Substance Abuse at Columbia University titled “Addiction Medicine: Closing the Gap Between Science and Practice,” CASA Columbia reiterated that, like heart disease, high blood pressure, diabetes and asthma, addiction has specific risk factors and, if not effectively treated, can lead to other illnesses and even death.
It’s not a choice or bad behavior. Instead, addiction involves changes in the structure and function of the brain, which can result in compulsive substance use.
CASA Columbia cited recent studies that show that there are changes in brain structure and function seen when it comes to addiction involving nicotine, alcohol and other drugs. They can even be seen in relation to other compulsive behaviors such as gambling and certain sexual and food-related disorders, such as bulimia and compulsive eating. These changes in the brain may be brought on by risky substance use or may pre-exist.
How Substance Use Changes the Brain
We all have basic needs — from hunger and thirst to affection and sex — and we feel pleasure when those needs are met. Natural desires that are satisfied result in the release of certain chemicals in the brain that are responsible for those pleasurable feelings that follow. Substance abuse works in a very similar way. Most addictive substances cause the brain to release high levels of these same chemicals that are associated with pleasure or reward.
The difference between drug or alcohol abuse and the meeting of needs like food or water is that continued use of these addictive substances can actually alter the structure and function of the brain. As a result, these changes eventually make it so that the individual user begins to need the substance to feel normal. This is usually accompanied by an intense desire or extreme cravings for the addictive substance.
Not all drugs affect us the same. Substances like marijuana and heroin have a similar structure to chemical messengers called neurotransmitters, which are naturally produced by the brain. This similarity allows the drugs to “fool” the brain’s receptors and activate nerve cells to send abnormal messages, NIDA reports.
Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters (mainly dopamine) or to prevent the normal recycling of these brain chemicals, which is needed to shut off the signaling between neurons.
The result is a brain awash in dopamine. The overstimulation of this reward system produces euphoric effects in response to psychoactive drugs. This reaction sets in motion a reinforcing pattern that “teaches” people to repeat the rewarding behavior of abusing drugs.
The Effects of Prolonged Substance Use
Long-term drug or alcohol use doesn’t just lead to a chemical addiction, these changes in the brain can also dramatically impact judgment and behavior. The compulsion to obtain and use illicit substances compared with impaired judgment means that individuals seek out drugs despite potential negative or harmful consequences. And while quitting undoubtedly results in improved health, not all changes in the brain are reversed after a person stops using substances.
These sometimes-permanent changes can leave those with addiction vulnerable to physical and environmental cues that they associate with substance use, also known as triggers, which can increase their risk of relapse.
As a person continues to abuse drugs, the brain adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. The result is a lessening of dopamine’s impact on the reward circuit, which reduces the abuser’s ability to enjoy not only the drugs but also other events in life that previously brought pleasure.
This decrease compels the addicted person to keep abusing drugs in an attempt to bring the dopamine function back to normal, but now larger amounts of the drug are required to achieve the same dopamine high—an effect known as tolerance.
Treatment for the Disease of Addiction
Fortunately, treatment is available to help counteract addiction’s powerful disruptive effects. Research shows that combining addiction treatment medications with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient’s drug abuse patterns and any co-occurring medical, psychiatric and social problems can lead to sustained recovery.
Similar to other chronic diseases, addiction can be managed successfully. If you or a loved one is struggling with an addiction and a co-occurring disorder, call us today at 706-914-2327. We’re available 24 hours a day, seven days a week and can provide information on treatment programs, help with insurance and answer questions about the treatment process.