When people began to study addiction in the early 20th century, they reached a consensus that it was a form of moral failing and lack of willpower. Continuing research has revealed that these initial ideas were pretty far off the mark.
In the 1950s, we came to recognise alcoholism as a form of chronic disease. We now know that genetic factors, family history of addiction, and other personal trauma contribute significantly to addiction risk. We also know that addiction creates significant changes in the brain that make it impossible to beat addiction by merely asserting willpower. The current view is that all forms of addiction are most accurately viewed as a disease that affects “brain reward, motivation, memory, and related circuitry” in the words of the American Society of Addiction Medicine.
To succeed in getting free from addiction, a real addict needs a solid understanding of their condition and its causes and effects and a good set of tools and techniques for getting clean and staying clean. Let’s take a closer look at how addiction changes the brain.
Every substance or addictive habit produces different physiological results, and each affects the brain differently. For instance, chronic “Ecstasy” or MDMA use severely impairs memory, as does constant heavy alcohol use. Heavy marijuana smokers have a smaller orbitofrontal cortex, a part of the brain that is active during decision making and emotional processing. These changes that are particular to specific substances or habits are harmful, but they do not appear to contribute to the addictive power of a drug or habit. Indeed, recognizing these undesirable changes can help provide an addict with the motivation that they need to support a successful recovery effort.
While each drug and habit has its unique effects, some effects seem to occur across all different types of addiction. These effects help us understand why addiction is so difficult to overcome. Recognizing these effects helps an addict prepare for the difficult task ahead and know why it is hard to follow a recovery plan, even after realizing a genuine need to get well. Addiction changes the reward and motivation circuitry of the brain, hijacking mechanisms that drive healthy people to thrive and using them to compel addicts to seek out opportunities to engage in self-destructive behaviour.
Drugs and addictive activities like gambling, produce feelings of pleasure. While researchers once thought the natural brain chemical dopamine was responsible for feelings of pleasure, they now believe dopamine release is correlated with happiness but perhaps does not directly cause the sensation. Other chemicals produced in the brain’s basal ganglia area, referred to as “the reward circuit,” account for these feelings. Addictive substances and behaviours cause a strong surge of these chemicals. These releases are more extensive than those caused by healthy natural highs, like feelings of accomplishment or connection.
Addicts become accustomed to the surge and experience a muted reaction to the comparatively smaller natural high. An addict will gradually become accustomed to the rush produced by addiction and will require a higher dose or a more reckless wager to achieve the same effect as tolerance begins to set in. Thus as the addiction progresses, it becomes the only adequate source of pleasure for the addict.
Both pleasurable experiences arising from healthy activity and drug use or other addictive behaviours trigger the release of dopamine. Dopamine tells our brain that something good is happening, and we should remember how to repeat it. Dopamine is our chemical ally, helping us to form good habits until we fall prey to addiction. Then it is a powerful foe, programming bad habits into our brain circuitry. Just as addiction causes stronger surges of pleasure-inducing brain chemicals than healthy activity, it also creates more significant dopamine releases. These powerful surges contribute to the creation of chemically reinforced habits that are very difficult to break. And even years after leaving the patterns behind, triggers etched in the brain create an ongoing risk of relapse.
In a very literal sense, addiction begins to take over an addict’s brain, robbing them of their will. This is why it is more than just a matter of resolving to ‘be a better person’ and exerting some will power. It is challenging, but there is good news. Millions and millions of people have successfully gotten clean and are staying clean every day, one day a time, using evidence-based methods to remain free from the grip of addiction. Every recovering addict is unique, and each has their own complicated story. But if they can do it, you can too. All you need is a resolute commitment to do the work to get better and stay better and some experts to help you get on the right path.
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