Why Addiction Really is a Brain Disease
A funny thing happens in our brain when we get a craving for something. Parts of the brain light up with the mere thought of a warm piece of bread or a crispy slice of bacon. These cravings act as an interrupter to normal cognitive functioning.
Our brain quite literally becomes overwhelmed and focus is easily lost. For some, this feeling passes and they’re able to rein in their intense cravings. For others, loss of control becomes their new normality and can lead to substance abuse and addiction.
How does this disconnect happen and what can we do? In this article, we’ll go over where in the brain addiction is born, and break down the neuroscience of this often misunderstood brain disease for a better understanding.
Sobering Statistics
Addiction does not discriminate based on age, race, gender, or economic status. There are nearly 23 million US citizens that currently deal with drug or alcohol addictions. That’s nearly one American out of every 10.
Of those 23 million, not everyone has access to or is able to receive treatment, thus leaving many to wallow in the perpetual cycle of feeding their addiction. The two types of addictions, chemical and behavioral, work similarly in that the compulsion to carry out repeated behavior is present. What is it within the brain that causes that compulsion to manifest?
Dopamine and the Brain
Addiction is a disease stemming from surges of dopamine and the brain’s conditioned response to it. We know that dopamine contributes to feelings of pleasure. The release of dopamine into the brain’s reward center then causes our brain to focus, or zero in on, that pleasurable experience.
This combination of release and focus generally locks in a strong memory. This could be anything from a really good meal to viewing a stunning piece of art. Think of dopamine as a little gold star alarm that goes off every time you feel good, making you want to do it again.
This dopamine bridge of ‘enjoyable sensation’ to ‘desire’ plays a part in the development of addiction.
Too Much Dopamine
After a while, too much of a good thing does indeed turn into a bad thing. Addictive substances like drugs or alcohol flood the reward center of the brain. All of a sudden, that little gold star alarm is bigger, brighter, and shows up more quickly.
Once addiction sets in, the brain can’t handle the alarm bells and attempts to restore equilibrium by either decreasing dopamine production or reduces the dopamine receptors. Either way, it now takes more of the same substance for that alarm to start going off, but the craving to feel it is still there.
Causes of Addiction
So, why is it that some brains enjoy and seek out the alarm bells more than others? There is a range of factors that may explain this.
Biologically speaking it could be attributed to:
- Genes
- Health History
- Age of initial use
Apart from biological factors, there are environmental factors that come into play as well. Some of which are:
- Social pressures
- Homelife situations
- Social or academic challenges
None of these indicate addiction will present itself, they are merely factors that can play a part. Remember, addiction isn’t a criminal, social, or moral failing. It’s a brain disease that manifests because of underlying neurological problems.
Brain Games
While there is no single cause we can attribute as to why addiction forms, we do know that dopamine plays a supporting role. Dopamine is present when synapses become strengthened in the hippocampus and it is present during the strengthening of memories in the amygdala.
This is important because these regions of the brain, along with the prefrontal cortex and basal ganglia, all become negatively altered with drug use. Addiction is complex, but the brain is even more so. Let’s take a brief look at each region.
Prefrontal Cortex
The prefrontal cortex is a part of our brain that makes us uniquely human. It is a part of the brain that matures gradually, yet its functioning also diminishes with age.
It’s responsible for thought, problem-solving, decision making, social processing, and most importantly under the lens of addiction, it is the part of the brain that exerts self-control over impulses.
Essentially, the prefrontal cortex is the part of the brain that grants us executive functioning skills. Certain behaviors or character traits are present in those with poor executive functioning such as trouble with self-control, difficulty prioritizing, poor working memory, and so on.
Basal Ganglia
The basal ganglia is actually a grouping of structures within the brain. Its main responsibility is for motor control but is also responsible for things like emotional behaviors and habit formation. These areas are important to the brain’s reward circuit.
Drugs over-activate the reward circuit, leading to a euphoric high. As mentioned above, too much exposure to this euphoria and your brain will try to restore equilibrium thus adapting to the drug itself. Once your brain becomes accustomed to this lit-up reward circuit, it makes it difficult to feel pleasure from anything other than the drug in question.
Amygdala
The amygdala is a small, almond-shaped structure set deep within the brain. The amygdala pulls together emotions such as anxiety, irritability, and fear. Motivation is also part of the integrated structure of the amygdala. This is important for those dealing with substance abuse as the emotions like anxiety and irritability present themselves upon substance withdrawal, thus leading the person using to use again.
Typically for those at the stage of addiction, this part of the brain becomes overly sensitive. Rather than chasing a high, the amygdala prompts those to use again in order to rid themselves of the feeling of discomfort that comes from withdrawal.
Pleasure in the Brain
The question then presents itself: why does addiction manifest in some brains after substance use and not in others? It’s a tricky and multi-faceted question. We do know it originates in the brain, and everyone’s brain registers pleasure in a similar fashion.
We also know this chronic disease changes brain structure and brain function. For those with addiction, the circuits and neurons in the brain have been overloaded. The dopamine alarm bells start to ring more frequently and intensely, thus solidifying the memory of pleasure.
The brain is constantly rewiring and learning new patterns. For those with addiction, the brain has essentially rewired itself with unhealthy habits and routines. It could be said that prior to using, the brain of those living with addiction may have already possessed weakened neural pathways or had irregularities already present in regions like the amygdala, hippocampus, or prefrontal cortex.
What hasn’t been mentioned yet is the nucleus accumbens in the brain.
Nucleus Accumbens
The nucleus accumbens is a cluster of cells underneath the cerebral cortex. It is considered the brain’s pleasure center. It could be said that one of the reasons for addiction may be linked to this particular region of the brain. Drugs or alcohol cause a large surge of dopamine to be released into the nucleus accumbens.
Where addiction comes in is when you look at the speed, intensity, and reliability of that dopamine release in the brain. Obviously, we can’t control this and this particular pattern can be different for everyone. However, the faster the brain releases it and solidifies that pleasurable memory, the more prone the brain becomes to addiction.
In addition, the way in which a drug is initially administered plays a part in that rush of dopamine release. For example, injection of a drug produces a faster and more intense signal to your brain as opposed to swallowing a pill. The stronger that rush, the more likely you are to become hooked.
In the case of addiction, repetitive exposure to a substance causes cells within the nucleus accumbens to talk with the prefrontal cortex, motivating us to seek out that pleasure again and again. Substance abuse then makes its entrance.
Healing
The brain may be fragile, but it also has incredible self-healing abilities. Regardless of damage from substance use disorder, the brain does have the ability to repair pathways and regenerate cells.
Some of the ways in which the brain can heal, even after years of drug or alcohol use:
- Detoxing
- Therapy
- Mindful meditation
Other forms of treatment may include self-help groups, support groups, or counseling.
Detoxing is, of course, a crucial first step.
Detoxing
By detoxing your body and brain from drugs, you are allowing yourself a fresh start. It won’t be easy at first as your brain’s chemical balance will be thrown off course. The interruption of constant stimulation causes your body to go into withdrawal in an attempt to recalibrate its natural chemical equilibrium.
It’s crucial to get to the point of detoxing your body from the extended use of substances. Once you reach that point, you can then begin the journey of relearning and reforming neural pathways that allow you to function without the intense craving for drugs or alcohol.
Therapy
Once you’ve completed a full detox, medically supervised or otherwise, the next important step you can take is to participate in some form of a therapy program.
Therapy will give you the necessary tools to rewire those previously destructive thought patterns. It can help minimize a chance of a relapse by helping your neural network function as it should. Therapy can help you work on strengthening control, rational thinking, and a general outlook on life.
The regions in your brain that had previously been overloaded and overworked (think amygdala and prefrontal cortex) now have a chance to work and process as they should.
Medication
Medication in the case of recovery can quite literally save a life. Certain medications serve different purposes, but one crucial aspect of medication during treatment is that it can help prevent a relapse.
Providers can recommend medication in congruence with outpatient therapy or other treatment approaches.
Meditation
It may sound unbelievable that meditation can help an addict overcome what was previously an all-encompassing disease.
Meditation, specifically mindful meditation, has been shown to form new pathways in the brain. Meditation increases connections within the brain that can help lessen the chance of relapse.
Meditation is also known for increasing grey matter within the brain. Healthy grey matter is incredibly important for things like decision-making and self-control. Grey matter can lead to a healthy hippocampus, which is the region of the brain responsible for learning new behaviors.
Meditation can also help repair grey matter in the amygdala, which as we know is responsible for things like fears and anxieties.
Brain Disease is No Laughing Grey Matter
There is still so much to learn on the topic of addiction and what truly drives someone to it. While it is incredibly difficult to get ahold of addiction on your own, help is out there and treatment of this brain disease is possible.
Whether we’re talking cardiovascular disease for the heart, or brain disease for addiction, one thing we need to remember is that everyone struggles. It’s also good to remember that the brain is incredibly flexible and a master at rewiring itself to optimal levels. Which means recovering from an addiction is possible.
Hope is not lost if you or someone you know is currently struggling with addiction. At Dream Recovery, we have a dedicated team and support system ready to help you get back on your feet. We have all the tools you need.
Feel free to contact us here. Why not get started today?
Sources
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- Bierer, M., MD. (2016, March 11). Is addiction a “brain disease”? (Harvard Health Publishing, Ed.). Retrieved from https://www.health.harvard.edu/blog/is-addiction-a-brain-disease-201603119260
- Help Guide Org. (2021, July 15). Understanding Addiction. Retrieved from https://www.helpguide.org/harvard/how-addiction-hijacks-the-brain.htm
- NIDA. 2020, June 15. Neurological Effects. Retrieved from https://www.drugabuse.gov/drug-topics/health-consequences-drug-misuse/neurological-effects on 2021, October 1
- NIDA. 2021, July 27. Drugs and the Brain. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain on 2021, October 1
- Tabitha M. Powledge, Addiction and the brain: The dopamine pathway is helping researchers find their way through the addiction maze, BioScience, Volume 49, Issue 7, July 1999, Pages 513–519, https://doi.org/10.2307/1313471
- U.S. Department of Health & Human Services. (n.d.). The Neurobiology of Substance Use, Misuse, and Addiction. Retrieved October 1, 2021, from https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-use-misuse-and-addiction
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