Why is it so hard to quit using addictive drugs? Science has the answer, and it has nothing to do with willpower.
Although once hotly debated, science has confirmed what medical professionals have suspected for years: addiction is a disease. Those who suffer from addiction don’t lack willpower, and they aren’t morally flawed. We now know that biological, genetic, and environmental factors combine to impact the brain, which in turn influences behavior. Here’s what science can tell you about addiction, whether you struggle yourself or want to help a loved one.
How Drugs Affect the Brain
When a person takes a drug, the brain releases dopamine, a neurotransmitter that creates feelings of pleasure. You get a natural hit of dopamine when you get a text from a friend, ace a test, or receive a compliment. It’s your brain’s way of saying: “Do more of this behavior.”
Some drugs hijack neurons by mimicking your brain’s natural neurotransmitters. Marijuana and heroin, for example, latch onto neurons and artificially activate them. Stimulants like cocaine or amphetamines trigger an over-production of natural neurotransmitters. Speaking to Sprout Health Group, neuroscientist and addiction psychiatrist Dr. Stephen L. Dewey, PhD, of New York University, recently explained how the brain reacts to this “hijacking.”
Because dopamine reward your brain for taking an addictive substance, you feel encouraged to take the drug again. The stronger the dopamine signal, the higher the chance of becoming addicted. With some drugs giving you up to 10 times your natural release of dopamine, the cravings to use can become quite strong.
As your brain becomes used to the artificial dopamine boost, it stops producing natural dopamine. This causes changes in the way people react to different situations and their environment.
“What happens is an individual engages in behavior that we all behave in, but they respond differently,” Dr. Dewey explains. Ultimately, the pursuit of more drugs to feel “normal” becomes a person’s primary motivation.
The Dangers of Prolonged Use
Dopamine also interacts with glutamate, another neurotransmitter associated with learning and memory. This can increase feelings of motivation to seek out the reward, actively urging you to take more of the drug.
The danger starts with prolonged use. Your brain can become overwhelmed by the deluge of dopamine. In response, it starts producing less or eliminates dopamine receptors, reducing the chances that it will become overwhelmed again. This is essentially a rewiring of the reward center, decreasing the impact of taking the drug.
As the “high” diminishes, you need larger and larger doses to achieve the same effect. This process is known as developing a tolerance. At the same time, your brain becomes depleted of dopamine it needs to function properly, which can lead to depression. This, in turn, can make it even more difficult to quit using.
Is Addiction a Disease? Why Breaking Free is So Hard
By the time a person becomes addicted to a substance, significant changes to the brain have occurred. The dopamine deluge-depletion cycle leads to intense cravings and withdrawal symptoms. Some people develop memory responses to certain cues associated with a drug. This means they have become conditioned to think about the substance under specific circumstances, and they may continue to do so for the remainder of their lives.
“These cues are the number-one cause of triggers,” Dr. Dewey explains. Cues can be commonplace, including photographs of people, places or events. “Some people are cued by music.”
Moreover, the brain starts to rely on the substance to trigger dopamine releases. Without the drug, achieving pleasurable feelings may be incredibly difficult. In fact, Positron Emission Topography (PET) scans, which measure activity in the brain, show that in someone severely addicted to drugs, the brain becomes inactive while sober and only comes out of “sleep mode” while on drugs. When alcoholics say they drink to “feel normal,” brain scans show this isn’t just an emotional statement. This is one reason it can be hard to tell when someone is an alcoholic.
How Age Affects Addictive Behavior
Addiction can occur at any age, including as a senior citizen. However, the younger a person is when they first encounter an addictive substance, the more likely it is that they will become addicted. Because the brain doesn’t fully develop until a person reaches their mid-20s, many neurological pathways have yet to solidify in teens and young adults. This leaves young minds more vulnerable to rewiring that can make addiction particularly powerful.
Older adults are at risk for other reasons. With more health conditions and chronic pain than other age groups, senior citizens are often prescribed more prescription drugs, including opioids, which can be incredibly addictive. Adults in high-stress jobs are more at risk of becoming addicted to mood-stabilizing prescription drugs or sleep aids, such as Klonopin or Ambien. It’s important to remember that with enough exposure to an addictive drug, anyone can become dependent, regardless of age.
How Your Mental Health Affects Addiction
In addition to explaining why addiction is a disease, science can also help to explain the correlation between mental health and addiction.
Some mental health disorders, such as depression and anxiety, can increase a person’s odds of developing a substance abuse disorder. Similarly, individuals who suffer from personality disorders or schizophrenia may also be more likely to develop drug addictions.
Self-medication is one reason that mental health issues occur alongside addiction. For some, the dopamine hit from a drug might alleviate feelings of depression or anxiety. Others might come to rely on the calming effect of a prescription drug. With time, however, substance abuse only worsens mental health issues. It’s impossible to address one issue if it is masked by another.
The only effective way to manage a mental health issue, also called a co-occurring disorder when part of a substance abuse disorder, is to seek professional treatment. With dedicated treatment, you can learn what medications or strategies will help you manage your symptoms in a healthy way, rather than relying on the escape of addictive drugs.
Not sure if you have a mental health issue? Seeking treatment for addiction can help you find out. During your personal assessment, you’ll see medical professionals who will evaluate your mental health to see if an underlying issue might affect you.
Recognizing Addictive Behavior
While the signs of addiction can vary from one person to the next, a few universal signs can help you recognize addictive behavior.
One red flag is continuing to use a substance even after it is no longer pleasurable. If you start to see a substance as a necessary evil to “feel normal,” whether it’s alcohol, marijuana, or a prescription mood-stabilizer, this is a sign of addiction.
Withdrawal symptoms are another sign of a problem. Common withdrawal symptoms include headache, nausea, anxiety, agitation, difficulty concentrating and muscle aches. If you experience any of these symptoms, contact a doctor, as withdrawal can be medically serious.
Sacrificing other areas of your life in exchange for satisfying a craving is a final indication of addiction. For example, gambling away money needed to pay bills or living expenses, skipping work or school to use, or missing obligations with friends or family in order to use.
If any of these signs feel familiar, it’s important to seek help and support.
Getting Help for Addiction
If you or a loved one struggles with addiction, you don’t have to face the disease alone. Knowing the science can help you understand how addictive substances affect your brain, but only support from medical professionals can help your mind heal.
Regardless of your life situation or current obligations, there’s a treatment option just right for you. Inpatient programs allow you to focus fully on regaining your health, while outpatient programs provide the same support and guidance in a more flexible environment. To learn about your own options for recovery, call us at the number below.
Updated with insights from Dr. Dewey on July 9, 2020.Have questions about addiction?
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