Is Addiction A Brain Disease?
Understanding the affects that Addiction has on the brain
One of the many observations that people have about addictions is that it does not necessarily affect everyone. Some abuse substances for many years but they never develop any addictions. In the same manner, there are also individuals who may have just begun using and abusing substances and yet they are already showing clear signs of tolerance and dependence, indications of substance addiction. This is why many scientists believe in the multi-factorial causation of addiction. However, brain imaging tests of individuals with addictions now point to a problem in the brain’s anatomy and physiology that has been grossly altered by these substances.
Substances – drugs and alcohol – inherently change the natural biochemistry of the brain particularly the neurotransmitters. Some substances flood the brain with these neurotransmitters while some would prevent either their synthesis or their physiologic action. Some substances also make changes in the receptors for these neurotransmitters either increasing the number of receptors or blocking them completely. The point is that these substances affect the physiologic actions of normal neurotransmitters.
The National Institute on Drug Abuse identified three fundamental areas of the brain that are affected by drugs and alcohol. The Limbic system is primarily responsible for emotional responses, particularly reward and pleasure. It is believed that activation of the Limbic system can lead to a repetition of the pleasurable experience. The brainstem is another part of the brain affected by drugs and alcohol. These structures are responsible for autonomic processes such as respiration, blood pressure, digestion, and cardiac rhythm. As it is connected to the spinal cord, it serves as the gateway between the higher cortical regions of the brain and the rest of the body. Lastly, the cerebral cortex which has specific functions. The frontal lobe serves as the motor cortex and is important in critical thinking, problem-solving, memory, learning, and other cognitive processes.
Dopamine is a neurotransmitter that is at the core of the reward and pleasure system of the brain. Normally, when an event is considered pleasurable, the rewards center of the brain is activated. However, it takes some time for the brain to synthesize and release dopamine. Unfortunately, illicit substances trick the brain by short-circuiting the reward center so that more and more dopamine is released in an instant. This provides a massive influx of dopamine leading to an intense pleasurable feeling but not necessarily associated with a pleasurable experience as interpreted by the brain’s reward center. Sadly, the sudden influx of dopamine seriously overwhelms the natural receptors of the brain. This leads to the synthesis of significantly less dopamine or the complete cessation of dopamine synthesis altogether. The reward circuitry of the brain is severely undermined characterized by the development of a vicious cycle of tolerance, one that is quite difficult to break from.
Aside from the effects of substances on the reward system of the brain, some substances can also affect cognitive functioning. In fact, studies now show that 3 out of 4 chronic alcoholics have considerable deficits in their cognitive functioning. One of the most common causes of dementia in adults, second only to Alzheimer’s, is alcohol-related dementia of which Wernicke-Korsakoff Syndrome is one very specific type. Cognitive deficits can greatly impair one’s ability to function optimally in real life.
Addiction, as a brain disease, requires a more rational approach to its management. Detoxification is important in order to help rewire the brain to its normal rewards center. Cognitive and Behavioral Therapy can also help restructure and relearn some of the healthier and more adaptive behaviors that may have been masked by the use of addictive substances. Effective coping mechanisms can be reinforced and ineffective ones replaced with better and more appropriate methods.