Unfortunately, it is common for individuals to believe that substance use disorder (SUD) results from a moral weakness or lack of willpower. However, these assumptions are stigmas that have developed from a lack of education and understanding. The National Institute on Drug Abuse (NIDA) defines addiction as “a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences.” Although most people’s initial decision to use alcohol or other drugs is voluntary, recurrent substance use can trigger destructive changes in the brain that motivates them to use substances repeatedly.
Further, addiction is often acknowledged as a brain disorder that can cause severe changes in brain structure and functioning. Nearly all areas of the brain are impacted by substance use in unique ways. Similarly, specific substances can produce varying effects on an individual’s brain.
It is important to learn how SUD affects the brain to reduce stigma toward those who struggle with it. Learning about addiction on a neurological level can also help people better understand what is happening in their brains and motivate them to seek treatment and support.
The Importance of the Human Brain
Before understanding how drug use, alcohol use, and addiction affect the brain, it is important to become familiar with what the brain is and how it works. The brain is arguably the most important organ in the body. It is also the most complex. The brain is the centre of human intelligence and activity. Everyone needs their brain for everything they do.
The brain is responsible for regulating the body’s basic functions, such as breathing and keeping the heart beating. It also enables people to process and respond to their environment, such as helping them interpret their senses or encouraging them to flee from danger. In other words, the brain makes people who they are and drives their actions.
The Brain Is Malleable
One of the most important features of the human brain “is its ability to be malleable. allowing it to adapt continually to changes in the environment,” according to the Journal of Neurochemistry. The malleability of the brain is also known as neuroplasticity.
The brain is comprised of billions of tiny cells, called neurons, that interact with one another to carry out certain functions. Although each of us is born with the majority of neurons already present in our brains, neuroplasticity allows our nerve cells to change and adapt throughout time.
Understanding How the Brain Works
NIDA explains that the complexity of the human brain is comparable to the hard drive of a computer. The difference is that, instead of electrical circuits within technological devices, the brain is made up of neurons. All neurons — in different parts of the brain, spinal cord, and nerves throughout the body — work together to perform specific functions. However, neurons are categorized into different circuits and networks that have their own responsibilities.
Every neuron acts as a switch that controls the flow of information throughout the brain and body. Neurons send signals and messages to one another by releasing neurotransmitters into the gap between one cell and another receiving cell. When a neurotransmitter is released, it crosses through the gap (known as a synapse) and attaches to receptors on the receiving neuron. This is similar to how a key fits into a lock. As a result of this, the receiving neuron will experience changes.
Within the brain, there are also transporter molecules that help bring back neurotransmitters to the original cell that released them. Transporters limit or block the signal between neurons, which can produce abnormal messages between cells.
How Does Drug Use Interfere With Communication in the Brain?
Essentially, alcohol and other drug use interferes with normal communication between neurons in the brain. While the total number of neurotransmitters in the brain is unknown, research shows that there are over 100 distinct types of neurotransmitters. Every drug impacts each of these neurotransmitters in a unique way.
For example, some drugs can exaggerate or amplify neurotransmitter signals, while others can block signals. Further, some drugs can prevent transport molecules from naturally recycling, which interferes with the overall communication process. Some drugs, such as cannabis, even mimic the chemical structure of natural neurotransmitters, which can particularly trick the brain and body. Even when drugs mimic natural neurotransmitters, they still have abnormal activating effects on neurons.
Research in this area is moving quickly, yet has only recently begun to explore the distinct effects of drugs on neurotransmitter communication in the brain. Here are two examples:
Stimulant Drugs
Stimulants are a class of drugs that increase activity in the central nervous system (CNS). As a result, individuals who use stimulants report increased energy and focus. Also known as “uppers,” common stimulants include:
- Amphetamines: Prescription medications commonly used to treat attention-deficit/hyperactivity disorder (ADHD) such as Adderall®, Concerta®, Dexedrine®, Focalin®, Metadate®, Methylin®, and Ritalin®
- Cocaine: Crystalline powder derived from coca leaves
- Methamphetamine: A synthetic stimulant that is often used illegally, often known as meth
The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that stimulants modify normal communication within the brain by inhibiting the reuptake and release of dopamine, an important neurotransmitter. In other words, excess dopamine is left in the synapse.
Each stimulant does this in a slightly different way, and the effects of stimulants on the brain can vary depending on who is consuming the substance. This also explains why individuals with attention-deficit/hyperactivity disorder (ADHD) respond very differently to amphetamines compared to those without ADHD.
Depressant Drugs
Opposite to stimulants, depressants are a class of drugs that slow CNS activity. Individuals who use depressants report effects such as drowsiness and increased relaxation. Common types of depressants include:
- Alcohol
- Barbiturates: Sedative-hypnotic prescription medications used to promote sleep, relieve feelings of anxiety, and prevent seizures
- Benzodiazepines: Sedative medications used to treat anxiety and insomnia
- Opioids: Prescription medications used by doctors to treat pain
According to NIDA, “Most CNS depressants act on the brain by increasing activity of gamma-aminobutyric acid (GABA), a chemical that inhibits brain activity. This action causes the drowsy and calming effects that make the medicine effective for anxiety and sleep disorders.” Essentially, depressant drugs slow down message transport between the brain and body. As a result, they decrease an individual’s concentration and coordination, interfering with their ability to respond to their environment as quickly as usual.
The Role of Dopamine in Repeating Drug Use
Although every drug produces varying effects on the brain, all addictive substances interfere with the brain’s regulation and production of the neurotransmitter dopamine. According to Oxidative Medicine and Cellular Longevity, dopamine “plays a vital role in reward and movement regulation in the brain.” Dopamine is the key neurotransmitter involved in how humans experience pleasure and satisfaction. More specifically, dopamine helps regulate people’s motivation, arousal, reinforcement, and sense of reward.
The brain produces bursts of dopamine when an individual engages in activities that please them. These bursts of dopamine act as a signal to the brain that a certain behaviour is pleasurable and thus needs to be remembered. NIDA explains, “This dopamine signal causes changes in neural connectivity that make it easier to repeat the activity again and again without thinking about it, leading to the formation of habits.”
Dopamine and Drug Consumption
Outside of substance use, bursts of dopamine usually result from normal, healthy activities such as eating, socializing, participating in enjoyable hobbies, and having sex. However, the use of alcohol and other drugs — especially first-time use — can produce surges of dopamine greater than what can be experienced from natural activities.
When substances are used more frequently and in greater intensities, they can produce even larger surges of dopamine. Put more simply, drug use and associated dopamine surges “teach” the brain to engage in substance use repeatedly at the expense of experiencing pleasure from healthier and more natural activities.
Dopamine and External Cues
An individual’s brain does not only associate drug consumption with pleasure. It also associates external cues that are connected to alcohol and drug use with pleasure. For example, the brain can associate certain environmental with substance use. The brain’s reward circuit can then trigger uncontrollable cravings when exposed to these environmental cues. Unfortunately, this can condition an individual’s reward circuit and dopamine production to a point where substance use becomes habitual.
These brain changes are difficult to reverse and are often long-lasting. This also explains why individuals in long-term recovery may feel triggered by certain environments or sensory cues even after being sober for years.
The Effects of Addiction on Specific Brain Areas
Every brain area is uniquely impacted by recurrent drug use. However, most research highlights three brain areas that are significantly altered by addiction. These include the basal ganglia, the extended amygdala, and the prefrontal cortex. Understanding how these three areas are affected by chronic substance use can help an individual better understand the severity of the cognitive consequences that can result from addiction.
The Basal Ganglia
Sometimes known as “the reward circuit,” the basal ganglia are a group of structures responsible for carrying out functions including:
- Controlling the body’s voluntary movements
- Processing and evaluating one’s risks and goals
- Learning and forming habits
- Identifying and reinforcing pleasurable behaviours
When a person engages in substance use more frequently, the basal ganglia adapt. They facilitate a new normal for the brain’s dopamine production and lower the brain’s sensitivity to pleasurable experiences. As a result of changes in this brain area, it can be difficult for a person with an addiction to experience pleasure from anything other than drug use, and that only in increasing amounts or frequency.
The Extended Amygdala
In the brain, the extended amygdala is a group of structures responsible for “evaluating the emotional value of sensory stimuli,” according to the Journal of Neuropsychiatry and Clinical Neurosciences. It is responsible for carrying out various functions, including:
- Regulating emotions
- Encoding memories
- Processing fearful and threatening stimuli
- Mediating stressful feelings, including anxiety and irritability
When an individual is coming down from the “high” of substance use, their brain and body often experience withdrawal symptoms. The severity of drug withdrawals tends to increase alongside drug tolerance. This means that as an individual increases the amount of alcohol or other drugs they are consuming, they will experience more severe withdrawals.
As a result of chronic drug use, the extended amygdala becomes increasingly sensitive. Withdrawal symptoms, such as anxiety, irritability, and cravings, can surface to motivate an individual to use again. Often, individuals struggling with addiction reach a point where their use of drugs comes as an attempt to experience relief from withdrawal rather than to feel high.
Likewise, general feelings of stress in this brain area can motivate substance use. The extended amygdala wants to protect a person from pain and anxiety. Likewise, it recognizes that substance use can help an individual avoid pain and experience pleasure. While the brain has good intentions, it does not always recognise that what it thinks is the solution is part of the problem. Retraining this brain area in recovery requires learning healthy coping mechanisms for navigating stress and anxiety.
The Prefrontal Cortex
Lastly, the prefrontal cortex (PFC) is a section of the frontal cortex, lying in the frontmost part of the brain. The PFC performs many important responsibilities, including:
- Regulating autonomic body functions
- Dictating our personality and values
- Influencing attention and impulse inhibition (self-control)
- Promoting cognitive flexibility
- Powering one’s ability to think, plan, and make healthy decisions
This part of the brain is the last to fully develop, uniquely affecting teens and young adults. Similar to the other brain areas mentioned, the PFC becomes more sensitive in the wake of chronic substance use. As a result of the interactions between these brain areas, an individual with SUD may begin to seek substances with reduced impulse control. They may experience less self-control and a diminishing ability to make healthy decisions for themselves.
Effective Addiction Recovery Requires Professional Intervention
Although addiction is chronic, it is also treatable. It is common for people to question the use of professional interventions when seeking recovery from addiction. Most individuals who struggle with addiction may wonder if they can successfully recover on their own. Contrary to what they may think, professional intervention is usually required to achieve a successful recovery.
If addiction was the result of moral weakness or lack of willpower, perhaps an individual would be able to recover from addiction on their own. However, addiction is a brain disease. Understanding it as such can encourage individuals with SUD to seek the treatment that they need to recover. Likewise, it also helps dispel the myths and stigmas regarding addiction and other mental health disorders.
Each person must try to gauge the extent and severity of their substance use issues before committing to treatment. This can help individuals better understand their need for treatment and determine what treatment program will most effectively meet their needs.
Alcohol and Drug Detox
Before starting treatment, most individuals with addiction must consider participating in professional detox services. Detox is the process of ridding one’s body and brain of the remnants of alcohol or other drugs.
People may attempt to quit their substance use cold turkey. This can cause a variety of health problems. Additionally, many individuals who quit cold turkey are not being held accountable by an outside support system to stay sober long-term. This can inevitably increase an individual’s risk of using again.
When attempting to stop chronic substance use, an individual will likely experience a variety of withdrawal symptoms. The intensity and severity of withdrawal symptoms can depend on how frequently and intensely an individual has been engaging in substance use. Withdrawal symptoms are commonly uncomfortable, and these symptoms can become unmanageable.
Professional detox services can provide necessary physical and psychological support around-the-clock for those working to achieve abstinence. Often, medications are also provided to help ease withdrawal symptoms and make a client as comfortable as possible.
Treatment Following Detox
Following alcohol or drug detox, an individual must get connected with long-term treatment services. Here at PCP – Perry Clayman Project, we believe the three key phases of rehabilitation include:
- Detox
- Rehabilitation therapy
- Aftercare
Treatment requires individuals to talk with professionals about their relationship with addictive substances. Therapy can help clients address any underlying mental health issues. Additionally, therapy helps the client better understand how their lifestyle has changed as a result of alcohol and drug use.
Interventions can include group and individual counselling, life skills building, and additional therapies. There are a variety of treatment options, including inpatient and outpatient programs, that can work with clients’ unique schedules. Most importantly, know that treatment is available and recovery is possible.
Addiction is a condition that deeply affects the brain. Professional treatment is often required to intervene, as it can help reverse brain changes that would otherwise be long-lasting. Rehab Today by PCP – Perry Clayman Project private rehab clinics are dedicated to helping clients change their lives for the better. We know what it is like to be in your shoes because most of our staff have experienced addiction and recovery ourselves. We offer a variety of treatment programs, which are uniquely tailored to your unique needs and goals for treatment. We can get you connected with the next step in your recovery. For free advice and more information, call us today at 08000 380 480.