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How does addiction affect the brain?

Answered by Dr. David Zoeller M.D. 0

Drugs, drinking and other addictive behaviors (like gambling or sex) change the way brain cells communicate with each other. Addiction is a powerful disease that restructures the way you think and feel.

When addictive behavior is repeated, the way your brain responds to pleasure and rewards starts to change. The brain learns to associate drugs with pleasure, which reinforces these behaviors and builds neural pathways that make you more likely to do it again.

Over time, the brain responds by “turning down the volume” on dopamine receptors, known as building up a tolerance. Tolerance is a natural response that helps protect your brain, but it also makes it impossible to reach the same high as before. This is one way addiction gets worse over time.

Lack of control is another fundamental part of addiction. It is why people who are struggling with an addiction will continue to get high despite the consequences. Once addiction takes over, the compulsion to use is so strong that you no longer have a choice.

Regardless of the substance or behavior, addiction makes real, measurable changes to your brain. Researchers are still unpacking new ways that being addicted can affect cognitive function.

Page Topics
Addiction and the Brain: Parts Affected | Causes of Addiction | Chemical Signals | Recovery from Addiction | Rewiring after Addiction | The Disease of Addiction | Negative Effects |

What part of the brain is affected by addiction?

Three particular areas in the brain play a key role in developing an addiction:

  1. Basal Ganglia – The Basal Ganglia is an important part of the brain’s rewards system, which sends signals telling the individual to continue the addictive behaviors. It also contributes to brain functions like motivation, routines behaviors and patterns. https://www.ncbi.nlm.nih.gov/books/NBK424849/
  2. Extended Amygdala – This part of the brain is responsible for regulating stress and fight or flight response. Research indicates that this part of the brain is key to developing drug dependence. https://www.ncbi.nlm.nih.gov/books/NBK424849/
  3. Prefrontal Cortex – The Prefrontal Cortex affects decision-making and regulates impulses. This is why people continue to engage in addictive behavior, despite the consequences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201373/
The Prefrontal Cortex, Basal Ganglia, and Extended Amygdala all contribute to how addiction develops in the brain

The effects of substance abuse and addiction aren’t limited to just these areas, though. The human brain functions as a network of interconnected parts. Changes to one region of the brain will impact others.

What causes addiction in the brain?

Both genetics and environmental factors play a role in how addictions develop.

Genetic – If either of your parents has been addicted to drugs, your chances of being addicted increase. The presence of other genetic mental disorders also plays a role in how likely you are to become addicted to drugs or alcohol.

There is no single gene that causes addiction, though. A combination of multiple genetic factors determines your risk.

Environmental– This accounts for all the outside influences that can lead someone into addiction. If you grow up in a household where drugs are around, you’re statistically more likely to develop an addiction.

Other environmental factors that contribute to addiction include:

  • Peer pressure
  • Past traumatic experiences
  • Socioeconomic factors
  • Availability of support & treatment

Having parents with an addiction problem or growing up around drugs does not necessarily mean that you will become an addict yourself, though. It only increases your chances.

Which neurotransmitters are involved in drug addiction?

A neurotransmitter is chemical signal allows brain cells to communicate with each other. Dopamine is the primary neurotransmitter involved in addiction. Dopamine is responsible for many of the pleasurable feelings we experience as humans, like eating good food or laughing with friends. It’s also closely associated with addiction.

Drugs work by mimicking dopamine, increasing dopamine levels or by increasing the sensitivity of dopamine receptors. The surge of pleasure from dopamine is what convinces the brain that a drug is rewarding, and it wants more.

Heroin, an example of increased dopamine released within the brain.

Other neurotransmitters like serotonin, GABA and acetylcholine also impact how addiction is formed. For example, serotonin plays an important role in how people form habits and behaviors that contribute to substance abuse. In alcoholics, low serotonin levels are correlated with a stronger compulsion to drink.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC80880/

How long does it take for the brain to recover from addiction?

Most people are surprised at how quickly they feel better once they get past initial withdrawal symptoms. Within a few days, most people feel less cloudy and have more positive energy. The timeline depends on

  1. Which substance was being used?
  2. How much was being used?
  3. Overall health
  4. Presence of other mental health disorders
  5. Support system & access to treatment

Don’t get discouraged. It may take months before you feel completely back to normal, but you’ll feel better as you make progress along the way.

fMRI brain changes after cocaine abuse show decreased dopamine receptor levels, with regrowth over time abstinent.

You can break down brain recovery into three parts:

  • Dopamine Production: Drugs trigger a dopamine release Abused substances trigger dopamine production at high levels and a rapid pace. Over time, the brain learns to stop producing dopamine naturally and must relearn to do so.
  • Retraining the Brain: This may mean eliminating habits that pull the individual towards addiction, engaging in new thought patterns, or teaching it to respond differently to stimuli.
  • Cravings: The desire to use is most intense during your first few days sober. Over time, cravings are reduced to passive thoughts that are easily shaken off. 

No one becomes addicted to drugs and alcohol overnight, and just the same it takes time for the brain to heal from addiction. Be patient and trust the process.

How do you rewire your brain from addiction?

After addiction, the brain begins to heal itself and return to its normal functioning. The process can take several weeks to several months, but eventually, you will feel better. Here are some tips that are proven to help your brain heal from addiction:

  1. Be patient and give yourself some time – Simply put, your mind needs time to heal. You didn’t become addicted overnight, and the brain must go through the healing process like any other organ.
  2. Stay Active in your Recovery – This includes attending recovery meetings, meditating and helping others. The most important thing is that you build a routine. Staying consistently active is the best thing you can do to prevent relapse and keep your mind and body on a healthy course.
  3. Diet & Exercise – Both diet and exercise can help restore your brain function. In 2005, a Swedish study proved that running increases cell growth in the hippocampus.
  4. Make sleep a priority. Addiction and lack of sleep involve many of the same processes in the brain. And, research shows that people are more likely to engage in risky behaviors if they are sleep deprived.
  5. Find a fun and engaging hobby, like writing, painting or learning to play an instrument. The more you enjoy it, the more likely you are to follow through and actually see the benefits.

You can never fully eliminate the seeds in the brain that contribute to addiction, but you can reverse some of the damage that addiction causes. Be patient with yourself. Healing from addiction takes time, but with the right help, recovery is possible.

Why is addiction considered a brain disease?

The brains of people with addiction are different from those who don’t have it. This is something we have known since the 1980s, and further research has only solidified this. 

Both the American Medical Association and the World Health Organization consider addiction to be a illness.

Addiction has characteristics that are consistent with other diseases, such as:

  • It is a primary diagnosis that causes other medical issues
  • Addiction is a progressive disease, meaning it gets worse over time.
  • Addiction is chronic. There is no cure for addiction and people have it for life.
  • Childhood trauma can cause changes in the neurological wiring of the brain. Neurological wiring differences impact an individual’s ability to cope with stressors, making them more likely to turn to drugs and alcohol.

Once the brain disease model of addiction emerged, therapies were modified to treat the brain, rather than treating addiction as a lack of willpower.

[Video]

Why is the brain disease model of addiction so controversial?

There are numerous reasons why people find the brain-disease model of addiction controversial. In the past, people thought that addiction was a moral failing, something that “bad” people engage in rather than a disease like any other. This is untrue for multiple reasons.

  • It ignores or minimizes the role that society plays in addiction
  • It doesn’t account for environmental factors
  • It looks at how addicted brains are different after substance abuse, not before
  • It neglects the importance of learning and memory in the addiction process

Over the years, the medical view of addiction has challenged these ideas and proved (with data) that being addicted is not about willpower.

Despite the facts, some people still treat addiction as if it were a choice. Today, addiction specialists use the biopsychosocial framework, which accounts for the complex relationships between biology, behavior, and environment.

Addiction is not a disease of willpower. It is a disease of instinct. It lives in the part of the brain that tells you to breathe.

What are the negative effects of drugs and alcohol on the brain?

Drugs and alcohol have negative impacts on the brain, including:

  1. Damaging brain cells
  2. Changing the chemical balance within the brain
  3. Starving the brain of essential nutrients

Most of these impacts are quickly reversed once a person becomes abstinent. But, there are exceptions.

Wet brain or Wernicke-Korsakoff syndrome is permanent brain damage from alcoholism. Heavy drinking causes a deficiency of Vitamin B1 in the brain, causing memory loss, lack of coordination and other dementia-like symptoms.

The best way to prevent these long-term effects is by treating your addiction now before it’s too late. The sooner you get help, the less likely your brain will be impacted in the long term.

JourneyPure.com doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, count records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the fields and their own personal recovery.

  • Bassuk, E. L., Hanson, J., Greene, R. N., Richard, M., & Laudet, A. (2016). Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review. Journal of Substance Abuse Treatment, 63, 1–9. https://doi.org/https://doi.org/10.1016/j.jsat.2016.01.003

    Bjørnebekk, A., Mathé, A. A., & Brené, S. (2005). The antidepressant effect of running is associated with increased hippocampal cell proliferation. The international journal of neuropsychopharmacology, 8(3), 357–368. https://doi.org/10.1017/S1461145705005122

    Goldstein, R. Z., & Volkow, N. D. (2002). Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. The American journal of psychiatry, 159(10), 1642–1652. https://doi.org/10.1176/appi.ajp.159.10.1642

    Gould T. J. (2010). Addiction and cognition. Addiction science & clinical practice, 5(2), 4–14.

    LeMarquand, D., Pihl, R. O., & Benkelfat, C. (1994). Serotonin and alcohol intake, abuse, and dependence: findings of animal studies. Biological psychiatry, 36(6), 395–421. https://doi.org/10.1016/0006-3223(94)91215-7

    NIDA. 2020, July 10. Drugs and the Brain. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain on 2021, April 26

    NIDA. 2020, July 10. Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery on 2021, April 26

    Nixon, S. J., & Lewis, B. (2020). Brain Structure and Function in Recovery. Alcohol research : current reviews, 40(3), 04. https://doi.org/10.35946/arcr.v40.3.04

    Pinilla F. G. (2006). The impact of diet and exercise on brain plasticity and disease. Nutrition and health, 18(3), 277–284. https://doi.org/10.1177/026010600601800310

    Robinson, T. E., & Berridge, K. C. (1993). The neural basis of drug craving: an incentive-sensitization theory of addiction. Brain research. Brain research reviews, 18(3), 247–291. https://doi.org/10.1016/0165-0173(93)90013-p

    Seo, D., & Sinha, R. (2015). Neuroplasticity and Predictors of Alcohol Recovery. Alcohol research : current reviews, 37(1), 143–152.

    Stuckey, H. L., & Nobel, J. (2010). The connection between art, healing, and public health: a review of current literature. American journal of public health, 100(2), 254–263. https://doi.org/10.2105/AJPH.2008.156497

    Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 2, THE NEUROBIOLOGY OF SUBSTANCE USE, MISUSE, AND ADDICTION. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424849/

    Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic Advances from the Brain Disease Model of Addiction. The New England Journal of Medicine, 374, 363–371. https://www.nejm.org/doi/full/10.1056/NEJMra1511480

    (2020, October 20). Is Lack of Sleep a Risk Factor for Relapse? National Institutes of Health HEAL Initiative; U.S. Department of Health and Human Services. https://heal.nih.gov/news/stories/sleep-disruption-relapse

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Dr. David Zoeller M.D.

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Dr. Zoeller has been practicing internal medicine for more than 30 years with a special interest in brain and addiction science. He is a Diplomate of the American Board of Pain Medicine and certified in addiction medicine by the American Board of Preventive Medicine. After starting his career as a Chemical Engineer at IBM, Dr. Zoeller graduated from the Louisville School of Medicine. He currently serves as an associate professor at the University of Kentucky, the University of Louisville and Vanderbilt University.

  • Medical executive at JourneyPure, a nationally-recognized drug & alcohol treatment center with locations across the country
  • 30 years as a medical doctor
  • Certified in addiction medicine by the American Board of Preventive Medicine
  • Diplomate of the American Board of Pain Medicine
  • Associate professor at the University of Kentucky, the University of Louisville and Vanderbilt University
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