Substance Abuse and Our Brains: Challenges for Recovery

Substance abuse has plagued mankind for most of our existence. It has a devastating effect on individuals, families, and society. Statistics bear this out: the financial cost of substance abuse is estimated to be $700 billion dollars annually, over 100 people die a day from drug overdoses, and there were approximately 20.6 million people in the United States over the age of 12 with an addiction in 2011 (NIDA). Those figures are just a small sampling of its impact. Fortunately, current research has given us a better understanding of addiction and provided us with more tools to fight it. A huge step in gaining insights, is finding out more of how our brain works and its role in addiction.

The brain is made up of many different and complex components. Some parts have very specific functions, while others have multiple responsibilities. There is also some redundancy and overlapping of tasks in brain regions. However, they all work together for one thing, our survival. Our brain guides us to situations that are important for our continued existence. A part of our brain called the reward center, is concerned exclusively for our survival. Food, water, and sex activate our reward center. This mechanism allows us to continue to seek out experiences that will ensure our existence. Since we perceive that rewards are important for survival, our brains are essentially hard wired for rewards.

When we receive a reward, our brain releases a neurotransmitter called dopamine and that produces pleasure.  This is called the reward pathway. Our brain guides us to not only seeks out rewards but also predict them.  When we experience a reward, it is recorded in our brain and we are likely to do it again (creating a memory). Again, from an evolutionary perspective, it really makes sense. Unfortunately, evolution does not have an answer for drug and alcohol abuse.

Substances introduced into our systems (brain) activates our reward center. A pleasure response results that far exceeds any natural experiences we encounter. Mood altering substances work in one of two ways. They either block the pathways in our brain to allow a massive buildup of dopamine, or it stimulates the release of large amounts of dopamine. To get an idea of how powerful this experience can be for some individuals, drug induced pleasure is almost 10 times more intense than any natural pleasures we can experience. It provides a short cut allowing the experience to be not only intense, but fast acting as well. The increases the likelihood of repeating the use.  Substance use is a very difficult pleasure for us to compete with naturally. Evolution has been overtaken by manmade substances(addiction). The longer this goes on, the more our brains adapt to it.  At some point the brain stops making its own dopamine and depends on the substance to fulfill this need. Substance users also start requiring higher doses to receive these rewards. Our brain changes because of substance abuse.

The reward circuit in the brain includes areas involved in motivation and memory as well as pleasure. Substances stimulate and overload the same circuit. This is how compulsive use takes place. A conditioned response is created through memories associated with use. This is what causes cravings for substances.  These cravings (and memories) can last several years of use stops.  A needle (for heroin users), a razor blade (cocaine users), a bottle of alcohol (alcohol user), or even a song can create an intense reaction and craving. Emotions (internal triggers) such as stress can also create strong feelings to use. Users also develop a reliance on substances to cope with moods and lose their own ability to manage their emotions. Prolonged substance abusers will use mood altering substances just to cope with day to day stress.

The longer the addiction has gone on for the more difficult (not impossible) recovery becomes.  Not only is brain chemistry changed to support the addiction, behavioral and social patterns become embedded as well. Lifestyle can revolve around getting the next high.

To break away from addiction, users need to make major changes in their life.  Included are some suggestions in trying to move away from substance abuse/addiction:

  • Surround yourself with people who are supportive of your recovery. This could include support groups, friends, and/or family. The tricky part is for some substance abusers, families may have distanced themselves due to their use. Understand, trust and confidence in your recovery by family members does not start once a person declares their intent. Time and consistent behavior are needed.
  • Recognize positive influences in your life. A change of friends who support your goal of abstinence should be a priority.
  • Identify triggers, both internal and external (people, places, and things). Plan when they might present themselves and develop plans and strategies to address them.
  • Develop a healthy diet. Often this is an area neglected with substance abuse. A healthy diet will also help you feel better and think better.
  • Exercise can create a better feeling of yourself as well as aid in recovery from impact of substance abuse. It can also begin to revive your body’s own ability to release dopamine and other hormones that make you feel good.
  • Keep yourself active\busy. The more engaged you are the more distracted you will be from urges.
  • Participate in a support group. There are many different type of support groups that can help. This could also include religious groups as well.
  • Learn and utilize stress reduction techniques. This could include meditation, relaxation, and mindfulness techniques.
  • Keep a gratitude log. This will not only help you keep focus on the positives in life, but help you in maintaining your goals.

It is important to be patient. Recovery will not happen overnight. In fact, it could take several years in some cases before the brain gets rewired. New associations and connections need to be formed in establishing abstinence. Motivation may be difficult, especially in the earlier stages. The brains reward center needs to adjust to the amping down of the reward pathway. In some cases, medication is introduced. If the substances were used for self-medication, the mental health issue will resurface once use is stopped. It will also help to seek out professional help from someone experienced in substance abuse. This helps with accountability, support, guidance, and education in overcoming barriers.