The process of addiction..
…begins with the use of a substance (alcohol, marijuana, cocaine, etc.) to feel good or at least better, until ultimately we must use it just to feel normal and to function. We lose the ability to feel pleasure except through use of the drug. We start off thinking we will stop before it gets out of control. But, in addiction, we stop feeling good a long time before we stop using. According to Dr. Nora Volkow, one of the nation’s leading experts on drug addiction and its effects on the brain, “addiction is a result of adaptations in the brain that leads to changes in behavior. That translates…in the inability to control the intake of the drug”. It can cost us everything – our children, our relationships, and our employment. We lose the ability to regulate our own behavior, and we do things almost as a reflex rather than out of free will. In addiction, the area of the brain that allows us to make free choices is not working properly.
All drugs of abuse activate dopamine
.. a naturally occurring chemical in the brain that plays a major role in motivating behavior by producing the sensation of pleasure. These drugs “hijack” the brain’s pleasure system, and they reward more efficiently than our brains do naturally. However, they ultimately reduce the amount of naturally produced dopamine in our brains. Thus, we become less able to feel good without the drug of abuse. In this process, the brain becomes “hardwired” to the change, and addiction results. Lack of the drug puts the addict in a state of deprivation, and craving takes over the body. Procuring our drug of addiction becomes the primary focus of our lives.
Experts have pondered whether addiction is a psychological disease or a physical disease. Dr. Volkow’s opinion is that addiction is a disease of the brain that translates into abnormal behavior. It is an interaction between genes and environment. Some of us are born genetically vulnerable to addiction, or to depression or other problems. Likewise, there are some environments that put us at a higher risk for addiction, while other environments are protective. Adolescents who are unsupervised, situations with high levels of stress, high levels of abuse, and high levels of access to drugs are situations that put us at high risk for addiction. People are more likely to become addicted if they start taking drugs in adolescence or childhood.
Brain imaging has taught us much about how the brain changes in addiction. Often, by staying “clean” the brain can recover completely or at least significantly. What is the process to getting clean? Recovery always begins with detox – getting the drug out of one’s system. Then an individual should be assessed for co-occurring disorders such as depression or anxiety. Medications, therapies, and services are treatment modes for attaining recovery. Once a person is in recovery, AA, NA, church groups, and other support groups can assist in maintaining one’s sobriety. The best outcome is achieved when one continues a period of supervised normalcy for at least a year.
Source: HBO Addiction Series in conjunction with National Institute on Drugs Abuse and National Institute on Alcohol Abuse and Alcoholism
Janis Caserta, LPC, LAC