Substance use disorders can be traced to changes in the brain. Although every substance has different effects on the brain, they can all induce a pleasurable surge of dopamine. This is because the function of brain circuits or the brain’s reward system is involved.
These brain structures, also known as neurotransmitters, also play a key role in learning, memory retainment, decision-making, and self-control.
Neurotransmitters, Brain Circuits, and Pleasure
Neurotransmitters are chemicals that transmit messages between nerve cells. Dopamine is one kind of neurotransmitter. Other common neurotransmitters of the brain include glutamate, serotonin, and acetylcholine.
Each neurotransmitter is associated with particular effects depending on its distribution among the brain’s various functional areas. Dopamine generates from a region of the brain known as the basal ganglia. This area is in charge of controlling rewards. It also affects one’s ability to learn based on rewards.
People who use substances enjoy the “pleasure” of sensations because these brain circuits are adapting to the infusion of these substances. Over time, the same dosage of substances may no longer induce the same pleasure. This is known as tolerance which reflects the way the human brain has rebalanced to a “new normal.”
These same circuits also manage the ability to take pleasure from daily life activities, such as eating good food, having sex, and enjoying social interactions. When the level of pleasure is artificially hijacked to a high baseline, these average life activities may feel less enjoyable. To feel these sensations again, one may need a higher dosage of substances.
More Changes in the Brain With Long-Term Use
Repeated and long-term use of substances “train” the brain to only associate the rewarding euphoria with addictive cues in life, including people or places associated with substance use. These neurological associations maintain focus on thinking about using. Many things in life may become reminders of getting high.
Meanwhile, two other brain areas—the extended amygdala and the prefrontal cortex—evolve. The former controls responses to stress. When this area malfunctions, it will cause bursts of stress neurotransmitters that feel like a painful stick pushing the brain to escape unpleasant situations. Such unpleasant situations include times when the person is not using drugs or alcohol. The person then may develop anxiety and obsessive compulsions associated with substance use.
In similar ways, when the prefrontal cortex—a control center for judgment and decision-making—malfunctions, emotional distress may be experienced. This generates most withdrawal symptoms, motivating people to use substances again to escape the pain at all costs. By the time withdrawal occurs, substance use is the only way to produce relief from these bad feelings. Other priorities are no longer important.
Neurotransmitters, Self-Control, and Behavioral Therapy
People with substance addiction may still exert self-control. They still move through life and are accountable for their actions. However, their self-control has been compromised and they are less able to override the powerful urge to seek relief from withdrawal symptoms. Even with long-term strong willpower to finally quit, with many substance-related cues in life, constant cravings may re-emerge. Relapse occurs when these urges become so strong that willpower is eroded.
If substance addiction changes brain structures to such an extent that it becomes a brain disease, why is behavioral therapy needed? Can cognitive-behavioral therapy (CBT), for example, reverse the course of the disease in the brain? Research shows that CBT-related neurological changes are possible. It can be as effective as medication. Most treatment centers integrate CBT into their regular programs.
Recovery and Brain Health
The human brain has a remarkable power of self-healing. Even though substance addiction may have changed and even damaged brain structure and chemistry, there is a high chance that the brain can heal with proper treatment.
Before the brain can begin healing, the body needs to be clean of any residual substances. Detox can take days or weeks, depending on the severity of the addiction. When the brain heals, it will begin by recovering the volume of lost grey matter. This may start to happen within one week after detox. Other areas of the brain and the white matter in the pre-frontal cortex take several months or longer to recover.
Rebuilding the neural pathways to reinforce healthier choices and habits depends on each individual’s circumstances. There are substances that create permanent damage to the brain, which takes much longer to heal. Examples are opioids and cocaine. Many recovery experts suggest 90 days for dopamine recovery.
Fortunately, neuroplasticity of the brain may allow rewiring of the neural pathways to overcome self-destructive habits and behaviors and create paths that lead to healthy and sober life choices.
Substance addiction is a complex brain disease. With professional care by medically trained health professionals, addiction is treatable. Find a quality facility that provides the level of care that meets your needs. Many people with a substance use disorder have co-occurring mental health issues. If that is the case for you, you need to find a treatment center where recovery experts and mental health professionals work closely together to care for their clients. At Casa Recovery, our professional team helps recovering individuals and their families benefit from evidence-based methods. Each client’s treatment team will work with them to provide customized efficient and effective treatment methods that have been developed and applied in clinical settings. Early intervention is key. Call us today at (888) 928-2272. A new life is waiting, and we are here to walk alongside you on this journey.