Addiction–The Hijacked Brain
Addiction is a brain disease. Drug abuse is preventable behavior. Drug addiction is a treatable disease. So many people think that it's a lack of willpower. But, it's not. Addiction is a chronic, pervasive, progressive brain disease that worsens over time, devastating millions of families worldwide.
Some people are genetically more at risk than others. If you have a sibling, aunt, uncle, grandparent who is addicted (to anything) , then you're at higher risk of become an addict yourself. You're vulnerable to addiction. That doesn't mean that you're doomed.
It's all about dopamine
Dopamine is released in the brain in response to, and in anticipation of, a reward—be it alcohol, drugs, cigarettes, sex, food, or a shopping spree, to name a few rewards. The reward center in the middle of the brain becomes overactive with usage of a substance or activity that stimulates that area.
The substance wreaks havoc with brain chemistry and structure, which can clearly be seen on brain scans. Over time with continued usage, the chronic flooding of dopamine results in the depletion and deregulation of dopamine as well as other neurotransmitters involved in stress and reward. Consequently, by the time an addiction is established, the drug brings little pleasure and only helps the user to feel temporarily ‘normal'.
The "Go System"
Deep in the brain, we all have a reward system, a pleasure center that evolved to help us to pursue rewards. This was necessary for our survival millions of years ago. When the reward system in the middle of the brain becomes active, it's as if it says, "Go! Go! Go!" Go for the drug! Go for that extra dessert! Go for the excessive alcohol! Go looking for porn on the internet! Go! Go! Go!
The "Stop System"
Another part of the brain, the prefrontal cortex or higher brain, evolved over time to help us to weigh the consequences of our decisions. It helps us to put a lid on impulsive behavior. It says, "Stop!"
The signals to the prefrontal cortex, however, tend to be a bit slower. So, we need to stop and think things out before forging ahead with an impulsive decision. To make things even more frustrating for parents, the brain isn't finished growing until we're about twenty-five or thirty years old. So we tend to have an undeveloped stop system before those ages.
The stop system in our brain says, "This is not smart to drive so fast, eat so much, or yell at a stranger." So, why doesn't it work so well with substance abuse?
Putting it in the simplest terms, the "go system" hijacks the "stop system" in the course of this brain disease called addiction. This is why addicts often lose everything before life smacks them in the face hard enough to get their attention that there is a problem--a BIG problem that they have been in denial about for quite some time.
The Twelve Steps of Alcoholics Anonymous begins with admitting powerlessness. From my point of view, the hijacked brain contributes to powerlessness. When addicts/alcoholics say that they can control their usage despite evidence to the contrary (that friends and family can clearly see), they are not understanding the first step.
In order to get better, the addict needs several things. One of them is a period of sobriety in which they are not activating the reward system of the brain through ANY addictive substances or behaviors. Since dopamine and other neurotransmitters have been affected, most addicts that I've seen over the years need another chemical source of help--antidepressants--in order to feel good enough to make it through that critical first year of sobriety.
I recently attended a substance abuse conference in which Dr. Michael Dennis, senior research psychologist and director of Chestnut Health Systems in Bloomington IL, spoke about the realities of drug dependency. Dr. Dennis was the coordinating center principal investigator of the largest adolescent treatment experiment to date in the United States, the Cannabis Youth Treatment (CYT) study. He has many more very impressive credentials. Some of the sobering thoughts that he said include:
- The younger a person is when they begin using drugs, the longer the person uses drugs in their lifetime. Early use is highly correlated with dependency.
- On average, most substance abusing teenagers are in treatment for two months. This is not enough for the vast majority of teens who are classified as having a substance abuse or substance dependent disorder.
- The average adult substance abuser takes three or four treatment episodes over a period of nine years to achieve one consecutive year of sobriety.
Knowing that, parents of teenagers ought to get a thorough drug and alcohol evaluation (including a SASSI-A2 assessment) with a licensed substance abuse specialist and FOLLOW the treatment recommendations made by that specialist. So much heartache could be avoided if parents would take the recommendations seriously.