Why Is Addiction Called a “Brain Disease ” by Many Addiction Professionals?

Addictions (Substance Use Disorders) are extremely powerful.  So much so that even after years or decades of abstinence and recovery, an individual can still experience strong cravings, and be vulnerable to relapse.  Neuroimaging has allowed researches to investigate the acute and long-term effects of addiction on the brain.  The majority of addiction experts agree that addiction greatly impacts the brain, and many have coined it a “brain disease.”

 

Listed below are just a few key and interesting findings of neuroimaging that depict how addiction impacts the brain:

 

 

There are many simple things in life that we may take for granted that bring us pleasure.  For example, it could be a sunset or sunrise, being surrounded by beautiful nature, eating a delicious meal, a loving hug or kiss from your significant other, a workout in the gym, finishing a hard project at work, and many other such parts of life that bring us happiness.  All such pleasures center in the brain, during which the brain releases “feel good chemicals” such as dopamine and serotonin.

 

Substances such as alcohol, opioids, benzodiazepines, cocaine, sugar, nicotine, and other such addictive substances and activities such as gambling, sex, shopping, gaming, social media, and other such addictive activities release an immense rush of these feel good chemicals in the brain (some more so than others).  As humans, it is our natural tendency to want to feel good by increasing pleasure and minimizing pain (both physical and emotional).  As such, many individuals tend to overuse substances or overdo activities that make them feel such intense pleasures.

 

Over time, if the substance or activity becomes habitual, the individual needs more and more of it to produce the same effect (the phenomenon of tolerance).  Furthermore, natural life pleasures such as that sunset or tasty meal will no longer produce the same amount of pleasure as it once did prior to the brain being exposed to such unnatural highs for an extended period of time.  Cue addiction.  Not only has the person become addicted at this point, but oftentimes also develops a low mood (depression) because natural life pleasures no longer bring pleasure.

 

 

Individuals who have developed addictions often struggle with impulse control.  This is why the risk and rate of relapse is so high among individuals who enter recovery.  Approximately 40-60% of individuals who are in a 30-day inpatient rehab for drug and alcohol abuse relapse within the first 30 days of leaving, and up to 80% relapse within the first year.  Impulse control is a primary factor that contributes to such high relapse rates.

 

Since human brains (and beings) are naturally inclined to want to feel pleasure, the smallest amount of pain or discomfort can trigger an individual to want to take something or do something that will alter their feelings in a positive way.  When such thoughts enter the human brain (i.e. triggers) individuals become reactive.  The reaction for an individual who has habitually used a substance or activity to feel good is to engage in that behavior.

 

For all individuals, there is a moment between a trigger and a reaction - a time to pause and think.  When an individual does not take this time to pause and think, but rather is reactive, they are being impulsive.  Impulsivity is often heightened among individuals who are long-term abusers of drugs, alcohol, and other such addictions due to disruption of the part of the brain that is responsible for impulse control.

 

 

When most people think of triggers for an addicted individual, they think on a macro-level.  Macro-triggers are big triggers that are fairly obvious like smelling alcohol, walking past a bar or liquor store, being at a party, getting a call from a drug dealer or party friend, seeing a casino advertisement, death of a loved one, etc.  Macro-level triggers also include feelings such as frustration, stress, anxiety, sadness, anger and other such negative emotions that arise that might drive an individual to want to engage in their addiction to alleviate their emotional pain.  Mental health concerns such as depression, anxiety, bipolar disorder and many others also serve as macro-level triggers.

 

Micro-level triggers on the other hand comprise of extremely miniscule things that drive one to think about engaging in their addiction.  Micro-level triggers often do not even enter the conscious mind.  They are sneaky and often are hard to identify.  For example, a study was conducted on addicted individuals in recovery who were shown various images on a screen in short bursts that each lasted less than a second.  When images that were drug or alcohol related came up on the screen, the individual’s pleasure centers of the brain were instantaneously lit up.  This neuroimaging study demonstrated the far-reaching impact of triggers that do not even enter the conscious mind.

 

These are just a few examples of short and long-term impacts of addiction on the brain.  Addictions have also been found to cause changes in the brain systems involved with motivation and memory.  Due to such changes, many professionals have coined addiction a disease of the brain and follow the disease model of addiction, including several medical associations such as the American Medical Association and the American Society of Addiction Medicine.  Addiction is sometimes compared to physical health issues such as diabetes, cancer, and heart disease, all of which are caused by a combination of behavioral, environmental, and biological factors.

 

Due to the changes that occur in the brain of addicted individuals, those who have experienced addiction have a strong propensity towards relapse, even after years of recovery.  This is why it is so important for such individuals to remain vigilant and create a regular healthy lifestyle that will support ongoing sustainable recovery.  Like a muscle, the more consistent we are with training our brain, the healthier it will become.  Furthermore, the good news is that like all human organs, the brain too has an incredible power to heal with time and through professional help.  Evidence based treatments, holistic healing, and other recovery methods have proven to reverse the damage caused by addiction in many cases.

 

Author
Lin Anderson & Aaron Sternlicht

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