The Medical Science of Addiction

Breaking out of an addictive cycle is difficult but not impossible. Having an addiction leaves long-term effects on your mind, making it harder for you to move on. A person with an addiction has different brain chemistry; the brain’s ability to register enjoyment is taken over by the response to the addictive substance. Having an addiction literally changes how the brain works. The definition of an addiction is a very strong desire for a substance or activity, an inability to control how much and when you use or seek this substance, and continued use even though it is causing adverse effects on the person.

New Insights into a Complex Problem

Almost nobody sets out to become addicted on purpose, but it can happen to almost anyone. For example, in America, according to their government, nearly 1 in 10 people is addicted to drugs or alcohol, with nearly 70% of those addicts being alcoholics. Other than alcohol, the most common addictive substances are cocaine, narcotics, and marijuana. However, it is also possible to become addicted to activities such as gambling or social media use. Specialized therapy exists for those addicted to Internet use or casino gaming.

The Brain’s Pleasure Centres

The human brain only has one way to register pleasure; it responds in the same way to any enjoyable activity, be it a good meal, an intimate encounter, a monetary win, or psychoactive drug use. The pleasure centre of the brain is called the nucleus accumbens, and it is located underneath the cerebral cortex. To signal a pleasurable sensation, this nucleus accumbens releases a neurotransmitter (brain chemical) called dopamine. Dopamine interacts with other cells in the brain to cause a feeling of happiness. Addictive psychoactive drugs cause a large release of dopamine from this pleasure centre; these drugs include well-known illegal substances like heroin or cocaine, but nicotine and even caffeine cause this effect as well. Combining the usage of a drug with another pleasurable activity, such as a sexual climax, results in faster development of the addiction because this results in a larger release of dopamine during a short period of time.

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The Addiction “Learning Process”

Older studies led scientists to believe that pleasure by itself was what caused addiction and what caused addicts to struggle to break out. However, more recent research shows that the reasons behind addiction are much more complex. For example, scientists have learned that dopamine doesn’t just contribute to feelings of pleasure and happiness but also plays an important role in memory. This connects the gap between enjoying something and needing to have it every day.

Some current theories include other neurotransmitters, such as glutamate, in the addiction process. They hypothesize that the combination of dopamine and glutamate hijacks the brain’s reward system. This is a system that keeps humans alive, as it links activities of survival, like eating and mating, with pleasurable feelings. Addictive substances break this system and essentially convinces the brain that it requires that substance to continue living.

Building Tolerance

As time progresses and the addict continues to use the substance, the brain starts to adapt. This makes the object of the addiction, be it a substance or an activity, less rewarding. This happens because addiction shortcuts the pleasure system and floods the brain with dopamine and other neurotransmitters. This confuses the brain and allows the compulsion of seeking the addictive substance to take over. Once the pleasurable feelings (the “high”) wear off, the memory of the feeling remains and the desire to have those feelings again builds. In nature, it takes time and effort to get to anything that feeds the reward system, so tolerance doesn’t develop and the survival activity is still rewarded.

Learning plays a role here as well. The brain stores the information that the substance or activity leads to pleasurable feelings and also stores the environmental stimuli associated with it in order to find it again. These memories result in a conditioned response (cravings) in the addict whenever the environmental stimuli are encountered. For example, a heroin addict might feel a craving when seeing a hypodermic needle, while an alcoholic might not react to the needle but have strong feelings about a bottle of rum. These cravings don’t just keep the addiction going but can also cause a person to relapse after a long period of sobriety, which helps to explain why some people might “randomly” experience a relapse.

The science behind addiction is still being studied; more is being learned every day. The way we deal with addicts and addiction needs to change to match up with the science. Hopefully, this will lead to more effective treatments for this destructive mental illness.

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