Is addiction a disease or a choice? While there are strong psychological factors that contribute to addiction, there are equally strong physiological components. For addicts and their families, understanding the relationship between addiction and the brain can be crucial for recovery. I was always told growing up that addiction being labeled as a disease was an excuse for someone who lacked will power. Through study and collegiate classes I found new knowledge that I feel is important to consider.
Dopamine and the Brain
Every emotion someone feels, from happiness to sadness, is the result of chemicals in the brain called neurotransmitters. Neurotransmitters are released in response to stimuli, and they travel through specialized neurons. Stress triggers the release of cortisol, soothing experiences trigger serotonin and rewarding experiences trigger dopamine.
Dopamine's primary role is incentive salience, or teaching goal-oriented behavior. In day-to-day life, fulfilling experiences like eating a good meal stimulate the ventral tegmental area (VTA), the brain's reward center. The VTA releases a burst of dopamine through its specialized dopaminergic neurons in response. The VTA dopamine system makes us feel the thrill of reward, and it drives us to want it again.
Addiction and Dopamine
Addictive activities hijack the VTA dopamine system. They trigger a flood of dopamine anywhere from two to ten times higher than the usual amount, producing the tell-tale "high." The extreme rush teaches us to want the addictive substance or activity faster and with greater intensity than any other thing.
Unfortunately, the brain is not built to handle massive surges of dopamine. Over-stimulation destroys the dopaminergic neurons' sensitivity to smaller amounts of the neurotransmitter, and everyday rewarding activities cease feeling good. The user ends up needing his drug just to feel normal. Addiction has set in.
Breaking the Cycle
In medicine, a disease is defined as any abnormal condition that negatively affects someone's life. Addiction keeps the brain in a constant state of abnormality. When addiction destroys the user's ability to feel normal, it becomes a serious but treatable disease. In essence an individual has the choice before they use an addictive substance, but once time progresses after continued use they become chemically dependent on the substance. Though it is important to realize that with proper help it can be overcome.
During detox, an addict's body is purged of drugs and dopamine levels plummet. Unbearable cravings pervade at first, but with therapy and medication, his brain will have the chance to heal. Recovery services can be necessary for two weeks or as long as six months. His neural receptors gradually become sensitive to normal quantities of dopamine again, and he has a chance at living a normal, rewarding life.
There are no guaranteed successes for addiction treatment, but an approach that combines medical and emotional wisdom is key for evening the odds. Learning that the impact addictive substances has on the brain is reversible offers hope in the physically and emotionally grueling process of recovery.