Addiction and the brain

The chemicals in substances such as nicotine, alcohol, amphetamines, and opiates cause a neurochemical reaction that releases artificial, but intense levels of dopamine.

As the addiction becomes stronger, natural levels of dopamine in the brain are decreased (1) meaning that habitual drug users find little pleasure in anything other than abusing their drug of choice.

Abusing any harmful substances for any length of time can be dangerous, however, long-term addiction to drugs or alcohol can result in life-altering and irreversible damage such as brain damage, coma or even death.

Physical effects of addiction caused by altered brain chemicals

Because the brain is vital to the proper functioning of our entire body, chemicals from harmful substances entering the brain cause several harmful neurological and even physical side effects.

Some of the physical side effects are:

  • Rapid heartbeat
  • Increased appetite or loss of appetite
  • Unexplained weight loss
  • Rotting teeth or loss of teeth
  • Skin rashes or legions
  • Insomnia
  • Cold sweats
  • Gastrointestinal issues including constipation, vomiting and diarrhoea

Psychological effects of addiction caused by altered brain chemicals

Some of the most notable side effects of addiction are:

  • Psychosis
  • Anxiety or depression
  • Feeling shame or guilt
  • Restlessness
  • Mood swings
  • Hallucinations
  • Irritability
  • Lack of motivation
  • Loss of interest in things you once enjoyed
  • Suicidal thoughts
  • Feeling worthless

The development of addiction – hijacking the brain’s reward system

The brain works with the body to maintain stability and balance, this is known as homeostasis (2). Substances such as drugs and alcohol affect that natural balance and so the brain has to make the necessary changes to adjust to its new situation.

Our brains are programmed to release feel-good chemicals when we do something that brings us pleasure. This is why people feel good when they eat something delicious, hear their favourite song or take part in an activity they enjoy, such as dancing.

The brain stores these activities as a reminder for you to do them again so it can release more of the feel-good chemicals, most notably dopamine.

While different substances cause people to react differently, all addictive substances used by humans activate the brain’s reward system by releasing a rush of dopamine.

Even though it is an artificially produced rush of dopamine, the brain registers it as a pleasurable experience and stores it to remind you to do it again.

Every time you use the substance again, the craving becomes stronger until you are in the midst of a full-blown addiction. Once your brain realises that you are using drugs that artificially produce dopamine, it will decrease its production of this hormone accordingly.

Studies show that decreased levels of dopamine are linked to impulsive behaviour which is tied to a compulsive need to administer drugs (3). At this stage, you will find it difficult to find pleasure in anything other than taking the drug that you are addicted to.

This is the reason withdrawal symptoms are so severe. Once you stop taking the drug, the brain reacts by trying to correct any imbalances and you will have intense cravings for the substance in order to feel “normal” again.

How withdrawal affects the brain

Long-term addiction completely changes the chemicals in your brain and how it functions. However, the brain is an incredibly adaptive organ and as it can learn to adapt to your addiction, it can also “unlearn” those unhealthy behaviours.

Unfortunately, however, the risk of relapse never truly disappears, and the journey of withdrawal is likely to be an unpleasant one.

Symptoms of withdrawal can vary depending on the substance that was used, but some of the most common symptoms are:

  • Loss of appetite
  • Insomnia
  • Vomiting and diarrhoea
  • Muscle pain
  • Spasms
  • Seizures
  • Cold and flu symptoms
  • Delirium tremens (DTs)
  • Chronic fatigue
  • Hallucinations
  • Psychosis
  • Depression
  • Anxiety

Physical symptoms of withdrawal may only last up to a few weeks, however, the psychological effects such as anxiety and depression can last much longer and may require long-term treatment.

Helping the brain recover from addiction

While addiction – especially long-term addiction – causes some damage to the brain, studies show that the brain produces new cells and neural pathways for the entirety of your life (4).

This means that it is possible to have a healthy brain after you have overcome your addiction. It is worth remembering that recovering from addiction takes a lot of patience, discipline, and support and you will not feel magically better overnight.

Your recovery will depend on the substance you were dependent on, and the level of addiction.

Before the brain can begin to recover, the body needs to be fully detoxed from the substance.

There is some uncertainty among researchers with regards to how long it takes for dopamine levels to return to normal after addiction, but most believe that it takes between 3 months and 1 year (5).

Therapies to assist the brain after an addiction

Someone battling with addiction will be offered several treatment options to help them overcome the disease, including medication, therapy, and neuropsychiatric treatment.

Neuropsychiatric treatment is a type of treatment that stimulates certain areas of your brain to re-establish normal brain function after long bouts of addiction.

Some of the main ones are:

1. Transcranial magnetic stimulation (TMS)

Transcranial Magnetic Stimulation was originally used to treat clinical depression, however, researchers discovered that it could be useful in the treatment of substance use disorders also.

It is a non-invasive treatment that can be performed at an outpatient facility. It works by connecting a device to the patient’s head and generating electrical currents towards certain parts of the brain.

Its aim is to give the patient better control over their moods, and it has been known to ease cravings (6).

2. Transcranial direct current stimulation (TDCS)

Transcranial direct current stimulation is also a non-invasive treatment that can be carried out at an outpatient facility. It is similar to TMS in that it uses electrical currents to alter brain function. Studies have shown it to be effective in reducing cravings in people with substance use disorders (7).

3. Deep brain stimulation

Deep brain stimulation seems much scarier than the previous two therapies as it includes having two small holes drilled into the skull and electrodes placed inside areas of the brain.

These electrodes are stimulated by generators that are also implanted inside the brain. This is still a rather new type of treatment but has proven to be quite successful in the reduction of cravings and the likelihood of relapse (8).

4. Biofeedback therapy

During biofeedback therapy, you will have several small electrical sensors connected to different parts of your body that sends messages back to you about your body and its functions.

It teaches you to use relaxation techniques to control how your body responds to stressful situations. It is non-invasive and is mostly carried out at an outpatient facility, however, some devices may be suitable for home use.