How an Addicted Brain Works

Summary: Addiction occurs as a result of the reward system becoming overwhelmed in a way that leads to chronic and permanent alterations in the brain.

Source: Yale

Addiction is now understood to be a brain disease. Whether it’s alcohol, prescription pain pills, nicotine, gambling, or something else, overcoming an addiction isn’t as simple as just stopping or exercising greater control over impulses.

That’s because addiction develops when the pleasure circuits in the brain get overwhelmed, in a way that can become chronic and sometimes even permanent. This is what’s at play when you hear about reward “systems” or “pathways” and the role of dopamine when it comes to addiction. But what does any of that really mean?

One of the most primitive parts of the brain, the reward system, developed as a way to reinforce behaviors we need to survive—such as eating. When we eat foods, the reward pathways activate a chemical called dopamine, which, in turn, releases a jolt of satisfaction. This encourages you to eat again in the future.

When a person develops an addiction to a substance, it’s because the brain has started to change. This happens because addictive substances trigger an outsized response when they reach the brain. Instead of a simple, pleasurable surge of dopamine, many drugs of abuse—such as opioids, cocaine, or nicotine—cause dopamine to flood the reward pathway, 10 times more than a natural reward.

Credit: Yale

The brain remembers this surge and associates it with the addictive substance. However, with chronic use of the substance, over time the brain’s circuits adapt and become less sensitive to dopamine. Achieving that pleasurable sensation becomes increasingly important, but at the same time, you build tolerance and need more and more of that substance to generate the level of high you crave.

Addiction can also cause problems with focus, memory, and learning, not to mention decision-making and judgment. Seeking drugs, therefore, is driven by habit—and not conscious, rational decisions.

This shows a brain
One of the most primitive parts of the brain, the reward system, developed as a way to reinforce behaviors we need to survive—such as eating. Image is in the public domain

Unfortunately, the belief that people with addictions are simply making bad choices pervades. Furthermore, the use of stigmatizing language, such as “junkie” and “addict” and getting “clean,” often creates barriers when it comes to accessing treatment. There’s also stigma that surrounds treatment methods, creating additional challenges.

Though treatment modalities differ based on an individual’s history and the particular addiction he or she has developed, medications can make all the difference.

“A lot of people think that the goal of treatment for opioid use disorder, for example, is not taking any medication at all,” says David A. Fiellin, MD, a Yale Medicine primary care and addiction medicine specialist.

“Research shows that medication-based treatments are the most effective treatment. Opioid use disorder is a medical condition just like depression, diabetes or hypertension, and as with those conditions, it is most effectively treated with a combination of medication and counseling.”

About this addiction research news

Author: Press Office
Source: Yale
Contact: Press Office – Yale
Image: The image is in the public domain

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  1. Every person has more parts in self , every stimulans make change in brain and body. You can choice what is best mood for you is in particular situation. Knowledge, awareness and action can develop better knowledge of themselves and equally self-management. The goal, the result like you want is equals the ability to manage yourself. Learn to drive a machine

  2. The best and most effective treatment for any addiction is psychedelics. Why this isn’t more widely known already is ridiculous, I’ve personally witnessed people overcoming addiction with the use of magic mushrooms, ayahuasca, lsd. Ibogaine is particularly useful for those with opiate addictions, it can “cure” an opiate addiction in a matter of hours with no withdrawal side effects

    1. i·bo·ga·ine

      a hallucinogenic compound derived from the roots of a West African shrub, sometimes used as a treatment for heroin or cocaine addiction.

  3. Dopamine as the reward system is beginning to get a bit outdated. From the newer research (and experience) it would seem to be more accurate to call it the “desire” or “seeking” system. It can’t be satisfied – that next bit that’s just around the corner is what is being looked for!

    Although once that bit arrives it doesn’t satisfy either – because you can’t satisfy or satiate desire. You keep on seeking. The dopamine is the signal that the reward is coming, moreso than the actual reward itself.

    So when that next dopamine hit comes in, it’s telling you that the reward is just around the corner! One more drink, hit, bite, trigger-of-choice. That will be the one that satiates you and is the perfect thing you are looking for!

    It would be much easier if it were a reward. A reward can satiate. Desire… Just keeps on being around the corner.

    I forget my sources, but they’re multiple, and they’re out there. I’m pretty sure “desire system” is the right term I’m pulling from memory from a few books and research. There also some very interesting gambling studies based on dopamine signals and when they occur!

    1. If a person living with chronic pain, from a chronic degenerative desease has to take painkillers daily, but still refuses to increase the dosage in order to minimize level of addiction, and sides effects, and fear that one day the little help that there is will be taken away because someone, (activist or polition playing Dr, whatever) decides anyone using painkillers is an addict and turns it into an illigal substance – or one so heavily controlled those who have a legitimate need can no longer get the medicine (or what Dr’s have told this person is a legitimate need)…that’s doesn’t sound like an addiction to me. This person is clearly in increasing pain, but still refuses to increase the dosage, a level that is about half the currently alloud level. So what do you think, is this person addicted just because its pain killers?? (yes, itsclassified as an opiate) Because it’s opiates does that always, automatically mean it’s being “abused?

      1. Well, because it’s an opiate if it’s taken for any amount of extended time (I think I was told 4-6 days was what they were “meant” for . . Surgery & injury), so regardless of how little you take or how restrained you are you’re body WILL become DEPENDENT on them & you will have withdrawals when you try to stop them, there’s no way around it!! Now you ask is this person “addicted” just because it’s a pain killer . . . To be completely honest, yes this person is most likely addicted, but they are 100% without a doubt physically dependant upon them . . . You then conclude by asking just because it’s an opiate does that mean they’re just automatically abusing it; and this my friend it that oh so very fine line in the sand . . . You can be a responsible patient who is physically dependant on your meds but it’s not until you start “abusing” them that you’ll be able to graduate to official addict!!! However, at the end of the day the responsible patient will be just as sick as the abusing addict if they haven’t had their meds on schedule . . Dope sick is dope sick no matter how ya try to paint it unfortunately!! I too started very responsibly in my drs office 12-15 yrs ago . . . It’s a hell of a beast that deserves far more respect than it’s given 😞

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