The neurobiology of addiction

Seldom do we realize that all our beliefs, perceptions and behaviors are hardwired into the brain. Addictions, are also encoded into our brains, with certain structures playing an important role in the genesis of addictive behavior. Here we read about the neurobiology of addiction.

If one were making a list of all the  things that could be addictive, the list would contain mostly rewarding experiences. For example alcohol, cocaine, caffeine, nicotine, social network likes, counterstrike headshots, BF1 kills are all intensely rewarding. Despite having varied mechanisms of action and different effects, they follow a common pathway in producing addiction and dependence.

Anything that is rewarding has potential to become addictive. Exposure to novel rewards and drugs of abuse usually begins in adolescence. The brain is primed to receive rewards and modify itself to keep the rewards coming. Most people who abuse drugs or are addicted to technology believe they are in complete control, however in reality the opposite is usually true. Continue reading to learn about the secrets of the addicted brain.

As the rewards are reinforced,  behaviors change neural networks and alter gene expression in ways that make quitting  drugs and activities very difficult!

Breaking addictive behavior into three stages.

• The intoxication stage – When one is high, or indulging in pleasurable activity (playing a computer game, or receiving a like on a photo)
• The withdrawal stage – The immediate period post the high or pleasurable activity.
• The Anticipation stage – Time spent expecting the pleasurable effects of drugs or other pleasurable activities.

 

During the intoxication stage, there is a robust release of dopamine ( the pleasure hormone) in the nucleus accumbens ( a region of the brain responsible for reward), giving the user intense pleasure, proportional to the subjective “high”. The search for this pleasure now begins, with parts of the forebrain such the orbitofrontal cortex ( usually responsible for civil behavior) urging the user to go to any extent to obtain more of the drug(or more points on a video game) to experience another dopamine rush.

All of us have seen people drinking till the time they pass out and people refreshing their page every few seconds for hours on end.

Following the high, comes the low. When the pleasurable effects fade away as the drug washes out of the body, and levels of dopamine fall, leaving the user in a state of negativity. Remember that hangover, or that time when no body liked your photo?

A few hours after the negative affect stage, as the user walks by a bar, or sees someone smoking, or gets a like on a picture, there is fast increase in dopamine levels in response to anticipation of drug use which again motivates procuring behavior and use. In addicted states, the dopamine release during the anticipation of use exceeds dopamine release during drug use making it impossible for them to find the high they are looking for,  thereby leading to a never ending search for pleasure !

Everyone searches for that effect they had from their first cigarette, or their first drink or their first whiff of the magic green. It is sad that this search will never be fruitful !

Regions of the brain such as the insula ( craving for food, cocaine, cigarettes) connect bodily sensations to emotions, increasing the subjective emotional significance of drug procurement and use.

Thus continues a vicious circle wherein severe craving and intense anticipation of pleasurable effects, leads to drug use, and intoxication (which can never be as pleasurable as the time before), followed by a withdrawal and negative affect , till a environmental or personal cue triggers the anticipation phase again!

 

Even after a period of abstinence from the offending substance or activity , until the brain networks responsible for addiction are rewired, the risk of falling back into the bottomless ravine of addiction remains!

Thus screaming at someone who drinks a lot, or spends too much time on the internet isn’t going to work !  We need to break this cycle , for a substantial amount of time, till the addicted brain gets a chance to rewire itself into a non addicted state.

Being addicted does not make one a bad person, be supportive and seek help. With appropriate behavioral intervention and medications (if necessary), all addictions can be won over. If you are worried about a friend, family or loved one? Please contact us, we will do our best to help !

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