“But the thing about remembering is that you don’t forget.”
― Tim O’Brien, The Things They Carried
While addiction is viewed in most corners of the treatment and recovery communities (including the American Society of Addiction Medicine) as a chronic and relapsing brain disease, as I have pointed out in previous posts, this is usually a difficult idea for families and friend of addicts to accept. It is particularly hard when relapse occurs after a long period of sobriety. Loved ones wonder how a loss of control can occur when life has been normal and predictable for an extended period of time. It seems as though the addict made a terrible choice, with no thought at all about the impact such an eventful decision would have on everyone else. Is that the case? Yet another complicated question, but it is important to understand that, even after extended periods of sobriety and stability, brain structure and brain chemistry still matter. (Please continue reading)
Animal studies and imaging studies of the human brain have taught us that all natural reinforcerssuch as food and sex, and all psychoactive drugs increase the production of dopamine in the nucleus accumbens, which is a structure in the basal forebrain sometimes referred to as the brain’s“pleasure center”. When this part of the brain receives a massive hit of dopamine from the ingestion of a drug, the user feels high, and the experience of this huge reward constitutes a powerful learning experience. Repeated experiences of intense reward eventually make other parts of life far less interesting and important to the brain than the pursuit and use of addictive substances and activities. Moreover and very importantly, the flow of dopamine to the nucleus accumbens increases not only when the addict is using a drug, but when the addict’s brain anticipates receiving it because it is coming into contact with cues that are associated with use. This is why 12-step programs remind people in recovery to avoid “slippery people places and things”. Those slippery entities are paving the way to relapse by priming the brain with a dopamine rush.