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Millions of Americans are struggling with addiction to drugs or alcohol. Drugs include both illicit substances and prescription medications. Many of those affected have sought treatment while others are unable to stop abusing these substances.

Even after addiction treatment, these individuals struggle to stay sober and many of them relapse. For instance, the Institute on Drug Abuse reports that 40 to 60 percent of those treated for addiction will eventually relapse. And there’s a reason for this.

Substance abuse affects brain chemistry in a way that could leave the user addicted and dependent on the substance for the rest of their life. Comprehensive addiction treatment has shown to be the most effective way of helping an addict recover from drug or alcohol addiction. But it is hardly a guarantee that the problem will completely go away.

What is Substance Abuse?

Also known as substance use disorder, it is the repeated and frequent use of drugs or alcohol. These substances cause a psychoactive reaction and alter moods and behaviors. Eventually, the individual can become dependent on or addicted to the substance. The following are some commonly abused drugs:

Street/Illicit Drugs

  • Heroin
  • Methamphetamine
  • Cocaine
  • Marijuana

Prescription Opioids or Painkillers

  • Codeine
  • Amphetamine
  • Oxycodone
  • Hydrocodone
  • Fentanyl

What is Addiction?

Addiction is the uncontrollable and impulsive seeking and using of drugs or alcohol. It starts with use for pleasure, but once the person becomes “hooked,” they basically are no longer a master of their own mind. They may know it’s a harmful practice but are unable to quit. Other signs of addiction are:

  • Lying or stealing to get the substance
  • Increase in drug or alcohol dose
  • Uncontrollable cravings
  • Using prescription medication belonging to someone else
  • Social withdrawal
  • Negative changes in behavior e.g., aggression or hostility
  • Denying the addiction
  • Withdrawal symptoms, e.g., nausea or vomiting when they skip a dose of the substance

Effects of Drugs and Alcohol Abuse on Brain Chemistry

The difficulty people face with getting over their addiction to drugs or alcohol has to do with how these substances affect the brain. This led to addiction being classified as a brain disorder. Parts of the brain affected are:

  • The basal ganglia
  • The extended amygdala
  • The prefrontal cortex

These are parts of the brain that regulate functions such as thinking, judgment, emotions, self-control, and problem solving. The brain stem is also affected, particularly by the abuse of opiates and opioid painkillers.

Repeated use of opiates or opioids takes an effect on the natural opioid receptors in the brain. It produces a chemical surge of endorphins and other neurotransmitters in the brain. At first, it creates a pleasurable feeling, also known as a euphoria. But then, the brain begins craving for more and more of the dopamine effect.

Repeated Substance Use and the Dopamine Effect

Over time, the same amounts of drugs, or alcohol, no longer have the same effect. This forces the user to increase their dose to get that same level of high and is an underlying cause of overdose.

In fact, the user is so hooked that the need to use the substance becomes their new normal. Once dopamine, another neurotransmitter, is activated by the substance it makes the user repeatedly seek the pleasurable experience and the habit of drug or alcohol use forms.

At this point, any attempt to stop substance use will trigger some uncomfortable and often severe withdrawal symptoms. The severity of the symptoms is one of the main reasons why many people do not seek addiction treatment. However, once the person continues to reward the brain with the substance they will continue to receive the pleasurable feelings, motivation, and burst of energy in return.

This only serves to reinforce the addiction and makes it worse. The user becomes trapped in a never-ending cycle unless and until he or she seeks formal substance abuse treatment. This usually involves clinical detoxification to remove the substance from the body followed by psychotherapy to treat any underlying mental health issue associated with drug or alcohol abuse. The risk of relapse still looms since addiction is a brain disorder. Even one drink or smoke or sniff can trigger a relapse.

The Takeaway

Once a person becomes addicted to drugs or alcohol, it changes their brain chemistry in a way that makes it difficult, probably impossible, to restore it to where it was before addiction. This explains why substance abuse treatment focuses on rewiring the brain and behavioral modifications to assist the individual in staying away from drugs or alcohol. However, treatment does not cure the problem and the chance of relapse remains high for many recovering addicts.