When it comes to the biological roots of addiction, the brain takes the center stage. Marijuana, cocaine, opioids, and other substances interact with the pleasure center of the brain, leading to long-term reliance on substances to feel euphoria, or even to feel normal. This reliance is a result of the brain becoming accustomed to the large rushes of neurotransmitters provided by the substances, as well as their impact on the pleasure center of the brain.
One of the neurotransmitters that are commonly affected by substance use is dopamine. Dopamine is released in the brain when a pleasurable activity happens, telling the brain that the pleasurable activity is something that should be repeated. This happens when any kind of pleasurable activity happens, such as eating, socializing, or doing other things that are essential for survival. The release of dopamine ultimately forms habits of things that are pleasurable, as feeling pleasure from these behaviors tells the brain that they should be repeated. However, when someone uses an addictive substance, there is much more dopamine released than there is with normal activities. As a result, the desire to repeat the use of the addictive substance is stronger than it would be with typical activities, leading to an addiction.
Long-term use of addictive substances has other impacts on the pleasure center of the brain as well. The brain becomes used to the repeated over activation of the pleasure center of the brain, and as a result, it becomes less sensitive to other pleasurable activities, relying on the substance for the stimulation that they would normally be able to get through other activities. Because users get so accustomed to the stimulation coming from the substance, they end up needing more of it to feel the same high, as well as needing the substance merely to relieve the temporary discomfort that is normally experienced. Long-term use of addictive substances can have a variety of adverse effects on the brain, such as impairing impulse control, making it harder for users to control compulsive behaviors, and hindering basic neurological processes like coordination, memory, and learning.
The safest and most effective way to treat the biological aspects of addiction is to start with medical detox from the substances. Medical detox usually lasts for several days to two weeks and provides 24-hour medical and psychological supervision for the user as they come off the substances they have been using. Medical detox is safer than stopping a substance “cold turkey”, especially with substances like opioids and benzodiazepines, which might require weaning and the help of long-acting agonist medication to come off safely. The ultimate goal of most medical detox programs is to help the user to become medically stable enough to participate in long-term substance abuse treatment programs. These could be outpatient programs with extensive community support, or inpatient or residential treatment programs that could last 90 or more days. These long-term treatment options allow the brain to repair the damage of extensive substance use and develop new habits and neural connections. Substance abuse treatment often includes a wide range of therapies such as individual behavioral therapy and medication-assisted treatment, as well as community support such as 12-Step groups.
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