Wasted | Part 2
How Addiction Reworks Brain Chemistry
There are a variety of factors that cause people to become addicted to drugs and alcohol: family history, mental health disorders, peer pressure, lack of family involvement, and early use. Codependency often exists in relationships where one person enables the destructive behavior of another. This is Part 2 of a brief series on addiction. You can read Part 1 below.
👋 👋 👋 I’d also like to welcome new subscribers Olwen, Laura, and Dawn…Thanks for joining our community!
Last week, I wrote about whether or not addiction is a disease or a choice.
(There’s a lot of data to consider when deciding which answer is correct. Based on the individual situation, I believe both can be true.)
Because of the interaction of genetics and environment, a person cannot be born with an alcohol use disorder. Although people can have genes that predispose them to developing an alcohol use disorder, genetics only account for approximately half of a person’s overall risk. The rest of these predispositions come from the social and environmental factors that a person encounters throughout their childhood and life.1
My ex-husband Alan was a perfect example. Both of his maternal grandparents were alcoholics. The predisposition for AUD (Alcohol Use Disorder) was already printed on his DNA. This burdened him with a 50% chance of becoming addicted before he ever took his first drink.
I didn’t grow up in his house and can only speak to what he told me and what I observed. Alan related stories of his dad using his belt to inflict corporal punishment on his children. I also heard stories of verbal humiliation towards his overweight daughter when she was a child.
I heard his dad use shame and humiliation when denigrating his sons, both of whom worked for him. He would criticize something they did at work and also their performance on the football field. Alan and his brother were standouts, which fed their father’s toxic masculinity.
For the record, their father also had good qualities. He was a hard worker and provided well for his family. Unfortunately, he felt the need to remind them of this daily.
While successful in business, he failed in parenting. Each of his children has suffered in various ways throughout their lives.
How Drugs Retrain the Brain
Despite differing opinions, there IS consensus regarding the science.
Dependence on drugs or alcohol rewires brain structure in two ways:
It interferes with how the nerve cells send, receive, and process information.
It triggers dopamine, which activates every time we do something enjoyable.
Dopamine is an important neurotransmitter and also a hormone.
Dopamine is a hormone secreted by the adrenal gland. The hypothalamus produces it in the brain, where it is referred to as a neurohormone.
Dopamine is a neurotransmitter involved in many bodily functions, from movement and memory to sleep and learning.
As a neurotransmitter, it works as a chemical messenger and communicates between nerve cells in the brain and the rest of the body.
As a neurohormone, dopamine causes blood vessels to relax and constrict and reduces insulin in the pancreas, among other things.
But its role as the “feel good” hormone is probably most well known. Specific cues trigger our reward system and cause dopamine to start flowing. 2
Sugar is one of my cues! When dopamine is activated, it makes us want to continue doing whatever ramped it up in the first place.
As the Lays brand taught us in the early sixties, “You can’t eat just one.” That applies to more than just potato chips. (See doughnuts above - 😉)
Well, with some self-control, you actually CAN eat just one, but dopamine makes it much harder.
And this process applies to more than just food.
Don’t you feel yucky without your morning coffee or tea? ☕️ ☕️
And think about smokers. They can only abstain for a short time before the nicotine craving starts.
However, compared to other triggers, mood-altering drugs cause an intensified dopamine response, causing the brain to overreact. This heightened response does not naturally stop once the behavior is initiated or completed (as is the case with natural reward behaviors such as eating or having sex). Therefore, cravings for the rewards associated with the drug continue to occur, even during drug use, which leads to compulsive, repetitive use. 3
Once the addiction develops, it causes changes in the prefrontal cortex and hippocampus. And guess what cognitive function happens in those areas?
Decision making.
Once these changes occur, willpower also changes. The brain attempts to prevent withdrawal symptoms (the physical discomfort or misery felt during non-drinking phases), including negative emotional states.
Addiction overrules common sense.
Many addicts know they have a problem and try to stop, but the fierce withdrawal symptoms cause them to relapse. Most people need professional intervention, including in-house extended rehabilitation and outside support services.
I watched my husband go through withdrawal in the ICU of a local hospital. He had to be restrained, suffering from pain, hallucinations, and delusions. I was speechless, watching his shaking hands light an imaginary cigarette and then smoking it. When I expressed my shock to the doctor, he said that before modern medicine, people often died from withdrawal symptoms.
I hope never to witness a loved one go through that again, and I hope you don’t have to either.
But at the time, I didn’t fully comprehend what Alan had been dealing with all those years that led up to this horrible outcome. Maybe if I’d seen his habit as a disease (or at least partly so), I would have responded differently.
Unfortunately, many people like Alan refuse to get the help needed to purge their bodies and minds from the grip of addiction.
While he was hospitalized, I went to my former home and hid all the alcohol in the attic. I (foolishly) believed that a near-death experience and getting clean would be enough to turn his life around.
My son brought him home after discharge, and Alan requested a few groceries and a six-pack of Budweiser. Our boy told him he would pick up the groceries, but no beer. So, Alan grabbed his keys and went to the store, once again choosing booze over everything else.
(If you or a loved one needs help, don't hesitate to contact SAMHSA. It’s an essential first step on the road to recovery.)
NEXT WEEK: I’m visiting family out of state, but I’ll share a brief selection from my Poetry is Emotion collection.
The Wasted series continues on 9/24. There are so many underlying topics related to addiction. Is there something you’d like me to include in this series? Let me know in the comments.
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Thanks for sharing these personal stories and also for the overview of addiction knowledge.
I work as a volunteer for an organization helping families whose loved ones have a severe mental illness. When addictions are paired with mental illness, the cognitive abilities of many patients who have both disorders most definitely are damaged, sometimes permanently. The subject of addiction is such an important one. Better understanding of brain function is vital to treatment and potentially positive outcomes.