If you or a loved one is abusing drugs, it is natural to feel frustrated that it is not possible to simply quit cold turkey. Even with drug rehabilitation treatment, relapse may still occur. It is easy to assume that individuals who abuse drugs lack moral principles or the willpower to stop and that all they need to do is change their behavior.
In reality, however, good intentions or willpower are not enough to overcome addiction. Drug abuse affects the way the brain works, causing chemical and physiological changes that keep an individual addicted to drugs.
Understanding Addiction: Factors that Keep the Brain Addicted
According to the National Institute on Drug Abuse, addiction is a “chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite the harmful consequences to the addicted individual and to those around him or her.” While the initial decision to use drugs may be voluntary, over time, addiction changes an individual’s self-control and the ability to just “say no” to drugs.
The National Institute on Drug Abuse considers addiction to be similar to other chronic, relapsing diseases, including heart disease, asthma and diabetes. Like with these chronic diseases, it is not unusual for an individual to relapse and begin using drugs again, even after completing treatment.
Addiction and the Brain
One of the key factors causing addiction is the way drugs affect the brain. Drugs contain chemical that alter the brain’s communication system, disrupting how nerve cells typically send, receive and process information. While different drugs affect the brain differently, in general, drugs disrupt the brain by either imitating the brain’s natural chemical messengers or over-stimulating the brain’s “reward circuit”, causing an imbalance.
For example, some drugs like heroin mimic the chemical structure of neurotransmitters, which are naturally produced by the brain. These drugs trick the brain’s receptors, causing the activation of nerve cells that send abnormal messages through the brain. Other drugs, like cocaine, cause nerve cells to release abnormally large amounts of neurotransmitters like dopamine. The brain is then flooded with neurotransmitters and unable to “switch off” — leading to a constant overstimulation of the brain’s reward system. These feelings of pleasure and positive emotion reinforce the brain’s desire to abuse drugs in order to continue experiencing these euphoric emotions — leading to an ongoing patter of drug abuse and addiction.
With continued drug use, the brain adapts to these changes in chemical balance. For example, a constant surge in dopamine from cocaine use will cause the brain to produce less natural dopamine, affecting the brain’s natural reward circuit. Consequently, when an individual stops using drugs, the affects of addiction linger.
The brain is still under-producing dopamine, which means the individual experiences no pleasure in life events that once naturally brought happiness. Individuals thus return to abusing the drug in order to feel the same emotional high — leading to increased drug use. The brain is effectively addicted to the drugs.
Social and Emotional Factors Underlying Drug Addiction
In addition to the chemical issues affecting addiction, social and emotional factors can also keep an individual abusing drugs. For example, if an individual is dealing with a traumatic emotional experience, such as rape or abuse, or post traumatic stress disorder (PTSD), drugs may provide an emotional “escape” from this trauma. Social pressure from an individual’s peer group can also make it more difficult to stop using drugs. Finally, individuals who do try to quit but end up relapsing can feel frustrated and disappointed and mistakenly believe it is impossible to stop the cycle of addiction.
Relapse, however, does not mean that the treatment is a failure or that it is not possible to stop abusing drugs. Instead, relapse is an important indication that continued treatment is necessary or that an alternative treatment may be more beneficial for helping an individual to regain control. With continued treatment, long-term sobriety is possible.