Addiction: The Brain Disease

By Terence T. Gorski

woman with happy and sad face

Addiction is a brain disease. The use of alcohol and other drugs causes three abnormal addictive brain responses. These three addictive brain responses make it easy for addicted people to keep using alcohol or other drugs while making it difficult for them to stop and stay stopped.

The Addictive Brain Response

When addicted people use alcohol or other drugs they experience an Addictive Brain Response that:
• Floods the brain with pleasure chemicals that make them feel an intense sense of pleasure called euphoria.
• Deprives the brain of warning chemicals, which takes away feelings of stress, anxiety, and fear.
• When they stop using alcohol and other drugs, the brain does not just go back to normal.

There is a rebound in brain chemistry that causes the levels of pleasure chemicals in the brain to go up and down in a chaotic and unpredictable way.

Brain Chemistry Fluctuations

First, the brain stops producing the pleasure chemicals that are flooding the brain. This causes the level of pleasure chemicals to drop rapidly. They often drop so fast that they go below the normal level before the brain turns production back on. When the pleasure chemicals drop too low the addict feels a sense of agitated depression.

When the brain registers that the level of pleasure chemical is too low, the brain turns the production of the pleasure chemicals back on. This causes the level of warning chemicals to rapidly increase.

The pleasure chemicals often rise above normal levels before the brain slows down production. This creates a feeling of euphoria. When the pleasure chemicals drop, the brain produces high levels of warning chemicals that create fear and anxiety. When the brain registers the high level of warning chemicals, it slows down the production of the warning chemicals and increases the production of the pleasure chemicals. The changing brain chemistry pattern causes the person to fluctuate between periods of euphoria and then suddenly crash in periods of agitated depression which then cycles back to euphoria. With each cycle the brain begins stabilizing and returning to normal, but it can take several days of abstinence.

This period is when the brain chemistry is unstable and fluctuating. The brain swings from not having enough pleasure chemicals to feel normal, to having a flood of pleasure chemicals that make them euphoric. At the same time, the brain swings from having so many warning chemicals that we feel paranoid and hyper vigilant; to having too few warning chemicals that make us feel an unrealistic sense of courage and confidence.

This process keeps reversing itself. The pleasure chemicals spike back up creating a sudden sense of well being and the warning chemicals drop back down taking away stress, anxiety, and fear.

Levels of brain chemicals keep shifting back and forth from too high to too low until the brain eventually gets back into a normal balance. These fluctuations in brain chemistry make people feel agitated and depressed. It makes it hard to think clearly and causes difficulties solving usually simple problems. Emotionally, people shift from being over reactive to feeling numb. This causes trouble-controlling behavior and may cause people to do things that they normally would not do. They experience memory problems and have trouble sleeping restfully. As addicted people use more alcohol and other drugs over a longer period, their symptoms keep getting worse and lasting longer.

The feeling of euphoria caused by alcohol or other drug use makes it hard for addicted people to believe that alcohol or other drugs are damaging the brain. The symptoms of progressive brain dysfunction become clear when addicted people try to stop using alcohol or other drugs. They experience craving, irritability, difficulty thinking clearly, difficulty sleeping, and agitated depression when they stop using.

There is often a progression from use, to abuse, to addiction. Here is how it works:

• Non-Problem Use: Addicted people often start using alcohol or other drugs in a casual and infrequent way that does not cause problems.

• Frequent & Heavy Use: The euphoric response feels so good that people at risk of getting addicted start using more often. They start to need to use more alcohol or other drugs to get the euphoric feeling they want. This is called tolerance. They are using alcohol and other drugs for the euphoric effect and stop paying attention to how much they are using.

• Abuse (Use That Causes Problems): As the quantity and frequency of alcohol and drug use increases, people slowly start to have problems. They gradually move into a pattern of abuse. Remember, abuse is using alcohol and other drugs in a way that causes problems. Typically, these problems begin to affect family members, friends, and their work.

• Addiction: They continue to use frequently and heavily until the alcohol or other drugs cause permanent changes in brain chemistry. Once the addiction is activated, there is no turning back. The addiction takes on a life of its own and will continue to progress through three predictable stages: Early, Middle, and Chronic, as long as the person keeps using alcohol and other drugs.

The early stage of addiction is marked by a growing dependency on alcohol and other drugs. Early stage addicts are still able to feel good and function well. There are no serious problems so they see no need to cut back or stop. Their growing tolerance is forcing them to use more to get the same effect. Their high tolerance let’s them use more without becoming intoxicated or having other noticeable problems. People in the early stage of addiction are often viewed by others as heavy social drinkers or recreational drug users who can handle alcohol and other drugs better than most people.

The middle stages of addiction are marked by a progressive loss of control. Sometimes when they start using, everything goes well. At other times they use more than they intended to use to get the euphoric effect they want. Sometimes they use in moderation without getting into trouble or doing anything that they are ashamed or embarrassed about later. At other times, however, they lose control, use more than they intended to use, and keep using for longer periods than they planned. Sometimes they miss important events because they lose track of time. Their judgment is impaired so they do things while drinking and drugging that they never intended to do. As a result, they start having problems and feeling guilty and ashamed. This starts to happen more often, but there are still times when they can use without losing control and getting into trouble.

As the alcohol and drug-related problems become more severe, addicted people start to get scared, but are still having some good times. They become conflicted. A part of them thinks they might have a problem and should cut back or stop. Another part of them remembers how good it feels to use and how many times they have used in the past without getting into trouble.

They start having difficulty thinking clearly and avoid talking about their alcohol and other drug use or related problems whenever possible. If someone asks them about it or points out the problems they are having they get uncomfortable, change the subject, or tell
outright lies. This is the beginning of serious problems with denial.

At this stage addicted people begin avoiding sober and responsible people who tell them the truth. They start surrounding themselves with people who use alcohol and other drugs frequently and heavily.

When they do have problems they deny them or rationalize them away. They start making solemn promises to themselves and others to stop, cut back, and to clean up their act. “I’ll never get that drunk or stoned again,” they promise themselves. They never define exactly how much is “that much.” Therefore, when it happens again, they can rationalize the problem away. Then they forget about it, and forget that they forgot. This creates the illusion that the problem never happened. In reality, however, the problems are happening
and they are getting worse.

Finally, addiction moves into the Late (Chronic) Stages that are marked by progressive physical, psychological, and social deterioration. Late stage addicts start having serious alcohol and other drug-related health problems that keep getting worse.

Psychologically, they are constantly feeling cravings, drug-induced euphoria, intoxication, anger, fear, guilt, shame, and pain. They don’t want to think or talk about their addiction so they push other people away and start isolating themselves. If their friends or family gets concerned, they brush them off, tell them some convenient lies, and give them the clear message to mind their own business.

They try to stop but can’t stay stopped. This destroys their self-confidence and self-worth. They start feeling ashamed of themselves and go underground. They try to hide what is
happening, but by this time they are having serious physical, psychological, and social problems that are starting to catch up with them. They are having serious problems on the job or at school. The cost of maintaining their addiction is causing serious financial problems. They may also be having legal problems such as being caught drinking or drugging on the job, getting arrested for driving under the influence, or possessing and using illegal drugs.

Prescription drug addicts use more than prescribed and start using more than one doctor to get the same prescription or they order additional medication on the Internet.

The problems keep getting worse until one of four things happens:
(1) They die as a result of alcohol or other drug-related illness, violence, or accidents; (2) They commit suicide to end the pain, (3) They get put in jail or committed to a mental institution; or (4) They get into recovery from addiction.

References provided upon request.

Terence T. Gorski is the Founder and President, The CENAPS Corporation. He is an internationally recognized expert on substance abuse, mental health, violence, & crime. He is best known for his contributions to relapse prevention, managing chemically dependent
offenders and developing community-based teams for managing the problems of alcohol, drugs, violence, and crime. He is a prolific author and has published numerous books and articles.