© 2018 Independent Recovery Solutions LLC; West Palm Beach, FL

Reward and Addiction


Addiction is a complicated disorder that hijacks proper functioning of the individual’s brain.  How does this happen though?  Why can’t those who abuse drugs and alcohol regulate this behavior properly and make a decision to quit?  We will attempt to briefly explain this phenomenon.





Reward


The brain is a complex organ which sends electrical impulses to guide behavior.  The area of the brain that does this is a much older part of the brain, which is the midbrain.  The midbrain can be best understood by considering less evolved organisms such as a fish.  Fish are like swimming midbrains, eat that, mate that, run away from that, and kill that.  This is all done instinctually and without conscious thought or decision.  These organisms are not sentient and are not aware that they are performing these functions.  Humans, and perhaps some other mammals, have developed a large frontal cortex which regulates these instinctual impulses, which is what allows us to have our organized societies and culture.  Without this regulation, we would be walking midbrains, eating, killing, and mating, depending on what our brain thinks we need.  This would be chaos.



Dopamine


So, how does the brain know how to not act out on these impulses?  Well, the brain uses dopamine to train you.  Inputs and behaviors release amounts of dopamine and are prioritized hierarchically depending on the amount of dopamine released.  This is why calorically dense foods like pizza, fried food, and dessert are so good.  It is not because they have an intrinsic taste that is good, it is because your brain has assigned them higher survival value.  Your brain has literally instructed you to think that something “tastes better.”  Fat has nine calories per gram, while carbohydrates and protein have four.  To ensure that you eat as much fat as possible and increase your chances of survival, the brain has made them taste better (this is from a purely caloric/energy standpoint).  Think about it.  A potato is good, but it’s just a potato, and is mainly carbohydrates.  Fry it into a chip, and it suddenly becomes really good and you can eat the whole bag without a thought.  Or bake it and slather it with butter, sour cream, and bacon, and it becomes much better than a baked potato.  Why does full fat milk taste better than skim milk?  Fat!


This all may seem very simple, but this is how the brain teaches you to survive.  The problem is substances and addictive behaviors break this system.  This system is not perfect, and some substances and behaviors become assigned a very high survival value and the brain releases large amounts of dopamine to ensure that it is acquired.  This means that individuals will prioritize substance use or the behavior over everything else in their life, because while fat is better than carbohydrates, heroin or gambling is better than fat.  The ironic nature of this situation is tragic, because these substances and behaviors are not worthy of this survival value.  They do not provide an actual reward that is helpful to survival.  In fact, with substance use, this could lead to overdose due to excessive use, or organ failure due to prolonged use.  This is what makes addiction so complicated is that the brain fights back because it thinks the substance or the behavior are paramount for survival, even if the individual knows logically it is not and that it may be killing them.



Repairing Damage


Once this system is compromised, it becomes very difficult to fix.  As previously discussed, the brain fights back because of its need to survive.  The only way to correct this is to remove all substances from the body for a period of time and allow the brain to heal.  This typically occurs with a brain state called anhedonia and this is a very difficult experience.  Due to chronic drug or behavioral abuse, ordinary pleasures are no longer pleasurable, which leads to frequent relapse to substances or behaviors.  Often individuals will act out on lesser substances or behaviors, such as caffeine, nicotine, or sex.  These cross-addictive behaviors should be minimized as well, to allow the brain to heal quickly.  In addition to removal of substances, behavioral and motivational change must occur as well.  This will best be accomplished with counseling and concurrent 12-step or support group-based assistance.



Independent Recovery


At Independent Recovery, we are strong advocates for 12-step based programs, but we are also advocates for counseling and science.  We believe that educating individuals and families about the nature of substance use is important.  If you would like to be educated more about substance use, please reach out to us for a free consultation.  We are happy to provide you with some information about substance use and addictive behaviors, as well as our services.  So, head on over to your Get Started page and we will be in touch with you shortly!