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Myths undermining recovery part 3: Addiction is a choice

Deliberate self-destruction, a character flaw and weak morals are some of the many stereotypes those with addictions endure. It is important to realize that addiction is none of the above.

It is a brain disease and it requires treatment.

The American Society of Addiction Medicine essentially defines addiction as a chronic disease that affects the brain’s reward, motivation, memory and related circuitry. Such dysfunctions in the brain lead to long-standing consequences that encompass biological, psychological, social and spiritual aspects.

The brain registers pleasure through the release of the neurotransmitter dopamine in the brain. All illicit drugs are responsible for creating a surge of dopamine. The likelihood of addiction from a particular substance depends on the speed, intensity and reliability of that release.

Dopamine interacts with another neurotransmitter called glutamate to overtake the brain’s system of reward-related learning, which links activities necessary for human survival with pleasure and reward. Addictive substances stimulate and overload the same circuits that involve areas of motivation, memory and pleasure. Repeated exposure to an addictive substance causes nerve cells in the prefrontal cortex (the area of the brain involved in planning and executing tasks) to alter liking something with obsessing over it.

Eventually a tolerance is developed as addictive drugs provide a shortcut to natural rewards, overwhelming the brain receptors with an increased influx of dopamine. The brain, as a response, produces less dopamine or eliminates dopamine receptors causing an individual to increase the amount of an addictive substance.

Ultimately, compulsions take over. Even after the pleasure associated with the addictive substance subsides, the need to recreate the effect and its memory remains. These cravings are responsible not just for developing an addiction, but also for a relapse.

Dr. David Jentsch, alongside his colleagues at the University of California, Los Angeles (UCLA), conducted a study to depict how chronic drug use influences one’s ability to quit. The study involved exposing seven adult male monkeys to increasing doses of methamphetamine over a course of 31 days. The monkeys’ cognition was closely monitored before, during and after the methamphetamine exposure through magnetic resonance images (MRI) of the brain before and after the exposure.

Prior to methamphetamine exposure, the experimental monkeys’ performance, regarding exercises involving inhibitory control, was as good as that of the seven control monkeys that received only saline injections. When retested after three weeks of methamphetamine exposure, their performance had declined significantly.

Similarly, the MRIs of the experimental monkeys’ putamen that initially matched those of the control monkeys’ prior to methamphetamine exposure differed afterwards. Significant increases in gray matter in the right putamen were noticed.

Dr. Jentsch noted the reduced gray matter, which occurs in human users, further weakened the inhibitory control over habitual responses.

“Methamphetamine dependence is currently a problem with no good medical treatments,” Dr. Jentsch said. “When you say a disease like methamphetamine dependence is costly, it’s not just costing money, but lives, productivity, happiness and joy. Its impact bleeds through families and society.”

Every year, the abuse of illegal drugs and alcohol causes the death of more than 100,000 people in the U.S., according to the National Institute on Drug Abuse. Many hesitate to seek treatment due to misperceptions and biased judgments. The 24/7 Recovery Helpline connects those in need with treatment programs and facilities to help them break free of addiction. If you or a loved one currently seeks recovery, call us right away at 855-441-4405.

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