It takes two elemental factors to produce an addicted individual… First, it takes a substance or behavior that stimulates the reward center of the brain. The reward center is located in an area called the limbic system, in the midbrain. The midbrain lies below the prefrontal cortex, under the “thinking” brain that thinks consciously and makes decisions. Stimulating the brain reward center requires an action (for example, eating or sex) or the ingestion of a substance via smoking, swallowing, snorting, or injecting that is experienced as “rewarding,” or in other words, pleasurable. Broccoli and aspirin don’t stimulate the reward center of the brain, but alcohol, marijuana, xanax, Valium, heroin, opioid pain medications, cocaine, and crystal meth do. Food, chocolate, and sex all stimulate that part of your brain, but certain drugs actually “hijack” the reward center by causing the brain to release excessive amount of chemicals (called neurotransmitters), resulting in a much higher level of pleasure than the normal everyday things that people generally get pleasure from. The second elemental factor is that with enough time and experience using mind-and mood-altering substances, the brain chemistry of the now-addicted person is so out of balance that he or she can no longer derive pleasure from normally pleasurable activities. The addict has stimulated his or her brain so much with extraordinarily chemically rewarding substances that life’s normal, everyday pleasures are no longer rewarding. Drugs end up displacing the normally pleasurable activities of eating, drinking, and having sex. Drugs distort the functioning of the brain’s reward center to the point that addicted persons believe they have to take them in order to survive. Only abstinence over time in recovery can return them to what is called allostasis, or a steady state in the brain. Allostasis refers to the ongoing adaptive efforts of the body to maintain stability (homeostasis) in response to stressors. It takes both of those components to turn a nonaddicted person (a cucumber, to use our analogy from the first chapter) into someone who is addicted (a pickle), plus several other factors we don’t fully understand. we know that addiction is partly genetic. Research generally seems to indicate that addiction has about a 65 percent genetic component and a 35 percent environmental and interactional component. Thirty-five years of experience in addiction treatment leads me to believe that the genetic influence is greater than that, but these are the figures most often cited. This blog post is an excerpt from The therapist’s Guide to Addiction Medicine – A Handbook for Addiction Counselors and Therapists – by Barry Solof, MD, FASAM; Published by Central Recovery Press (CRP).
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