Hi again, teasle asked me about something I posted earlier on the thread, about permanent changes in the brain of an alcohol dependent person. This is an article which goes into the science behind it, it's a bit technical but I found it encompasses many things I've posted before:
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Addiction: what is it?
A famous public speaker once said "An addiction is a pathological relationship with a mood-altering activity with life-damaging consequences." That is a pretty good description of the biopsychosocial disorder, substance dependence.
Addictions are common disorders. Not everyone is susceptible to them. Nobody intentionally becomes addicted. The greatest problem with this chronic, progressive, and sometimes fatal disease is that it tells you you haven't got it. It's called "denial," "projection," "rationalization," or "intellectualization."
Neurobiology of addictions
Addiction is a disorder or disease of the brain. The parts of the brain responsible for reward, pleasure, and reinforcement simply don't work well enough in the addicted person. This condition is thought to be either genetically acquired or due to environmental stressors combined with prolonged or excessive ingestion of the addictive substance. Addiction-prone people are said to lack "hedonic tone." This means they spend more time feeling bad and are more likely to experience negative emotions such as dysphoria, anxiety, and feelings of depression. They are unable to comfort or soothe themselves. They discover, usually in their teens, that certain substances, such as alcohol, marijuana, stimulants, sedatives, narcotic analgesics, and nicotine make them feel better, even normal for a while. The problem is that over time the brain adapts, a process called "neuroadaptation," which changes the structure, function, and chemistry of the brain. And so tolerance develops: it takes more drug to get the same effect. It becomes nearly impossible to get high. When they try to stop they feel much more dysphoria, anxiety, or depression. Some of this neuroadaptation is reversible, but with prolonged, high-dose use of certain drugs, some of it may be permanent.
The pathology responsible for predisposition addiction is located in the mesolimbic portion of the central nervous system, however, like other complex chronic progressive illnesses, there are components of addictive disorders that involve psychological and social domains. Environmental exposure to the drug, cultural norms about use of the drug, emotional trauma, stressors, psychological makeup, and psychiatric problems can all serve as contributing risk factors, along with genetics, probably the greatest risk factor.
As the disorder progresses, psychological and psychiatric problems manifest and interpersonal problems worsen. So, although the biomedical disorder is located in the brain, substance dependence is biopsychosocial and spiritual in its cause and its manifestations. In order to successfully treat addictions, the most effective approach should incorporate biological, psychological, and social strategies and changes.
Author: Ray Baker, MD