‘Can’t you see what you’re doing?’
It is not easy to live with someone who has an addiction problem. It causes damage to the whole household's mental and emotional well-being. Having someone high on his drug of choice consistently can be stressful and cause anxiety. The person can no longer fulfill a role in the family dynamics. It can also present physical danger when someone with an addiction problem lashes out or become angry or irritable.
At Largest Heart, we are often asked why someone just can't stop what they are doing. Why is addiction such as horrible thing? Why can't people see what they are doing to themselves and others? Why can’t Mom just stop?
The answer may surprise you.
Addiction is a chronic illness.
The person can’t stop.
Addiction does not happen because someone is morally weak or doesn't have willpower. It is not that the person doesn't want to stop. In many cases, it is because the person just can’t.
Years of research and investigating what substance abuse does to the brain found that addiction is an illness that changes the brain. Addiction may initially result from genes and lifestyle choices that may be part of a person’s culture or environment, but ultimately the abuse changes the brain.
In the beginning
Of course, when someone first starts to do drugs or drink, they do so happily, believing they are in control of their lives. However, in time, one needs more drugs or alcohol to get to the same level of pleasure as in the beginning. Progressive changes in the brain mean that individuals can no longer choose. They need drugs or alcohol, even if it means they can lose everything.
The pathways to addiction
There are several critical areas in the brain that help addiction to fester. Brain pathways that contain dopamine are where many substances ‘take hold’.
Dopamine is a brain chemical that carries signals from one area in the brain to another. Dopamine is often present in pathways that have to do with reward-motivated behavior.
In healthy people, dopamine is released in response to natural things such as food or exercise – in a way, saying, 'I enjoyed that!' But substance abuse hijacks dopamine pathways, telling the brain that the drug or alcohol is also 'good.' Drugs and alcohol release much more dopamine than nature intended. The constant influx of dopamine increases feelings of reward and pleasure.
Surges of dopamine interact with glutamate, the neurotransmitter that remembers what causes pleasure. The glutamate starts to form a memory of places, smells, or emotions, linking it to substance abuse. When the person encounters the ‘memory’ again, such as a particular restaurant or bar, the brain craves the same pleasure. Free will is no longer an issue here, as the neurotransmitter now dictates what happens.
The brain is not naturally wired for alcohol or drug-infused dopamine surges, and in time, it overwhelms the brain to produce less natural dopamine. As a result, the person can now tolerate much higher volumes of their substance of choice and need much more to try and get to the same level of pleasure again. This worsens the problem, creating a terrible circle of needing to take the drug to feel well and, later, increasing the dose just to get to that space. This is a compulsion.
These changes in the brain can persist for years, even if the person quits. This is why the risk of relapse is always there for an addict.
Once one understands how the brain 'assists' in addiction, one can understand why it is so hard to struggle with substance abuse. Unfortunately, Mom cannot just stop – although she might want to.
Addiction as a disease does not mean that addicts have no responsibility for what they do. Addiction can affect the brain, but people can still distinguish between right and wrong and recognize that what they are doing is harmful.
The good news is that one can manage addiction successfully with individualized treatment. There is no one-size-fits-all, and the process will take time, but it is possible. Find some more resources here on our website! We are here to help.