MONTHLY BLOG SIX APRIL 2024

Addiction

Last month’s blog referred to addiction so perhaps more information may be of help in understanding it. Addiction is a complex phenomenon that involves both psychological and biological factors. It is a progressive disorder characterized by compelling and repetitive engagement in a substance or behaviour, despite negative consequences.

So, individuals with addiction may use substances such as alcohol, inhalants, opioids, cocaine, and nicotine. Addiction can also manifest through behaviours like gambling. Some key features of addiction include a person becoming reliant on the substance or behaviour and over time, the body adapts, leading to increased tolerance. Then, when the substance or behaviour is discontinued, withdrawal symptoms will often occur.

Neurotransmitters

The importance of neurotransmitters cannot be over-estimated. They are chemical messengers throughout your vast network of nerves and your body cannot function without them. They engage in everything you do, think and feel.

Your nervous system controls such functions as your:

• Heartbeat and blood pressure.
• Breathing.
• Muscle movements.
• Thoughts, memory, learning and feelings.
• Sleep, healing and aging.
• Stress response.
• Hormone regulation.
• Digestion, sense of hunger and thirst.
• Senses (response to what you see, hear, feel, touch and taste)

Neurotransmitter – Dopamine.

The star player in addiction is a neurotransmitter called dopamine. When abusive drugs are consumed or compulsive behaviour is engaged in, they directly stimulate the brain’s reward centre, leading to a rapid release of dopamine. Known as the pleasure transmitter dopamine encourages repetition, effectively hacking the brain to create a direct and addictive path to feeling good ¹.

Dealing with addiction

Given the power of dopamine, there is no magic drug that will remove addiction easily. The anxiety caused by withdrawal will usually be helped with a doctor’s prescription, but the real goal is called restoring the body’s natural level balance (homeostasis). In her book, ‘dopamine nation,’ Dr Anna Lembke, tells a patient that she would like him to do something really hard i.e. stop using cannabis for a month.  This will be hard because a patient will feel worse at first.

After a month or six weeks, Dr Lembke notes that medical opinion is divided for less severe forms of addiction where a patient might return to using their drug in a more controlled way. In the case of alcohol addiction Dr Lembke says that ‘for decades the wisdom of alcoholics anonymous dictated that abstinence is the only option for people with addiction.’  The implication seems obvious i.e. whatever the severity of addiction, it is sensible to engage the support of a medical practitioner trained and/or experienced in helping the addictive.

All book extracts are shown in italics.

This blog has extracts from: ‘dopamine nation’ by Dr Anna Lembke. Penguin Random House 2021.

And Addiction and the Brain in Psychology Today.