Addiction Masterclass: Your Brain On Addiction

If everything is merely a neurochemical process in our brains, that means addiction is as well. I'm Evan. I'm your resident mental health and addiction therapist, and this is my addiction masterclass. Today, I'm going to break down the reward system in our brain and how these brain processes contribute to addiction and substance use disorders. What makes our brain so spectacular is that it's different parts working together to help us with survival. And for human beings, what makes us different is the development of our prefrontal cortex, the part of our brain that makes us uniquely human, the part of our brain that lets us learn, strategize, think ahead, mathematics, art, higher functioning, and reasoning.

And when it comes to addiction, what happens is pretty interesting. Whereas there's often a malfunction in our prefrontal cortex, but also in the deeper part of our brains. As the great scientist and scientific educator Carl Sagan once put it in his pivotal series, Cosmos, our brain evolved from the inside out, and that outward part is the prefrontal cortex. But the deepest part of our brain, the part of our brain we share with the reptiles, is known as the midbrain. This part of our brain is all about survival.

It's all about finding food, water, shelter. This part of our brain drives our basic bodily functions that we're unconscious of. However, it also drives our behaviors to do these things that feel good immediately and that are pro survival and pushing the species forward. Now, when it comes to the midbrain, there's also a malfunctioning process. When it comes to addiction, the best way to think about it, in my opinion, is a stoplight. The midbrain acts as the green light, telling us to do things that are pro survival.

And the prefrontal cortex is like the red light. It's the adult in the room tells us, hey, we need to pump the brakes, and we need to regulate this. For example, my green light in brain, my midbrain, may say, hey, eat that whole bag of chips. This cheeseburger, it feels really good. And it's pro survival because I need to eat, I need to store fat for calories. However, the red light in my brain knows that, hey, I know I have access to food, and if I eat too much, I'll actually be unhealthy in the long term.

Therefore, I regulate. Now, as you know, this may be a difficult process. Sometimes that balance is out of whack, because we need both things to work together to be optimally healthy and happy. The further, the deeper we get into addiction, the balance gets thrown off. Let's talk about it. As people dive deeper and deeper into a substance addiction, the brain is essentially tricked. It thinks that it needs that substance for survival. Therefore, the green light gets turned on more and more, and it's more powerful.

And that red light is not able to turn down. It becomes weakened. And even that red light, part of our brain sometimes starts to go with the flow. The whole system is like, this is very pleasurable, and therefore, there's much less of an incentive to stop. It becomes more rewarding than even food and sex. These basic functions for survival and pushing the species forward. That's how powerful substances are. That's why people may lose a lot of weight, or they give up every single thing they have in their life.

In pursuit of this purpose of finding this ultimate survival tool. Now, it's important to know that there is one neurochemical that is most associated with addiction and the survival process, and that is dopamine. Dopamine is that chemical associated with the green light. It's seeking things that are immediately gratifying, reinforcing. It also is a little bit more complicated that it has functions as far as our motor movements as well. But one of the main things it does is it helps anticipate reward.

If I know a reward is coming, it gives me a pleasurable feeling. Activities, behaviors, and substances that are most addictive tend to be ones that release the highest levels of dopamine. For example, heroin and methamphetamines release some of the highest levels of dopamine of any substance. And this is one of the reasons why it. It's so highly addictive. Now, the more an individual use substances, it essentially gets reinforced in the brain, and we form new neural pathways. Now, neural pathways and connections are how we learn new skills and behaviors and continue to repeat them.

For example, if I'm learning a new sport or a new language, those neural pathways slowly grow. And the more competent I become in something, the more developed they are and the better I am at doing it. Now, the same thing happens with addiction. The more I reinforce that neural pathway of using dopamine related substances to feel pleasure or for survival. They become more in depth. And the more in depth and complex and larger they grow, the harder it is to change those. I like to think of neural pathways like plants, because they often look like that in the brain.

When you hook someone up to a brain scan and you have them do a certain task and switch tasks, you'll see different parts of the brain light up. So a neural pathway is like a plant, where the more you feed it, the more it grows. And when it comes to addiction, the more of a neural pathway you have, the more your brain compels you to use it, the more that green light comes on, which is essentially asking you to feed it. And the more you feed it, the more it grows. And eventually, I think of those plants as having, like, little heads on them that grow.

Those heads are like babies, right? They cry, and they want you to feed them with more substances. And the more there are, the more they yell at you, the louder that noise is, and the more you want to feed it. And that process is known as withdrawal. Your body crying out in pain because it needs that substance, because that's what it's used to, that's what it's learned, that's what it thinks it needs. And therefore, your body readjusts, but not in a good way, because substances are a false means of survival.

Yet they are so powerful now, with these new neural pathways in the midbrain running the show, it becomes much more difficult to focus on other areas of your life, because so much energy is put into this false means of survival. And that's why you give up everything the deeper you go into addiction and why you keep using it despite the consequences. Because once you stop, it is extremely painful. If dopamine is pleasure, then pain and stress are what tell you to stop doing something or telling you to do something that it thinks you need to survive and therefore causes pain.

And that is the green and red light and why it could be so difficult for people to form new neural pathways. Now, the beauty of recovery is that we're able to form new neural pathways. We're able to shift the energy out of those ones that are self destructive and immediately gratifying, and put those towards pro recovery, things like forming new connections or going to therapy. And the more we do that, the more we strengthen the healthy ones and the more we weaken the ones that were built over time.

Now, this is a difficult process, but once you're able to get through those early stages, where those voices are crying out, if you don't feed them, they get quieter and quieter. They never go away. When you form that pathway, it's always there. However, it is much less strengthened. And the process of relapse, unfortunately, is when you start feeding those pathways again, they're already carved out. So you pretty much go back to the way that it was and continue to make them deeper. And that's why it's so important to continue feeding the healthy, positive pathways.

You start to feel better, you start to feel like I don't need this anymore. And I don't need to continue self destructing because I found a new way to live. Addiction is all about serving a purpose. It's not just about survival. It's about whether people are using to heal chronic pain or covering up trauma or boredom, whatever that purpose is. When you're able to find a new, healthy means of engaging in that purpose and not instantly gratifying through addiction, the better life is going to be. The more healthy and happy you become.

Like I mentioned, the deeper we get into addiction, the more powerful that green light is and the weaker the red light is. So the red light, which is our higher minded thinking, the one I'm talking to right now, the one who assesses, analyzes life, your own narrator, your sense of. Of self. The deeper you get into addiction, the more it gets taken out of the driver's seat, to the passenger seat, to the back, and even into the trunk, where you feel like you don't have a say in what you do or your behavior.

That's why it may seem like people are almost possessed when they're deep in their addiction. They have a different personality. It seems like you're not talking to that person, you know? And love and recovery is all about getting that self back into the driver's seat, getting back to who you are, and trying to live a healthier and happier life.