What is happening in the brain?
Addicted people always ask themselves this question: Why can't I quit even though I want it so much? Why can't I quit even though I have lost so much and paid a heavy price? Relatives of addicts also ask such questions: Why can't he quit, even though he is such a successful person and ruins our lives and his own?
Scientists are also researching the answer to this question, and it is now known that this inability to quit is good or bad for addicts. It has been found that it is not related to whether they have a weak or strong will or whether they make enough effort. It is now thought that there is something wrong in the brains of addicts.
Addicts pay many personal, relational and social costs. Once matter becomes the number one priority in their lives, it means they leave aside many things in their lives. The addict's relationships are damaged, his education loses the quality of his profession, and many of his responsibilities become disregarded. They experience losses in every aspect of their lives and this list goes on and on. Physical and mental illnesses, deteriorating economies, and the social isolation they all accompany are added to this process. These are effects seen from outside. However, addicts also have serious damage to brain structures that are not visible and unknown from the outside. This is the biochemical damage that occurs in the decision-making and behavioral control parts of the addict's brain.
For this reason, even if the addict really decides to change his life, it is not easy to do so. No matter how willing and well-intentioned one is, it is difficult to take the next step and achieve results. It is not enough to say "enough is enough", but those with a very low addiction level may be able to achieve it. Most can only leave for a short time. Because their brains have changed due to the damage caused by the substance they use. For this reason, they cannot get rid of addiction.
Many people who decide to quit substances make at least three or four unsuccessful attempts before they manage to maintain sobriety for a year. It may take 8-10 years, during which many attempts are made, until you quit using the substance completely. Many factors determine quitting success There are factors such as: the patient's age, who is administering the treatment, how long the addict has been using the substance, the extent to which the addiction affects the patient's psychological state, the type and amount of substances used.
Although it is not possible to get rid of addiction, it is possible to recover. But it is very important to know what recovery means. Once a person becomes addicted, he or she will not be in the same situation again as a person who has never used the substance. However, with good treatment, he can live without using substances again. However, if he uses the substance again, he returns to where he left off before quitting and continues to use it at least at the same dose.
Recovery is a much more complex and difficult process than just quitting substance use. This process involves the re-establishment of brain circuits damaged by alcohol or drugs.
There are various messenger chemicals in the human brain that ensure the flow of information between cells. These are called neurotransmitters. How well or poorly these messengers perform their duties can be determined by brain imaging techniques. Drug use damages this chemical communication system of the brain. The neurotransmitters most damaged are dopamine, serotonin, GABA and glutamate. While every drug used affects the amount of dopamine, for example, LSD and ecstasy affect the functioning of serotonin, heroin and morphine affect opiate receptors, and alcohol affects GABA and glutamate.
Research conducted to date has shown that all addictive drugs directly and indirectly activate the pleasure activities of the brain. . In other words, drugs affect the network that controls and regulates the feeling of pleasure. When we experience pleasant things, such as eating, watching a beautiful view, laughing out loud, our brain releases dopamine. In this way, we feel warm, calm and happy. However, after a while, the amount of dopamine secreted decreases and returns to its previous state. We continue the normal course of life and move towards new times that will be happy.
We are moving towards happiness and we want it because our experience is memorized in the part of the brain that we call the limbic system, which is the key center of notions such as pleasure, emotion and memory. The dopamine pathway, where dopamine is released in the brain, records the actual experience of pleasure. and remembers the necessary movements to reach it again and has it repeated. During the calm period between two pleasurable activities, neurotransmitters decrease to their natural levels.
When alcohol or drugs are used, the rate of these neurotransmitters in the body increases 5-fold as the first effect. The dopamine level rises even higher than the level reached while eating and maintains this level for a long time. No matter how long or short this experience is, it is remembered in the hippocampus and amygdala, which are the motivation center and called the "continuation system". These sharp and exciting experiences, with intense dopamine release, are kept in memory. Even the memories of these experiences in the memory cause dopamine to be released and a state of happiness is achieved, and these impulses motivate the person to experience the same experience again.
This is a deception, of course. The amount of dopamine increases with each use of the drug, but it does not always reach the level used when it was first used. After all, our decision-making-internal metabolic system has been disrupted by the entry of a foreign substance from outside. Foreign-pseudo transmitters entering the information transmission network replace real transmitters, and the brain begins to reduce its natural release and wait for these effects to occur from outside.
With repeated intakes of the same dose, the dopamine dose and happiness rate gradually decrease. In other words, with the decreasing amount of dopamine, each use becomes less exciting than the previous one. Over time, the excitement decreases and the collapse process begins. This is caused by the brain being deceived into thinking that the peak of pleasure achieved through drugs is the most necessary thing in life. This constantly losing pleasure spiral causes the sensitivity of the brain's transmitters to begin to decrease. In this case, the brain activates defense mechanisms to protect itself and reduces the amount of dopamine. From this point on, the addict begins to use the substance not for pleasure but to feel normal. Because dopamine, which increases with drug use, is no longer secreted very little or not at all in the brain.
“Stop System”
Just as there is a continue system in the brain, there is also a stop system. This system is a system where we collect information, weigh the risks, analyze the advantages and consequences, and determine the next behavior. Is this action right or is this idea useful? It is a center where many judgments are made, such as whether it is illegal or safe. These stop and go systems decide whether things are going correctly or not by staying in constant communication with each other. This determines when to continue and when to stop. Of course, this does not mean that these two systems can never be separated from each other.
The worst part of substance use is that it disrupts and destroys the coordination connection between them, rather than disrupting the normal functioning of the stop and continue systems. The continuation system goes beyond the controls brought by the stop system, and substance use behavior continues without stopping.
Recent research has shown that drugs affect not only the pleasure pathways in the brain, but also the pathways related to memory and learning. As addiction develops, things the brain has learned before are weakened or forgotten, and completely different things are learned. This causes the information bases that determine the working principles of the stop and go system to change and the activating qualities to differ. In PET studies conducted with cocaine addicts, it was determined that the amount of dopamine in the brains of cocaine addicts was very low or nonexistent when they encountered a beautiful landscape or a picture of a baby, while when they were shown a spoon full of cocaine or images of the places where they used the substance, brain activation in the hippocampus and amygdala regions of the patients peaked. All these effects occur despite the patients' long periods of sobriety or all the negativities caused by substance use. At this point, while the continuation system is working, the stop system, which stores the negative effects that are expected to keep the person away from substance use, remains silent.
These studies show that the real recovery of addicts will be possible by re-establishing these neurochemical processing systems on new working principles. This will be possible with personalized psychotherapy and the use of appropriate medications, and with a social life universe that will make behavioral and affective patterns more qualified.
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