What Happens In Addiction??

It can probably said that everybody struggles with addiction. Not only the classic examples that often first come to mind of drugs and alcohol, but coffee, Netflix, sugar, exercising, chocolate, sex, pop, gambling, social media, etc. These are all things people may say they are “addicted” to. People become addicted to things because of the release of dopamine in their brain into their reward system. It makes them feel good and they want to do it more. They may even feel “withdrawal” symptoms if they don’t get their morning coffee or haven’t gotten to check Facebook in a while.


It can be hard to break old habits, but most people can survive and function if they don’t get their Pepsi for the day (even if they REALLY want some). The thing that people need to understand is that drugs of abuse and alcohol can actually cause structural and chemical changes in the brain, its neurons, and its signaling pathways. This makes it almost impossible for them to be able to stop using these substances without treatment or medication. They actually cannot help their behaviors even if they really want to stop, because their brain has changed and is controlling their actions in a different way.


The structural and chemical changes and pathways in the brain that may be affected are very intricate, but some basic changes from drugs of abuse and alcohol include the following:

  • Increased dopamine – this acts on medium spiny neurons in the striatum (associated with reward).
  • Synaptic plasticity – more medium spiny neurons grow as there is hyper-stimulation from the drugs, this means that they are even more susceptible to the dopamine being released. This can contribute to behaviors of drug users such as tolerance, sensitization, and dependence.
    • Tolerance – you need more of the drug to get the same “high”/effect/experience – receptors may be downregulated, so you need more of the substance to make up for that.
    • Sensitization – you need less of the substance to crave it more intensely.
    • Dependence – without the substance, you start to experience withdrawal symptoms.
    • This is essentially a downward spiral because you start to need more of the drug to feel the same effects, but you need less of the drug to want it more. Then if you don’t get the drug, you have withdrawal symptoms, which can be life-threatening in some cases. So not good….
  • Changes in signaling molecules – in the article we read, it mentions several signaling molecules, kinases, phosphatases, and transcription factors. Changes in these cause downstream effects that contribute to synaptic plasticity, drug behaviors, and long-term potentiation, which is further damaging to neurons.


Addiction to drugs of abuse and alcohol is scary as you hear stories of people dying from overdoses, hurting loved ones or causing car accidents, doing things they do not even know they are doing which can often result in injury, and having it consume their lives so much they lose their jobs, family, money, and that is all they can think about. The problem is there are so many things going on in the brain, it is hard to “treat” addiction. Rehab and treatment centers often incorporate therapy which is great, but it does not change the chemical and structural changes in the brain, which are essentially controlling the addicted person telling them to continue to use the drug. Medication can help with some withdrawal symptoms, but is it still not fully understood how restore receptors, neurons, and signaling to its normal baseline state, or how long that can take naturally. It also greatly increases the chance of relapse. You also have to take into account the psychological dependencies that can develop as well through drug and alcohol abuse.


Identifying signs of addiction is important as it may help save someone’s life if they get treatment. Especially as you hear of younger teenager becoming addicted to drugs, perhaps education may help reduce the risk of that. Remember how hard it feels for you to stop watching your favorite Netflix show sometimes, and remember that people who struggle with drug and alcohol addiction feel that much more strongly and all the time. Don’t look down on them, but let’s strive to give people they help that they need.