Addiction creates structural changes in the brain’s reward network. These changes can cause people to lose control over their substance use and neglect other activities and responsibilities. Seeking recovery is a challenging prospect to attempt alone, however, there is hope. One of the key aspects in achieving addiction recovery is the role of neuroplasticity: the brain’s ability to heal, change, and adapt.
How Addiction Affects the Brain
Repeated substance use is a learned behavior like any other, but it differs from other learned behaviors in that addictive drugs directly influence the brain’s reward network. When it comes to substance use disorder, there are three major neurological components at play:
- Neurotransmitters, such as dopamine and serotonin
- Brain receptors, which catch neurotransmitters after they are released
- Neuroplasticity, or the brain’s ability to adapt and change to current circumstances
These three elements can help to explain the disease model of addiction and help you understand how neuroplasticity plays a crucial role in recovery.
Neurotransmitters
Alcohol, cocaine, and other drugs create a large influx of dopamine, a neurotransmitter. Neurotransmitters are essentially message packets that signal different responses; in the case of dopamine, the message is “reward!” The brain typically releases dopamine during activities that provide pleasure or fulfill a basic need, such as eating or socializing with your friends.
Different drugs release or imitate various neurotransmitters, but addictive substances are linked to dopamine. This specific neurotransmitter has been consistently linked to repeated behaviors and has been strongly connected to substance use disorders¹.
Receptors
When a neurotransmitter is released in the brain, a specialized receptor catches it to receive the message. These receptors can change in quantity and shape in response to neurotransmitter levels; an increase in dopamine levels would decrease dopamine receptors and vice versa. After sustained substance use, a person’s brain becomes so accustomed to large amounts of dopamine that it reduces its level of dopamine receptors².
Receptors can also change in shape as a consequence of substance use. A receptor is like a keyhole; it requires a specific shape to receive the neurotransmitter’s message, and changing that shape means it will reject that neurotransmitter. Changes in the dopamine receptor’s shape can lead to a loss of rewarding sensations from everyday activities that used to be pleasurable.
Neuroplasticity
The changes discussed above are examples of neuroplasticity. A person’s brain is constantly adjusting to new environments and situations. In the case of addiction, the brain strives to find homeostasis while being awash in addictive chemicals. With continued substance use, the brain builds up a tolerance. When substance use is interrupted, the brain experiences withdrawal³.
Neuroplasticity is simply the brain’s ability to change, grow, and reorganize in response to new information, sensory stimulation, development, damage, or dysfunction⁴. Substance use directly impacts neuroplasticity by introducing a new variable into the environment, and the brain responds accordingly based on the type of substance and the amount used.
How the Brain Recovers From Addiction
Fortunately, the structural brain changes associated with substance use disorders are not permanent, but they take time to heal. Just as a brain adjusts to higher levels of substance use by downregulating receptors, abstaining from drugs causes the opposite effect. With time, the brain will produce new dopamine receptors in response to the absence of narcotics⁵.
Recovering from a substance use disorder requires more than dopamine alone. Truly recovering from addiction can require a massive change in your behaviors, thoughts, and attitude. People in active addiction spend large amounts of time thinking about using. Substance-focused behaviors create brain changes and should be replaced with healthier alternatives.
You can think of the brain’s circuitry as a series of canals. When you repeat behaviors, a small canal expands to allow extra energy flow. In this way, repeated drug use can make rivers out of streams, and it becomes increasingly likely that you repeat substance use despite its harmful consequences.
In the same way, you can create other positive behaviors and habits after drug use stops to give your excess energy a positive outlet. The energy someone previously spent on substance use needs to go somewhere. Participating in exercise, recreation, spending time with family, or pursuing career advancement are all positive outlets for energy. Repeating these behaviors makes the neuronal canals grow in a healthy way.
Treatment Modalities That Support Neuroplasticity
Specific therapeutic modalities can accelerate brain healing and offer relief from the effects of withdrawal. Therapy and other cognitive exercises can promote neuroplasticity, and other treatment options can also encourage healing. Quality addiction treatment centers typically incorporate several methods to promote brain healing, including:
- Exercise
- Music therapy
- Recreation therapy
- Experiential therapy
- Nutrition classes
The critical component to increasing your brain’s neuroplasticity is engaging in challenging activities that you find inherently rewarding. You can further enhance the effects of these activities by ensuring that you eat a healthy diet and remain socially engaged with your peers or family.
Modern addiction treatment focuses on helping people struggling with a substance use disorder change their thoughts, behaviors, and lifestyles. Treatments like recreational therapy and mindfulness-based interventions may seem counterproductive because, at first glance, it might seem like they don’t treat addiction directly. But a mind/body/spirit approach to treatment can help create positive replacement rewards for substance use that can make lasting brain changes.
Deep Transcranial Magnetic Stimulation (Deep TMS) and Hyperbaric Oxygen Therapy (HBOT) directly improve the brain’s ability to heal itself. Deep TMS accomplishes this by stimulating key regions of the brain associated with substance use disorders with magnetic waves. The stimulation causes the release of neurotransmitters and helps people in recovery change their behaviors. HBOT takes an indirect approach, providing the brain the materials (namely, oxygen) it needs to heal itself.
How Long Does It Take to Heal From Addiction?
You may be wondering how long it takes for the brain to recover from addiction fully. While the physical effects of detox and withdrawal typically clear up in a matter of weeks, brain changes often take much longer to recover fully. The amount of time differs based on several factors:
- The length of time in active addiction
- The type and amount of substances
- Age and genetics
- The behaviors engaged in after achieving abstinence
- Co-occurring disorders
- The amount of support you have
All factors considered, most people resume normal brain function after about 14 months of continuous effort².
Is Addiction Permanent?
So is addiction is a lifelong disease if the brain can recover? The brain’s neuroplasticity does indeed provide a remarkable ability to heal, but it cannot erase memories and learned behaviors.
Returning to our canal example of how the brain learns new behaviors, a person who struggles to control their substance use has created massive pipelines for the behaviors surrounding their addiction. During recovery, these canals are inactive: they no longer engage in drug use, seek out substances, or spend time coming up with ways to continue their addiction. But just because the canals are inactive doesn’t necessarily mean that they go away forever.
Have you ever picked up an old hobby after not practicing for years? It could be playing guitar, swimming, or riding a bicycle. It might feel awkward at first, but you remember precisely what you need to do in a short time. Relapsing is similar; while you might feel different initially, your brain remembers addiction’s behaviors and patterns and quickly encourages you back to misusing substances. This is why more than 85% of people relapse after treatment⁶, and why 18-26% of people readmit to a treatment center⁷.
Thinking Outside of the Brain
A common mistake that people make when attempting to understand their own addiction or that of a loved one is focusing exclusively on changes in the brain. While there has been substantial work done exploring how the brain reacts to drugs and the role of neuroplasticity in recovery, higher-level functioning also plays a pivotal role in recovery.
The connections, neurotransmitters, and receptors in your brain all play a role in learning, thinking, and behaviors. But focusing on the thoughts and behaviors themselves is currently the best method for treating substance use disorders. Engaging in individual therapy, process groups, and support groups will have a much more significant impact on your recovery than simply waiting for your brain to heal.
The ability to think about your problems, challenge those thoughts, and choose different behaviors is what makes you human. Effective treatments for substance use disorder focus less on the brain and more on our thoughts and actions. They are time-tested therapies that are highly effective at helping people achieve and maintain their abstinence. Don’t neglect your emotions and feelings in favor of prioritizing the more clinical aspects of neuroplasticity. The best approach is a customized, comprehensive treatment plan.
Thinking Outside of the Brain
At All Points North Lodge, we use a balanced approach to healing rooted in evidence-based practices, cutting-edge technology, and clinical excellence in the optimal healing environment for the best possible treatment outcomes. If you want to learn more about how All Points North Lodge uses several strategies to enhance neuroplasticity and help people recover from addiction, contact our team of treatment experts at 424-644-6486 or start a live chat now.
Reference
- Koob, G., Volkow, N. Neurocircuitry of Addiction. Neuropsychopharmacol 35, 217–238 (2010). https://doi.org/10.1038/npp.2009.110
- Volkow, Nora D., et al. “Loss of Dopamine Transporters in Methamphetamine Abusers Recovers with Protracted Abstinence.” Journal of Neuroscience, Society for Neuroscience, 1 Dec. 2001, https://www.jneurosci.org/content/21/23/9414.full.
- Kalivas, P., O’Brien, C. Drug Addiction as a Pathology of Staged Neuroplasticity. Neuropsychopharmacol 33, 166–180 (2008). https://doi.org/10.1038/sj.npp.1301564
- Rugnetta, Michael. “neuroplasticity”. Encyclopedia Britannica, 3 Sep. 2020, https://www.britannica.com/science/neuroplasticity. Accessed 9 March 2022.
- O’Brien, Charles P. “Neuroplasticity in addictive disorders.” Dialogues in clinical neuroscience vol. 11,3 (2009): 350-3. doi:10.31887/DCNS.2009.11.3/cpobrien
- Sinha, Rajita. “New findings on biological factors predicting addiction relapse vulnerability.” Current psychiatry reports vol. 13,5 (2011): 398-405. doi:10.1007/s11920-011-0224-0
- Reif, Sharon et al. “Reducing Behavioral Health Inpatient Readmissions for People With Substance Use Disorders: Do Follow-Up Services Matter?.” Psychiatric services (Washington, D.C.) vol. 68,8 (2017): 810-818. doi:10.1176/appi.ps.201600339