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Addiction and the Brain

“I don’t understand why he just can’t stop abusing alcohol.” Turns out that addiction is a whole lot more complicated than just saying “no.” Although the stigma of addiction as a moral failing persists, we now know that addiction is a brain disease. The September issue of National Geographic deals with the science of addiction and how “addiction disrupts pathways and processes that underlie desire, habit formation, pleasure, learning, emotional regulation, and cognition.” It causes hundreds of changes in brain chemistry and remolds it to value drugs and alcohol. Antonello Bonci, a neurologist at the National Institute of Drug Abuse says, “In a sense, addiction is a pathological form of learning.”


Knowledge is power. Learning about the science of addiction can help us better understand and cope with our loved one’s self-defeating behaviors. Resources are available, including the article mentioned above, which considers the chicken-and-egg question: “Does addiction cause these (brain) impairments, or do brain vulnerabilities due to genetics, trauma, stress, and other factors increase the risk of becoming addicted?” Perhaps some day science will provide a definitive answer to that question. In the meantime we know that addiction is a chronic disease that requires long term management for successful recovery. Understanding what’s happening that makes a loved one behave the way she does under the influence of drugs or alcohol can lead to less judgment and more compassion. This knowledge has helped me to become less reactive. I try to remember that behind my adult son’s disease is a person. I try to avoid “You’re wrong” and “I’m right” scenarios. I try to think before I speak. I try to judge less and empathize more. And I try to forgive myself when I react with anger, frustration, impatience, and self-pity.


Since addiction is a complex disease, quitting generally takes more than good intentions and a desire to stop. Treatment can help people recover. Currently, two approaches prevail: first, the cure lies in fixing the brain’s faulty chemistry or rewiring it through medication, such as naltrexone and buprenorphine. Psychosocial support is viewed as an add-on to medication. A second method stresses psychological work (such as 12-step programs and other psychotherapeutic approaches) with medication as an adjunct. And recently mindfulness which includes meditation and other holistic techniques has been shown to be effective. What’s important here is trying to find the best fit for a loved one when he or she is ready to quit. There isn’t any one size fits all treatment and relapse rates are high. The good news is that ever-advancing treatment approaches can help people recover from addiction and lead productive lives. Over 23 million Americans have benefited from treatment and living in long-term recovery. They celebrate this achievement in story and film.

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