Why is it hard for some people to stop using substances; do they lack the will power? No, it’s because the substance itself has stolen the normal balance of the brain (Shatterproof, 2022b). Substance Use Disorder (SUD) is a brain disease and not a choice.
Our brain has a reward system that responds to dopamine, a neurotransmitter (NIDA, 2020a). Dopamine is how we learn what we like and don’t like in daily life, which includes drinking a big glass of water when we are thirsty, getting a good hug from a loved one, or getting to eat our favorite food. DING, DING, DING, the brain will let out dopamine telling us that those things feel good (Shatterproof, 2022b).
The brain has a normal range of dopamine fluctuation. However, with substances, the fluctuations in dopamine are extreme (Shatterproof, 2022b). They are so extreme that the brain becomes desensitized to the subtle and healthy fluctuations (Shatterproof, 2022b). Many times, people with SUD will become malnourished or have strained relationships with friends and family simply because the reward system in their brain is not feeling the effects of those daily pleasures (NIDA, 2020a). The main pleasure they receive in life is from the substance itself, and their body feels the substance is needed to survive; even though it is making them sick.
Below is a graph showing the extreme effects of dopamine from different substances and gives insight as to why people with SUD sometimes need evidence-based interventions to help them recover.
Retrieved from: https://truthpharm.org/addiction-treatment/science-of-addiction/
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