Dopamine, often dubbed the “motivation molecule,” plays a pivotal role in human behavior. Essential for functions ranging from forming bonds to driving ambition, dopamine influences our everyday actions. From the moment we wake up to pursuing our goals, dopamine serves as the driving force behind our endeavors.
Understanding the significance of dopamine levels provides insights into addiction. On a typical day, our dopamine levels fluctuate, impacting our mood and motivation. However, substances like methamphetamine disrupt this balance, leading to excessive dopamine release. As addiction takes hold, the brain’s reward system is hijacked, diminishing the pleasure derived from ordinary activities. This neurological aspect underscores the urgency of addressing addiction as a medical concern.
While dopamine levels fluctuate between 40-100 nanograms per deciliter under normal conditions, addictive drugs can spike them over ten times higher. This overwhelming surge overpowers the brain’s reward circuitry. Healthy rewards like celebrating a birthday pale in comparison to the artificial dopamine deluge from drugs. Behaviors like procreating, eating, and drinking that evolutionarily raised dopamine to promote survival now take a backseat to compulsive substance use. The brain prioritizes addiction as the only way to survive, rationalizing destructive choices to obtain the next high at any cost. This neurological reprogramming fuels the hallmark diagnostic traits of addiction: impaired control, social impairment, and risky use.
Or, to put it bluntly: the brain’s reward center is re-wired in such a way that basic survival instincts are replaced with a desire for the drug. This is not something a person can will themselves to correct. Their brain function has been impacted, and it will take a prolonged period of sobriety to begin to correct it.
Consider the image below:
The brain scan on the left shows the dopamine D2 receptors in a healthy human brain which is unaffected by addiction. This represents a brain that experiences motivation from things like reward, praise, hunger, sex, etc. But the brain in the middle and on the right have a much lower concentration of D2 receptors. That’s because cocaine has taken the place of these receptors and changed the way the body processes motivation. The brain is now motivated to use cocaine, and immediately after cocaine use, the brain is flooded by artificial “cocaine dopamine.” The brain produces less on its own because the substance – cocaine, in this example – provides plenty, and provides it often enough that the brain’s natural function is disrupted.
Cocaine use becomes a matter of survival for the brain, in a way that food, water, and human relationship once was. And as you can see in the brain scan on the far right side, the D2 receptor levels have only just started to re-regulate after four full months of sobriety. In reality, this process can take up to two years.
So – what difference does all this make? Simply put, the decision to stop using simply isn’t enough. The brain panics, feeling as though it will not survive, and puts tremendous pressure (almost irresistible pressure) on the individual to use their drug of choice again.
The intensity of drug cravings differs vastly from ordinary desires. Brain imaging reveals cravings for an addictive substance can exceed even the desperation of starvation or dehydration – biological imperatives where humans will steal or harm to survive. This primal need stems from dopamine depletion during withdrawal, where levels can plummet from a normal 50 nanograms to just 10 nanograms per deciliter.
In this state of perceived dire survival threat, the brain’s primal instincts take over, justifying irrational, dangerous acts like theft or assault solely to feed the craving. Selling personal valuables or disregarding core morals become acceptable means of self-preservation to the addicted mind. Behaviors once deemed reprehensible transform into symptoms of the dysregulated dopamine system underlying the disorder.
This altered neurochemistry also sheds light on why conventional therapy often proves ineffective for newly recovering individuals. Without restoring dopamine balance first, the cognitive and emotional processing required for counseling cannot properly occur.
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