The inner effects of addictive behaviours cause tremendous suffering. Knowing the science behind addiction can help those addicted to substances and their treatment specialists better understand what is happening, and help lessen that suffering.
What is addiction?
Addiction is a chemical dependency on a substance that can influence the inner state of the mind and body. Substances enter into the bloodstream and are then routed to the brain. Mind altering substances shift one's state of being, creating an altering state by activating a hyper-production of neurotransmitters called 'dopamine". Neurotransmitters are known to be the messengers and now understood to transmit information to the brain.
What is dopamine?
Dopamine has two parts, one being the memory cell and transportation of the message to the pleasure reward center of the brain - creating a euphoric effect. The more substances are used, the more the brain gets conditioned, then leading to a state called tolerance. Therefore the brain requires more of the substance to create the same amount of dopamine. There does come a point where the brain can no longer produce a satisfactory amount of dopamine, regardless of how much substances are ingested. When this occurs, signals are sent from the brain leading to symptoms of withdrawal.
What is withdrawal?
When individuals do not have access to substances, their nervous system becomes psychologically and physiologically activated and in a state of crisis. This can lead to acute withdrawal symptoms including:
What other factors are involved in addiction?
A large majority of individuals having an addiction also suffer from an overactive or underactive nervous system as a result of complex early childhood trauma, where their nervous systems have been mapped to be overactive, living in a heightened state of fear arousal or underactive living in a more dissociative state.
When environmental trauma and victimization occur, the nervous system baseline operating functioning lives within feeling too much or too little.
Early on in life, many of my clients have learned to maladaptively manage the inner state of their nervous system, being over responsive and living in a state of fear or under responsive and living in a state of numbness, disconnection, fatigue, and becoming socially withdrawn by substance use and misuse. Learning healthier adaptive coping strategies to manage these states is critical to treating addictions.
When addiction treatment does not understand the impact of trauma on the nervous system, they are only treating the symptoms, not the underlying causes. These approaches fall short of understanding the impact of trauma and the nervous system. Providing individuals with the knowledge, training and skills to manage their inner state adaptively needs to be a key component of treatment or therapy itself. Without a doubt, trauma reinforces the substance abuse cycle.
How does this affect addiction treatment?
The treatment of addictions needs to shift from a pathologizing approach of a highly vulnerable population and move towards understanding addictions itself as a response to prior experiences of trauma. Safety is a "basic need" in Maslow's hierarchy. Without safety, people will always seek out quick, down and dirty easy ways to cope and survive, henceforth addictions.
Providing information on the neurobiology of trauma and addictive cycles on the brain and incorporating more current 'bottom up' approaches to treatment that consider teaching inner state regulation will significantly support those working with and treating those with addictions.