Addictive substances, such as heroin, ketamine, and cocaine, all interact with key areas of the brain, causing harmful changes to take shape over time.
In effect, these patterns of addiction all work together to promote continued drug use. Without needed treatment, they will continue to worsen over time. During a growing addiction, the brain’s weakening state gradually gives way to the three stages of addiction.
Understanding Your Brain on Drugs
Anyone who’s lived with addiction for any length of time falls into a cycle of behavior that’s fueled by the body’s need for the drug and the mind’s dependence on the drug’s effects. The addiction cycle evolves over time as the brain becomes increasingly dependent on the drug to function.
Historically, researchers inaccurately believed that a person’s propensity toward addiction was fueled by individual shortcomings, such as a disregard for authority or another character flaw. However, more contemporary addiction models show that the disease follows a distinct neurobiological framework as it begins, develops, and grows over time.
Viewed under this lens, we can see that addiction is a progressive, relapsing brain-related disorder. As it progresses, it triggers different neuroadaptations that make an individual more inclined to pursue illicit substances, despite the consequences they may face.
Over time, the neurobiological effects of drug use occur in three phases: bingeing, withdrawal and anticipation. While there are six distinct stages of addiction, these three phases specifically describe the changes that happen to a person’s brain as addiction begins to take hold.
The Three Neurobiological Stages of Addiction
Stage 1: Bingeing
Most addictive drugs force the brain to produce excess amounts of neurotransmitter chemicals, including dopamine. Put simply, their brain associates the pleasant feelings that the drug elicits as a reward, and they begin to seek out as much of it as possible. Consequently, the cells that produce these chemicals become overworked and develop structural damage over time.
When this happens, it takes larger amounts of the drug to produce the desired “high” effect. Before long, a person must ingest multiple doses or incredibly large dosage amounts, also known as bingeing, in order to experience any effects at all. They also begin to experience a greater dopamine release from the environment surrounding the drug use than the actual drug at all. They begin to crave not only the drug but also the people, places, and things that they associate with it. Resarchers call this incentive salience.
Understanding this, it’s critical for addiction treatment programs to stress abstaining from the environment that fuels drug use. Once they leave a program, clients should not re-integrate with the same people or places that encouraged them to use drugs in the first place.
Stage 2: Withdrawal
As people engage in chronic, continued drug use, they will eventually feel less euphoric when they do. This is because their bodies fail to register the reward in the same way they once did. At the same time, they also begin to experience more agitation because their mind doesn’t have as much capacity to handle stress. Thus, even a minor inconvenience can trigger a significant emotional response.
Things designed to elicit natural rewards, like exercise and food, likewise feel less stimulating. This anti-reward response can cause the individual to become unsatisfied in their everyday life, leading to feelings of anxiety and depression.
These withdrawal episodes play a pivotal role in driving continued drug use as users resort to self-medicating uncomfortable symptoms with more of the drug. Withdrawal symptoms, such as agitation, depression, anxiety, insomnia and restlessness, grow more and more severe as the brain undergoes even more damage from continued drug use.
Treatment providers may use various approaches to help clients through this stage, including neuromodulatory medications like buprenorphine, acamprosate, and naltrexone. These medications are designed to target the parts of the brain responsible for impulse control, cravings, and decision making. They may also use neuromodulation therapies, like transcranial magnetic stimulation (TMS), to stimulate targeted nerve cells in the brain.
Stage 3: Anticipation
The brain’s response to the drug comes full circle once a person starts to anticipate or crave the drug’s effects on an ongoing basis. Preoccupation, or anticipation, begins to take over their minds any time they’re not high. If the addiction has become full-scale, they may only be able to go a few hours without using. The physical and psychological effects of this stage are known as cravings.
This stage indicates that a person’s thinking, emotions and overall belief systems have become dependent on the drug to cope with daily life. The part of the brain associated with anticipation is the prefrontal cortex, or PFC. This is the part of the brain responsible for executive functions, such as event planning, thought regulation, and task management. It becomes consumed with scheduling drug use, and planning the next high.
At this point, addicts organize their daily activities around getting and using the drug with little to no regard for any negative consequences that result. A treatment plan that includes mediation, counseling, peer support, and aftercare planning is recommended.
Treatment Considerations
From the physical hold that drugs exert on the body to the psychological dependence that develops along the way, the three stages of neurobiological addiction form a vicious cycle of drug use that won’t end until a person gets needed treatment help. In effect, the longer a person puts off getting treatment help, the harder it is to break the addiction cycle.
Drug and alcohol rehab centers can help individuals address the physical and psychological effects of addiction. Whether you need medical detox, inpatient care, or outpatient services, there’s a program out there that can help. Search our online database today to find an accredited, trusted facility near you.