"The Neurobiology of Addiction" focuses on the scientific study of addiction from a

neurological perspective. An overview of the reward circuit, often known as the

pleasure pathway.

Greetings. I am Maureen Boyle, the Chief Quality and Science Officer of ASAM. We will
discuss the neurobiological processes occurring in the brain of an individual with
addiction, and explore the implications for the prevention and treatment of this
disorder. However, it is crucial to understand that the brain disease model of addiction
is but a single element within the broader biopsychosocial model before delving into
the specifics of how the brain alters. Multiple biological, psychological, and social
elements converge to either increase the likelihood of developing an addiction or
provide a safeguard against it.

The environment has a profound impact on our brains, while we, in turn, shape our
environment by our actions. These factors are inseparable. For instance, if you hold
the belief that drug use is morally reprehensible, your physiological and neurochemical
response to it may significantly vary from those who see it as socially acceptable within
your society. Understanding the role that each of these factors plays in the
development and continuation of addiction is crucial. This understanding allows us to
identify the factors that can be changed in ourselves or in society to support recovery
and individuals struggling with addiction, or to prevent addiction from occurring in the
first place.

What occurs in the brain of an individual who develops an addiction? Multiple brain
circuits involved in addiction are impacted, including those responsible for decision
making, impulse control, stress regulation, learning and memory processes,
motivation, and reward processing. I will analyze the alterations occurring in several
systems of individuals with addiction and elucidate how these changes contribute to
the increasing challenge of ceasing addictive behaviors. The reward circuit is the
principal circuit impacted by addiction. This circuit enhances behaviors that are crucial
for the survival of both the individual and the species. These behaviors may include
activities such as consuming food, engaging in sexual activities, and fulfilling parental
responsibilities.

Every addictive drug elicits a rise in dopamine within the reward circuit, either via
direct or indirect means. The left graphic depicts the precise location of the circuitry
inside your brain. When we engage in pleasurable activities, such as eating, there is a
little release of dopamine in a specific region known as the nucleus accumbens. This
release of dopamine serves to strengthen and encourage the repetition of that action.
The instruction emphasizes the need to repeat the action for our continued existence.
Drugs, on the other hand, stimulate the circuit with far more intensity than natural
rewards. The graph on the right illustrates the substantial surge of dopamine that is
generated by amphetamines. This greatly increases the tendency to repeat drug use.

Over time, the repeated influxes of dopamine cause the circuitry to reconfigure itself
in order to strengthen the behavior of taking drugs; the drug then becomes the
dominant driving factor. The robust stimulation essentially signals to your brain that
the medicine has more significance for your life compared to natural actions that elicit
a less intense response from the system. Frequent overstimulation of the reward
circuit results in gradual and compensatory alterations in the brain. This is due to the
brain's preference for equilibrium. The neurobiological repercussions of addiction
often arise as a result of the brain's efforts to counterbalance the persistent presence
of a drug. One fundamental tenet in neuroscience is that the brain has a natural
inclination to maintain activity levels within a reasonable range. The organism seeks to
sustain homeostasis, which refers to the equilibrium within its neural networks. When
an excessive amount of dopamine is present in the circuit, the brain attempts to adapt
by reducing its sensitivity to dopamine. It does this by decreasing the quantity of
dopamine receptors in the circuit. However, when discontinuing the medicine, the
excessive influx of dopamine ceases, resulting in a deficiency of dopamine receptors.
Consequently, the circuit becomes imbalanced in the other way. Essentially, when the
circuit is activated at a low level, it results in reduced sensitivity to pleasurable
experiences, which is known as anhedonia. This condition refers to an absence of
pleasure derived from typical sources of enjoyment in life, such as indulging in a
satisfying meal or engaging in quality time with a loved one.

Comparable alterations occur across several neural pathways in the brain when an
individual is afflicted with an addiction. Substance abuse alters brain function,
prompting the brain to make adjustments in order to restore equilibrium.
Subsequently, upon cessation of drug or alcohol use, an imbalance ensues, prompting
a strong need for the substance to restore equilibrium. Opioids have several effects,
including pain reduction.