Quitting drugs doesn't happen easily; it requires a lifelong commitment to sobriety. For many individuals hoping to stop their drug or alcohol habit, it can be incredibly frustrating to go cold turkey. Understanding the neurobiology of addiction sheds light on why quitting substance use is such a challenge.
Brain Changes Associated With Addiction
On the surface, drugs seem to have little in common. From cocaine to heroin to bath salts to methamphetamines, each substance has its own unique form and effects. In a neurochemical sense, however, most substances have the same mechanism of action.
Addictive substances enter the brain and stimulate brain cells to release a neurotransmitter called dopamine. Dopamine, sometimes called the pleasure hormone, is responsible for flooding the brain with positive feelings. The brain is wired to want more and more of those rewarding feelings. As a result, substance users begin to crave the substance and need increasingly high amounts of it to feel pleasure.
What Happens When A Person Quits?
When an individual struggling with addiction tries to give up drug use, the brain is reluctant to see the substance go. The reward circuitry in the brain has been totally rewired, coming to rely on the addictive substance to get that pleasurable feeling. The result is powerful cravings, as normal sources of dopamine-related pleasure (food, sex, exercise) simply don't suffice. The brain also urges the person to seek the drug to meet its need for dopamine. Fighting against these strong impulses and rewiring the brain to respond to normal sources of pleasure makes ending drug use extremely challenging.
Lifestyle factors also play a role in why it is so challenging for addicted individuals to give up using the drug. Substance use often comes with certain lifestyle choices, including a group of friends, common hangout spots, interactions with dealers, and a drug-seeking routine. Many individuals trying to end substance abuse lose more than just the addictive drug: they lose friends, find it difficult to connect with family members, struggle to perform at work, and find their previous routine in shambles.
An important part of rehab is rebuilding relationships with loved ones and creating a new routine that doesn't include the drug. However, the temptation to return to a previous lifestyle is compelling and causes many people to lose their fight for sobriety.