What Happens to the Brain During Addiction?

Those who know someone who’s struggled with substance abuse (or struggled themselves) know that addiction is not a choice. It’s not just a lack of willpower or poor decision-making — it’s a chronic condition that affects the brain in ways that make quitting incredibly difficult.

Understanding how addiction changes the brain allows you to shift your perspective on the issue. For those struggling, knowing that addiction isn’t a moral failure but a medical condition can help relieve some of the guilt and shame they may feel. This provides them the emotional space to start the recovery process with a clearer mind, focusing on what they can do to heal rather than blaming themselves.

For those whose loved one is struggling with addiction, understanding what happens to the brain during addiction can provide a sense of hope. The brain has an incredible ability to heal, meaning recovery is possible with the right treatment, tools, and support. 

How Addiction Changes the Brain

Addiction alters the brain’s reward system, making certain behaviors and substances feel overwhelmingly pleasurable. At the same time, it weakens the brain’s ability to experience pleasure from everyday activities. 

This rewiring can make it feel almost impossible for someone to stop, even if they know it’s hurting them. Here’s how it works:

Changes to the Reward System

The brain has a natural reward system that encourages behaviors necessary for survival, like eating and socializing. When someone uses substances like drugs or alcohol, they trigger this system by releasing large amounts of dopamine, a feel-good chemical. The rush can feel rewarding and reinforce the behavior, making the person want to repeat the experience. This is how recreational drug use can evolve into addiction without the user making a conscious choice to do so.

Drugs and alcohol cause a big spike in dopamine, giving the user intense pleasure or euphoria. Over time, the brain starts to rely on substances to get that big dopamine rush rather than natural activities like eating, exercising, socializing, etc. These activities naturally trigger the release of dopamine, but the release is typically smaller and more balanced compared to the large, intense rush caused by substances like drugs or alcohol. 

This leads to needing the substance to feel “normal” because it’s harder for the person to experience pleasure from everyday activities that used to feel rewarding. When this happens, the person becomes less interested in things they once enjoyed, which can result in behavioral and personality changes.

Tolerance Development

When someone uses a substance repeatedly, their brain’s reward system becomes less sensitive to it. This means that the initial amount of the substance that once caused a strong effect no longer feels as intense or rewarding. To compensate for this, the person might use more of the substance to try to feel the same high or pleasure they experienced at the start.

This process happens because the brain’s neurotransmitter systems adjust. For example, with drugs like alcohol or opioids, the brain might reduce the number of receptors that respond to those substances. Or, it might produce less of the chemicals that are typically boosted by those substances. 

As a result, it takes increasingly larger amounts to get the same effect, which can lead to higher consumption and a stronger physical dependence on the substance. This cycle of needing more to feel the same can make it harder to stop using, as the body becomes conditioned to rely on the substance to function normally.

Structural Changes 

Addiction can also physically change the structure of specific brain regions, including the prefrontal cortex and amygdala. The prefrontal cortex helps with decision-making, impulse control, and reasoning. In people with addiction, this area becomes less active, making it harder to resist urges or consider the consequences of substance use.

The amygdala is involved in emotions and stress responses. Addiction can make the amygdala more sensitive to stress and cravings, increasing the likelihood of relapse during stressful situations.

Disruption of Memory and Learning

Addiction can affect areas of the brain related to memory and learning, making it harder to learn new behaviors and reinforce healthier habits. It can impair the functioning of the hippocampus — the part of the brain is responsible for forming new memories — which can lead to problems with learning new coping strategies and remembering the negative consequences of substance use. The brain also learns to associate certain triggers (places, people, situations) with substance use, which can make it difficult to break the cycle of addiction.

Effects of Long-Term Addiction

The longer the addiction lasts, the more entrenched these changes become, leading to persistent issues with self-control, memory, and emotion regulation. While recovery is possible, retraining the brain and restoring balance in the reward system and other affected areas requires time and effort. Therapy, support, and, in some cases, medication can help the brain heal and regain function.

The Cycle of Craving and Relapse

Once you understand how addiction changes the brain, the cycle of addiction becomes easier to understand, too. Let’s put the pieces together to provide a full picture of how the cycle works. The more you can interrupt the cycle at each step, the easier it will be to stay on the path to recovery.

1. The Trigger

The cycle usually starts with a trigger. This is something that reminds the person of their addiction. It could be a place, a person, or even a feeling. For example, if someone used to drink when they felt stressed, the feeling of stress could trigger a craving for alcohol. The brain has learned to connect certain situations with using the substance, and when those situations happen again, the brain “says” it’s time for the substance.

2. The Craving

Once the trigger happens, the next step is the craving. A craving is a strong desire or urge to use the substance again. It’s not just a thought, but something that can feel really powerful and hard to control. The brain has become used to the rush of feeling good when using, and the craving is the brain’s way of pushing you toward that high. The craving can feel overwhelming and make it hard to think clearly or make good choices.

3. The Use

When the craving becomes too strong, a person might decide to use again. This is where they give in to the urge and use the substance they’ve been trying to avoid. At this point, the brain’s reward system is activated again. The person might feel a temporary sense of relief or pleasure, which feels good in the moment. However, this doesn’t last long, and it often makes things worse in the long run.

4. The Guilt and Shame

After using, many people experience guilt or shame. They feel bad about breaking their promise to themselves or others. They might feel like they’ve failed, which can lead to feelings of disappointment or self-loathing. This guilt can be tough because it can make someone feel like they’ll never get better or that they can’t control their addiction.

5. The Rationalization

To cope with these feelings, the person might start to make excuses or rationalize their behavior. They might think things like, “It’s not that bad,” or “I’ll quit tomorrow.” This rationalization helps them justify the decision to use, even if deep down they know it wasn’t a good choice. It’s like the brain is trying to make the person feel better about what happened, even if it means ignoring the long-term consequences.

6. The Cycle Starts Over

After rationalizing the use, the cycle starts all over again. The brain learns that using substances helps relieve uncomfortable feelings, even temporarily, so the cravings can come back stronger the next time. The more this happens, the more the brain gets used to this cycle, making it harder to break free.

How to Heal the Brain After Addiction

Healing the brain from addiction involves multiple approaches to help restore balance and regain control over thoughts and behaviors. Here’s a more detailed breakdown of how to heal:

1. Therapy (Cognitive-Behavioral Therapy – CBT)

CBT focuses on changing negative thought patterns and behaviors. It teaches people how to recognize triggers (situations, feelings, or thoughts that lead to cravings) and replace unhealthy responses with healthier coping mechanisms.

Over time, CBT helps the brain form new neural connections, allowing for healthier ways of thinking and reacting. It also helps reduce cravings’ intensity by shifting how the brain processes triggers.

2. Medication-Assisted Treatment (MAT)

Certain medications can help manage cravings and withdrawal symptoms by balancing brain chemicals like dopamine, serotonin, and glutamate. These medications can make it easier to focus on therapy and recovery without the overwhelming urge to use.

For opioid addiction, drugs like methadone or buprenorphine reduce cravings and withdrawal symptoms. For alcohol addiction, medications like disulfiram or acamprosate can help maintain sobriety by making alcohol less appealing or reducing its pleasurable effects.

3. Support Systems

Having a support system post-treatment, whether it’s family, friends, or a counselor, offers empathy, encouragement, and understanding. Consistent participation in support groups provides accountability, motivation, and encouragement, which can prevent relapse and reinforce healthy coping strategies. Support groups like Narcotics Anonymous (NA) or Alcoholics Anonymous (AA) create a community of people who understand addiction and recovery. 

Talking with others who have gone through the same struggles helps break the isolation that often comes with addiction. This connection can reduce feelings of loneliness and remind the person that they are not alone in their struggle.

4. Mindfulness and Stress-Reduction Techniques

Mindfulness practices, such as meditation or yoga, can help rewire the brain by training it to be more present and less reactive to stress and cravings. When someone practices mindfulness, they’re learning to focus on the current moment without judgment. Over time, this can strengthen areas of the brain responsible for self-regulation, emotional control, and decision-making.

One of the main ways mindfulness helps the brain recover from addiction is by increasing activity in the prefrontal cortex. This is the area of the brain involved in higher-level thinking like planning, impulse control, and making decisions. This part of the brain helps override the more automatic, impulsive reactions that come from the limbic system (which plays a key role in cravings and emotional responses). Mindfulness can also decrease activity in the amygdala, which is involved in stress and fear responses, helping to reduce emotional reactivity and making it easier to stay calm in difficult situations.

5. Lifestyle Changes and Healthy Habits

Exercise, proper sleep, and healthy eating are essential for brain healing. Exercise boosts the production of endorphins, which can help replace the “high” once provided by substances. A balanced diet and good sleep help regulate brain chemicals and improve overall mental health. When practiced long-term these habits can help the brain return to a more balanced, natural state. This reduces dependency on substances for mood regulation and helps prevent relapse.

6. Time and Patience

Addiction causes significant changes to the brain’s structure and function, and these changes take time to reverse. It’s not something that can be fixed quickly, but with consistent effort, the brain can slowly heal, regain balance, and start to rewire itself.

Time also allows for the development of new habits and coping mechanisms. As someone works through their recovery, they can begin to build healthier routines and ways of thinking that become more automatic. It’s through these small, everyday efforts that long-term change happens.

Start Healing From Addiction 

Healing the brain from addiction is a multifaceted process that requires therapy, medication, support, lifestyle changes, and time. At Northpoint Recover, our inpatient addiction treatment programs will help you do just that. 

We’ll work with you to create a custom treatment plan based on your unique needs and experiences. Alumni of our program also have access to relapse prevention resources and a support network to help them stick to their recovery. 

Contact us today to learn how our treatment programs can change your or your loved one’s life for the better.