The human brain has been compared to the universe, and for good reason. There is no other metaphor that does justice to the brain’s miraculous complexity and capacity. The numbers alone are beyond comprehension—trillions of specialized cells, 100 billion or more neurons, synapses and chemical transmitters that generate up to 500 trillion connections.
It is this brilliant and self-communicating universe that is put at risk when we, or people we love, develop an uncontrolled craving for alcohol and other drugs. Step by step, the extravagant potential of our brain is reduced to a narrow and destructive mission—ingesting a chemical substance of which we can never get enough. The result is a self-perpetuating form of brain damage that leaves virtually no part of the human personality unharmed.
Although the molecular and cellular details differ depending on the chemistry of individual drugs, in general the pattern of transformation within the brain is the same for all addictive substances:
• To cope with the high levels of dopamine generated by drugs, the brain makes cellular and structural changes to produce less dopamine of its own;
• Without normal levels of dopamine—the feel-good molecule—the everyday mood of drug users goes into a significant decline;
• Because they don’t feel good naturally, drug users becomes increasingly dependent on drugs for the experience of pleasure;
• Dependence leads to tolerance—users take more and more drugs for less and less effect.
In the end, addicts find themselves compulsively using chemical substances that they no longer like or even want. Their behavior is now virtually unconscious, a reflex response to an emergency message from a dopamine-depleted brain. Addictive drugs are as essential to your life as eating and drinking and you will not survive without them. This agitating SOS is a relentless neurobiological misfire to which the user must respond—by using more of the drugs that are causing the brain’s short circuit.
Step 1: Playing with Fire: Who’s At Risk?