Can the Brain Recover from Addiction?

Recovery Tools from Asana Recovery August 16, 2023

Addiction does not just wreak havoc on our relationships and day-to-day lives. It also causes damage to many parts of the body, including the brain. That’s the bad news.

The good news is: the human brain undergoes profound changes throughout our lifespan, constantly adapting and rewiring itself to form new connections and pathways. This remarkable phenomenon, known as neuroplasticity, enables us to acquire new skills, recover from injuries and even reshape our personalities, making it possible that the brain can recover from the damage of addiction.

Now, most people with addiction feel shame and guilt because of our addictive behaviors. We’re also prone to distorted thinking, so we often approach problems with a defeatist, black-or-white viewpoint. So, if you start to read this article and find yourself thinking something like ‘oh wow, I’ve already done so much damage to my brain, what’s the point of even staying clean?’ stop right there. Look at that statement for what it is: a lie your brain is telling you.

In the Surgeon General’s Report on Alcohol, Drugs, and Health, the authors found many “reasons for hope and optimism,” and we can too! Let’s start by looking at what addiction and recovery do to our brains.

How Addiction Changes the Brain

Substance use disorders are complex conditions that involve changes in brain functioning and behavior. They result from repeated use of drugs or alcohol, which can lead to addiction. Addiction is marked by changes in brain circuits related to pleasure, learning, stress, decision-making, and self-control.

Addiction Trains Our Brains

Different substances can have varying effects on the brain, but all addictive drugs, including alcohol, opioids, and cocaine, stimulate the release of dopamine in the basal ganglia, a region of the brain responsible for reward and learning. With continued substance use, these brain circuits adapt and become less sensitive to dopamine, leading to tolerance. As a result, individuals may need to increase the amount of the substance in order to achieve the same level of pleasure or "high" they experienced initially. This can also affect their ability to experience pleasure from ordinary rewards in life.

“Repeated use of a substance “trains” the brain to associate the rewarding high with other cues in the person’s life,” the Surgeon General’s report says.

Addiction Causes Structural Changes

Repeated drug use creates structural changes in the extended amygdala and prefrontal cortex. The Surgeon General’s report describes the functions of the amygdala like this: “The extended amygdala controls our responses to stress. If dopamine bursts in the reward circuitry in the basal ganglia are like a carrot that lures the brain toward rewards, bursts of stress neurotransmitters in the extended amygdala are like a painful stick that pushes the brain to escape unpleasant situations.”

The prefrontal cortex is not just responsible for logical thinking. It also shapes our decisions, reasoning, and social behavior. Additionally, it plays a significant role in regulating emotions and preventing impulsive responses. “Healthy adults are usually able to control their impulses when necessary, because these impulses are balanced by the judgment and decision-making circuits of the prefrontal cortex,” the report explains. “Unfortunately, these prefrontal circuits are also disrupted in substance use disorders. The result is a reduced ability to control the powerful impulses toward alcohol or drug use despite awareness that stopping is in the person’s best long-term interest.”

Can the Brain Recover?

To sum up, addiction trains our brains to view addiction-related stimuli as rewarding and to find it harder to find pleasure in activities unrelated to addiction (i.e. day-to-day life.) Additionally, repeated drug use causes structural changes to our brains that can make it challenging to control impulses and make good decisions.

One of the Key Findings in the Surgeon General’s report is: “Remission from substance use disorders—the reduction of key symptoms below the diagnostic threshold—is more common than most people realize. “Supported” scientific evidence indicates that approximately 50 percent of adults who once met diagnostic criteria for a substance use disorder—or about 25 million people—are currently in stable remission (1 year or longer).”

While the Surgeon General’s report illustrates that recovery from addiction - or “remission” - is possible, it does not recommend a specific approach to treating Substance Use Disorders. It says:

• “Well-supported scientific evidence demonstrates the effectiveness of 12-step mutual aid groups focused on alcohol and 12-step facilitation interventions” and that

• “There are many paths to recovery. People will choose their pathway based on their cultural values, their socioeconomic status, their psychological and behavioral needs, and the nature of their substance use disorder.”

So, is it possible for the brain to recover from addiction? The simple and very, very sweet answer is: yes. But, for those of us on a path to recovery, we don’t even need the Surgeon General’s report to know that. We see it every day we stay sober!

Questions? Comments? Personal experiences? Tell us in the ‘comments.’