How does addiction change the brain?

The brain is constructed of nerves which send messages to each other by way of chemicals and electrical impulses. There are certain areas of the brain that show more chemical and electrical activity when people are excited or experiencing pleasure. We have learned that certain drugs can turn “on” those pleasure areas just as if someone was doing something pleasurable. Because people like that feeling, they tend to keep taking the drug seeking the same pleasurable response. The problem is that for many drugs, once people start taking them, their bodies get used to the drug and they need more of the drug to feel the pleasure. 

Why do some people develop addiction while others don’t?

Even with all the current research in the field, the National Institute on Drug Abuse (NIDA) reports experts are still working to fully understand what causes some people to become addicted to substances. The current consensus suggests that there is not one single trigger that causes addictions, but instead there are various biological and environmental factors and the interplay of these factors, that increase the risk of someone developing a substance use disorder. Factors like genes, age, gender, and environment can lead to an increase of use and addiction. Based on current knowledge, it seems that our genes, as influenced by social environmental factors, account for 40-60% of a person’s risk of developing a substance abuse disorder (NIDA Website). Other factors, such as socioeconomic status, social groups, family involvements, pre-existing mental disorders and risk-taking behaviors all play a role in the onset of addiction.

What are the warning signs someone is suffering from addiction?

The warning signs of addiction exceed those you might expect from someone misusing drugs. Addiction signs include: tolerance (increased need for a substance to experience the same effects), the ongoing use of a substance even in the face of negative consequences, changes in lifestyle and coping strategies that now include the substance as a primary self-care strategy, the person has lost interest in previous life and/or social activities, makes poor choices in order to access the substance, changes in sleeping and eating habits, changes in social relationships, lack of personal hygiene.

How can you support someone suffering from addiction?

We cannot force people to get better; they have to want to make changes to get healthy and sober. In most cases, the help of medical and mental health professionals is required to ensure a safe and long-term recovery of this chronic disease. The best things we can do for individuals suffering from addiction is to educate ourselves on the services available, seek advice and guidance from addiction professionals, open dialogue that lets the individuals work through the reasons to seek treatment, and be supportive without being enabling.

Can an addiction counselor or mental health counselor help? What do they do?

Substance use counselors work with people who suffer from alcohol abuse, drug dependency, and other subsets of substance addiction.

Licensed Mental Health Counselor (LMHC)-trained Substance Use Counselors add additional training into the psychological factors that trigger, are a consequence of substance use disorder. Depending upon the treatment environment, these dual-trained counselors may provide clinical treatment to both the mental health and substance issues or, based on their training, know how and when to collaborate with other mental health professionals and organizations. Substance use treatment does not subscribe to a “one size fits all” mentality, and outcome is dependent on several different factors including, but not limited to:

• The appropriateness of treatment;
• The extent and nature of the person’s problem;
• The availability of additional services;
• The quality of interaction between the person and his or her treatment providers; and
• The support system that the individual either has or cultivates during treatment

Counselors manage the full range of treatment from patient assessment to collaborating with a variety of other health professionals. Intake usually involves evaluating the patients mental state as well as setting realistic estimations for a patients capacity towards effective treatment. Counselors recommend specified treatment plans for patients, often in consultation with the patient’s family and/or other healthcare professionals.

Learn more about becoming trained as a Licensed Mental Health Counselor and receiving a certificate in substance abuse counseling.

Dr. Faye Fried-Walkenfeld is a psychologist and Chair of the Department of Behavioral Science at Touro College. She is also program director and associate professor at Touro’s Clinical Mental Health Counseling program.