Although young people are particularly vulnerable to the adverse effects of substance use, not all adolescents who experiment with alcohol or drugs go on to develop a substance use disorder. Studies that follow groups of adolescents over time to learn about the developing human brain should be conducted. These studies should investigate how pre-existing neurobiological factors contribute to substance use, misuse, and addiction, and how adolescent substance use affects brain function and behavior. Its key characteristics can range from regular substance use to cravings and dependence, severe effects, loss of control, risky behavior, tolerance, social isolation, physical and mental health decline, etc.

Phase 4: Addiction

Relapse is a common part of the journey, with many individuals cycling back through earlier phases of addiction before achieving lasting sobriety. Understanding the Addiction Relapse Cycle is crucial for developing effective strategies to prevent and manage setbacks. This crisis point might come in the form of a health scare, legal troubles, or the loss of a job or relationship. It’s often during these moments of clarity (or desperation) that individuals seek treatment, taking choose the correct cycle of addiction. the first steps towards breaking free from the addiction cycle.

Continued Use / Abuse

Chronic neuroinflammation in the context of addiction can lead to widespread neural dysfunction and exacerbate the cycle of drug craving and relapse. The withdrawal/negative affect stage comprises acute and post-acute withdrawal phenomenology. One adaption arises from within the reward system, where chronic exposure to a reward decreases dopaminergic tone in the NAcc. In addition, the glutaminergic-gabaergic balance in the reward system shifts toward one of increased glutaminergic tone and lessened gabaergic tone. This in-system adaptation leads to diminished euphoria from the reward, reduced tolerance for stress, and increased feelings of agitation while simultaneously decreasing the effects of natural rewards like sex and food.

Medical Disclaimer

Dopamine is a type of neurotransmitter, something that is made by your body to send messages between nerve cells. Bursts of dopamine signals can cause changes in neural connectivity that signal to your brain to repeat that activity, the one that is causing pleasure. Treatment and therapy can be effective at any stage in the addiction cycle, the types of treatment and effective modalities will vary based on the individual, symptoms, and stage of drug use. Addiction is a chronic, relapsing disease that necessitates continuous treatment, even during periods of maintenance or recovery. The American Psychiatric Association defines addiction as a complex condition, manifesting as uncontrollable substance use despite harmful consequences (APA, 2013). Individuals in this stage may find that much of their time is spent obtaining, using, and recovering from the effects of the substance.

What Are the 5 Stages in the Addiction Cycle?

Navigating this path requires courage, support, and an understanding of the processes involved in breaking free from addiction’s hold. Addiction primarily takes root in the brain, fundamentally altering its function and structure. The brain is wired to reward us when we do things that are pleasurable or necessary for survival, such as eating or socializing, by releasing a neurotransmitter called dopamine. Options range from medication-assisted treatment to cognitive-behavioral therapy, group counseling, and holistic approaches like mindfulness and yoga.

Studies have identified features of addiction such as a strong desire for the addictive behavior or substance, loss of control over its use, and continued involvement with it despite harmful repercussions. The binge/intoxication stage of the addiction cycle is the stage at which an individual consumes the substance of choice. This stage heavily involves the basal ganglia (Figure 2.4) and its two key brain sub-regions, the nucleus accumbens and the dorsal striatum. A growing body of substance use research conducted with humans is complementing the work in animals. For example, human studies have benefited greatly from the use of brain-imaging technologies, such as magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. These technologies allow researchers to “see” inside the living human brain so that they can investigate and characterize the biochemical, functional, and structural changes in the brain that result from alcohol and drug use.

• This leads to an ongoing withdrawal state in which low mood, anxiety, and physical illness are the baseline.
• The model is not applicable to the majority of individuals who are diagnosed with substance use disorders (even those who may be diagnosed with severe substance use disorders).
• It’s possible for a person to still be in somewhat of control at this stage.
• This can cause a person who’d otherwise enjoy casual drinking or avoid substance abuse to become addicted to alcohol or drugs.
• The signature of this phase is a preoccupation with using the substance, known as «cravings.» The prefrontal cortex (PFC) is the brain region primarily involved in the preoccupation/anticipation stage.
• I believe people can heal with unconditional support and having a sense of connection and purpose.

The decreased effects of natural rewards translate to decreased satisfaction in interpersonal relationships at work and home. To understand how addictive substances affect the brain, it is important to first understand the basic biology of healthy brain function. Within the brain, a mix of chemical and electrical processes controls the body’s most basic functions, like breathing and digestion. Until recently, much of our knowledge about the neurobiology of substance use, misuse, and addiction came from the study of laboratory animals. Although no animal model fully reflects the human experience, animal studies let researchers investigate addiction under highly controlled conditions that may not be possible or ethical to replicate in humans. These types of studies have greatly helped to answer questions about how particular genes, developmental processes, and environmental factors, such as stressors, affect substance-taking behavior.

Effects of Substance Use on Brain Circuits and Functions

For example, Drug rehabilitation initial use could start as prescription medications from a doctor or through peer pressure. The stages of the addiction cycle are based on research from the Substance Abuse and Mental Health Services Administration (SAMSHA), which identified the areas of the brain where these stages occur. However, if the person has been using a drug to treat another condition and becomes dependent on that drug to feel good separate from the condition being treated, it may be a type of dependence that leads to addiction.

Brain Disease Model of Addiction

Research indicates that stress, trauma, and mental health disorders are deeply intertwined with the development and perpetuation of addictive behaviors. Notably, alcohol and other substances can activate biological stress pathways akin to those triggered by psychological stress and trauma, potentially exacerbating cravings and compulsive substance-seeking behaviors. Decades of research demonstrate that chronic substance misuse leads to profound disruptions of brain circuits involved in the experience of pleasure or reward, habit formation, stress, and decision-making. This work has paved the way for the development of a variety of therapies that effectively help people reduce or abstain from alcohol and drug misuse and regain control over their lives. In spite of this progress, our understanding of how substance use affects the brain and behavior is far from complete.

Clinicians should assess the patient’s level of motivation and respect their stage of change. Treatments can utilize psychosocial supports such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Depending on the addictive disorder, clinicians can consider the possibility of psychotherapy and pharmacotherapy.