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Understanding the science of addiction

Kemi (not real name), a 32-year-old marketing manager in a Kampala firm, had always been the life of the party.

She loved trying new drinks and experimenting with marijuana to enhance her social experiences. At first, it was just a weekend thing, but soon she found herself drinking and smoking almost daily to cope with stress and anxiety.

As Kemi’s substance use escalated, she began to exhibit classic signs of addiction. She developed tolerance, needing more drinks and marijuana to feel the same high. She experienced withdrawal symptoms like irritability and insomnia when she couldn’t use. Despite negative consequences like missed workdays and strained relationships, Kemi couldn’t seem to stop.

Kemi’s friends and family staged an intervention, urging her to seek help, but she refused, thinking she could handle it on her own. One day, Kemi was rushed to the hospital with severe liver failure. Her doctors told her family that her liver was beyond repair, and she needed a transplant.

But it was too late. Kemi’s addiction had progressed too far, and after two weeks in ICU, she succumbed to liver failure. By understanding the science of addiction and seeking help, Kemi could have overcome her addiction and lived a healthier, happier life.

Addiction is a complex and multifaceted phenomenon that affects millions of people worldwide. While it is often misunderstood as a moral failing or a weakness, addiction is, in fact, a chronic disease that affects the brain’s reward, stress, and motivation systems.

The science of addiction reveals that it is a condition that can be caused by a combination of genetic, environmental, and psychological factors, and it can be treated with a range of evidence-based interventions.

Reward system: the brain has a built-in system in the midbrain called the reward system. Its job is to help us learn and repeat behaviour that is good for us, like eating food, spending time with loved ones. When we do something pleasurable, our brains give us a reward by releasing a chemical called dopamine. Dopamine makes us feel happy and satisfied.

Now, substances like drugs and alcohol, as well as behaviour like gambling, pornography, gaming, et al, can trick our brain’s reward system.

When we use them, they release a lot of dopamine, making us feel good. This can lead to a problem because our brain starts to associate these behaviours and using substances with feeling pleasure. Our brain adapts to the constant stimulation from substance use or problem behaviour. It gets used to the extra dopamine and starts to need more and more of it to feel normal.

This can lead to repeated use and eventually addiction. Tolerance is what happens when your brain gets used to a substance, like a drug or alcohol, or a behaviour like gambling, pornography, gaming, et al. At first, a small amount might make you feel good or relaxed. But over time, your brain starts to adapt and change (this is called neuroplasticity).

It is like your brain saying, “Hey, I have seen this substance or experienced this behaviour before, I know what to do with it”

As a result, the substance or behaviour doesn’t have the same effect as it used to. You might need more of it to feel the same way you did before. This is tolerance. It is like your brain has become desensitized to the substance or behaviour, and you need more of it to get the same feeling.

Here’s an example: imagine you are drinking coffee every day. At first, one cup might give you a big energy boost. But after a while, you might find that you need two or three cups to feel the same energy boost. That’s tolerance! Your brain has adapted to the caffeine, and you need more of it to get the same effect.

With substances and problem behaviour, tolerance can lead to vicious cycles. You might consume more and more of the substance or behaviour to try to get the same feeling, but your brain just adapts again, and you need even more. This can lead to serious problems like addiction and health issues.

So, tolerance is like your brain’s way of adapting to substances or problem behaviour, but often leads to trouble. Dependence is when your brain starts to rely on a substance or behaviour, to feel normal. It is like your brain has gotten used to having the substances or behaviour around and cannot function properly without it.

When the substance or behaviour is absent or reduced, withdrawal symptoms can occur. Withdrawal symptoms can be uncomfortable, painful, and even fatal. They make you feel like you need the substance or behaviour again to feel better.

Dependence is like a river that has been changed from its original path. The river starts flowing freely at first, but as it keeps on, it creates a new route, which makes a deep and winding channel. After some time, the river turns to this new path and it is hard for it to go back to the former course.

Similarly, when we use substances, the brain rewires itself, and this new wiring is difficult to undo. The brain is flexible and adapts itself; thus, it becomes difficult to cease or to alter the course, even if we wish to. This is dependence.

Just like it is not easy to change the course of a river that has already formed a deep path, it is also quite difficult to undo the changes in the brain that have already been made and have led to dependence.

Neuroplasticity is like the brain’s superpower! It means that our brain can change and adapt throughout our lives based on our experiences. This is really important because it allows us to learn and remember new things, like how to ride or play a musical instrument.

But repeated substance use can change the brain’s structure and function in ways that contribute to addiction. The brain rewires itself to accommodate the substance or behaviour, making it harder to stop using it even if we want to.

Addiction is the final phase, where the brain has adapted to the substance or behaviour and relies on it to function normally. behaviour and relies on it to function normally.

The tragic outcome to Kemi’s story could have been avoided if she had sought treatment earlier. It is crucial to recognize the severity of addiction and seek help to prevent a tragic outcome. By understanding the science of addiction, we can work towards effective prevention, treatment, and recovery strategies, saving countless lives and restoring hope to individuals and families affected by this debilitating disease.

The writer is the executive director of Focus on Recovery Uganda, and FORE Tranquil Homes, also a director at Break Free Mental Health Treatment and Rehabilitation Centre.


0 #1 Johnson Maganja 2024-06-13 14:22
Great piece of article bro!
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