The previous blogs in this series explored Binge / Intoxication and Withdrawal / Negative Affect, the first two stages of the “Addiction Cycle”, and how substances take over the parts of your brain related to pleasure and stress and set the stage for feeling miserable when you don’t consume drugs or alcohol. These forces in your brain are very powerful. Yet, drugs and alcohol don’t stop there. They affect the part of your brain involved in decision making. So, while you may want to make the choice to stop, your brain’s decision making areas are fighting against you due to the effects of drugs and alcohol.
The third stage of the addiction cycle is called the Preoccupation / Anticipation stage.
What is the Preoccupation/Anticipation Stage?
“This stage of addiction involves the brain’s prefrontal cortex, the region that controls executive function: the ability to organize thoughts and activities, prioritize tasks, manage time, make decisions, and regulate one’s own actions, emotions, and impulses. Executive function is essential for a person to make appropriate choices about whether or not to use a substance and to override often strong urges to use, especially when the person experiences triggers, such as stimuli associated with that substance (e.g., being at a party where alcohol is served or where people are smoking) or stressful experiences.”
This part of the brain can be thought of as having a “go” system and a “stop” system. The “go” system, under normal circumstances, helps you plan for daily activities and have the motivation towards moving forward on a goal. The “stop” system helps you inhibit all the impulsive and distracting thoughts and emotions that are generated from other parts of the brain. As an example, you want to go on a road trip. Your “go” system will motivate and enable you to plan when and how to get to your location. Your “stop” system will keep you from ramming your car into the person that just cut you off in traffic, even though you really want to.
Those suffering with substance use disorders have dysfunction in both their “go” and “stop” systems. Substances can strengthen the “go” system, which can lead to the drastic impulsivity seen in behavior and emotions of those struggling with addictions. At the same time, drugs and alcohol inhibit the “stop” system making it harder to filter out negative thoughts and emotions. Going back to our road trip analogy, it would be as if you knew you wanted to go on the trip, but had limited ability to plan out how to do it. Then once you got in the car, your foot was stuck on the gas and your brake pedal didn’t work. It is easy to see that the “crash” is coming soon.
Luckily, there are effective therapies and treatments to help those struggling with addictions to get back in control. One of the key features of many therapies used in substance use disorders is to help you strengthen your “stop” system and to slow down your dysfunctional “go” system. Many psychological therapies target the pre-frontal cortex and help you to bring these two systems into balance.
Hopefully, this three-part series has helped you understand how substances can trap you in the addiction cycle, but also given you hope by explaining that there are effective treatments for whatever part of the cycle you are currently in. All you have to do is reach out for help.