In part one of this series we introduced the three stage “Addiction Cycle” which includes Binge/Intoxication, Withdrawal/Negative Affect and Preoccupation/Anticipation. We also discussed how in the Binge/Intoxication stage, substances “highjack” your brain’s natural reward or “pleasure” centers and make it difficult for you to get enjoyment from anything else other than drugs or alcohol. This hostile takeover of your reward system sets the foundation for the second stage of the addiction cycle: Withdrawal/Negative Affect.
In the Withdrawal/Negative Affect stage, two separate processes facilitate continued use of drugs or alcohol. First, as we just described above, the natural reward centers of the brain are impaired, so it is difficult for those suffering from a substance use disorder to achieve the same “good feeling” or pleasure from normal activities. The withdrawal from the substance causes psychological and physical cravings for that “good feeling” that can now only be achieved by using drugs or alcohol. The drive to achieve this “feeling” can be overwhelming.
The second process that occurs in this stage is activation of the natural stress mechanisms of the brain. In the part of the brain called the amygdala, withdrawal from a substance causes the release of neurotransmitters that increase feelings of stress, anxiety, restlessness and negative mood. This leads to a doubling of the effects of drugs and alcohol: you can’t feel any pleasure from normal activities and you actually feel stressed out and sad. It is easy to see why it is so difficult for those struggling with a substance use disorder to stop the use of the substance.
Luckily, there are treatments that address both mechanisms. In opioid use disorder, medications can stimulate the reward centers in a steady fashion in order to eliminate the binge/withdrawal cycle until you can be slowly weaned off the opioid. Also, there are activities you can perform and medications that can decrease the stress response caused by withdrawal. These enable you to be in a better mental condition to use the abstinence techniques that are taught by addiction counselors.
The Withdrawal/Negative Affect stage causes powerful effects on the brains of those suffering from substance use disorders, but there are help and treatments available.
In the next part of this series we will discuss the final stage of the Addiction Cycle, Preoccupation/Anticipation. If you’d like to learn more about the Binge/Intoxication stage, you can read the first blog post in this series.