Low Dopamine and Addiction: The Brain-Reward Connection
People with addiction often wonder what creates the cycle. It’s common to have thoughts like, “How did I get here?” and “Why is it so hard to stop?” Many factors can influence the development of substance use disorders and feed addiction as time goes on. It’s not a matter of willpower. In many cases, low dopamine and addiction go hand in hand.
The Brain’s Reward System 101
The brain’s reward system is a network of structures. It is designed to reinforce behaviors necessary for our survival. For example, eating, reproduction, and social connection. It does this by associating these behaviors with pleasure and motivation. Dopamine plays a vital role in the brain’s reward system. It is the brain’s primary chemical messenger for motivation and reward learning. When dopamine is released in the brain, we experience positive effects such as increased focus, satisfaction, and pleasure. When the brain learns that an activity increases dopamine levels, we are motivated to repeat it.
How Substances Hijack Dopamine
Drugs raise dopamine levels in the brain. Importantly, substances increase your dopamine levels much more than things like food, hobbies, socializing, and sex do. Drugs cause larger-than-normal, unnatural surges of dopamine. When you use substances continuously, it trains your brain to produce less dopamine on its own. It starts to rely on drugs for the chemical. In turn, people who misuse substances tend to stop feeling pleasure from other activities that would typically cause smaller, natural, healthy spikes in dopamine. Your baseline levels of dopamine are now low. That’s how substance abuse ultimately hijacks dopamine and creates the cycle of addiction.
Why Low Dopamine Drives Cravings
Dopamine is necessary for staying alive. When your dopamine levels are low, your brain seeks it out to restore balance. One of the ways that this can manifest is in the form of drug cravings. Specifically, this is what happens when a person’s body and brain have become accustomed to the substance and have come to rely on it for those large, unnatural surges of dopamine. The cyclic nature of low dopamine and cravings can be explained in three phases:
- Dopamine surge > First, you try a drug, and you get that burst of dopamine.
- Tolerance > You use the drug repeatedly, which creates tolerance. Your baseline dopamine levels drop, and your brain becomes less responsive to dopamine. This is why people with substance use disorders notice that they either feel less of a high when they use the same amount of a substance as they did before, or they find themselves using it in higher amounts to achieve the same effects.
- Withdrawal and dependence > With repeated use of addictive behaviors and substances, neural pathways strengthen over time. The brain wires itself to associate drugs and alcohol with survival. You become reliant on the substance and experience great discomfort (withdrawal symptoms) when you don’t have access to it.
Some people are more prone to addiction than others. At times, the way someone’s brain processes dopamine influences their likelihood of developing a substance use disorder. However, it is important to remember that people can and do recover–including those who are at an increased risk. Learning about the dopamine reward system can help you better understand yourself, the nature of your addiction, and why treatment works.
The ADHD & Addiction Overlap
ADHD affects how the brain processes and regulates dopamine. In ADHD brains, dopamine is recycled too quickly. People with ADHD often have fewer dopamine receptors and lower baseline dopamine levels. This causes people with ADHD to seek out quick sources of stimulation to boost dopamine. With this in mind, it likely doesn’t surprise you that people with ADHD are significantly more likely to have substance use disorders compared to people without ADHD.
When possible, early intervention matters for those with ADHD. A lot of people have misconceptions about ADHD treatment. Specifically, stimulant-based ADHD medication. When people get timely ADHD treatment in the form of ADHD medication, it lowers their risk of developing a substance use disorder by up to 85%. A lot of people who get diagnosed later in life experience a great deal of grief. This can include people who only learn that they have ADHD after developing a substance use disorder.
That said, having ADHD doesn’t mean that you’re sentenced to comorbidities like drug and alcohol abuse. Instead, working to better understand your brain in treatment can be key for recovery, quality of life, and life satisfaction. Treatment for addiction and ADHD can both involve psychoeducation, which helps people learn more about how their minds work and how to work with them.
Restoring Dopamine Balance in Recovery
With time, the brain does heal from the effects of past substance abuse. When you get and stay sober, your brain’s receptors become more sensitive to dopamine from rewarding activities in everyday life, like hobbies and socializing, just like they were prior to addiction. This is known as “upregulation.” While it is a gradual process, your brain returns to its baseline state. Full brain recovery is possible for most people.
Restoring dopamine balance in recovery requires patience. It is often uncomfortable mentally and physically at first. That’s one of many reasons as to why addiction treatment is so important. Usually, it involves:
- Detox. During the acute withdrawal stage (which happens when you first stop using substances), dopamine levels can be particularly low, potentially causing uncomfortable physical and emotional symptoms. At times, these can be dangerous without medical intervention. Detox helps you get through this stage safely.
- Addiction treatment. After detox, continued care is crucial. This could be in the form of an inpatient treatment program or an outpatient treatment program. A step-down approach is generally recommended.
- Co-occurring disorders. If you have a co-occurring condition, treatment professionals should use a dual diagnosis approach. For example, combining ADHD treatment with addiction treatment provides whole person care for people with both.
Sanford Behavioral Health offers a full continuum of care for people overcoming addiction and co-occurring concerns. We make it possible to receive seamless treatment at every stage of the recovery process. And, we’ll always work with you to individualize your care to fit your unique needs, like addressing ADHD and addiction simultaneously if applicable.
How Treatment Helps
Treatment helps people with substance use disorders rebuild their lives and regain their health, including brain health and the brain-reward connection, in more than one way. Here are some of the benefits of addiction treatment.
- Emotional support. Whether you’re in inpatient or outpatient treatment, your care team will provide essential emotional support as your brain and body work to return to their baseline state.
- Supervision. Medically supervised detox and inpatient treatment programs provide 24/7 supervision in a drug and alcohol-free environment. This helps people avoid giving in to drug cravings at a time when they may be particularly susceptible.
- Accountability. Both inpatient and outpatient drug and alcohol rehab programs help you stay accountable and focused on your recovery.
- Structure. Treatment programs are structured. They include groups, individual therapy sessions, and other activities (e.g., meals, recreation), that help you get used to following healthy routines. Even if you’re in the lowest level of care or are following an aftercare plan, therapists can help you build and execute routines.
- Self-understanding. Addiction treatment helps people understand why they use drugs and alcohol and how to meet their needs without substances. This can include the connection between low dopamine and addiction. If you have a co-occurring concern like ADHD, depression, or trauma–or even specific life experiences, like emotional invalidation–therapy also gives you the chance to understand how these things affect you and how to navigate them.
- Behavioral activation. When dopamine is low, motivation is low. Behavioral activation is a therapy technique that helps you engage in activities that support your recovery, mood, and well-being, even when you may not feel particularly motivated.
- Skill development. Addiction treatment can help you build a breadth of necessary skills. For example, coping skills for managing substance abuse triggers, communication skills, and others, such as problem-solving and decision-making skills.
- Peer connection. Group activities in addiction treatment give you the chance to connect with other people who are going through the same thing. You can support each other, learn together, and establish a sense of camaraderie, which can be healing.
Learn more about addiction treatment at Sanford Behavioral Health today. Contact us online or call 616.202.3326 to get started.
