• September 2019 •

From Juan Navarro, Executive Director
Los Angeles Centers for Alcohol and Drug Abuse

Your Brain on Drugs

When it’s hot enough to fry an egg on the sidewalk, I think about that old TV announcement. The one where someone cracks an egg into a hot pan. Back in the day, we explained things simply:  abusing drugs “fries” your brain.  And it does, but today we know why.

Neuroscience(the study of the brain), and cognitive psychology (the study of why we do what we do), have made quantum leaps since the fried egg days. Neuroimaging technologies research has shown that pleasurable activities – such as drinking, drug use, gambling, shopping, and sex – can actually hijack the brain.  It happens because our built-in rewards network is always at work to satisfy basic human needs. If it didn’t feel good to eat when we’re hungry, we might die of starvation. Instead, our brain rewards us with a surge of the feel-good neurotransmitter dopamine when we do things needed to sustain life.

Unfortunately, it’s a delicate system. Pleasure reward circuits are connected to circuits for motivation and memory.  Addictive substances and behaviors can overstimulate this circuitry (here’s where the frying comes in), causing overload. In nature, rewards come with time and effort.  But addictive drugs and behaviors provide a shortcut, a type of malware that floods the brain with dopamine and other neurotransmitters. Since the human brain can’t withstand this onslaught, it responds by producing less dopamine or eliminating the dopamine receptors. In response, we increase our addictive behavior, desperately trying to replicate that original dopamine reward. It’s all about physiology.  Contemporary knowledge of “your brain on drugs” has changed the definition of addiction to a chronic brain disease. Science has proven once and for all that “moral weakness’ or “lack of willpower” are not the causes of addiction.

Explore your brain on alcohol and drugs with a video from: NatGeo


Matthew M.

“My name is Matt and I guess I got into drugs to be more calm. I had a lot of stupid, crazy thoughts going all the time. It made me afraid of what I could do.  When I found some pills that kind of shut up my brain so I could relax, that was it for me. I had to have more. Didn’t have to worry about being a major disappointment to my dad and everybody else. Didn’t have to think about all the things I should be doing, I could just be peaceful. But I took it kinda too far, I was like a vegetable, you know? I would listen to music, use, drink, sleep. Nothing else mattered. One day I woke up in some E.R. and (I had) no clue how the hell I got there. Turned out I overdosed. My parents put me in treatment, which I really, really hated at first. But when my counselor showed me ways to calm down and be peaceful in my life, I started to listen because those things worked!  I’m kind of a different guy than I was. I’m grateful to the program for this new start. Recovery is ok.”

Cognitive Behavioral Therapy

If addiction — the most serious form of substance use disorder — is a chronic brain disease, then treatment must address brain function. Cognitive Behavioral Therapy or CBT does this by changing critical neural networks that shape how we think and feel.

Our brain contains roughly 86 billion neurons, each of which is connected to about 10,000 others. The connections between these neurons organize themselves according to topics or themes which become neural networks over time, for example, craving drugs. When we are mindful about where our attention goes, we are able to train our neural networks be more helpful, adaptive, and healthy. When we shift away from the old, unhelpful networks that contain negative self-talk or beliefs, they actually begin to wither away as we cease to activate them.

CBT works by 1 becoming aware of the network we are in by becoming aware of our thoughts; 2) recognizing how being in that network (having that thought) is helpful or not; 3) becoming aware of the consequences of spending time in that network (engaging with that thought), and 4) shifting out of that network (the thought) into more helpful networks.

Watch this EBP in action: A live CBT session

CBT Role-Play - Treating Heroin Use by Dr. Todd Grande