Professionals refer to “addiction,” or “addictive disease,” rather than to heroin addiction, cocaine addiction, etc. The fact of the matter, little understood by the world at large, is that we don’t become addicted to drugs, but to the effects that they have on our brains — specifically on the pleasure center. The pleasure center is located in the sub-cortical region of the brain which means, among other things, that we can’t control it directly. (That’s why “Just Say No” is a cruel joke.)
Drugs short-circuit the process by either stimulating the production of these neurotransmitters, or by mimicking their actions. Drugs allow us to control the production of the good feelings. Since we are pre-programmed to seek those feelings, we tend to do it quite a lot. Over time, actual physical changes take place in our brains in order to accommodate the unnatural levels of chemicals.
This occurs in several ways, but we’ll simplify it by saying that our neurons grow additional receptor sites to deal with the surplus. This means, in turn, that we need more of the drug’s effects to reach the levels that give us pleasure. This tolerance is one of the first signs of developing addiction. Eventually we reach a point where we need the stimulation in order to function anything like normally, and we’re hooked for sure.
When we go “cold turkey,” the sudden absence of chemicals causes the syndromes that we call acute withdrawal. The length of the acute phase lasts anywhere from a few days to several weeks, depending on the drug. Simple drugs, like alcohol, have the shortest acute phases, while those that metabolize into other active compounds can take much longer. Methadone is an excellent example. It has not only a longer but more severe acute withdrawal than other opiates. The symptoms of withdrawal, generally speaking, are the reverse of whatever effects the drugs had. Opioids, for example, calm us and slow the action of our digestive tract, and the withdrawal symptoms are the jitters, nausea, diarrhea and the creepy-crawlies, among others.
Those extra receptor sites slowly become dormant and stop pestering us for stimulation, but the main thing to remember is that while the body and brain recover from the changes, the changes do not necessarily go away, and if they do, it is usually over a period of years.
If we use drugs or alcohol in early recovery, we will interfere with the progression to normalcy. Any extra stimulation, whether by the drug of choice or another, can have this effect; we don’t have to get drunk or high. The neurotransmitters involved are the same combination, and using any mood-altering drug can lead back to an active addiction. At the very least, it will prolong the recovery process.
Even after our brains are back as close to normal as they’re going to get, exposure to drugs can reactivate those dormant receptor sites, and start the cravings all over again. This is true of marijuana and booze, as well as other drugs, since they all work by stimulating the reward center. In addition, drugs tend to make us more likely to do stupid things, like use more drugs.
So we can obviously drink or use cannabis if we wish. As addicts are so fond of pointing out, “It’s my life!”* However, if we do so even in small amounts, we are likely to end up deep in addiction again.
*How bogus is that? Like we have no effect on anyone but ourselves. Addict thinking.