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Published on March 28, 2022

The Science of Addiction: How Your Brain Reacts to and Rewards Substance Use

Understanding and breaking the cycle can help build healthier habits.

It's no secret that the pandemic has been a significant challenge for people across the nation and around the world. Many of us think first about guarding our physical health against COVID-19, but our mental health is equally at risk during these times. Unfortunately, the ways we cope with threats often do more harm than good.

Chief among these unhealthy coping strategies is the increase in substance use that experts have seen during the pandemic. According to the Centers for Disease Control and Prevention (CDC), 13% of Americans have reported starting or increasing substance use as a way of coping with the stress and emotions related to COVID-19.

"It's not uncommon to use substances like alcohol to cope with stress, but it’s a slippery slope from social use to abuse and substance use disorder," said Nancy DeAngelis, CRNP, Director of Behavioral Health, Jefferson Health – Abington. "Being aware of how and why you're using substances, and how that changes over time, is important to staying healthy physically, mentally and emotionally."

How Substances Like Alcohol and Other Drugs Hijack Your Brain

Your brain is responsible for everything from solving complex problems to regulating bodily functions you never think about. It completes these tasks, in part, through specialized cells called neurons that carry signals throughout the brain and nervous system.

"Neurotransmitters are the chemical substances released by neurons that transmit signals to the next neuron, or to and from other parts of your body like muscles and sensory organs," said DeAngelis. "Substances like alcohol and other drugs affect how these neurons work, both while you're under the influence of that substance and long after it has left your system."

Among the most common neurotransmitters are serotonin, which reduces anxiety; endorphins, which are the body's natural pain killers; and dopamine, the so-called "feel good" neurotransmitter.

Substances like alcohol and drugs hijack this system, flooding the space between your neurons with an unnaturally high amount of neurotransmitters. While an activity like exercise may give you a brief spike in dopamine above your baseline, you experience a much bigger spike that lasts significantly longer from alcohol, cannabis, cocaine and other drugs.

"The problem with alcohol and drug use is that your neurotransmitter levels can drop below your natural baseline when you're not using the substance," said DeAngelis. "It can also lead to a state called downregulation where you have fewer receptors on your neurons to capture neurotransmitters, which makes it hard to take pleasure in normal activities without the substance."

How to Recognize When You Need Help

Adults over 21 years old frequently enjoy a beer at a baseball game or a few glasses of wine at the holidays or other special occasions. In moderation, this type of social use likely will not create a lower quality of life.

However, social use can stray into binge use, abuse or substance use disorder. This progression became a greater risk during the pandemic, when people could no longer socialize in public but continued—and increased—their substance use.

"If you think your use of alcohol and other drugs has become a problem, start monitoring your intake, what prompts you to use and what consequences you experience," said DeAngelis. "If you continue despite negative consequences, this is a good indication that you should talk to your primary care physician about getting help to reduce or eliminate your substance use."

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