"Why doesn't he just stop drinking?" "Why does she keep using heroin if she knows the consequences?" People can ask these questions when they see someone struggling with substance abuse—they may think that if a person recognizes the dangers, they should be able to stop. But it's not that simple.
Addiction is not a choice that is made and can be stopped by the simple desire to quit. Research has shown that addiction is a disease. It affects the brain in staggering ways, making the cravings and the reliance on drugs or alcohol involuntary.
Most drugs target the reward center of the brain. When someone uses a drug, dopamine is released and floods their brain. Dopamine is a neurotransmitter that signals pleasure and reward. When an action causes dopamine levels to rise, the person is motivated to repeat that action. In this case, when the use of a drug causes a person to feel pleasure, they are motivated to use the drug again to replicate the feeling. Compulsive cravings start occurring, and the person becomes addicted.
Over the long term, the flood of dopamine from the use of drugs or alcohol causes the brain to slow the natural production of dopamine and/or reduce its response to the dopamine. This can further the addiction, as the person now needs the drug to feel pleasure and happiness.
Addiction not only affects and alters the reward center of the brain but also causes changes to other parts of the brain. According to the National Institute on Drug Abuse, the use of drugs and alcohol affects the parts of the brain responsible for learning, memory, habits, impulse inhibition, decision making, cognitive awareness, mood, and stress reactivity. These changes to a person's brain chemistry can contribute to the continuing use of drugs and alcohol. It is hard for an addicted person to simply use "willpower" to quit when so many vital cognitive functions have been affected.
It is important to recognize that addiction is a disease, not a choice, and to take steps to reduce both the stigma and the problem. If you or someone you know is struggling with substance abuse, remember that it is not as simple as just making the decision to quit. As with other diseases, professional help is often needed to recover. For more information about the effects of drug abuse and treatment options, visit RecoverGateway.org.