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Substance Use, Addiction, and Dopamine Oh My!

Updated: Mar 9, 2023

So, here you are looking at info on addiction. If you have come this far, then at the very least, you have thought about change, but are struggling to either get started or maintain your progress. Thank you for taking the time to read some information about the issue and the work we would do together. First, let’s take some time to understand the issue.

Dopamine!!! Weeeeeee!!!

So Dopamine is your brain’s “feel good” chemical. It gets released whenever you do something pleasurable. The normal pattern is that you get a “boost” from the activity and then the chemical levels out. Sometimes, however, you get a “spike” and then a sharper decrease afterwards that

leaves you wanting to do it again. When that happens, the next spike tends to be a little lower than the first, and that starts the pattern we call “chasing the dragon.” Nothing seems quite like that first high but you try anyway. This becomes an obsession. The obsession starts to take over as you start to risk greater use and greater consequence with each use. In the meantime, each peak has slowly shrunk, while your valleys begin to deepen below the norm. In those valley times, you may feel off, down, depressed, and sick. It gets to be where you need to use just to keep from that happening. Each sickness gets worse and you don’t even get the high anymore. These are the pits of addiction that are often a catalyst for change. You start to lose track of what you have been doing and how you have been living and the price you have paid along the way. Sometimes you just wake up to that cost, and sometimes life sends you a wakeup call. You might be hit with the cliché bottoms of “jails, institutions, and death” that force you to stop. However, forcing you to stop doesn’t always mean forcing you to change. In those moments some choose to change, some give up, some go deeper, and some change their substance or behavior in hopes that the next one will “work.” Some never get “that” far to begin with and they get complacent. Regardless, you start to feel a lack of joy and satisfaction from any of your life. Nothing makes you quite happy enough anymore. That’s because your brain has been conditioned to secrete Dopamine (the feel good stuff) in a flooding nature at the onset of a certain specific trigger, but the brain has adjusted to the trigger and flood. You have become “dependent.”


There is good news, you can recover! There are a lot of options out there depending on your severity of use and the potential dangers of stopping the substance (alcohol and benzo withdrawal being potentially lethal if not medically managed). Your brain over time will heal and you will be able to have fun and enjoy life again. When you are ready to make a decision to start a new life, you will have support. Unfortunately, most therapists in my position will have a hard time working with the beginning stages of change for some of these patterns, but if you are safe and stable enough to manage outpatient sessions, then let’s take a look at what our work will be. Keep your eyes open for the next post on “Relapse Prevention and My Disdain for the Idea”…. Yes, that’s right, I said that….. #cliffhanger

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