Contributed by Sharon Therien, freelance writer and blogger at 

Addiction creates many changes to the brain, affecting pleasure and reward, decision-making and other brain functions. Changes to the reward center is one of the major ways consistent drug use affects the brain. Drug use leads to sudden drastic increases of the brain chemical dopamine, and the brain reacts by making less dopamine regularly or adjusting how many dopamine receptors are available. When the brain makes these changes, the person now finds it extremely hard to feel pleasure without taking an addictive substance, so he or she continues using the drug or alcohol to increase dopamine levels and feel better.

Beyond dopamine, continued drug use can cause additional effects in the brain, including alterations to circuits and neurons. A person’s mental function, memory and the brain’s effect on behaviors can all change. Dr. Alan I. Leshner of the National Institute on Drug Abuse explained that changes that happen in the forebrain have been associated with aspects of addiction, such as cravings and cue-induced cravings.

While continued drug use and addiction can profoundly change the brain, Leshner explained that the brain can heal itself to a certain extent and it can adapt – for instance, it could use a different circuit when one has been damaged. Certain medications may be able to help with brain healing, as could natural techniques such as diet and exercise. In addition, therapeutic techniques are capable of providing positive changes to the brain.

Therapy has been shown to change the brain in many positive ways, which are generally in applications of helping people with mental disorders. These changes have potential for healing the brain of addicted people as well. And at the same time, therapy could help with both substance use disorder and a co-occurring mental disorder when one is present.

Psychotherapy, which is also known as talk therapy, has been shown time and again to have positive effects on the brain. Cognitive behavioral therapy is a main variety of psychotherapy that is often associated with positive brain changes in studies.

A February 2016 study in the journal Translational Psychiatry studied the effects of cognitive behavioral therapy on social anxiety disorder. It found that cognitive behavioral therapy given through the internet reduced brain volume in study participants and cut down on brain activity, which were both positive changes. The study saw significant brain changes after only nine weeks of therapy in participants.

A study through the UCLA School of Medicine found that 10 weeks of cognitive behavioral therapy changed the brain of participants with obsessive compulsive disorder as much as reuptake inhibitor medications did. Also, a study in The Journal of Neuropsychiatry and Clinical Neurosciences found changes to neural circuits from cognitive behavioral therapy in participants with anxiety disorders.

An introduction to a special issue of Psychology of Addictive Behaviors talks about how early research has been studying the effects of psychotherapy on the brain for mental disorders and addiction. Nonetheless, the introduction notes that this form of research, especially with relation to how therapy could change the brain of people with a drug or alcohol addiction, is new and expanding. Research is looking at how psychotherapy could help brain-based mechanisms related to addiction risk to potentially prevent addiction and how it could rewire the brain once already addicted. A bulk of research discusses the brain’s potential for changing, or plasticity, and that psychotherapy has the potential for creating some of that change, in part by encouraging the brain to learn. This subject needs to be studied more, especially for the implications with addictions, and the research seems to be going in that direction.

One preliminary study published in the May 2012 issue of Drug and Alcohol Dependence studied participants with substance use disorders using a computer-assisted form of cognitive behavioral therapy. The study showed that the therapy had a positive effect on various brain areas associated with motivation, impulsivity, mental control and attention.

An article in the September 2014 issue of Neuroscience & Biobehavioral Reviews noted that cognitive behavioral therapy can help to undo the behavioral patterns in the brain that are associated with addiction. It is capable of this because of its ability to help the person identify craving cues and guide him in learning new ways to think and behave.

The article explained that cognitive behavioral therapy could help with behaviors that the person is consciously aware of. In addition, it noted that mindfulness has potential to help a person discover unconscious cravings and cues by how the body and emotions are responding. Therefore, cognitive behavioral and mindfulness therapies could potentially help an addicted brain by working on different aspects.

It seems apparent that psychotherapy is capable of changing the brain, as studies have been showing it time and again. An August 2011 report in Psychiatric Times noted that studies using neuroimaging technology have shown changes in the brain from this form of therapy for a range of mental disorders. It explained that some studies have shown the ways that psychotherapy has created changes, which include by improving problem-solving and other functions, and thus affecting areas of the brain associated with those functions.

Therapy is an important component of addiction treatment. A wealth of information shows that it has created positive changes in the brain. These changes could provide benefit after addiction has harmed the brain.

Also, therapy helps people in treatment to understand more about what lead them to addiction and what changes they need to make to get out of it. They can learn techniques to change their behaviors, thoughts and patterns. For instance, Lea Winerman said in the June 2013 issue of Monitor on Psychology that cognitive behavioral therapy helps addicted people identify their thoughts and actions that are harmful and work to avoid them or handle them.

Numerous studies noted that it’s possible for the future of addiction treatment to include personalized therapies that target the specific mechanisms each person is facing in the brain due to his or her personal addiction.



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