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Marc L Feldman, Psy.D., CAADC

Addiction, The Brain, and Alice in Chains

"I've eaten the sun, so my tongue has been burned of the taste." This is a lyric from the song, "Down in a Hole", by the band, Alice in Chains, whose original lead vocalist, Layne Staley, died of a heroin overdose in 2002. I have always liked this line, because I believe it eloquently captures how the drugs of abuse dampen the pleasure center and pleasure pathways of the brain, as they become less responsive to pleasurable feelings over time. Not only does this require the use of greater amounts of the substance to achieve the same effect ,but the normal things in life that we find to be rewarding and pleasurable, such as food, sex, and relationships with others, are no longer strong enough to stimulate the brain's pleasure center and pathways. Thus, a major factor that maintains one's addiction is the inability to derive pleasure from anything other than one's drug of choice, due to biological changes in the brain that are caused by repeated substance use. This phenomenon has also been observed in other addictions, such as sex, food, and gambling. It also plays a major role in maintaining early sobriety, because it may take months, for some even longer, for the pleasure center and associated pathways of the brain to function as they had before the addiction, leaving one to feel as if he or she will never feel good again, perhaps even inducing depression. This experience, known as post-acute withdrawal, is often a major obstacle in maintaining sobriety, which can lead to relapse in an attempt to find happiness or pleasure once again. The good news, as I alluded to earlier, is that the brain will "heal" over time, but this process can be facilitated by finding novel and healthy experiences, that do not involve substance use, or other potentially destructive behaviors. It is also important to reconnect with hobbies or activities that were experienced as rewarding and pleasurable before the substance use began.   

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