During Dr. Stephan Steidl’s guest lecture he brought up a very thought provoking topic, the idea that repeated drug use doesn't just affect behavior, but it also rewires the brain physically. Dr.Steidl’s research focused on how cocaine disrupts the reward pathways that rely on dopamine and glutamine signaling. The reason this was so thought provoking is because it challenges the bias that most people have that people with additions have weak willpower or bad decisions, it is not about that, it is a neurological change.
This reframing changes the way we think about addiction. If the brain itself is being altered by repeated drug exposure, then the question of “why can’t they stop?” becomes a lot more complicated than it seems. Research backs this up in a surprising way. A 2019 study found that rats exposed to cocaine intermittently didn’t become less sensitive to the drug over time; they became more sensitive to it, developing stronger dopamine responses and behavior that looked a lot like addiction (Kawa et al., 2019). Meaning the brain wasn’t building a tolerance as people expect, but it was doing the exact opposite.
What makes this even more complicated is what repeated drug use does to decision-making. A 2020 review found that long-term substance use can reduce activity in the prefrontal cortex, a part of the brain involved in judgment, planning, and impulse control (Volkow & Boyle, 2020). This is important because it helps explain why someone dealing with addictions might keep using even when they know it is hurting them. It is not that they don’t care; it is that the party of the brain that helps regulate that kind of thinking has been affected.
Dr. Steidl also made the point that these changes in reward pathways don’t just go away when someone stops using drugs. That is a big part of why relapse happens, even after someone has been sober for a long time. Something as simple as a familiar place, a stressful situation, or a reminder connected to past drug use can reactivate those pathways and bring cravings back. The brain holds onto those patterns even when the behavior has stopped.
What all of this really comes down to is that addiction is not just a behavioral issue; it is a neurological one. Understanding that the brain is physically changing through repeated drug use shifts the way we should be thinking about addiction as a society. It is not just about making better choices; it is about what happens to the brain when those choices get made over and over again. The research that supports Dr. Steidl’s lecture makes it clear that addiction is deeply connected to how the brain adapts to repeated experiences, and that is something worth taking seriously.
References:
Kawa, Alex B., et al. “Less Is More: Prolonged Intermittent Access Cocaine Self-Administration
Produces Incentive-Sensitization and Addiction-like Behavior.” Psychopharmacology,
Vol. 233, no. 19-20, 2 Aug. 2016, pp. 3587-3602,
https://doi.org/10.1007/s00213-016-4393-8.
Volkow, Nora D., and Maureen Boyle. “Neuroscience of Addiction: Relevance to Prevention and
Treatment.” American Journal of Psychiatry, vol. 175, no. 8, Aug. 2018, pp. 729-740,
ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2018.17101174, https://doi.org/10.1176/appi.ajp.2018.17101174.
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