One of the biggest questions people who have never struggled with addiction ask is why people don’t recognize how bad their drug use has gotten. Why not seek help when you first realize you might have a problem? Surely addicts must see the damage they’re causing to themselves and others. Why would you even use illegal drugs once, never mind over and over? Part of the answer has to do with the way drugs affect the brain.

Normally when we make a decision, particularly an important one, we weight the pros and cons. We consider all aspects of any possible outcomes, such as risks, morality, financial impact, or the effect on others. When your brain is repeatedly exposed to drugs, however, this cost-benefit analysis falls by the wayside because your mind tells you that any possible results will be positive.

The frontal cortex, or the area of the brain where risks and benefits are weighed and decisions made, is disrupted by drug use. At the same time, dopamine pathways in the midbrain, which affect pleasure and reinforcement, are affected, which makes the brain want to repeat the experience of taking drugs. Other disorders not related to drug use have been linked to the disruption of these brain systems, such as obsessive-compulsive disorder and gambling addiction.

Neurons in the midbrain release and absorb more dopamine when the results of your decisions are better than expected, and less dopamine when things don’t meet your expectations. When the outcome matches your expectations, dopamine levels are undisturbed. The brain learns from these outcomes, so if you’re repeatedly feeling pleasure from drug use, the brain begins to recognize it as something that leads to good results.

Knowing that both of these areas of the brain are tied into repeated drug use and impaired decision making has given researchers a new focus for addiction treatment. There are neural networks that link different regions of the brain, and scientists believe that these could be targeted with medication to repair the interrupted signals. Studies using MRI technology to view brain activity have also helped identify some specific areas of the brain that are affected by drugs. Researchers believing that by identifying and activating or deactivating connected regions, they can cut off the sensation of cravings.


Drug use also affects dopamine production, which can affect the ability to make decisions. If the brain is being flooded with dopamine, everything feels like a reward. This means that your ability to tell the difference between positive and negative experiences is impaired. As a result, people can make extremely poor decisions while being absolutely certain that the results will be good.

Years of substance abuse can make significant changes to the brain. This is one of the reasons why medication and therapy are so important, and why trying to go it alone isn’t a good idea.

If you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504.