The Science Behind Addictions

 


My prayers of late have been fueled by the desire to help people with addictions. While I don't know if I am wording my prayers correctly, I do know that God knows my will and desire to help people heal, a desire I have had my entire life. When I was young I loved to watch doctor television series. There was Dr. Kldare (1961–1966), Ben Casey (1961-1966) and Marcus Welby, M.D. (1969-1976) and later I occasionally watched an American Frontier drama, Dr. Quinn, Medicine Woman (1993-1998) set in the 1800s about a female doctor which storyline also included a little romance.

After I left home in the 1970s I rarely had a television, but through visits to friends or nights at hotels I discovered Dr. Quinn and House (2004-2012). Being fascinated with House, a drama series about Dr. Gregory House who was a medical genius, a few years ago one of my sons got me all the series to watch. Although I loved all the fascinating medical dramas that the show presented and love the main actor, Hugh Laurie, from his acting in the British comedy television series Jeeves and Wooster, his character in House portrays a narcissist, drug addict, cynic, and atheist. In one series he goes to a clinic for rehabilitation from his Vicodin drug addiction that he used as a pain killer, then in a later show he was back on Vicodin after some emotional pain he went through.

On the one hand, it was great to see people on the show being healed of long undiagnosed problems and illnesses, but I still so longed to see Dr. House healed of his immoral behavior and lack of will to lead a healthy life. Yet, in order to continue a storyline for eight series and keep the viewing audience coming back, Dr. House never heals of his cynicism, atheism, drug addiction, porn, or the main cause of these issues, his wounded heart presumably from his early abusive relationship with his father. His character is very hard to love but you are drawn to feel compassion for him because he has no God to turn to for help and makes enemies with most everyone, apparently, able to dish out hurtful remarks without a bit of conscience.

Although the main character and story are unreal, the show depicts the real-life traumas many go through in life. We are in the middle of an epidemic of addiction and we are stuck in treating it ineffectively when there are better methods available, which I will later address in the second part. Since I live in America I will give some statistics about this nation, but the problem is worldwide. One in ten Americans is in the throes of some type of substance use disorder. That’s 23 million and those figures don't even count tobacco addiction and the myriad millions who have behavioral addictions to gambling, porn, shopping, gaming, etc. nor, the one-third of Americans who overeat and are said to be addicted to food.

In America, you only have to open your eyes to see one of the big problems feeding these addictions. Tobacco companies, pharmaceutical companies (and the AMA), casinos, lotteries, alcohol companies, agribusiness, and big food companies, casinos, lotteries, and many stores at the mall all seem to know how to induce addiction for their own purposes.

Alcohol is the most common drug of abuse among addiction treatment programs. In the U.S. there are about 14 million adults who have an alcoholism problem. It is estimated that globally around 1.4 percent of the population have an alcohol use disorder.

According to statistics, porn sites get more visitors each month than Netflix, Amazon, and Twitter combined. Their 15 billion dollar profit brings in more money than Major League Baseball, The NFL, and The NBA combined. A Christian survey of U.S. men found that one-third of men between the ages of 18 and 30 either think that they are addicted or are unsure if they are addicted to pornography. The figure for all ages in the survey was 18%, which equates to 21 million men.

A lot of addiction counselors and therapists are former addicts. They have a lot to contribute to how the habits develop and how they broke free and I have learned a lot from them. Not having an addictive personality myself I only have the contribution on how I did not begin bad habits to begin with. I have contemplated how people get started on addictions as well as why some people can try recreational drugs and not become addicts. As a teen, I tried smoking a cigarette when my boyfriend pressured me, but found it abhorrent. We separated when he moved past my boundaries. I was only 15. Another boyfriend had me try marijuana and I found that unimpressive and never went out with him again. I have had beer but found after a couple of sips my legs felt odd and heavy and I can't drink anymore. I dislike the taste of wine but would sip a little as my husband liked it very much. Hard liquor I also found distasteful. Being very observant of people I saw what liquor does to them and I had and have no desire to be uninhibited and controlled by a substance I consume.

Thankfully, I did not have parents who had addictions outside of the normal caffeine daily consumption. My father did smoke a pipe occasionally but he did give that habit up. Neither parent drank beer or alcohol and that may have contributed to my lack of desire to smoke or drink. Still, even though they drank coffee and tea I never drank coffee or even had a desire to even taste it, to this day.

As I have contemplated why this lack of developing substance addictions within me I believe it is because of my strong will and desire to stay healthy, lead a moral life and love God, and thus love my body, mind, and soul God that has given me to learn and grow and share His love. It seemed unfathomable to me to stay healthy and sound in body and mind if one had something they were consuming or attracted to that took them away from this soundness. The Apostle Paul speaks of this when he wrote that we should honor the body because it is to be the temple of God.

“Do you not know that you yourselves are God’s temple and that God’s Spirit dwells in your midst? If anyone destroys God’s temple, God will destroy that person. For God’s temple is sacred, and you together are that temple" (1 Cor. 3:16-17).

I have used my strong will to resist temptation. Just as an aside, we as parents should be careful not to break our children's will, rather to discipline in love, not force. I wasn't disciplined in love and I was spanked yet somehow my will wasn't broken. All credit goes to God as my love of God gave me the desire to do His will and turn over my problems to Him and ask for help whenever I needed help. Thus I have not had the personality to avoid pain or emotional suffering but rather to ride the wave of what comes in my life and find God's way out of suffering. This is what I hope to contribute to help others that there is a way to freedom from controlling habits and consumption abuse by turning to God instead.

There was one area I felt was a bad habit and close to an addiction and that was with sweets. My family never served us children sodas and not a lot of cookies and cakes, still, I was attracted to candy and found myself buying penny candy with the money I would get from trading in empty soda bottles I would find at the side of the road. When I started getting cavities from the candy and realized what caused cavities I stopped the candy. Pastries and cookies were harder to give up so I turned to baking with honey and making my own sweet desserts. Still, I wasn't satisfied. I felt sugar controlled me so I vowed to God to give up all sugar in every form for six months. And I stuck to that vow because I could not imagine breaking a vow to God, and by God's grace, I was free of any sugar addiction from then on.

My heart goes out to those who I see hurt by their addictions as well as their loved ones. Thankfully, my children have not had any major addictions either but one of my children's spouses does have some minor ones. He consumes a lot of alcohol, caffeine, and sugar and chews tobacco. His upbringing did not include any education on the harm of using these substances or the harm it does to his family. In his environment, all these substances are just normal, unfortunately. So consequently, he has no desire or will to give any of them up or ask for help because he believes he needs no help—he is just normal like everyone else he grew up around. He has helped me see that my prayers need to include asking for God to send help to those who don't even know they need help.

When I discovered that most of the men in my church group were addicted to pornography I was very surprised. I thought being religious would strengthen people to resist temptation. Unfortunately, it is not that easy. We can pray and ask God for help but most of us know that God does not usually give us instantaneous healing or instantaneous answers to our prayers. We need to do our part as God has given us the gift of free will. Asking God for help does not always mean that we actually want that help or believe we deserve that help. Addictions can cause us to feel unworthy, and thereby unlovable by God. And for some, they only accept a miracle and do not see that God often uses people to help others.

It is like the old story of God sending help to the person who is stranded on the roof of their house as the floodwaters rage about them. Three times God sends someone to help them but each time they turn it down waiting for God to perform the miracle. Eventually, the person drowns as the waters cover his roof. When he gets to heaven he asks God, "I had faith God, why didn't you save me?" God told him "I sent you the man in the rowboat, the man in a motorboat and the man in the helicopter! What more were you looking for?"

God does send us help but sometimes we just don't see it. In a story I recently read it was very clear God was sending help to this woman. She had gotten an abortion and felt very guilty and ashamed and as she became more depressed she decided to kill herself. Just as she was about to slit her wrists the phone rang. It was a man from her church who said God had told him she needed his help. She went on to lead a wonderful life and married a man who she remains married to now for 45 years. They had four children and although everything was well she could not feel any joy because of her sin, guilt and the fear of what she would meet in heaven for the child she had killed.

Then one day she had a spiritual experience after church where she was taken up to heaven and met Jesus and her aborted child who appeared to be about seven. Jesus was laughing with her daughter who was dancing for Him and she knew that she was forgiven witnessing this, both by Jesus and the child. If we do not believe we are worthy to be loved by God or accept forgiveness for our sins it is easy to lapse into sinful behavior because "what does it matter anyway?"

So let's look at some of the dynamics of addictions and how one might overcome them. Everybody most likely knows someone who struggles with addiction. Whether it is alcohol, drugs, nicotine, gambling, pornography, or something as seemingly harmless as food or shopping, an addiction starts as a habit, and eventually the changes in the brain adversely affect one's choices and will with serious consequences.

Types of Addictions
If there are any doubts that addictions are not only destructive to yourself, but to loved ones and society as a whole, here are listed a few addictions and what harm they do to the person with them, as well as others.

  • Prescription and Illicit Drugs
    When I was in middle school before the War on Drugs campaign started by the U.S. government in 1971, we saw a film about recreational drug abuse. I don't know how it got put in our school program but I am thankful for seeing that film. It taught me that recreational drugs are dangerous. I remember how addictive heroin was from that film and learning that after one or two interactions with the drug you could be hooked, it works that fast on the brain. First, you get a rush of good feelings, and then feel "high" and relaxed. Then follows drowsiness and nausea. After a bit of time, the cravings come upon you and make you want to get that feeling again. Once several doses have been taken if the user tries to stop they get withdrawal symptoms which can include feelings of panic, sleeplessness, bad chills, and sweats, muscle pain, stomach cramps, nausea, vomiting, and diarrhea.

Growing up in the sixties and the hippie movement, free love and the use of marijuana and LSD was the new thing. While LSD is supposedly physically non-addictive you become psychologically addicted to the drug’s hallucinogenic effects. Learning that a "bad trip" could happen at any time, leaving one vulnerable to the same reoccurring bad trip effects, was enough for me to never be tempted to try the drug even once. Yet with so many prominent people talking about the beautiful highs they had from the drug and peer pressure it would be easy to want to take the hook and just "try it" once where then the temptation continues and eventually the psychological addiction.

The initial decision to take illicit drugs is typically voluntary. Yet, many in the U.S. began their addiction with prescription pain killers as I mentioned was depicted in the House series, and then transition to heroin use. However, with continued use, a person’s ability to exert self-control can become seriously impaired. (How drugs work in the brain to cause addictions will be covered below.) In the U.S. 128 people die every day after overdosing on opioids (prescription pain killers and street drugs that come from the opium poppy plant). The Centers for Disease Control and Prevention (CDC) estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

  • Nicotine
    Nicotine is an addictive stimulant found in cigarettes and other forms of tobacco. Nicotine causes an increase in blood pressure, breathing, and heart rate. Tobacco smoke increases a user’s risk of cancer, emphysema, bronchial disorders, and cardiovascular disease. Cigarette smoking accounts for at least 30 percent of all cancer deaths, especially lung cancer. The mortality rate associated with tobacco addiction is staggering. The World Health Organization (WHO) said that tobacco use worldwide has killed approximately 100 million people during the 20th century, and, if current smoking trends continue, the cumulative death toll for this century has been projected to reach 1 billion.
  • Alcohol
    Alcohol consumption can damage the brain, most body organs and cause irreversible liver damage with heavy drinking. Areas of the brain that are especially vulnerable to alcohol-related damage are the cerebral cortex (largely responsible for our higher brain functions, including problem-solving and decision making), the hippocampus (important for memory and learning), and the cerebellum (important for movement coordination). Every day, almost 30 people in the United States die in drunk-driving crashes. According to the CDC, the cost of excessive alcohol abuse in the United States alone exceeds over $200 billion annually. It’s also estimated that 40 percent of the costs of excessive alcohol consumption is paid for by the federal, state, and local government. These expenses include healthcare, crime and law enforcement, and motor vehicle crashes. 
  • Marijuana (cannabis)
    Marijuana use is slowly becoming legal in some states in the U.S., and a few other areas around the world governments are decriminalizing/legalizing it. In the non-legal states and countries, marijuana is the most commonly abused illegal substance. This drug impairs short-term memory and learning, the ability to focus attention, and coordination. It can cause permanent IQ loss. Marijuana affects timing, movement, and coordination with slower reactions, decreased coordination, and difficulty reacting to signals and sounds when driving under the influence. It also increases heart rate, can harm the lungs and can increase the risk of psychosis in those with an underlying vulnerability.
  • Sugar
    Sugar consumption can create a short-term high and a spark of energy in the body. Some studies have suggested sugar is as addictive as cocaine. However, due to the addictive nature of sugar, long-term health effects from overindulgence of sugar leads to higher blood pressure, inflammation, obesity, diabetes, and fatty liver disease. All these adverse effects are linked to an increased risk of heart attack and stroke.

Additionally, people who suffer from constant tiredness may reach for carb-rich sugary foods for a boost. Sugar releases endorphins and combines with other chemicals in the body, resulting in a surge of energy. Once someone mentally connects sugar with help providing energy, they may become dependent on it, usually inadvertently. People may begin to crave sugar to balance irritability, emotional lows, and other conditions. Eventually, there is little control over avoiding sugary foods, culminating in a sugar addiction.

  • Gambling
    A person with a gambling addiction suffers from serious effects on their personal lives with harmful repercussions to not only their families but their employers as well. These serious effects include loss of jobs, failed relationships, and severe debt. People who live with this addiction may suffer depression, anxiety, insomnia, and mood disorders. Gambling addicts pursue riskier ventures and bet increasingly larger amounts of money to receive the same pleasure they once did. If gambling is not stopped it can lead to trouble with debt to loan sharks and eventually bankruptcy as credit cards and home equity are maxed out and the gambler defaults on the loans.
  • Pornography
    Viewing pornography negatively affects relationships and sexual satisfaction.  In relational sex, the partners are being with each other. Sensual pleasure is given and received in tandem. Not so for pornography. Pornography is objectified sex where men’s brains become wired to be the observer and receiver of sex and where the woman is usually treated like an object. Studies have shown that divorce doubles for both men and women who started using porn after getting married. Pornography use begets loneliness, and loneliness begets pornography use.  Pornography provides temporary relief, but ultimately induces greater feelings of loneliness and isolation, disrupting normal attachment behavior, leading to greater difficulty forming stable, satisfying relationships.

The Science Behind Addictions
Addiction is defined by the American Society of Addiction Medicine (ASAM) as  “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

In the early part of the 20th-century drug addiction was considered to be caused by moral weakness, a lack of willpower, or an unwillingness to stop. Today scientific research now promotes that people lose control because their brains change as they continue their bad habits. The American Medical Association (AMA) classified alcoholism as a disease in 1956 and included addictions as a disease in 1987. In 2011 ASAM joined them in defining addiction as a chronic brain disorder, not a behavior problem, or just the result of making bad choices.

Note that with current limited evidence on behavioral addictions they have been excluded in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), with the exception of Gambling Disorder.

Research has identified a number of areas in the brain that are key to how addictions evolve. When addiction develops there are changes in the function of brain circuits that are involved in pleasure (the reward system), learning, stress, decision making, and self-control. The part of the brain that makes up our reward system releases a chemical that science calls dopamine, a feel-good neurotransmitter (a chemical messenger) into the nucleus accumbens (the brain’s pleasure center) and vital for reinforcing behavior that is necessary for survival. The neurotransmitter then ferries the information between neurons.

Seeking and experiencing pleasure are innate survival features of the brain and this is where the brain specializes in giving us the feeling of pleasure from all sorts of things we like to do in life. When dopamine is released throughout the brain it creates a memory and triggers the reward system in the brain, promoting a deep satisfaction and feelings of pleasure resulting in someone more likely to continue the drive to repeat or continue the actions that triggered the pleasurable response. This same pathway in the brain is also used to regulate emotions and motivation. Any repetitive behavior can release dopamine such as playing video games, food addictions, and shopping.

There are four major dopamine pathways that dopamine travels and there are different functions within these pathways. (See above diagram. Click on the picture for an enlarged view.) The most widely accepted theory connected with dopamine function is on the mesolimbic dopamine pathway where it functions as a pleasure/reward neurotransmitter, yet dopamine and its function is far more complicated and far beyond the scope of this article's focus on addictions. Still, it is helpful to know that other pathways convey important information to the brain and body such as:

  • Learning
  • Motivation
  • Heart rate
  • Blood vessel function
  • Kidney function
  • Lactation
  • Sleep
  • Mood
  • Attention
  • Control of nausea and vomiting
  • Pain processing
  • Movement

Below is a more detailed description of what is involved with the neurons taken from the book, Upgrade Your Teaching:: Understanding by Design Meets Neuroscience by Jay McTighe, and Judy Willis.

Most of the dopamine neurons of the brain originate in the midbrain and are found in either the substantia nigra or the ventral tegmental area, which is located adjacent to the substantia nigra. Neurotransmission involves axons and dendrites, two kinds of extensions of neurons that act as senders and receivers of neural electrical signals. Dopamine carries these signals from the axons of one neuron, across a liquid-filled gap called a synapse, to the dendrites of another neuron.

The action of dopamine that is relevant to the pleasure or reward response derives from triggers that stimulate its release from a holding center called the nucleus accumbens, found near the amygdala. This increase in circulating dopamine is seen in all mammals and activates those feelings you experience as intrinsic pleasure and satisfaction.

This pleasure/reward system is a fantastic way God has given us to enjoy life and seek to continue loving relationships, enjoy music, and other joyful activities like watching a sunset, as well as ensuring that humankind will seek out things needed for survival.

The picture to the right (click to enlarge) shows some of the other structures that contribute to the reward circuit—the amygdala, the hippocampus, and the prefrontal cortex—are exceptionally sensitive to (and reinforcing of) behavior that induces pleasure, such as sex, food consumption, and drug use.

Levels of dopamine in the prefrontal cortex control the flow of information from other areas of the brain and help in improved working memory. There is a delicate balance of dopamine in this region and as levels increase or decrease to abnormal levels, disorders can develop leading to a decline in neurocognitive functions (having the ability to think and reason), especially with memory, attention, and problem-solving.

A key effect that all drugs that cause dependence and addiction appear to have in common is a dramatic increase in dopamine signaling in the nucleus accumbens, leading to euphoria and a desire to repeat the experience. The following shows the dramatic dopamine increase comparison.

"The normal, daily amount of dopamine the average brain produces is typically around 50 nanograms per deciliter—100 on an exceptionally good day. These figures will skyrocket when substances like tobacco (450), marijuana (650), and heroin (975) are introduced." according to Corey Waller, director of Spectrum Health Medical Group-Center for Integrative Medicine. In fact, it can reach a whopping 1,100 nanograms per deciliter under the effects of methamphetamine. That’s instantly 10 times what the brain is supposed to be able to take.”

The result of this dopamine overflow is the feeling of being high.

This over-stimulation may, according to university researchers, “decrease the brain’s response to natural rewards” and may result in a person’s inability to feel pleasure except as triggered by the abuse substance. Because dopamine is the chemical that drives us to seek positive experiences and avoid negative ones, when this reward system is damaged, human behavior patterns may change to seek out harmful situations and substances as a means of pleasure.

The science behind increased cravings

As a long-term result of substance use, the body begins to produce less dopamine. To understand why we need to first look again at how neurons work.

Neurotransmitter Vesicles store neurons. Neurons send electrical signals through your brain and the rest of your nervous system in order to manage everything that happens in the body. Neurotransmitters control these electrical signals secreted from within the neurons and sent out in the brain to other surrounding neurons in order to activate (or deactivate) them.

In the normal communication process, dopamine is released by a neuron into the synapse (the small gap between two neurons), where it binds to specialized proteins called dopamine receptors on the neighboring neuron. Neurons absorb these neurotransmitters through receptors. Each neurotransmitter is like a key, and it fits into its own specific receptor, which acts like a lock. In order to maintain balance, the brain is able to change these receptor "locks" to fit other neurotransmitters when there is too much, or not enough, of a certain neurotransmitter in the system. While there are many different kinds of neurotransmitters, each neuron is only designed to produce one or two specific types. Generally, neurons are grouped together based on the neurotransmitters they produce and receive, which is why specific areas of the brain regulate certain functions. Another specialized protein called a transporter removes dopamine from the synapse to be recycled for further use.

Once a neurotransmitter has interacted with its receptor on the receiving neuron, neuron to neuron communication is complete. The neurotransmitter molecules drop off the receptors.

Loose again in the synapse, they meet one of three fates:

  • Some attach to another receptor.
  • Some encounter an enzyme, a chemical that breaks them apart.
  • Some reenter the sending neuron via a special structure that spans the neuron membrane, called a transporter. Once back inside the neuron, they are available for re-release in future neurotransmission episodes.

Normally, the cycle of release, breakup, and neuron re-entry maintains the amount of neurotransmitter in the synapse, and hence neurotransmission, within certain limits. In most cases, when an addictive substance enters the brain, it causes neurotransmission to increase or decrease dramatically beyond these limits. A substance that disrupts one neurotransmitter can have secondary impacts on others. For example, nicotine stimulates cells directly by activating their receptors for acetylcholine, and indirectly by inducing higher levels of glutamate, a neurotransmitter that acts as an accelerator for neuron activity throughout the brain. Too much glutamate leads to seizures and the death of brain cells and could be the reason smokers have a thinner brain cortex – the grey matter of the brain – and impaired thinking as shown on MRI scans.

Over time, the brain reduces the number of dopamine receptors in the brain to adjust for the increased dopamine in the system. Three negative effects results. First, this reduction in dopamine receptors causes impulsive behavior because the reduced dopamine receptors in the substantia nigra have been tied in lab studies to escalating and compulsive self-administration of drugs. Second, reduced dopamine receptors result in a loss of pleasure in activities that were once enjoyed, in turn leading to depressive feelings causing the user to consume more of the abusive substance in an attempt to feel pleasure again. Third, self-control is further reduced as the toxic effects of long-term abuse use begin to erode grey matter in the prefrontal cortex. This grey matter reduction reduces the ability of a user to rationally consider the consequences of what they are consuming as a result of a reduction in the prefrontal cortex's role in regulating the brain's reward system. Remember, the prefrontal cortex controls reasoning and memory.

The hippocampus plays a critical role in the formation, organization, and storage of new memories as well as connecting certain sensations and emotions to these memories. Another negative effect occurs in the hippocampus with low dopamine. Users cannot retain information because long-term memory cannot settle in the hippocampus. While they can hear words initially their brains don’t hold on to long-term memories.

Dr. Waller said the science behind these reduced levels can be compared to the cravings of individuals on the verge of starvation and dehydration. By monitoring people with no fluid intake for three days in addition to those with no food intake for five days in functional MRIs using sensory stimuli, water cravings were measured to be the size of a baseball while food cravings were the size of a basketball. In comparison, she says, individuals 30 days sober were asked to describe the effects of their drug of choice, and their cravings were the size of a baseball field.

Science and their Addiction Cure
As already stated above, science defines addictions to substances as a disease. The belief on curing brain disease is similar to treating those with chronic diseases such as heart disease or asthma, treatment for drug addiction usually isn't a cure. Treatment for addictions is not promoted as a cure but something that can "be managed" and with success by counteracting the addiction's disruptive effects upon the brain. Thereby, the positive result is a change in the user's disruptive behavior, with the end goal to help the addict regain control of their lives.

The below picture shows a before and after picture of a drug addict. The left brain is a normal brain with red indicating dopamine, the middle brain shows that dopamine has been severely reduced. The right brain shows what the addicted middle brain looks like after a long period of time free from the addiction. The black areas where there once was gray matter show there was a loss of brain tissue that may never be recovered.

Source: J Neurosci 21:9414 – 9418, 2001


What is usually involved with recovery treatment are drugs. Most recovery clinics believe medication should be the first line of treatment, usually combined with some form of behavioral therapy or counseling. Medications are also available to help treat addiction to alcohol and nicotine. However, there are no medications currently available to assist in treatment for people with addictions to drugs like stimulants or cannabis, so treatment is done through behavioral therapies.

Because of severe withdrawal symptoms with some addictive substances such as alcohol, prescription drug use assists the brain and body through this withdrawal process. Heavy alcoholic drinkers especially can experience seizures and delirium tremors after withdrawing from all alcohol which, if left untreated with medication, can cause death.

The National Institute of Health (NIH) explains that most brain improvement occurs in the first year of abstinence, with some reports showing ongoing brain improvement with five to seven years of complete abstinence. Because some drugs kill neurons, which can’t regrow, some people will never return to their normal preaddictive state. Other connections between neurons may repair over months under total abstinence, while some changes in the brain are harder to heal and may last for years. Clinics often state something to the effect that although all functions will not return, at least with abstinence further brain damage is prevented.

Not all doctors agree with the label that addictions are a brain disease. Neither do many who have had personal contact with addicts. So in part II, I will present another side of the picture with what God can do for those who ask for healing, what responsibilities the addict needs to do, and the reasons why many do not accept the premise that the brain of an addict has a diseased brain.