Dopamine is a neurotransmitter with several functions and is most notably involved in feelings of pleasure and reward. Because of this, dopamine is closely associated with the development and continuation of addictive behaviors and substance abuse. Addiction can be treated and managed with the help of professional interventions.
- Dopamine reinforces pleasurable behaviors, which can lead to substance abuse.
- Drugs cause a surge of dopamine, reinforcing the desire for continued use.
- Dopamine is a key player in addiction, but other factors also contribute to it such as genetics, adverse childhood experiences, and life stressors.
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What is dopamine?
Dopamine is a neurotransmitter, a chemical messenger in the brain, involved in the brain’s reward circuit. When a person engages in a behavior or activity that the brain considers beneficial and pleasurable, such as exercise, eating, or sex, dopamine is released. This acts as a reward, reinforcing the behavior and making it more likely for the activity to be repeated. [1]
Dopamine is also involved in various other functions, including in the regulation of: [2][3]
- Mood
- Movement
- Motivation
- Kidney function
- Blood vessel function
- Sleep
- Learning
- Concentration
- Memory
- Pain processing
Various things can impact dopamine levels and having too much or too little dopamine can lead to mental and physical health consequences. Conditions associated with irregular dopamine levels include: [1][3]
- Psychosis
- Schizophrenia
- Addiction
- Parkinson’s disease
- Attention-deficit/hyperactivity disorder (ADHD)
How dopamine affects addiction
Experiencing pleasurable activities causes the release of dopamine, which tells the brain that the behavior is enjoyable and should be remembered and repeated. When this occurs with healthy activities, such as exercise, this results in the forming of positive habits. However, when this occurs with drug use, this can lead to harmful addiction. [4]
Drugs often cause a feeling of euphoria or ‘high’, which prompts the brain to release dopamine. Dopamine itself is not the cause of this pleasurable feeling, but rather amplifies it and acts as a reinforcement. Many drugs cause a dopamine release of up to ten times larger than that caused by healthy behaviors. [1][4]
The large surge of dopamine produces a significant reward and reinforcement, telling the brain that this behavior should be repeated as it is enjoyable. This causes an association between the drug and the euphoric feeling, along with any cues related to the behavior, such as people and places. [5]
These cues then act as a trigger in future situations, causing cravings for the drug and prompting the repetition of the behavior, leading to the forming of a habit. With continued use, the brain eventually produces less dopamine naturally, even during previously enjoyable behaviors. This causes persistent low mood, poor motivation, and a need to keep using the drug to experience any pleasure. [5][6]
Is dopamine the root cause of addiction?
Although dopamine plays a large role in the development of addiction, it is not the only cause or the root cause. Several factors can influence an individual’s choice to begin using drugs and the likelihood of an addiction forming. This includes: [7][8]
- Childhood experiences: Events in childhood can increase the risk of drug use and addiction in later life, including trauma, abuse, living with parents with addictions, and peer pressure at school.
- Genetics: Genetics are thought to play a large role in an individual’s risk of addiction, as it is common for children of those with substance use disorders to also experience addictions. Environmental factors likely contribute alongside genetics to increase this risk.
- Mental health: It is common for people with substance use disorders to experience co-existing mental health conditions that have contributed to the development of their addiction.
- Life stressors: Experiencing stressful or traumatic events can increase a person’s likelihood of starting or increasing substance use, which can lead to an addiction.
- Early use: Studies show that the younger a person is when they first use substances, the more likely they are to develop a substance use disorder. Various factors can contribute to this increased risk, including disruptions in brain development.
- Administration method: Administering drugs via injection or by smoking can cause the euphoric effects to be felt suddenly and fade quickly. This can reinforce use and lead to repeated dosing.
How do certain substances affect dopamine levels?
Studies show that most drugs of abuse, including alcohol, opioids, and stimulants, cause a significant increase in dopamine levels in the brain, contributing to their reinforcing effects and abuse potential. [4][6]
Some drugs, including heroin, benzodiazepines, ecstasy, alcohol, and marijuana, can mimic the chemical structure of neurotransmitters. This results in neurons being activated by the drug rather than natural neurotransmitters, causing abnormal activity and increased levels of dopamine release. [5][9]
Other drugs, such as cocaine and amphetamine, interfere with the way dopamine is released and recycled, which also causes abnormal levels of dopamine in the brain. Because of this excess of dopamine, long-term drug use causes reduced activity of dopamine receptors, leading to inability to experience pleasure from other activities. [5][6]
Is it possible to reverse dopamine tolerance levels?
With continued drug use, the reward circuit becomes overstimulated and cannot process or produce the same levels of dopamine. This causes tolerance to develop, resulting in reduced effects from the substance and a requirement to take increased amounts to achieve the desired effect. [9]
These changes occur in the brain as an addiction develops and can be long-lasting. However, it is possible to reverse these effects. By reducing or stopping substance use, the brain can have the opportunity to repair neural connections and restore natural dopamine levels. [4][10]
Over time, dopamine activity will return to its previous levels and the individual will again be able to experience pleasure and enjoyment from healthy activities. This can take a long time for some people and some of the harm caused by substance use may be irreversible. Healthy behaviors can help with this process, such as exercise, good diet, sleep, and mindfulness practices. [1][10]
What treatments can help with tolerance and dependence?
Treatments for tolerance and dependence can vary depending on the substance. Treatments can involve interventions such as: [4][11]
- Detox and maintenance medications, such as methadone and naltrexone
- Symptom management medications, such as lofexidine
- Therapies, such as cognitive behavioral therapy (CBT)
- Holistic care, such as creative therapies, exercise, and nutritional counseling
- Psychosocial interventions, such as financial and housing support
Generally, these interventions can be provided via outpatient services, which require attending appointments with professionals several times per week.
People with severe substance use disorders may benefit from inpatient care, which involves staying in a residential facility for a certain period to receive round-the-clock monitoring and treatment. This can be particularly beneficial for individuals who need support with detox and withdrawal to prevent dangerous consequences and relapse.
When should I see a healthcare professional for substance abuse?
Utilizing professional help can be beneficial in reducing or stopping substance use, particularly if you are experiencing signs of addiction, such as: [11][12]
- Social, professional, or daily functioning is impacted by use
- Yourself or others are physically, emotionally, or financially harmed by your use
- You have attempted to stop using but have been unsuccessful
- You put yourself in risky situations to obtain or use substances
- You experience cravings or withdrawal symptoms when not using substances
If you feel you would benefit from support in reducing substance use, you can contact your general practitioner, who may be able to refer you to specialist services or professionals.
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