This is is an issue not well understood by most doctors — hardly a surprise, really, when you consider that most doctors really know very little about the neurology of addiction. Bear with me here.

Addiction creates changes in the brain, principally in the way that the neurotransmitters dopamine and serotonin are produced, utilized and destroyed. Put simply, when we have a lot, we feel really good; with lesser amounts, not so good ranging to really awful.

Drugs and alcohol act in various ways to keep the levels high. The extra neurotransmitters attach to receptor sites. When a site is occupied, the nerves to which it is attached tell us that we feel good. Unfortunately, continued high levels cause the receptor sites to increase in number to handle the added chemicals. This means that we have to take more drugs to raise the level of neurotransmitters even higher, in order to satisfy all those additional receptors. This is a primary mechanism in the development of tolerance to drugs. The more receptors, the more drugs we need for a similar effect. When our levels of the feel-good chemicals drop even a little, there are all those empty receptor sites, and we feel a craving for more.

Recovery is mostly a matter of stopping the drugs and allowing the neurotransmitter levels to drop. At first, there is a rebound effect, and they drop below the “normal” level. This causes a number of issues that we lump together as withdrawal. As they begin to increase to nearer the normal levels, the acute withdrawal eases, but we still have all those extra receptors looking for goodies. The period until the number of receptor sites reduces to something like normal again is part of what we call PAWS. Depending on the addict’s health and a number of other factors that include individual brain chemistry and hereditary factors, that can take quite a while, as you well know. (Me too!)

Now here’s the catch: the brain doesn’t care what stimulates it to create or store additional “feel good” neurotransmitters. It can be opiates, speed, other drugs…or alcohol. Anything that causes an artificial increase will immediately put the brain on high alert, and it will begin signaling for more of the same. We call this phenomenon cross addiction. What it means is that people like yourself, who have never had a problem with a particular drug, can still trigger their addictions by using drugs that tell the brain that the good times are back.

Thanks for sharing. Hope this helps. It will get better.