We’ve all heard clichés like “alcohol kills brain cells” or “drugs fry your brain.” Watching someone who’s under the influence of drugs and alcohol, few of us are inclined to doubt it. However, the idea that a period of heavy substance use can leave you mentally damaged for life is also terribly discouraging. If you’ve struggled with drugs and alcohol, the following can give you some idea of how that might have affected your brain.
Most effects are temporary.
First of all, the vast majority of effects from most drugs only last as long as the drugs are in your system. If you drink too much, you can sleep it off. The next day or two might be rough, but you’ll be okay before long. Our bodies are pretty good at maintaining equilibrium, so individual episodes of drinking or drug use typically won’t have lasting effects except perhaps in extreme circumstances, like an overdose. It turns out that the anti-drug scare tactics of the 1980s and 1990s largely backfired, so it’s not a good idea to overstate the dangers of isolated drinking or drug use. It’s worth noting, however, that substance use does have a larger effect on the developing brain and people who experiment with drugs and alcohol at a younger age are more likely to have substance use issues later in life.
It may take months for your brain chemistry to rebalance.
A bigger concern than isolated use is developing a tolerance, which is another way of saying developing a dependence. This is when your body is so used to the presence of drugs and alcohol that it compensates in order to bring you back to equilibrium. Once you’ve developed a dependence, you need drugs or alcohol in your system to feel normal — and when you quit, you will probably notice some emotional and cognitive effects.
Exactly what those are depends on what substance you’ve recently quit. If you’ve quit drinking, you’re likely to experience irritability and insomnia. If you’ve quit cocaine, you’re likely to feel lethargic and unable to focus. While the effects of the drugs themselves might wear off pretty quickly, the effects of withdrawal might hang around for a while. Acute withdrawal typically only lasts about a week or two, but many people experience post-acute withdrawal syndrome, or PAWS. Symptoms of PAWS often include emotional numbness, depression, trouble concentrating, and lack of motivation. These are thought to be caused by changes in your brain’s dopamine system, which is related to motivation, reward, and goal-seeking behavior. This typically lasts a few months, but some people report symptoms lasting up to 18 months.
The long-term effects of addiction aren’t entirely clear.
There’s still quite a bit of discussion in the scientific community over whether addiction permanently changes your brain. We know that addiction does appear to cause some structural changes in your brain. As noted above, some of the most important changes have to do with the dopamine system. The dopamine system is designed to reward behaviors that keep us alive and help the species propagate. However, drugs and alcohol can throw this system into overdrive — especially among people with the right genetic predisposition.
This overclocking of the dopamine system has downstream effects, too. In your prefrontal cortex, there’s a region that becomes sensitized to stimuli that might lead to substance use. We call these stimuli “triggers,” and they are a direct result of the dopamine system realigning your brain’s priorities.
There is also a region of the prefrontal cortex that is primarily in charge of inhibiting behaviors — a sort of mental brake — and this region becomes weaker as addiction progresses. The result is that after a certain period of addiction, you have a brain that is completely bored with anything other than substance use, is extremely sensitive to the possibility of substance use, and is less able to inhibit behavior related to substance use.
Much of the debate around this subject relates to whether this structural change can go back to normal. It’s possible that some people’s brains were never “normal” to begin with. As noted above, there’s research showing that some brains are just wired to respond more strongly to drugs and alcohol. However, we do know that the dopamine system will gradually respond more normally to other stimuli over time and that the prefrontal cortex can change its structure in a matter of weeks using techniques like mindfulness meditation. In other words, we don’t know for sure whether your brain can ever return to some pristine, pre-addiction state, but it can certainly get much better.
Damage from long-term, heavy use may be permanent.
There are a few cases where brain damage from substance use may be permanent. Inhalants, for example, are extremely damaging to the brain. There’s also a condition called stimulant psychosis, which is usually temporary but may be permanent in a small percentage of cases. Korsakoff syndrome, also called “wet brain,” is typically caused by decades of heavy drinking and results in severe memory impairment, confabulation, and apathy. Probably the most common concern in terms of mental impairment is early-onset dementia. A large study¹ of more than a million patients in France found that alcohol use disorder was the single biggest cause of early-onset dementia.
Brains are more resilient than we used to think.
The good news for anyone recovering from addiction is that our brains are extremely adaptable and resilient. Even people who have had strokes that would have been debilitating 20 years ago are able to regain much of their original function. As recently as ten years ago, most neuroscientists believed the adult brain didn’t create new neurons, but now we know it does and that exercise promotes this function. In general, our brains will typically figure out a way to do what we repeatedly ask them to do and new methods and technologies can help them heal even faster.
It’s normal to worry that maybe you’ve abused your brain so much that it will never work quite right again. In some cases, your brain might have undergone some permanent changes, but our brains change anyway, whether we’ve struggled with substance use or not. The important thing to know is that brains are adaptable and they can always get better. At The Foundry, we use a variety of evidence-based methods to help our clients heal and create better lives. To learn more, explore our website or call us today at 1-844-955-1066.