What Is Withdrawal when it comes to addiction treatment?
Withdrawal consists of the physiological and psychological processes and changes that the body experiences when the substance of abuse is not available anymore.
Nearly every substance of abuse directly or indirectly acts in the brain’s “pleasure center” (the nucleus accumbens). There, it either stimulates the release of dopamine or enhances its activity, thus triggering intense feelings of pleasure. But there’s a price to pay for the wonderful feelings, for substances of abuse also cause changes in the brain that tend to lessen the alcohol or drug’s effects over time. As a result, taking the substance again and again causes less and less stimulation of the nucleus accumbens.
The substance gradually loses its pleasurable effects until eventually you experience no euphoria at all—unless you increase the dosage. Where originally it may have taken two beers to produce a feeling of euphoria, after a while four or five are needed, and eventually nine or ten, to produce the same effect. This phenomenon is called tolerance. Think of it as having to feed the “pleasure monster” more and more and more to keep it happy—and prevent it from getting angry.
The physical and emotional signs and symptoms of withdrawal appear when the substance of abuse is suddenly discontinued or decreased in dosage. The symptoms are usually the opposite of those caused by the substance. For example, alcohol consumption depresses the central nervous system, calming you down, putting you to sleep, making you feel at
peace, and suppressing brain activity. But alcohol withdrawal stimulates the central nervous system, causing excitement, agitation, sleeplessness, and seizures. depending on which substance you abuse and how long it stays in the body, withdrawal symptoms can appear within a few hours, days, or even weeks after you stop or cut back.
Withdrawal symptoms vary significantly from person to person, but there are patterns related to the fact that the nucleus accumbens has grown accustomed to receiving a great deal of the substance of abuse, and thus a great deal of stimulation. With the stimulatory effects gone, a “great silence” descends on the pleasure center. The nucleus accumbens
slows down, causing depression, anxiety, and cravings for the alcohol or drug.
And if the withdrawal symptoms are extreme, they can help drive you to continue using the substance despite significant harm—the definition of addiction.