Dr. Gabor Maté: When we do brain scans on adult addicts, you see several neural systems that just don’t work very well, including the opiate pain relief, pleasure, reward, attachment, and love circuitry.
Other problematic systems include the stress regulation circuitry, the impulse regulation circuitry, and especially the dopamine-driven incentive motivation circuitry. As a result, doctors often conclude that because these brain circuits aren’t working well, there has to be a brain disease and that addiction is that disease.
The actual truth is that these circuitries are shaped by early experience. From countless studies and from the overall consensus in brain developmental science today, we know these essential brain circuits develop through the interaction of genetics and experiences. Experiences turn genes on and off. What we are seeing in the adult is not the result of some inborn genetic disorder, but the result of childhood experience. That’s the first point.
The second point is that addictive behaviors, particularly substance use disorder, further distorts the structure of the brain. Certain neural changes can be seen in the majority of substance addicts. The longer they use, the more significant those changes are. However, the brain also has a remarkable capacity to change, which is called neuroplasticity. Neuroplasticity is the brain’s innate ability to develop new circuits, even later on in life, in response to new experiences.
With any developmental question, it’s a matter of what conditions do you provide. If you are growing plants, you have to set the right condition for the plants to blossom. This is the same for any organic creature. Whether in childhood or adulthood, the healthy development or the healthy redevelopment requires the right conditions.
From the outside, those conditions include a compassionate environment where you are seen and understood and not unduly criticized, attacked, stigmatized, or criminalized. It also includes, of course, nutrition. It includes contact with nature. It includes getting real help to process the childhood difficulties, adversities, and traumas that influenced your development in negative ways. It also involves mindful awareness practices that help to develop new circuits in the brain.
In other words, in response to this comprehensive question, it takes time to heal. The longer you have been addicted, the longer you used, the longer it may take, but it’s entirely possible. Indeed, the brain can change in positive ways at almost any age.