The Science Behind Sobriety: Exploring Neurobiology and Recovery

At one time or another, you might have heard “recovery from addiction” explained as a matter of sheer willpower, a straightforward battle of the mind against the cravings of the body. The journey to sobriety, in reality, is far more complex and dives deep into the intricate workings of the brain and our nervous systems.

How does neurobiology relate to addiction?

Prolonged substance use leading to addiction can disrupt the brain’s communication pathways, changing the way that it functions and even its physical appearance. The long-term effects negatively impact the brain regions responsible for balance, memory, speech and judgement. All of these increase the risk of injuries and other adverse effects.

These changes in the brain’s communication pathways make it harder for the user to think clearly and make their best decisions. A vicious cycle of reliance can easily form where a person uses drugs more frequently and in larger amounts to chase the same effects, leading to dependency.

Achieving and maintaining sobriety

Millions of people are affected by addiction, either themselves directly or by the ones they love and care for. People going through an addiction can often feel like a castaway, lost at sea, and all they crave is to get back to safe, solid land. Achieving sobriety is like the gentle wind that clears the air and carries them back to the shore, to their friends and loved ones.

Once you’ve achieved sobriety, maintaining it over time can present even bigger challenges. Research shows 40-60% of people with a substance use disorder relapse within the first year. Their addictions affect so many aspects of their lives, and so treatment should address the needs of the whole person to be successful.

Withdrawal symptoms while coming off drugs

When drugs are consumed, various neurobiological reactions take place that produce chemicals the body usually only produces naturally. Withdrawal then immediately stops these chemical reactions, wreaking havoc on the nervous system. Here’s what some of these symptoms might look like.

• Physical symptoms: Vomiting, sweating and shaking are typically related to the autonomic nervous system (ANS). With drugs like opioids, intestinal problems and severe abdominal cramps happen Insomnia and major appetite changes might also be found.
• Behavioural symptoms: Throughout withdrawal, the brain’s balance of chemicals becomes completely dysregulated. Dopamine levels relating to mood and behaviour alter rapidly so that a person might feel restless, irritable and generally on edge. Uncharacteristic aggression and hostility might form, which is especially distressing to see in a loved one.
• Psychological: The brain’s reward system goes through huge changes during withdrawal. Feel-good chemicals that occur naturally, like dopamine and serotonin, change in frequency. This often results in severe anxiety and depression.

What might a timeline of withdrawal typically look like?

Withdrawal symptoms vary from substance to substance, but in most cases, there are recurring themes and commonalities across a timeline that help understand the pacing of the withdrawal experience:

• 24 hours – Anxiety, agitation and muscle aches come with cravings for the drug itself. Symptoms can be more intense for drugs with short half-lives, like heroin or alcohol.
• 3 days – Physical symptoms like vomiting, diarrhoea and shaking, can peak. Sleep patterns can be at their worst, and emotional symptoms like irritability can intensify.
• One week – After a week, many physical symptoms can begin to subside. Behavioural and psychological symptoms persist, and cravings remain strong, so robust support is needed.
• 1 month – Around the one-month mark, cravings usually begin to dissipate, and the potential for improved routines and returns to responsibilities becomes apparent.

Why does this happen to your body?

Withdrawal symptoms occur because prolonged drug use significantly impacts the brain and body. The chemicals that help brain cells communicate are impaired, like when a user feels better after they use opioids. Less dopamine is produced naturally, so dopamine levels drop as usage decreases.

Chronic drug use over the long term causes parts of the nervous system to alter and deregulate. “Homeostasis” is a term that refers to the body’s ability to stay stable, and frequent drug use disrupts this balance.

After the initial withdrawal, something called “PAWS” or “Post-acute withdrawal syndrome” is common and can last for days, months or years, presenting a massive challenge to sustained sobriety. Users who go through it can be on the receiving end of disturbing effects, describing it as a “rollercoaster” where symptoms feel like they change, minute by minute.

Moving forward with techniques for maintaining sobriety

The few months to a year after beginning the recovery journey are critical as the brain is undergoing huge changes and adjustments. We know that continuous and long-lasting sobriety is a challenge, so here are some tips and how the brain can benefit:

• Identify personal triggers: Your brain associates certain people, places, things and situations with drug use, which can create cravings for the addictive substance. Recognising these personal patterns helps. Seek internal triggers too, like your feelings, thoughts and emotions.
• Stick to a structured routine: Having a chaotic or disorganised lifestyle can really get in the way of your recovery. Creating a structured routine helps build new, healthy neural pathways in the brain—the part of the brain responsible for planning and decision-making benefits from a regular schedule that reduces impulsivity.
• Join a support group: Joining a support group and surrounding yourself with supportive loved ones creates homes associated with bonding and trust. These positive feelings help reduce stress and anxiety, which are common triggers for relapse.

What makes relapses so common?

Stress cues linked to rehab appear in multiple forms, such as people, places, things and moods. When someone is reminded of alcohol by being in a pub, for example, the brain can release positive chemicals regardless of the intake of alcohol. This makes alcohol withdrawal particularly difficult, as the brain never really stops seeking patterns.

Alcohol remains within reach in every off-licence and pub corner, and research has shown that in 500 alcoholism studies, more than 75% of subjects relapsed within one year of treatment. The constant change in the brain’s pathways likely relates to this disheartening statistic.

In a broader, social sense, modern depictions of rehab and detox don’t always reflect the truth to people either. Scenes of withdrawal in movies like “Trainspotting” and shows like “Breaking Bad” can only really provide a snapshot of detox and rehab. The recovery journey takes months and years, not one or two seasons.

But, relapse does not equal failure, nor is it only a weakness. It takes more than just willpower to maintain sobriety.

No one-size-fits-all programme exists for people. Life’s challenges present themselves in ways that are as unpredictable as the weather. Equating one instance of relapse to total failure can be very discouraging, so it’s crucial to remember that recovery is a process, not a one-time event.

How we at UKAT can help

Tackling addiction is what we’re here for, and as we’ve helped people tread the many paths of recovery, we’ve set up our rehab centres for compassionate and comprehensive programmes.

Our programmes are tailored to the exact needs of everyone who enters our doors. From those in need of recovery to the loved ones who help manage them through it, we see ourselves as carers and providers of medical and holistic treatments.

Choosing recovery with us is the first step towards achieving and maintaining sobriety, until the final stage of letting go of addiction and leading a healthier, happier life.