Dr. Kathleen Brady, a professor of psychiatry at the Medical School of the University South Carolina, in the HBO documentary film talks about common issues related to the topic of substance abuse. At the beginning of the interview, Dr. Brady provides us with well-known and well-establish definition of addiction as a brain disease and a compulsive use of drugs and alcohol. Next, she talks about the etiology of addiction, and defines what is a good treatment. In the last part of the video, professor Brady discusses the implications of co-occurrence of mental health disorders and substance use disorders, and the possible causes of relapse. I agree with her theory that stress is the major contributor to the initiation of substance use, is at …show more content…
Brady also delivers another, less known to me but more interesting explanation of what causes relapse. She believes that it is all about pleasure, or rather the lack of it. Anhedonia, the inability to experience pleasant feelings, can be induced by repetitive, compulsive, and prolonged drug use. As we know, the brain chemistry changes dramatically when exposed to long periods of drinking or drugging. Primarily, the psychoactive substances “hijack” the brain that starts producing more dopamine, the neurotransmitter associated with the feelings of pleasure and rewards. The brain “high” on dopamine makes us feel joy, happiness, euphoria, and the desire to experience these positive emotions again and again is what drives the addiction. In other words, it is the pursuit of pleasure that makes people seek drugs. Long-term substance abuse results in an increase in brain tolerance, and eventually leads to reduction of the dopamine receptors and the condition called anhedonia. After I listen to the interview with Dr. Brady, I understood better why the beginning of recovery, especially the first 90 days, is so difficult for many individuals. It is the time when recovering addicts have to live without the feeling of pleasure. After losing its charm, life seems sad and boring. Many people experience depression, stress, anxiety, and cravings. One of the biggest dangers of anhedonia is that it can drive a sobering alcoholic or drug addict into relapse, in an attempt to reactivate the positive