TRUE OR FALSE
Addiction alters the brain’s structure and function, making it a chronic disease rather than a moral failure.
True
Addiction changes dopamine signaling and brain region communication
The part of the brain that controls impulse inhibition and rational thought is the __________.
Frontal cortex
Which of the following best describes why the midbrain overrides the frontal cortex during addiction?
A. The midbrain processes abstract reasoning faster.
B. The midbrain interprets the drug as essential to survival.
C. The frontal cortex fails to produce dopamine entirely.
D. The midbrain is conscious of moral consequences.
Answer: B
The midbrain treats the drug like water or food for survival.
This actor began their career as a child star, went through public struggles with substance use in adolescence, then rebuilt a long Hollywood career and became a producer.
Drew Barrymore
Name one medical reason why alcohol withdrawal should be managed in a medical setting rather than at home.
Risk of seizures or delirium tremens — both can be life-threatening and sometimes require medication and monitoring.
The frontal cortex is primarily responsible for unconscious, automatic actions like breathing and heart rate.
False
That’s the midbrain and brainstem, not the cortex.
The part of the brain that drives survival instincts and automatic behaviors is the __________.
Midbrain
Which best explains why recovery programs emphasize both medication and counseling?
A. Counseling raises dopamine levels permanently.
B. Medications heal the midbrain instantly.
C. Addiction impacts both chemical and cognitive systems in the brain.
D. Therapy and medication work on unrelated issues.
Answer: C
After long periods of heavy substance use in the 1990s and early 2000s, this director/actor later entered recovery and has publicly discussed the role therapy played in his life.
Ben Affleck
Explain in one sentence why a treatment plan for addiction often includes both medication and behavioral therapy.
Medication stabilizes brain chemistry and reduces dangerous withdrawal/cravings while therapy rebuilds coping skills, emotional regulation, and decision-making.
The brain can adapt to high dopamine surges by lowering its natural production levels over time.
True
The neurotransmitter that reinforces reward, bonding, and motivation is __________.
Dopamine
After repeated drug use, the brain’s dopamine system becomes less responsive because:
A. The brain eliminates dopamine receptors to prevent overstimulation.
B. The body replaces dopamine with adrenaline.
C. The frontal cortex stops producing dopamine.
D. Dopamine molecules no longer cross synapses.
Answer: A
This is called dopamine downregulation.
This actor grew up in the spotlight, later admitted to drug and alcohol problems, and has talked about attending rehab more than once while continuing to work in film and TV.
Ewan McGregor
A patient reports that activities they once enjoyed now feel “empty” compared to drug use. Briefly describe the neurobiological change responsible.
Chronic drug-induced dopamine surges have led to receptor downregulation and blunted reward sensitivity, so natural stimuli release far less dopamine.
During addiction, survival instincts can be miswired to treat the drug of choice as essential for life.
TRUE
In addiction, brain scans show reduced activity in the __________ and increased activity in the __________.
Frontal cortex; midbrain
PET scans show that when an addicted individual sees their drug of choice:
A. The frontal cortex lights up with moral reasoning.
B. The midbrain activates strongly while the cortex shows little activity.
C. Both regions deactivate entirely.
D. The cerebellum shows dominant activity.
Answer: B
A musician who has discussed moving from heavy prescription drug and alcohol use toward recovery, later becoming an advocate for mental-health awareness in the music industry.
Macklemore
A recovering person still experiences strong, unconscious cravings when exposed to certain cues (places, smells). Which brain region is likely driving that cue-triggered behavior, and what two therapeutic approaches can help reduce cue-driven relapse risk?
The midbrain/limbic circuitry drives cue-triggered cravings.
Long-term addiction causes increased dopamine sensitivity, making normal activities feel even more rewarding.
False
The opposite happens — dopamine sensitivity decreases.
When dopamine levels fall too low, the brain enters __________ mode, often leading to risky or compulsive behaviors.
Survival
Which best explains why long-term addicts may lose interest in family, hobbies, or goals?
A. The brain reroutes dopamine responses to only reward drug-related stimuli.
B. Dopamine begins to reward stress instead of pleasure.
C. The brain’s limbic system shuts down emotional processing entirely.
D. The frontal cortex becomes immune to dopamine.
Answer: A
Drugs hijack the reward pathway, narrowing what triggers motivation.
This TV star and comedian publicly battled opioid and alcohol addiction, later becoming an outspoken supporter of rehab and harm-reduction services
Matthew Perry
Design a two-sentence rationale explaining why social supports (like group therapy or sober peers) are essential for restoring frontal-cortex-based control in early recovery.
Social supports provide consistent, emotionally meaningful reinforcement that can compensate for blunted natural rewards, helping re-establish positive dopamine signaling linked to healthy behaviors.