Craving

Why is craving so intense?

When a person is addicted, cravings are very intense. This intense craving for the drug becomes so powerful, that it seems as though the person will stop at nothing to get the drug; it is as if it rules the addict’s life. This is because drugs affect the “reward pleasure center” of the brain. The “reward pleasure center” of the brain extends from the mid-brain to the nucleus accumbens. Within this area, drugs disguise themselves, fooling the brain into thinking they are natural chemicals. Steven Hyman, MD, director of the National Institute of Mental Health, described the action of drugs on this part of the brain in an interview with Bill Moyers (aired on public television as part of Moyer' series on addiction titled Moyers on Addiction: Close to Home):

The nucleus accumbens seems to have a particular role in telling us what might be pleasing, what might be good for us. . . . Cocaine and amphetamine put more dopamine in key synapses over a longer period of time in this brain reward pathway than normal. And because they are so rewarding, because they tap right into a circuit that we have in our brains, whose job it is to say something like, "Yes, that was good. Let's do it again and let's remember exactly how we did it," people will take these drugs again and again and again.5

When a person uses drugs to stimulate the reward pleasure center of the brain, the drugs become as essential as food, or breathing. To the non-addict, remaining abstinent from food or from breathing seems ridiculous-these things are necessary for life. Because drugs affect the same area, they also seem to become as essential for life to the addict. With the need to use or drink so intense, the addict feels as though they must use. “I must use" overpowers any cognitive or rational thought of “I think I shouldn’t use”.

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