How Long Does It Take to Rewire the Brain from Addiction?

AUD and SUD are terrible afflictions to live with, causing changes to our physiology and psychology that at times are visible and obvious and at others less discernible. The skin, eyes and teeth tell a story of declining health, and they’re easy to spot—it’s like the person looks old and there’s a primal instinct telling you that they don’t appear healthy.

While the body takes a beating as an addict’s behavior spirals out of control, the damage they’re doing to their brain is less obvious—at least at first.

Addiction rewires the brain, essentially making the addict a totally different person. Their memory starts to fail, they become forgetful, their behavior becomes erratic and uncontrolled, and they start developing serious mental health issues that usually go unnoticed by other people in the early stages of mental decline.

Recent studies show that abusing alcohol and drugs actually shrinks the brain. That’s a pretty scary thought. Essentially, addiction ruins your intelligence, your ability to communicate effectively, and lessens your control over your thought processes and decision-making.

But what happens if the addict enters recovery and stays clean? Can they reverse this damage? Or is the old wife’s tale of “losing brain cells” true, and there’s no hope for cognitive recovery?

The Effect of Addiction on Brain Function and Neural Pathways

AUD and SUD rewire the brain through changing neural pathways to prioritize the reward from using substances over other natural factors that stimulate neurotransmitter production—like the satiation from eating  good meal or the stress-relief from walking on grass.

Technically, or medically in this case, addiction rewires four core areas of the brain. The mesolimbic pathway is the brains “reward system,” and it’s driven by the nucleus accumbens, ventral tegmental area (VTA), and prefrontal cortex.

The prefrontal cortex regulates emotions and governs your decision making. As this region of the brain deteriorates the addict finds it harder to resist cravings for their substance of choice. The hippocampus is the memory center of the brain and it shrinks over years of heavy abuse, affecting memory recall in the addict.

The Amygdala controls the stress response initiated by the sympathetic nervous system and advanced addiction keeps the addict in a perpetual “fight-or-flight” state where they’re on edge all the time.

What’s actually going on with brain chemistry during addiction? It’s all about dopamine—a neurotransmitter that’s driving your addiction and dominating your behavior. Let’s look into how dopamine governs the addiction cycle and the effects on the brain’s natural dopamine production brought about by AUD and SUD.

Dopamine – One Neurotransmitter to Rule them All

If we look under the hood at what’s going on in the addict’s brain, the key to understanding everything is the effect AUD and SUD have on neurotransmitter production. These biochemicals are produced in the brain and body and they drive neural functions and loads of other psychological and psychological processes.

But we’re only really interested in one of the 100+ neurotransmitters produced by the brain, namely—dopamine. You might have heard about dopamine if you’ve tuned into podcasts by Andrew Huberman on the topic of how dopamine affects our brain function and behavior.

In a nutshell, the brain releases dopamine as a reward for doing something pleasurable. We already touched lightly on this early with the examples of a good meal and walking on grass. But when you drink or do drugs, the effect of these “exogenous” substances entering your body is magnitudes greater than any natural influence.

The massive surge in dopamine levels caused by drugs acting on the brain are what make these substances so addictive. Dopamine controls the addiction cycle, and it’s what makes addicts chase their next high or the next drink.

The problem with addictions impact on dopamine production is that you’re feeding an exogenous substance into your body to elevate dopamine levels artificially. When the addict is feeding a heavy addiction, the hypothalamus—the region of the brain responsible for sending out signals to produce dopamine—doesn’t see a need to produce it organically because there’s plenty of it circulating already.

Drugs like methamphetamine prevent the “Reuptake” of dopamine into the brain, meaning that it creates a more elevated state of excitement in the user as they use more of their substance of choice. That’s why someone who’s had their first line or pipe is nowhere near as “tweaked out” as someone who’s been up for the last 72-hours straight.

But the bad news is that when there’s too much dopamine floating around in the brain, it desensitizes it to dopamine, meaning that the addict has to do more and more of their substance to achieve the same level of intoxication.

Since the hypothalamus sees no need to produce the neurotransmitter, the brain starts to experience severe deficiencies when the addict isn’t using, leading to an inability to feel emotion unless they’re using. This emotional hijacking makes the addict depressed and anxious when they enter withdrawal.

So, is the brain cooked? Or is there a way back for the addict? The good news is that the brain can recover normal neurotransmitter function over time.

Unpacking the Science Behind Brain Plasticity

Have you ever noticed how kids can pick up skills so quickly when they’re young? Have you also notice that its harder for adults to learn multiple skills at once? The reason for this anomaly is a medical term called “brain plasticity.”

No, the brain isn’t made of plastic Lego blocks, it’s a term used to describe how the brain is neurally malleable and capable of changing its structure and function to accommodate the present situation it faces.

You’ll never guess how it achieves this—if you guessed dopamine and neurotransmitters—you’ve been paying attention. Brain plasticity refers to the brains ability to rewire neural pathways and create new neural connections to strengthen its function and adapt to new experiences and circumstances.

The brain can transfer functions from damaged regions to healthy ones through a process called pruning, where it eliminates weak neural connections. Synaptogenesis is the term describing how the brain creates new neural connections, and the process of myelination strengthens the nerve sheath around neural pathways, improving the speed of signal processing in the brain and central nervous system.

This is great news for anyone feeling the cognitive decline associated with AUD and SUD and its impact on dopamine production and neural collapse. It means that your brain can recover with time and patience. It means that that old story of “you have holes in your brain” or “brains cells die and never come back,” is just a load of baloney, and you can make a full recovery if you put in the work and commit to stay sober and heal.

How Long Does It Take for the Brain to Recover from Substance Addiction?

The brain can make it back from the brink of cognitive disaster, but it takes some time. There’s no real cookie-cutter answer to the question of how long it takes to complete the healing process.

Someone who has an advanced meth problem will take a lot longer to heal than someone with an alcohol issue. It’s depends on the person, and that’s why addicts who commit to a recovery program go through an extensive medical and psychological evaluation before entering treatment.

Despite recovery being a deeply personal and individual journey, we can set some parameters around our expectations for recovery. As you know by now, the epicenter of the restoration process is dopamine production and maintenance. As the brain gets closer to healing fully, it restores its ability to produce and use dopamine, provided that the patient has learned the skillset to do so.

Let’s look at the guidelines for the recovery timeline, but let’s also keep them flexible enough to know that they are just a guide, and not set in stone.

The First Few Days – Withdrawal and Nervous System Distress

When the patient enters withdrawal it’s like turning off the dopamine taps completely. We won’t get into the physical aspects of withdrawal here—which are also terrible—that’s for another discussion.

But the effect of losing all dopamine production, and with no dopamine available, the hypothalamus goes into sort of state of shock and struggles to balance neurotransmitter production. Dopamine levels are therefore incredibly low leaving the patient feeling burned out and  devoid of emotion.

There’s not much the doctor can do to stimulate dopamine with medical strategies, like medication. The patient must simply give it time and do the best they can to accelerate the process with the tools and strategies they have available to them—more on that in a minute.

The First Few Weeks – Changes in Dopamine Production

If the patient is doing everything they can to optimize their recovery, then dopamine levels start to turn around in the first three weeks of getting clean. The CNS and hypothalamus eventually get their act together and start the slow, steady process of improving your own natural production of dopamine and gaining control of its use through the reuptake mechanism in the brain. Mood improves and irritability declines with every passing day that the patient stays on track with their recovery program.

The First Few Months – Strengthening Neural Pathways

As dopamine levels increase naturally, and new neural pathways start rewiring the brain to the patient’s current behavior in recovery, they start to get enjoyment from things in life like eating good food and walking on grass. 

The psychological cravings are much less intense, but they come up from time to time and it’s possible to suppress their power with the use of mindfulness strategies.

At this stage the patient starts to feel like they’re back in control—so it’s important to watch out for Pink Cloud syndrome where the patient gets a false sense of security that they have everything completely under control when they still have much work left to do.

A Year and Beyond – Cognitive and Emotional Recovery

After the 12 to 24-month mark, the brain has regained most, if not all, of its dopamine receptors. It’s stabilized production of the neurotransmitter and rewired the brain’s neural pathways to make a sober life seem like a real possibility, and the thought of your old behavior nothing more than a fleeting memory of someone you used to be.

Can You Speed Up the Brain Rewiring Process?

Dopamine recovery is variable, depending on the patient’s substance of choice and the extent of their habit, i.e., how long they’ve been using and how much they consume. For instance a heavy meth or coke user could take anywhere from 12 to 24 months to fully restore dopamine production and balance in the brain. For people addicted to alcohol or nicotine, it could take as little as three to six months for the patient to see noticeable improvements.

There are plenty of things the patient can do to speed up the process.

Holistic Healing Strategies – Exercise, Nutrition, and Mental Stimulation

Eating a healthy diet that gives the body the fuel it needs to generate neurotransmitter production is key. Drink enough water, get your vitamins, and exercise as often as you can. Practicing meditation and mindfulness skills dramatically accelerate neural recovery and improve brain plasticity.

Sleep – Supercharge the Healing Process and Fast-Track Cognitive Recovery

By far the biggest thing a patient can do to fast-track their recovery is to improve their sleep. Sleep is when your brain shuts down shop for the day and escapes the cognitive load you place on it during the day. It uses the downtime to clear oxidation from neural pathways and improve the rewiring process in terms of quality and results. The more sleep you get, and the more consistent your sleep schedule becomes, the faster your brain recovers.

The issue with patients in recovery is that they hardly ever sleep well. The impact of their abuse on the brain’s ability to govern the circadian rhythm and the production of melatonin is also damaged in the addiction cycle. If patients have a hard time falling asleep their doctor might put them on a short course of sleeping medication and scale it down to supplements like melatonin before removing all sleep aids to let the circadian rhythm strengthen itself.

So, wrapping up—know that if you’re struggling with addiction or battling with your recovery—you can get better. You will get better. All it takes is time and eventually your dopamine levels stabilize and you’ll feel fine—stay committed to your recovery and things will work out.