Tolerance: How it Works

Tolerance occurs when use of alcohol and drugs is repeated over time. Eventually, the effect of the original dose is diminished and more of the substance is required to attain the same result. The concept of tolerance applies not only to drugs and alcohol, but to problem behaviors such as gambling, sex, overeating or pornography.

Tolerance and the Brain

How does tolerance occur? The workings of the human brain are complex, but to the brain, all "pleasure" is the same; it doesn’t know the difference between a cocaine high, a win at the blackjack table or great sex. This is because the substance (or the behavior) causes an intense release of dopamine, a powerful chemical neurotransmitter that takes over the area responsible for pleasure (often known as the brain’s pleasure center or reward center).

The brain’s response to pleasure is actually a critical function because pleasurable feelings are associated with activities that sustain human life, including eating and procreation. Without these activities, the human race would soon cease to exist.

Addiction and Tolerance

Of course, there’s nothing positive about tolerance to alcohol, drugs or disruptive human behavior. As the brain is reprogrammed to need more and more of the addictive substance or destructive behavior, the brain’s reward system is no longer as efficient as it once was. Dopamine begins to lose its strength, and the person eventually begins to feels what is sometimes known as “the new normal.” This means that the individual no longer gets pleasurable feelings from the activity, but must continue increasing the level not to feel good, but to feel normal, or “just okay.” Eventually, the downward cycle accelerates and the individual requires more to simply stave off withdrawal symptoms. Feeling good or getting high is a thing of the past.

At this point, many individuals become fearful of stopping the substance or behavior, with good reason. As tolerance deepens, withdrawal can become more difficult. Repeated binges, followed by withdrawal attempts, make matters worse. Deadly overdoses often occur when an individual stops using drugs such as heroin for a time and the body begins to adjust. When the person uses again, he or she believes that the same high amount is needed, which the body can no longer tolerate.

Recovery is Possible

Although addiction seems difficult to overcome, qualified treatment providers can help. Although it isn’t always easy, it is very possible to return to a healthy, productive life, free of addiction to harmful substances and negative, stressful behaviors. The first step from a substance addiction is detox, which is managed medically so that withdrawal symptoms are reduced or diminished and thus easier to tolerate. At that point, individuals are ready to continue recovery.

Treatment is highly individualized and includes not only counseling, psycho-education and various forms of psychotherapy as well as the identification and treatment of the root cause of addiction, it also includes a healthy nutritional program and highly effective complementary approaches such as acupuncture, massage, personal training, reflexology and yoga.

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