Using the Power of the Brain to Treat Substance Use Disorder

by Lisa Frederiksen
May 18, 2020

One of the most important things moms can do is understand the power of the brain to treat substance use disorder. And what is meant by “the power of the brain”? It is the brain’s incredible ability to actually rewire (change) itself with the right kind of help.

You see, current brain research has debunked some of society’s long-held beliefs about the brain. These include the belief that our brains were hardwired around the time of puberty and that from then on, they were in a long, slow process of decline; or that heavy drinking or other drug use “killed” brain cells; or that you only used a very small percentage of your brain’s capacity.

So how does this relate to substance use disorder and treatment?

The brain, just a three-pound organ—three pounds!—controls everything we think, feel, say, and do. If our brain doesn’t work, our heart can’t pump, our lungs can’t breathe, and our limbs can’t move. If our brain doesn’t work, we couldn’t develop a substance use disorder, nor could we read, drive a car, walk, feel pain or love, experience stress—you get the picture.

The brain exerts this kind of control through an electrochemical signaling process. This is how brain cells talk to one another and then to and from other neurons throughout the body via the nervous system. This process is commonly referred to as neural networks, neural circuitry, or, more simply, brain wiring. These connections, in turn, “wire together” to form what are called brain maps. Brain maps are basically our routine thoughts, feelings, and behaviors—our habits—like the examples of reading, driving, or substance use disorder just mentioned.

This brain wiring and mapping is deeply influenced by the brain’s developmental stages. Given adolescence is a prime time for a person to develop or begin the development of a substance use disorder (SUD), I will focus on the following:

Brain Development during Adolescence

The brain goes through three key developmental stages during adolescence and continuing to an average age of twenty-two for girls/women and twenty-four for boys/men. These stages are puberty (starting around age twelve), continued wiring in the cerebral cortex (starting around age sixteen), and the pruning and strengthening process (adolescence through young adulthood). The image below gives you a visual of how much change occurs during these developmental stages.

MRI Study of Normal Brain Development


Now, I explained the stage of puberty in my MomPower post “Puberty, Risk Taking and Addiction,” so I’m going to cover the next two stages here:

  • Continued wiring in the cerebral cortex
  1. This refers to development in the “thinking” part of the brain, especially that which occurs in the prefrontal cortex. This is the “executive center” of the brain. It is this continued wiring in the cerebral cortex, especially the prefrontal cortex, that allows a young person to engage in sound reasoning, good judgment, complex planning, and appropriate impulse control, as well as weighing the consequences of their actions and learning from their mistakes (source link). This continued wiring also serves as the brakes on the risk-taking behaviors that started with puberty.
  • The “pruning and strengthening” process
    This process allows the brain to organize itself more efficiently. To do this, the brain pays attention to and “strengthens” the neural connections being frequently used. These become a person’s routine thoughts, feelings, behaviors—their habits. The neural connections not being frequently used get “pruned.” It’s not that they “die,” necessarily. Rather, the brain misses some important wiring, mapping, and strengthening opportunities. If an adolescent or young adult is using alcohol or other drugs routinely—especially if it’s to counter anxiety, stress, depression, not fitting in, fitting in, etc.—this process can cause that person to “map” (develop) a substance use disorder.


Getting the Right Kind of Help to Treat Substance Use Disorder

Getting the right kind of help means identifying the things that happened to a person’s brain as it was developing and then using targeted treatments to change those that are negative and strengthen those that are positive.

To give you an idea of what these targeted treatments might be, check out these resources on effective treatment for alcohol or other substance use disorders created by the National Institute on Drug Abuse (NIDA). One is for adults, titled Principles of Drug [and Alcohol] Addiction Treatment: A Research-Based Guide (Third Edition). The other is for adolescents, titled . Please know a person can change their brain at any age.

And for more on these brain concepts, please check out this PDF excerpt from my latest book.

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Lisa Frederiksen

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  1. Lisa,
    Looking at SUD from a neuroscience perspective is so refreshing. My three adult sons struggle with alcoholism and/or meth, and for years I’ve resisted the “hit bottom, tough love” approach. I rejected these not because I was so darn smart, but because I kept failing badly at implementing any solution that involved estrangement of my children. But thanks to my plasticky brain, this old dog is learning new tricks. I’m learning how to cope in ways that open the door for real treatment options. I’m learning how to communicate without judgment. I’m learning how to set a boundary that I can keep. Thanks for this informative article.
    I Won’t Give Up,
    Linda S. Clare

    • Hi Linda – what you are doing is awesome. I know when I started studying the research on the neuroscience of SUDs and of the toxic stress impacts of coping with a loved one’s SUD on family members – it was such a series of “AH HA!!!” moments for me, as well. Thanks for your comment. ~Lisa

  2. Nice review of brain wiring and development Lisa. Keep spreading the word. Wendie

    • Thanks so much for your comment Wendie.

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