The Science of Risk and Reward in the Brain and Its Relation to Addiction

VTA: Ventral Tegmental Area

NA: Nucleus Accumbens

PFC: Prefrontal Cortex

HIPP: Hippocampus

AMY: Amygdala

The risk reward pathway involves certain areas of our brain that determine whether the reward is worth the risk.  Our ancient ancestors found that the rewards of reproduction (sex), nutrition (food and water), shelter and parenting skills had the best chance of passing on their genes to future generations.  The chemical that is the end product in these areas of the brain is dopamine, also know as the pleasure chemical (neurotransmitter.) Drugs of abuse and addictive behaviors (such as gambling, computer and social media use disorder, eating disorders, etc) hijack this system leading people to seek out the reward, drug or behavior, no matter the risk.  The need for the drug or behavior supersedes the need to maintain a job in order to have food or shelter, or reproduction and parenting skills.  The drug or behavior becomes the only thing that brings pleasure. 

The main area of the brain involved are the VTA and NA (see diagram above.). These are important in regulating a behavioral response to emotional or motivational triggers.  These areas then spread out to include areas of memory, learning, and planning.  When drugs of abuse or addictive behaviors get involved, this is what leads to triggers and the development of cravings.  Sudden onset of cravings can even happen well after sobriety or period of abstinence. 

As mentioned earlier, dopamine release is the final product.  If there is enough dopamine released then the brain feels it is worth the risk of obtaining.  There are some studies that suggest that drugs of abuse or addictive behaviors increase the release of dopamine by up to 10,000 times the normal amount.  This explains why some people cannot find pleasure in anything except the drug of abuse or addictive behaviors. 

Drugs of abuse hijack the risk reward pathway by increasing the dopamine release into certain areas of the brain.  These areas also connect to multiple other areas of the brain causing cravings and triggers.  Treatment consists of helping a person learn what their triggers are and develop different coping skills so they can change the behavior response to that trigger.  There are medications that can help a person through the physical dependency and that can help them regulate the chemicals in their brain in response to those triggers to aid them in remaining sober.