Originally Posted by
defyinggravity 
(...I'm finishing my PhD in behavioral neuroscience focusing on the process of addiction...)
...I do believe addicts can live in recovery for the rest of their full, happy lives. But I believe that that takes learning how to "talk over" your deepest drives. It takes learning a new way of thinking and living. You have to learn over deeply ingrained patterns of behavior - patterns that are wired in. 12-step programs teach us that, rehab teaches us that, supportive recovering addict friends teach us that, addiction therapists teach us that, other forms of recovery that I've forgotten/unaware of teach us that. By implementing a structured treatment plan (whatever it may be) each and every day, addicts conquer their disease. By not using or drinking just for this one day, each day at a time, addicts treat their disease. By rehabilitating the mind and doing emotional and mental work to develop healthy and effective coping strategies, addicts stay sober.
In Behavioral Neuroscience do you learn the neurobiology or neuro anatomy/physiology aspects of addiction? I'm an RN and the part of rehab that fascinated me was the pathways of the addicted brain. What happens physically and physiologically. Our brain literally changes shape and we lose mass (happens with nicotine addiction as well).
In recovery we must build new brain pathways or as you say, "learn over deeply ingrained patterns of behavior."
The more practice one gets by doing things sober the stronger and more prominent those new pathways become. For example, when I first got sober I didn't know how to be social without my drug or drink. Being social over and over again sober, and over time I have learned that it can be done and quite successfully! This is my brain building a new pathway. I choose to use this pathway.
I was paralyzed mentally at first until I got active in my recovery and started doing everything sober (I used to think I couldn't do anything sober because I used every waking moment for years and years).
The catch is that the formerly active addict brain pathways will ALWAYS be there. Falling into "old behaviors" is very dangerous - it reignites those old pathways and frequently leads to relapse. But it doesn't have to....just what ever I do, I don't pick up and use or drink. I do something recovery related instead. It gets easier and easier over time because those new pathways are now prominent and readily available to me.
Also, when in active addiction, the active pathways are...get the drug or drink, use the drug or drink, get more, lie to get it, steal to get it, hide it, hide me (isolate), etc etc...which creates all kinds of emotional problems. This is why it is absolutely 100% necessary to address the mental/emotional side of addiction (psychiatry, therapy, sober networks (12 step, etc) to deal with the shame and guilt of the old behaviors and the damage done to oneself and others.
Only the last two paragraphs are my opinion. The rest is pretty well studied and documented.
Thanks for you post.
p.s. would love a conversation about specific neurotransmitters!