Hi Dr. Raj,I heard you on Hay House. You talked about addictions, and mentioned that dopamine increases as the substance we misuse is increased. After you have a period of abstinence, does the dopamine go back to normal levels? If so how long an abstinence is necessary. Thank you for your work and help. M.Answer:Hi M.Yes, as one abuses illicit substances (or alcohol), more and more dopamine is released in between the brain cells (neurons); this results in dopamine stores being depleted as well as the down regulation of the dopamine receptors in the brain; the problem that gets created is that when the person attempts to get abstinent, this change in dopamine receptors results in the person having difficulty feeling the same levels of pleasure that they felt prior to using the substance; these changes do go back towards the pre-use state but this can take up to 1 – 2 years; even after the brain “normalizes” it remembers and if the substance is used again, the changes happen again, only this time quicker! It’s like getting on a bicycle, you never forget and it comes back quickly even after you haven’t rode for a while. Creating a supportive network and getting into treatment is a critical part of increasing the odds of long term abstinence. Thank you for your question.