It’s All About the Dopamine

It’s been said that we are only puppets and dopamine is the puppet master. According to recent brain scan research, dopamine may be at the root of all our addictions. Very often, the choices we make are based on what we believe will give us the biggest hit of dopamine. When the brain expects a reward it will fire off dopamine in anticipation. When that reward does come, the brain fires off even more dopamine in response. Conversely, when the expected reward doesn’t happen dopamine levels will fall dramatically. And the feeling isn’t a pleasant one, in fact, it feels like pain.

Imagine, then, how that feeling is exaggerated when the expected surge of dopamine is to be received from a dopamine-enhancing drug like heroin.

Compare that to sex: Although we can live without the constant pleasure of sex – there are no withdrawal symptoms – this is often not the case with addictive drugs like heroin. When the expected surge doesn’t come on schedule, the results can be a dopamine crash of epic proportions. Then, to make matters worse, add to that the highly discomforting symptoms of withdrawal.

What Is Dopamine Anyway?

Dopamine is one of the chemical signals that passes information between the brain’s neurons, AKA a neurotransmitter. Dopamine affects emotions, movements, and sensations of pleasure and pain. Even our preference for the taste of certain foods comes down to dopamine: According to a study1, how we perceive the taste of food isn’t due to the essential quality of the food itself or even a product of our taste buds. Taste is determined by how dopamine affects our brain.

It is sometimes called the “reward hormone” or pleasure chemical. It is also associated with feelings of extreme pleasure, the reason such dopamine-releasing activities such as sex, obsession, love, gambling, and certain drugs can be highly addictive.

When flooded with a drug like heroin, the brain also releases the chemical GABA (gamma-aminobutyric acid). GABA signals the brain to stop creating dopamine. When opiate drugs attach to GABA, the chemical is unable to inhibit the production of dopamine. The result: an even bigger dopamine surge.

Sex & Heroin

We know that both sex and heroin flood the brain with high levels of dopamine. Perhaps not coincidentally, both sex and heroin excite the same region of the brain, a structure called the ventral tegmental area (VTA). This is the area that controls the release of dopamine. This explains why heroin addicts can experience orgasmic-like pleasure as a result of their drug use; it also explains why heroin addicts have suppressed sex drives. The reason: Because the VTA is already so intensely stimulated by the heroin.

So, between sex and heroin, in terms of dopamine release, which gives you the biggest rush?

Heroin can cause the body to release up to 10 times the normal levels of dopamine. (For comparison, activities such as eating and video games have been shown to double dopamine levels.) Brain scans of men experiencing orgasm look very similar to a person shooting heroin.

One thing heroin can do that sex cannot: It can create longer and faster dopamine surges.

And then there’s what is known as the Coolidge Effect: animal studies have shown, in males anyway, that for sex to produce consistently high levels of dopamine, the sexually prodigious person would require frequent novel partners. Similarly, for heroin, with repeated use, the nerve cells that dopamine acts upon become exhausted from stimulation. To this the brain will react by restricting its dopamine response. (This is not just true for heroin but for all forms of pleasurable behavior.) It appears that with overuse, some of the dopamine receptors themselves die off. For the user to reach the same desired effect, more of the drug is needed.

Sex Addict vs Heroin Addict

That sex can be an addiction at all has been the subject of much debate. Is it a disease or is it a habit? At present, it is technically considered a brain disorder. (It was rejected for inclusion in the Diagnostic and Statistical Manual 5, AKA DSM-V.)

But, if sex is indeed an addiction, why do some people become addicts and others do not? The causes of compulsive sexual behavior are currently not well understood. According to a recent study2, sex addiction and may work a lot like drug addiction in the brain. Three areas of the brain that are active with drug users anticipating using drugs were also the same areas active when test subjects were shown sexually explicit videos.

Over the long term, people who are addicted to drugs may feel extreme desire for the drug but don’t necessarily feel so much pleasure while taking it. Addiction may be much more about the craving of the experience than the experience itself.

Addiction is often defined as whenever a habit changes into an obligation. Clearly, the obligation to abuse drugs requires far more of a personal commitment. Behavioral addictions don’t have the physical signs that drug addictions have. Compulsive sexual behavior can be about much more than pornography. In some cases it can lead to risky sexual practices (sex with prostitutes, unprotected sex, etc.) and therefore have serious health and life consequences.

Still, when compared to the ravages of heroin addiction, sex addiction is mild in comparison. Heroin addiction destroys families, livelihoods, and lives. If you or a loved one is experiencing drug addiction, don’t wait to get help.

If you or a loved one have an addiction to alcohol, contact BLVD Treatment Centers. At BLVD Treatment Centers we custom tailor our recovery programs within the safe and nurturing confines of our rehab treatment centers. Located throughout California, in Los Angeles, Orange County, San Diego and in Portland, OR, our mission is to assess the severity of your addiction to help you achieve true recovery within 30 days. Call us now at 1-866.582.9844.


  1. Walter Kaye, MD, Professor of Psychiatry, Director of the Eating Disorder Treatment and Research Program at the University of California, San Diego School of Medicine
  2. PLOS One. Neural Correlates of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviours. Retrieved April 26, 2016.

Addiction Deathmatch: Heroin vs Sex