The Tail Wagging The Dog
Bill Loving, MD, ASAM

Imagine separating the brain into the areas of higher functions (above the ears) and lower primitive functions (below the ears). The higher functions such as speech, voluntary movement, will power, logic, judgment and ethics are located in the big wrinkled part of the brain above the ears. This area is called the cerebrum or neocortex. The primitive functions which are involuntary and instinctual in nature are located lower in the underbelly of the brain. This area is called the mid-brain and brain stem.

You might think that the pleasure or reward center is located in the area of higher function - but it is not. It is located in the primitive mid-brain. Stimulate this discrete area of the brain known as the reward center and the person feels pleasure, euphoria, or "high". This is "where the action is" in the alcoholic or chemically dependent person's brain. Because of their chemical structure, certain substances like alcohol, marijuana, cocaine, opiates and other drugs of abuse have their primary action at the reward center. When stimulated the reward center does two things - it makes chemically dependent or alcoholic people feel "high" and then it sends a message to the rest of the brain saying "do that again".

It has been discovered, through animal studies and sophisticated brain scans, that the alcoholic and chemically dependent person has an ultra-sensitive reward center, and this type of stimulation causes it to overreact. That means the chemically dependent person not only gets a higher "high" than the average person, but, even more significantly, gets super strong messages saying "DO IT AGAIN!" Not only are these messages to repeat the behavior very strong, but they come from the primitive area of the brain. This means they trump control by the higher function area of the brain. Chemically dependent people find themselves obeying the primitive brain's message even though it goes against their own logic, judgment, and ethics. The primitive brain then starts to run the show or control behavior, and the higher brain is just along for the ride.

The primary motivation and control of behavior is coming from the part of the brain below the ears. Above the ears the cerebrum just spends its time rationalizing, explaining away behavior, and lying, if necessary, to cover its tracks. One author said the brain gets "hijacked" by drugs and alcohol. When it comes to behavior, it is like the tail wagging the dog.