This paper reviews the new ideas emerging from neuroscience regarding the question of why some people are compelled to use drugs. During the process of drug exposure, the brain’s motivational system is changed in ways that co-opts the individual’s motivational system. Changes in the brain’s motivational structures along with changes in the brain’s self-regulatory structures compel an individual to drug use. Ways to reverse those changes in an addicted brain have been identified, as have ways to enhance self-regulatory control. The information from neuroscience offers a new perspective on “loss of control” as well as offering implications for treatment.