Drug
Abuse and Addiction
Many people do not understand why individuals
become addicted to drugs or how drugs change the brain
to foster compulsive drug abuse. They mistakenly view
drug abuse and addiction as strictly a social problem
and may characterize those who take drugs as morally
weak. One very common belief is that drug abusers should
be able to just stop taking drugs if they are only willing
to change their behavior. What people often underestimate
is the complexity of drug addiction - that it is a disease
that impacts the brain and because of that, stopping
drug abuse is not simply a matter of willpower. Through
scientific advances we now know much more about how
exactly drugs work in the brain, and we also know that
drug addiction can be successfully treated to help people
stop abusing drugs and resume their productive lives.
Drug abuse and addiction are a major burden to society.
Estimates of the total overall costs of substance abuse
in the United States - including health- and crime-related
costs as well as losses in productivity exceed half
a trillion dollars annually. This includes approximately
$181 billion for illicit drugs, $168 billion for tobacco,
and $185 billion for alcohol. Staggering as these numbers
are, however, they do not fully describe the breadth
of deleterious public health - and safety - implications,
which include family disintegration, loss of employment,
failure in school, domestic violence, child abuse, and
other crimes.
What is drug addiction?
Addiction is a chronic, often relapsing brain disease
that causes compulsive drug seeking and use despite
harmful consequences to the individual who is addicted
and to those around them. Drug addiction is a brain
disease because the abuse of drugs leads to changes
in the structure and function of the brain. Although
it is true that for most people the initial decision
to take drugs is voluntary, over time the changes in
the brain caused by repeated drug abuse can affect a
person’s self control and ability to make sound
decisions, and at the same time send intense impulses
to take drugs.
It is because of these changes in the brain that it
is so challenging for a person who is addicted to stop
abusing drugs. Fortunately, there are treatments that
help people to counteract addiction’s powerful
disruptive effects and regain control. Research shows
that combining addiction treatment medications, if available,
with behavioral therapy is the best way to ensure success
for most patients. Treatment approaches that are tailored
to each patient’s drug abuse patterns and any
co-occurring medical, psychiatric, and social problems
can lead to sustained recovery and a life without drug
abuse.
Similar to other chronic, relapsing diseases, such as
diabetes, asthma, or heart disease, drug addiction can
be managed successfully. And, as with other chronic
diseases, it is not uncommon for a person to relapse
and begin abusing drugs again. Relapse, however, does
not signal failure—rather, it indicates that treatment
should be reinstated, adjusted, or that alternate treatment
is needed to help the individual regain control and
recover.
What happens to your brain when you take drugs?
Drugs are chemicals that tap into the brain’s
communication system and disrupt the way nerve cells
normally send, receive, and process information. There
are at least two ways that drugs are able to do this:
(1) by imitating the brain’s natural chemical
messengers, and/or (2) by over stimulating the “reward
circuit” of the brain.
Some drugs, such as marijuana and heroin, have a similar
structure to chemical messengers, called neurotransmitters,
which are naturally produced by the brain. Because of
this similarity, these drugs are able to “fool”
the brain’s receptors and activate nerve cells
to send abnormal messages.
Other drugs, such as cocaine or methamphetamine, can
cause the nerve cells to release abnormally large amounts
of natural neurotransmitters, or prevent the normal
recycling of these brain chemicals, which is needed
to shut off the signal between neurons. This disruption
produces a greatly amplified message that ultimately
disrupts normal communication patterns.
Nearly all drugs, directly or indirectly, target the
brain's reward system by flooding the circuit with dopamine.
Dopamine is a neurotransmitter present in regions of
the brain that control movement, emotion, motivation,
and feelings of pleasure. The overstimulation of this
system, which normally responds to natural behaviors
that are linked to survival (eating, spending time with
loved ones, etc.), produces euphoric effects in response
to the drugs. This reaction sets in motion a pattern
that "teaches" people to repeat the behavior of abusing
drugs.
As a person continues to abuse drugs, the brain adapts
to the overwhelming surges in dopamine by producing
less dopamine or by reducing the number of dopamine
receptors in the reward circuit. As a result, dopamine's
impact on the reward circuit is lessened, reducing the
abuser's ability to enjoy the drugs and the things that
previously brought pleasure. This decrease compels those
addicted to drugs to keep abusing drugs in order to
attempt to bring their dopamine function back to normal.
And, they may now require larger amounts of the drug
than they first did to achieve the dopamine high - an
effect known as tolerance.
Long-term abuse causes changes in other brain chemical
systems and circuits as well. Glutamate is a neurotransmitter
that influences the reward circuit and the ability to
learn. When the optimal concentration of glutamate is
altered by drug abuse, the brain attempts to compensate,
which can impair cognitive function. Drugs of abuse
facilitate non conscious (conditioned) learning, which
leads the user to experience uncontrollable cravings
when they see a place or person they associate with
the drug experience, even when the drug itself is not
available. Brain imaging studies of drug-addicted individuals
show changes in areas of the brain that are critical
to judgment, decision making, learning and memory, and
behavior control. Together, these changes can drive
an abuser to seek out and take drugs compulsively despite
adverse consequences—in other words, to become
addicted to drugs.
Why do some people become addicted, while others
do not?
No single factor can predict whether or not a person
will become addicted to drugs. Risk for addiction is
influenced by a person’s biology, social environment,
and age or stage of development. The more risk factors
an individual has, the greater the chance that taking
drugs can lead to addiction. For example:
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Biology.
The genes that people are born with––in
combination with environmental influences - account
for about half of their addiction vulnerability.
Additionally, gender, ethnicity, and the presence
of other mental disorders may influence risk for
drug abuse and addiction. |
• |
Environment.
A person’s environment includes many different
influences - from family and friends to socioeconomic
status and quality of life in general. Factors such
as peer pressure, physical and sexual abuse, stress,
and parental involvement can greatly influence the
course of drug abuse and addiction in a person’s
life. |
• |
Development.
Genetic and environmental factors interact with
critical developmental stages in a person’s
life to affect addiction vulnerability, and adolescents
experience a double challenge. Although taking drugs
at any age can lead to addiction, the earlier that
drug use begins, the more likely it is to progress
to more serious abuse. And because adolescents’
brains are still developing in the areas that govern
decision making, judgment, and self control, they
are especially prone to risk-taking behaviors, including
trying drugs of abuse. |
Prevention is the Key
Drug addiction is a preventable disease. Results from
NIDA-funded research have shown that prevention programs
that involve families, schools, communities, and the media
are effective in reducing drug abuse. Although many events
and cultural factors affect drug abuse trends, when youths
perceive drug abuse as harmful, they reduce their drug
taking. It is necessary, therefore, to help youth and
the general public to understand the risks of drug abuse,
and for teachers, parents, and healthcare professionals
to keep sending the message that drug addiction can be
prevented if a person never abuses drugs.
Material above is courtesy of: http://www.cdc.gov
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