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.
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 that 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 over
stimulation 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.
Suffering from Drug
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