Drug Abuse, Addiction, and the Brain

Many people do not understand why people 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 who want to stop abusing drugs and resume productive lives.

What Is Drug Addiction?

Drug addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the drug addict and 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 impair a person's self-control and ability to make sound decisions, and at the same time create an intense impulse to take drugs.

It is because of these changes in the brain that it is so challenging for a person to stop abusing drugs. Fortunately, there are treatments that help people to counteract addiction's powerful disruptive effects and regain control of their lives. Research shows that combining addiction treatment medications, when appropriate, 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 concurrent medical, psychiatric, and social problems can help achieve  sustained recovery and a life without drugs.

As with other chronic diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed effectively. Yet, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse does not signal failure; rather, it indicates that treatment should be reinstated or adjusted, or that alternate treatment is needed to help the person regain control and recover.

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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: by imitating the brain's natural chemical messengers, and/or overstimulating 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 dopamine surges by producing less dopamine or reducing dopamine receptors. The user must therefore keep abusing drugs to bring his or her dopamine function back to ''normal'' or use more drugs in an effort to try to achieve a dopamine high.

Long-term drug abuse causes changes in other brain chemical systems and circuits, as well. 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 -- in other words, to become addicted to drugs. While these brain changes can powerfully influence behavior and the impulse to use drugs, people in the midst of an addiction do not completely lose  their ability to exercise judgment and make decisions; their desire to stop using drugs and pursue treatment hinges on the wish to live sober.  As with many chronic, relapsing disorders, recovery then becomes an active lifelong process.     

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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:

  • 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 Key

Drug addiction can be a preventable disease. Research has shown that prevention programs that involve the family, 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 health care professionals to keep sending the message that drug addiction can be prevented if a person never abuses drugs.

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