Drug Addiction
Historically, addiction has been defined as physical and psychological dependence on psychoactive substance(s) (for example alcohol, heroin and other drugs) which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain.
The American Society Of Addiction Medicine has this definition for Addiction:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors. The addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships. Like other chronic diseases, addiction can involve cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
National Institute on Drug Abuse
How Science Has Revolutionized the Understanding of Drug Addiction
Throughout much of the last century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When science began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punitive rather than preventative and therapeutic actions. Today, thanks to science, our views and our responses to drug abuse have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of drug addiction, enabling us to respond effectively to the problem.
As a result of scientific research, we know that addiction is a disease that affects both brain and behavior. We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease. Scientists use this knowledge to develop effective prevention and treatment approaches that reduce the toll drug abuse takes on individuals, families, and communities.
What is drug addiction?
Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain – they change its structure and how it works. These brain changes can be long lasting, and can lead to the harmful behaviors seen in people who abuse drugs.
Why do people take drugs?
In general, people begin taking drugs for a variety of reasons:
To feel good. Most abused drugs produce intense feelings of pleasure. This initial sensation of euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the “high” is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opiates such as heroin is followed by feelings of relaxation and satisfaction.
To feel better. Some people who suffer from social anxiety, stress-related disorders, and depression begin abusing drugs in an attempt to lessen feelings of distress. Stress can play a major role in beginning drug use, continuing drug abuse, or relapse in patients recovering from addiction.
To do better. The increasing pressure that some individuals feel to chemically enhance or improve their athletic or cognitive performance can similarly play a role in initial experimentation and continued drug abuse.
Curiosity and “because others are doing it.” In this respect adolescents are particularly vulnerable because of the strong influence of peer pressure; they are more likely, for example, to engage in “thrilling” and “daring” behaviors.
If taking drugs makes people feel good or better, what’s the problem?
At first, people may perceive what seem to be positive effects with drug use. They also may believe that they can control their use; however, drugs can quickly take over their lives. Consider how a social drinker can become intoxicated, put himself behind a wheel and quickly turn a pleasurable activity into a tragedy for him and others. Over time, if drug use continues, pleasurable activities become less pleasurable, and drug abuse becomes necessary for abusers to simply feel “normal.” Drug abusers reach a point where they seek and take drugs, despite the tremendous problems caused for themselves and their loved ones. Some individuals may start to feel the need to take higher or more frequent doses, even in the early stages of their drug use.
Is continued drug abuse a voluntary behavior?
The initial decision to take drugs is mostly voluntary. However, when drug abuse takes over, a person’s ability to exert self control can become seriously impaired. Brain imaging studies from drug-addicted individuals show physical changes in areas of the brain that are critical to judgment, decisionmaking, learning and memory, and behavior control. Scientists believe that these changes alter the way the brain works, and may help explain the compulsive and destructive behaviors of addiction.
Why do some people become addicted to drugs, while others do not?
As with any other disease, vulnerability to addiction differs from person to person. In general, the more risk factors an individual has, the greater the chance that taking drugs will lead to abuse and addiction. “Protective” factors reduce a person’s risk of developing addiction.
What factors determine if a person will become addicted?
No single factor determines whether a person will become addicted to drugs. The overall risk for addiction is impacted by the biological makeup of the individual – it can even be influenced by gender or ethnicity, his or her developmental stage, and the surrounding social environment (e.g., conditions at home, at school, and in the neighborhood).
Which biological factors increase risk of addiction?
Scientists estimate that genetic factors account for between 40 and 60 percent of a person’s vulnerability to addiction, including the effects of environment on gene expression and function. Adolescents and individuals with mental disorders are at greater risk of drug abuse and addiction than the general population.
What environmental factors increase the risk of addiction?
Home and Family. The influence of the home environment is usually most important in childhood. Parents or older family members who abuse alcohol or drugs, or who engage in criminal behavior, can increase children’s risks of developing their own drug problems.
Peer and School. Friends and acquaintances have the greatest influence during adolescence. Drug-abusing peers can sway even those without risk factors to try drugs for the first time. Academic failure or poor social skills can put a child further at risk for drug abuse.
What other factors increase the risk of addiction?
Early Use. Although taking drugs at any age can lead to addiction, research shows that the earlier a person begins to use drugs the more likely they are to progress to more serious abuse.8 This may reflect the harmful effect that drugs can have on the developing brain; it also may result from a constellation of early biological and social vulnerability factors, including genetic susceptibility, mental illness, unstable family relationships, and exposure to physical or sexual abuse. Still, the fact remains that early use is a strong indicator of problems ahead, among them, substance abuse and addiction.
Method of Administration. Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense “high” can fade within a few minutes, taking the abuser down to lower, more normal levels. It is a starkly felt contrast, and scientists believe that this low feeling drives individuals to repeated drug abuse in an attempt to recapture the high pleasurable state.
The brain continues to develop into adulthood and undergoes dramatic changes during adolescence.
One of the brain areas still maturing during adolescence is the prefrontal cortex11 – the part of the brain that enables us to assess situations, make sound decisions, and keep our emotions and desires under control. The fact that this critical part of an adolescent’s brain is still a work-in-progress puts them at increased risk for poor decisions (such as trying drugs or continued abuse). Also, introducing drugs while the brain is still developing may have profound and long-lasting consequences.
Why is adolescence a critical time for preventing drug addiction?
As noted previously, early use of drugs increases a person’s chances of more serious drug abuse and addiction. Remember, drugs change brains – and this can lead to addiction and other serious problems. So preventing early use of drugs or alcohol may reduce the risk of progressing to later abuse and addiction.
Risk of drug abuse increases greatly during times of transition, such as changing schools, moving, or divorce.12 If we can prevent drug abuse, we can prevent drug addiction. In early adolescence, when children advance from elementary through middle school, they face new and challenging social and academic situations. Often during this period, children are exposed to abusable substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug abuse by older teens, and social activities where drugs are used.
At the same time, many behaviors that are a normal aspect of their development, such as the desire to do something new or risky, may increase teen tendencies to experiment with drugs. Some teens may give in to the urging of drug-abusing friends to share the experience with them. Others may think that taking drugs (such as steroids) will improve their appearance or their athletic performance or that abusing substances such as alcohol or ecstasy (MDMA) will ease their anxiety in social situations.
Teens’ still-developing judgment and decisionmaking skills may limit their ability to assess risks accurately and make sound decisions about using drugs. Drug and alcohol abuse can disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control. So, it is not surprising that teens who abuse alcohol and other drugs often have family and school problems, poor academic performance, health-related problems (including mental health), and involvement with the juvenile justice system.
Oxycontin Intervention
Oxycontin is a prescription medication that is a delayed release form of the drug oxycodone. Because it is delayed release, an entire day’s worth of oxycodone can be contained in one tablet. Oxycontin addicts will very often crush the tablet before consuming it, releasing all of the oxycodone at once. Oxycodone is an opioid which means it belongs to the same class as heroin and morphine. Like these other opioids, oxycodone results in the development of tolerance and withdrawal meaning that when an addict tries to stop taking the drug they experience a very unpleasant set of symptoms including nausea, diarrhea, physical pain, sweating, insomnia, and depression. Avoidance of withdrawal can keep an addict locked in their addiction for years, even after they have decided they want to stop. Because Oxycontin is expensive when bought on the street (where most addicts eventually end up getting it) an Oxycontin addict will often resort to stealing or other illegal activity to support their habit. Staging an intervention for an Oxycontin addict can save them before they progress farther down the path of addiction and experience worse and worse financial, legal, and social consequences.
Meth Intervention
Methamphetamine (also known as meth, crystal, and crystal meth) causes significant damage to the brains and bodies of those addicted to it. When used in small amounts, methamphetamine results in an increase in energy and focus and many addicts report that at the beginning, their use actually made them more productive. Unfortunately, once addicted, methamphetamine users become non-functional, staying up sometimes for weeks at a time and developing a characteristic psychosis that involves auditory hallucinations and paranoia. Methamphetamine can cause irreparable damage to the brain and this “amphetamine induced psychosis” can sometimes become permanent. Other health effects of methamphetamine use include loss of teeth, strokes, and heart attacks. For this reason, the earlier a methamphetamine intervention can be staged the better.
Cocaine or Crack Intervention
Cocaine is one of the most addictive drugs available, particularly when it is injected or smoked as crack or freebase. Cocaine addicts may function normally at the beginning but inevitably lose control. Many cocaine addicts will engage in binges with heavy use for several days followed by periods of severe depression and irritability. As the addiction progresses, the addict frequently becomes so focused on using that work, friends, and family become neglected and are often eventually lost. For this reason, early intervention in cocaine addiction is crucial; it can prevent the addict from losing everything.
Heroin Intervention
Heroin has been a common drug of abuse for many years. Beginning in the 1990s, however, heroin use increased significantly because more potent forms became available which could be smoked or snorted, thus allowing individuals scared by injection drug use to try the drug without the use of a syringe. Unfortunately, many individuals who begin by smoking or snorting heroin progress to intravenous use, thus exposing themselves to numerous health consequences including AIDS, Hepatitis C, and endocarditis (a potentially lethal heart valve infection). Heroin has turned many promising young individuals into shells of people living only for their next shot. Because heroin addiction progresses very rapidly and can have such dire consequences, staging an intervention as soon as a problem becomes evident is crucial.
