Understanding Drug Addiction

Most people do not understand how or why others become addicted to drugs. Even in today’s modern world, there is a social stigma associated with drug addiction. It is often mistakenly assumed that drug abusers lack moral principles or willpower. With this misconception, people believe that drug addiction can simply be stopped by a drug abuser making the choice to change their behavior and just stop taking drugs. This notion is far from the reality of the complex disease of drug addiction.

Drug addiction is a chronic brain disease that causes the compulsive need for drugs despite the harmful consequences to the addicted individual and those around him or her. Even though the initial decision to use drugs is a voluntary one, the brain changes that occur over time impede one’s ability to resist intense impulses to take drugs.

Fortunately, there are treatments available to help drug addicts counter the brain’s disruptive effects. Research has demonstrated that effective treatment plans, such behavior therapy and addiction treatment medications, can lead to sustained recovery and life without the use of drugs. However, just like any other chronic disease like diabetes or heart disease, it is not uncommon for a person to relapse and start using drugs again. Keep in mind that relapse is not a sign of treatment failure but merely an indication that treatment needs to be reinstated or adjusted in order for the person to recover again.

The Brain Changes Caused by Drug Addiction

Drugs are comprised of chemicals that adversely affect the brain’s communication system. Specifically, the manner in which nerve cells send, receive and process information is disrupted. Drugs accomplish this by either over stimulating the reward circuit of the brain or by imitating the brain’s natural chemical messengers.

Some drugs like heroin and marijuana have a similar structure to chemical messengers known as neurotransmitters that are naturally produced by the brain. Due to this similarity, the brain’s receptors are fooled and activate nerve cells to transmit abnormal messages. Other drugs like methamphetamine and cocaine cause the nerve cells to produce large amounts of dopamine. As a result, the normal recycling of the neurotransmitter is disrupted, and the signaling between neurons does not shut off. The brain is then overloaded with dopamine in the brain regions that control feeling of pleasure, emotion and motivation. This overstimulation of the brain’s reward system creates a euphoric effect in response to psychoactive drugs. This chemical reaction sets the framework for a pattern that teaches the drug user to repeat the rewarding behavior (Shippenberg, Zapata & Chefer).

As an individual continues to take drugs, the brain naturally adapts to the excess dopamine by either reducing the number of dopamine receptors in the reward circuit or by producing less dopamine. The result is a lessening of dopamine’s impact on the reward circuit (Le Moal & Koob). This in effect reduces the individual’s ability to enjoy the drug and also other activities in life that once brought pleasure. The drug user winds up in a vicious cycle of trying to bring the dopamine function back to normal. However, in order to this, larger amounts of drugs are needed. This effect is known as tolerance.

In addition to causing changes in the dopamine system, long-term drug abuse causes changes in other circuits and brain chemical systems as well. Like dopamine, glutamate is a neurotransmitter that influences the reward circuit, and its concentration is altered by drug abuse. When the concentration is altered, the brain attempts to compensate (Shippenberg, Zapata & Chefer). Brain imaging studies have revealed that a disruption in glutamate levels shows changes in areas of the brain that are vital for behavior control, learning, memory, decision making and judgment. These adverse brain changes can cause an addict to take seek out and take drugs compulsively.

Reasons Why Some Become Addicted & Others Do Not

There is really no single factor that can determine whether or not a person will become addicted to drugs. The risk for addiction is typically influenced by a combination of factors. Factors like age, social environment and biology are strong risk factors. The more risk factors a person has, the greater chance there is for drug addiction.

Age: Although one can become addicted to drugs at any age, the earlier in age that drug use begins, the more likely it will progress to drug addiction. Adolescents are especially susceptible to drug abuse as the areas of the brain are still developing. Critical development stages of brain growth for self-control, decision making and judgment are still in process. This causes adolescents to be more prone to engaging in risk-taking behaviors.

Social Environment: One’s social environment includes influences from family, friends, quality of life and socioeconomic status. Factors like stress, parenting, physical abuse and peer pressure can greatly influence whether or not one begins to take drugs and escalate to drug addiction.

Biology: In combination with social environment, the genes that people are born with account for approximately half of addiction problems. Additionally, mental disorders, gender and ethnicity can influence the risk of drug abuse.

Common Drug Addictions and Statistics

Like any other trend, different drugs have risen and dropped in popularity. Cocaine was popular in the 1970s, crack was the drug of choice in the 1980s, club drugs like ecstasy were common the 1990s and heroin was chic in 2000. The current decade is seeing an increase in new synthetic versions of drugs and prescription drugs. Although some drugs may fade in popularity, they never disappear. There are still thousands of people addicted to cocaine, club drugs and heroin. The National Institute of Drug Abuse (NIDA) reports the most common drug addictions include alcohol, cannabinoids, opiates like heroin, club drugs, stimulants like cocaine and hallucinogens.

Drug addiction is an epidemic in the United States and has no boundaries. Urbanites, rural dwellers, men and women, rich and poor are all affected. According the the Substance Abuse and Mental Health Services Administration (SAMHSA):

Over 24 million U.S. residents over the age of 12 are currently suffering from drug addiction. Unfortunately, only a mere 10 percent will receive help from a professional treatment center.

  • More than six percent of all Americans from ages 16 to 25 have engaged in the non-medical use of prescription drugs.
  • About 25 percent of all 10th graders have used marijuana.
  • Annually, over 20,000 people die as a result of illicit drug use.
  • Over the last 20 years, U.S. drug addictions have increased by more than 500 percent.

The Stages of Drug Addiction

Drug addiction rarely happens overnight. Most individuals who become drug addicts start out using drugs casually and recreationally. After advancing through a number of stages, a final addiction is formed. It’s the result of a pathological progression that often results in the destruction of personal relationships, damage to health, legal problems, financial ruin and sometimes overdose. According to the University of Rochester Medical Center, drug abuse can be successfully treated at any stage of development.

The Experimental Stage: Human beings are curious by nature and often enjoy new experiences and sensations that add excitement to the world. Experimenting with drugs is way to add excitement and fun. Drug addicts don’t set out to become psychologically and physically dependent on drugs but with a desire to experience something new. Even though one may try cocaine at a party or on a date, there’s no plan to continue using drugs for months or years. In addition to seeking a new experience, individuals may use drugs without a prescription to relieve pain from a chronic injury. Borrowing a few Vicodin from a friend for pain relief is commonplace today. But when one self-medicates, the vulnerability to dependence and addiction is increased. The experimental stage is characterized by occasional use on a voluntary basis. Often, individuals feel that they can stop the drug use at any time and have full control in the experimental stage.

Regular Use Stage: Experimental use escalates to regular use when the user begins to take drugs as a usual routine. Students may begin to use meth to stay up studying for exams, and those who suffer from back pain may take Percocet without a prescription. Slowly, a pattern of regular use develops. Although the individual is not yet reliant on the drug, the brain is being trained to respond to the rewards of using the drug, such as a fun high, stress relief, pain reduction or weight loss. In this stage, the user still has control over the drug use but likely does not want to stop. There is no disruption in the user’s life; the drug just makes them feel better.

Risk-Taking Drug Stage: During this stage, non-problematic drug use begins to interfere with daily life and becomes a real problem. Drug use begins to affect job performance, relationships, grades and finances. Users may begin to drive while under the influence, sell drugs to buy more drugs or engaged is risky behaviors like unprotected sex. The problem becomes known to the individual as a result of being fired from a job, having a relationship breakup or being arrested for drug use. Once drug use advances to the risk-taking drug stage, quitting becomes more difficult to the individual’s inability to fight the cravings for the drug. Most users at this stage cannot imagine living without the drug. Life becomes more chaotic and unmanageable.

Drug Addiction Stage: Once a drug user reaches the drug addiction stage, the addiction takes on a compulsive quality. The drug is needed to function, and most drug addicts will do just about anything to get the drug. Life is out of control and the cravings are monumental and unbearable. In addition, a larger dose of the drug is needed to produce the desired result. In this stage, addicts are totally psychologically and physically dependent on the drug (Le Moal & Koob). The drug addiction stage often requires intervention at a treatment facility or drug rehabilitation center. Trying to quit on your own isn’t usually an option.

How Drug Abusers Benefit from Treatment

There are a number of drug treatment facilities that provide either outpatient or inpatient care for drug rehabilitation. Treatment may vary but behavioral therapy and prescribed drugs to reduce cravings are typical (Stephen & Peselow). Comprehensive care is usually marked by:

Improved Decision-Making Skills: During counseling for drug abuse, patients are taught how to make better decisions. These positive decision-making skills help addicts stay away from drugs and the kinds of setting that lead to the drug use.

Better Reactions to Triggers: Many people use drugs as a way to cope with stress or other environmental issues. Addiction treatment counselors assist patients with more effective ways to handle stress. Using new strategies, drug addicts are less likely to turn to drugs as a coping mechanism (Goldstein).

Healthier Lifestyle Habits: Most drug addiction treatment programs feature positive ways to increase the health of bodies, spirits and minds. Patients are introduced and encouraged to participate in nutritional counseling, meditation, yoga and regular exercise. The focus is to assist addicts with developing healthier lifestyle habits.

Support System: Whether attending counseling sessions or living side-by-side with other addicts at a treatment facility, drug addiction treatment programs provide the addict with a built-in support system. Patients can turn to their support system of peers or counselors when feeling stressed or tempted to relapse both during and after treatment. Having a support system also helps addicts not feel alone during the challenge of recovery.

Can Drug Addiction Be Prevented?

According to the NIDA, drug addiction can be prevented with effective prevention programs in place for schools, parents and the community level. However, the drug prevention programs need to be geared specifically for its audience and sound in its principles. Prevention programs need to enhance protective factors like parent intervention and reduce risk behaviors. Early intervention for risk behaviors, such as poor self-control and aggressive behavior, is essential at the elementary, middle and high school level. Prevention programs also need to address all form of drug abuse, including tobacco, alcohol, illegal drugs, inhalants and prescription drugs in the school environment.

Family-based prevention programs should be designed to enhance family bonding and relationships. Parenting skills should also be included in the program. Skills for developing parent-child communication and enforcing family policies on drug abuse are essential for an effective family-based prevention program. At the community level, prevention programs should address the type of drug abuse problem, target risk factors and implement protective factors.

Drug Addiction, Chemical Effects and Steps to Recovery

Drug addiction is a huge problem in the United States. Today, there are over 23.5 million people in the United States who have been either diagnosed or treated for the disease of drug addiction. It is an illness that not only affects those afflicted but has significant repercussions on our society’s culture and economy. The failure of both healthcare professionals and mainstream society to fully comprehend drug addiction has led to poor and unsustainable outcomes of treatment. So, how do we fix the problem? There’s really no surefire answer, but understanding the pathophysiological complexities of the disease and implementing effective strategies for recovery are a step in the right direction. And with over 100,000 U.S. deaths occurring every year due to drug addition, it is critical that we find a timely solution.

Chemical Effects and of Drug Addiction

The disease of drug addiction is twofold; there is both a physical and psychological dependence. Today, we know that these two dependence pathways are chemically related. According to recent medical studies, drug addiction is defined as “Chronic, compulsive and uncontrollable drug use that results in both physical and mental deterioration.”

Drug addiction is a difficult disease to treat because there are direct chemical corollaries that impact the human central nervous system. As a result, these chemicals directly affect the individual’s mood and affect. Drug chemicals also interfere with the pain and euphoric systems. These systems are known dyorphin A. It is this receptor system that either over-stimulated or under-stimulated due to excessive chemicals. This artificial stimulation has different results for individuals and can range from feelings of euphoria to pain suppression. Not only does the physical body become dependent, the psychological mind becomes dependent.

The Pathophysiology of Drug Addiction

The pathophysiology of the disease is chemically oriented. Basically, drug addiction is related to neurophysiological rewards and reinforcement. In the medical arena, it is often referred to as the reward pathway of the central nervous system. Specifically, drugs affect the neurotransmitters and hormones like dopamine, serotonin and GABA. The pathophysiological process of drug addiction interferes with the normal activity of the opioid receptors.

Steps to Recovery

The first step to recovery for drug addiction is recognition of the illness. Treating physicians, counselors and addicted individual must admit there is a serious problem. In addition, the addicted individual must want help. Without a coordinated and agreed strategy, recovery cannot begin. Unfortunately, there are many drug addicts who are unwilling to admit that they have a problem or are unwilling to take the necessary steps for recovery.

Recovery from drug addiction is both a physiological one as well as a psychological one. In many instances, individuals suffering from drug addiction must first be treated for the physical addiction before full, long-term treatment of the psychological aspects of drug addiction can be instituted. The drug pathway aspect of addiction and its chemical processes often result in the necessity to wean the individual off of whatever drug he or she may be addicted to. There are initial steps, such as using methadone or suboxone, to wean a drug addict off of heroin or smokers using transdermal patches to deliver controlled and gradual lower levels of nicotine.

Once the physical addiction has been identified and mitigated, the true, long-term treatment for drug addiction can begin. Most often, behavioral therapy is initiated. During behavioral therapy, patients are taught to recognize at-risk behaviors and to eradicate them. Counselors help patients implement strategies to not only prevent drug addiction but to prevent a future relapse. Even if the physical aspect of the disease has been effectively treated, relapse is almost always certain without some type of psychological counseling.

It is very important that both drug addicts and society realize that there is no cure for drug addiction. Rather, there is recovery, and the treatment for drug addiction is a lifelong commitment. This is due to the fact that once dependence pathways are established, the pathways are always present.

References:

  • National Institute of Health, U.S. Department of Health and Human Services (2010)
  • National Institutes of Health, NIDA (2012)
  • Rita Goldstein, “The Neurocircuitry of Impaired Insight in Drug Addiction” (2009)
  • Le Moal, Michel & George Koob, “Drug Addiction: Pathways to Disease” (2007)
  • T. Shippenberg, A. Zapata & V. Chefer, “The Pathophysiology of Drug Addiction” (2007)
  • Ross Stephen & Eric Peselow, “Pharmacotherapy of Addictive Disorders” (2009)