Many people don’t understand why or how other people become addicted to drugs. They may mistakenly think that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to. In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to. Fortunately, researchers know more than ever about how drugs affect the brain and have found treatments that can help people recover from drug addiction and lead productive lives.
Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted personâ€™s self-control and interfere with their ability to resist intense urges to take drugs. These brain changes can be persistent, which is why drug addiction is considered a “relapsing” diseaseâ€”people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug.
It’s common for a person to relapse, but relapse doesn’t mean that treatment doesnâ€™t work. As with other chronic health conditions, treatment should be ongoing and should be adjusted based on how the patient responds. Treatment plans need to be reviewed often and modified to fit the patientâ€™s changing needs.
If a person is compulsively seeking and using a drug(s) despite negative consequences, such as loss of job, debt, family problems, or physical problems brought on by drug abuse, then he or she probably is addicted. And while people who are addicted may believe they can stop any time, most often they cannot, and will need professional helpâ€”first to determine if they in fact are addicted, and then to obtain drug abuse treatment. Support from friends and family can be critical in getting people into treatment and helping them to maintain abstinence following treatment.
The physical signs of abuse or addiction can vary depending on the person and the drug being abused. For example, someone who abuses marijuana may have a chronic cough or worsening of asthmatic symptoms. Each drug has short-term and long-term physical effects. Stimulants like cocaine increase heart rate and blood pressure, whereas opioids like heroin may slow the heart rate and reduce respiration.
Most drugs affect the brain’s “reward circuit” by flooding it with the chemical messenger dopamine. This reward system controls the body’s ability to feel pleasure and motivates a person to repeat behaviors needed to thrive, such as eating and spending time with loved ones. This overstimulation of the reward circuit causes the intensely pleasurable “high” that can lead people to take a drug again and again.
As a person continues to use drugs, the brain adjusts to the excess dopamine by making less of it and/or reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drugâ€”an effect known as tolerance. They might take more of the drug, trying to achieve the same dopamine high. It can also cause them to get less pleasure from other things they once enjoyed, like food or social activities.
Long-term use also causes changes in other brain chemical systems and circuits as well, affecting functions that include:
Despite being aware of these harmful outcomes, many people who use drugs continue to take them, which is the nature of addiction.
No one factor can predict if a person will become addicted to drugs. A combination of factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction. For example:
Many substances including alcohol, nicotine, and other drugs of abuse can have negative effects on the developing fetus because they are transferred to the fetus across the placenta. For example, nicotine has been connected with premature birth and low birth weight as has the use of cocaine. Heroin exposure results in dependence in the newborn, requiring treatment for withdrawal symptoms. It is often difficult to tease apart the confluence of factors that go with drug abuse during pregnancyâ€”poor nutrition, inadequate prenatal care, stress, and psychiatric comorbiditiesâ€”all of which may impact fetal development.
As with most other chronic diseases, such as diabetes, asthma, or heart disease, treatment for drug addiction generally isnâ€™t a cure. However, addiction is treatable and can be successfully managed. People who are recovering from an addiction will be at risk for relapse for years and possibly for their whole lives. Research shows that combining addiction treatment medicines with behavioral therapy ensures the best chance of success for most patients. Treatment approaches tailored to each patientâ€™s drug use patterns and any co-occurring medical, mental, and social problems can lead to continued recovery.
More good news is that drug use and addiction are preventable. Results from NIDA-funded research have shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction. Although personal events and cultural factors affect drug use trends, when young people view drug use as harmful, they tend to decrease their drug taking. Therefore, education and outreach are key in helping people understand the possible risks of drug use. Teachers, parents, and health care providers have crucial roles in educating young people and preventing drug use and addiction.
Source:Â National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.
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