Understanding Drug Abuse and

Many people do not understand why or drug abuse and addiction, such as family how other people become addicted to disintegration, loss of employment, failure in drugs. It can be wrongfully assumed that school, domestic violence, and child abuse. drug abusers lack moral principles or willpower and that they could stop using What Is Drug Addiction? drugs simply by choosing to change their Addiction is a chronic, often relapsing brain behavior. In reality, drug addiction is a disease that causes compulsive drug seeking complex disease, and quitting takes more and use, despite harmful consequences to than good intentions. In fact, because the addicted individual and to those around drugs change the brain in ways that foster him or her. Although the initial decision to compulsive drug abuse, quitting is difficult, take drugs is voluntary for most people, the even for those who are ready to do so. brain changes that occur over time challenge Through scientific advances, we know more a person’s self control and ability to resist about how drugs work in the brain than intense impulses urging them to take drugs. ever, and we also know that drug addiction can be successfully treated to help people Fortunately, treatments are available to stop abusing drugs and lead productive help people counter addiction’s powerful lives. disruptive effects. Research shows that combining addiction treatment medications Drug abuse and addiction have negative with behavioral therapy is the best way to consequences for individuals and for ensure success for most patients. Treatment society. Estimates of the total overall costs approaches that are tailored to each patient’s of substance abuse in the United States, drug abuse patterns and any co-occurring including productivity and health- and medical, psychiatric, and social problems can crime-related costs, exceed $600 billion lead to sustained recovery and a life without annually. This includes approximately $181 drug abuse. billion for illicit drugs,1 $193 billion for tobacco,2 and $235 billion for alcohol.3 As Similar to other chronic, relapsing diseases, staggering as these numbers are, they do such as diabetes, asthma, or heart disease, not fully describe the breadth of destructive drug addiction can be managed successfully. public health and safety implications of And as with other chronic diseases, it is not

March 2011 Page 1 of 4 uncommon for a person to relapse and begin present in brain regions that control abusing drugs again. Relapse, however, does movement, emotion, motivation, and not signal treatment failure—rather, it indicates feelings of pleasure. The overstimulation of that treatment should be reinstated, adjusted, this , which normally responds or that an alternative treatment is needed to to natural behaviors linked to survival help the individual regain control and recover. (eating, spending time with loved ones, etc.), produces euphoric effects in response What Happens to Your Brain to psychoactive drugs. This reaction sets in When You Take Drugs? motion a reinforcing pattern that “teaches” people to repeat the rewarding behavior of Drugs contain chemicals that tap into the abusing drugs. brain’s communication system and disrupt As a person continues to abuse drugs, the the way nerve cells normally send, receive, brain adapts to the overwhelming surges and process information. There are at least in by producing less dopamine two ways that drugs cause this disruption: or by reducing the number of dopamine (1) by imitating the brain’s natural chemical receptors in the reward circuit. The result messengers and (2) by overstimulating the is a lessening of dopamine’s impact on “reward circuit” of the brain. the reward circuit, which reduces the abuser’s ability to enjoy the drugs, as well Some drugs (e.g., marijuana and heroin) have as the events in life that previously brought a similar structure to chemical messengers pleasure. This decrease compels the called , which are naturally addicted person to keep abusing drugs in produced by the brain. This similarity allows an attempt to bring the dopamine function the drugs to “fool” the brain’s receptors back to normal, except now larger amounts and activate nerve cells to send abnormal of the drug are required to achieve the messages. same dopamine high—an effect known as tolerance. Other drugs, such as or methamphetamine, can cause the nerve Long-term abuse causes changes in other cells to release abnormally large amounts of brain chemical systems and circuits as natural neurotransmitters (mainly dopamine) well. Glutamate is a that or to prevent the normal recycling of these influences the reward circuit and the ability brain chemicals, which is needed to shut off to learn. When the optimal concentration the signaling between neurons. The result is a of glutamate is altered by drug abuse, the brain awash in dopamine, a neurotransmitter brain attempts to compensate, which can

March 2011 Page 2 of 4 impair cognitive function. Brain imaging as peer pressure, physical and sexual studies of drug-addicted individuals show abuse, stress, and quality of parenting changes in areas of the brain that are critical can greatly influence the occurrence to judgment, decisionmaking, learning and of drug abuse and the escalation to memory, and behavior control. Together, addiction in a person’s life. these changes can drive an abuser to seek out and take drugs compulsively despite • Development. Genetic and adverse, even devastating consequences— environmental factors interact with critical that is the nature of addiction. developmental stages in a person’s life to affect addiction vulnerability. Although taking drugs at any age can lead to Why Do Some People addiction, the earlier that drug use Become Addicted While begins, the more likely it will progress Others Do Not? to more serious abuse, which poses a special challenge to adolescents. No single factor can predict whether a Because their brains are still developing person will become addicted to drugs. Risk in the areas that govern decisionmaking, for addiction is influenced by a combination judgment, and self-control, adolescents of factors that include individual biology, may be especially prone to risk-taking social environment, and age or stage of behaviors, including trying drugs of development. The more risk factors an abuse. individual has, the greater the chance that taking drugs can lead to addiction. For example: Prevention Is the Key

• Biology. The genes that people are born Drug addiction is a preventable disease. with––in combination with environmental Results from NIDA-funded research have influences––account for about half of shown that prevention programs involving their addiction vulnerability. Additionally, families, schools, communities, and the gender, ethnicity, and the presence of media are effective in reducing drug abuse. other mental disorders may influence risk Although many events and cultural factors for drug abuse and addiction. affect drug abuse trends, when youths perceive drug abuse as harmful, they • Environment. A person’s environment reduce their drug taking. Thus, education includes many different influences, from and outreach are key in helping youth and family and friends to socioeconomic status the general public understand the risks of and quality of life in general. Factors such drug abuse. Teachers, parents, medical and

March 2011 Page 3 of 4 public health professionals must keep sending For more information on prevention, please the message that drug addiction can be visit www.nida.nih.gov/drugpages/ prevented if one never abuses drugs. prevention.html.

Other Information Sources For more information on treatment, please visit www.nida.nih.gov/drugpages/ For information on understanding drug treatment.html. To find a publicly funded abuse and addiction, please see our booklet, treatment center in your State, please call Drugs, Brains, and Behavior—The Science 1-800-662-HELP or visit of Addiction, at www.nida.nih.gov/ www.findtreatment.samhsa.gov. scienceofaddiction.

References 1 Office of National Drug Control Policy.The Economic Costs of Drug Abuse in the United States, 1992–2002. Washington, DC: Executive Office of the President (Publication No. 207303), 2004.

2 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, U.S. Department of Health and Human Services.Best Practices for Comprehensive Tobacco Control Programs—2007. Available at: http://www.cdc.gov/tobacco/stateandcommunity/best_practices/ pdfs/2007/bestpractices_complete.pdf.

3 Rehm, J., Mathers, C., Popova, S., Thavorncharoensap, M., Teerawattananon Y., Patra, J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet, 373(9682):2223–2233, 2009.

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