Medical Definition of Addiction

Addiction is a complex, chronic relapsing disorder, characterised by compulsive substance use despite knowing and facing its adverse consequences.

Backed by extensive research, it is a well-established fact that addiction is a brain disorder rather than a lack of morality.

It involves rewiring of the mental pathways associated with reward, happiness, stress, and self-control.

Drugs produce their effects by acting on the receptors for certain brain chemicals, called neurotransmitters, present inside the brain. They manipulate their biochemistry and bring about functional changes, providing the user with false feelings of happiness and content. With time, the normal brain functioning starts to deteriorate, as it depends more on the exogenous stimulation. Gradually, the natural neurotransmitter production also diminishes as it depends heavily on external chemicals to act on the receptors. ^1,2

What are the Reasons for Taking Drugs?

Some common reasons for drug abuse include: ³

To feel happy: Drugs, by their ability to activate various receptors in the brain, can produce intense feelings of euphoria. The feeling of excitement and happiness are often compounded with some other desirable effects, depending upon the type of substance consumed. For instance, with heroin use, the feelings of satisfaction and relaxation follow euphoria. All these positive feelings, however, are very short-lived.
To reduce anxiety: Drugs are often consumed to deal with feelings of anxiety, depression, and stress.
To improve performance: Many people start consuming drugs to increase endurance and energy for better and more focused performance at their respective jobs; but, unfortunately, more often than not, it gets out of hand and turns into a compulsive habit.
Curiosity and social pressure: The use of drugs, particularly in teens, start with a curiosity to experience the feeling of intense joy and euphoria associated with drug use. Often, company and peer pressure also play an important role.

How can Drug Abuse Rewire the Brain?

Drugs interfere with brain signalling mechanisms. They alter the means (neurotransmitter) by which different neuron sends, receive and process messages to each other. ⁴ Some drugs, such as marijuana and heroin, can act directly on the receptors of the neurotransmitter and send false messages; while others, such as amphetamine and cocaine cause either release of a large amount of neurotransmitter or prevent their re-uptake. As a result, a chemical imbalance is produced in the working environment of the brain, leading to its malfunctioning.

The most important areas of the brain affected by drug abuse are: ⁵

The basal ganglia: This part plays a crucial role in promoting positive forms of motivation and is involved in pleasurable effects attained by eating, socialising, having sex, etc. It forms the reward centre of the brain. Drugs activate this area to produce a false feeling of happiness and pleasure. With time, the neurons in this area become less sensitive and do not respond to any activity that previously was a source of pleasure. At this point, the brain completely depends on the drugs, and the person has developed an addiction.
The extended amygdala: It is involved in the perception of emotions and memory. With prolonged drug abuse, the neuron's in this part motivate the person to consume drugs again, as soon as the effects of the previous dose diminish.
The prefrontal cortex: This area of the brain is responsible for the maturity of an individual. It provides the power to think, plan, solve issues, make decisions, and exert self-control over impulses. Drugs manipulate the neurons of the prefrontal cortex in such a way that the person loses his ability to control his impulses and compulsively seeks drugs.

How Does Drug Abuse Affect Brain Health in the Long-Term?

The risk that extensive drug abuse poses to brain health is a prolonged distortion in its Neuro-electro-chemistry. The abnormal changes are significant enough to be identified in brain imaging studies.

Initially, people start consuming drugs voluntarily, but with time, the loss of impulse control leads to the development of addiction problems. The intense desire to have the drug again and again, despite being well-aware of the adverse effects it has on one and one’s loved ones, become very problematic in the long run.

Risk Factors for Developing Drug Abuse Disorder

The initiation of drug consumption and the propensity of using it regularly to a point, where addition develops is often dependent on multiple factors. Both environmental and biological factors are important for drug consumption and compulsion. ⁶ These include:

Aggressive behaviour in early childhood
Lack of parental supervision
Low peer refusal skills
Poverty
Teenage
Presence of drugs at school
Mental illness
Exposure to violence (physical or sexual)

On the contrary, certain factors are protective against drug abuse. These are:

Self-control
Parental monitoring and support
Positive relationships
Good grades
Anti-drug policies in school.

Adolescents, with their brains still developing, are particularly an at-risk group

The brain continues to grow and mature throughout adolescence. Each experience or memory creates specific neural connections, that store, organize, and utilize the information in the future, where necessary. Over time, some of these connections become stronger; while others weaken, depending upon the experiences that one frequently goes through. In this way, a certain delicate network of neurons grows stronger, which is grossly depicted as the personality of an individual.

The exposure of the brain to noxious events such as drugs, malnutrition, bullying, and sleep deprivation negatively affects brain development, often leading to a flawed personality and emotional and physical instability. This is specifically applicable for the teenage group, in which the prefrontal cortex of the brain is growing very fast. The introduction of drugs in this period can particularly have profound harmful effects on future development and personality.

References:

NIDA. 2020, July 13. Drug Misuse and Addiction. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction on 2020, September 14
Nessa, A., Latif, S. A., Siddiqui, N. I., Hussain, M. A., & Hossain, M. A. (2008). Drug abuse and addiction. Mymensingh medical journal: MMJ, 17(2), 227–235.
Terry-McElrath, Y. M., O'Malley, P. M., & Johnston, L. D. (2009). Reasons for Drug Use among American Youth by Consumption Level, Gender, and Race/Ethnicity: 1976-2005. Journal of drug issues, 39(3), 677–714.
Tomkins, D. M., & Sellers, E. M. (2001). Addiction and the brain: the role of neurotransmitters in the cause and treatment of drug dependence. CMAJ: Canadian Medical Association journal = journal de l'Association medicale canadienne, 164(6), 817–821.
NIDA. 2020, July 10. Drugs and the Brain. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain on 2020, September 14
Meyers, J. L., & Dick, D. M. (2010). Genetic and environmental risk factors for adolescent-onset substance use disorders. Child and adolescent psychiatric clinics of North America, 19(3), 465–477.
Tierney, A. L., & Nelson, C. A., 3rd (2009). Brain Development and the Role of Experience in the Early Years. Zero to Three, 30(2), 9–13.

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