Genetic And Molecular Factors
Genetic factors are thought to account for 40 to 70 percent of individual differences in risk for addiction., Although multiple genes are likely involved in the development of addiction, only a few specific gene variants have been identified that either predispose to or protect against addiction. Some of these variants have been associated with the metabolism of alcohol and nicotine, while others involve receptors and other proteins associated with key neurotransmitters and molecules involved in all parts of the addiction cycle. Genes involved in strengthening the connections between neurons and in forming drug memories have also been associated with addiction risk., Like other chronic health conditions, substance use disorders are influenced by the complex interplay between a person’s genes and environment. Additional research on the mechanisms underlying gene by environment interactions is expected to provide insight into how substance use disorders develop and how they can be prevented and treated.
Areas Of The Brain Affected By Substance Use
While alcohol and drugs affect the entire brain, some regions are more involved with SUD than others. The National Institute on Drug Abuse explains the effects of drugs on the brain in the article Drugs, Brains, and Behavior: The Science of Addiction, which focuses on the overstimulation of three key brain areas: the basal ganglia, the extended amygdala, and the pre-frontal cortex.
- The basal ganglia, associated with the brains reward system, recognizes pleasurable activities such as enjoying a good meal or having fun with friends. When overstimulated by drug use, though, it loses sensitivity to natural neurotransmitters, such as dopamine. With continued drug use, drugs become the only stimulus that activates this reward center.
- The extended amygdala is associated with negative emotions such as stress, anxiety, and irritability. These are symptoms a person experiences when a substance leaves the bloodstream. To avoid the negative symptoms of withdrawal, individuals often take more drugs, creating a feedback loop.
- The pre-frontal cortex is the area of the brain that governs decision making, logic, problem-solving, self-control, and impulse control. When this area of the brain is affected by drugs, confusion and poor decisions dominate the cognitive process.
Several drugs, including alcohol, affect the cerebellum. The cerebellum assists with muscle control and coordination, which is why people who have had too many drinks may stumble and weave when they walk.
How Does Dopamine Reinforce Drug Use
The feeling of pleasure is how a healthy brain identifies and reinforces beneficial behaviors, such as eating, socializing, and sex. Our brains are wired to increase the odds that we will repeat pleasurable activities. The neurotransmitter dopamine is central to this. Whenever the reward circuit is activated by a healthy,
pleasurable experience, a burst of dopamine signals that something important is happening that needs to be remembered. This dopamine signal causes changes in neural connectivity that make it easier to repeat the activity again and again without thinking about it, leading to the formation of habits.
Just as drugs produce intense euphoria, they also produce much larger surges of dopamine, powerfully reinforcing the connection between consumption of the drug, the resulting pleasure, and all the external cues linked to the experience. Large surges of dopamine teach the brain to seek drugs at the expense of other, healthier goals and activities.
Do People Choose To Keep Using Drugs
The initial decision to take drugs is typically voluntary. But with continued use, a person’s ability to exert self-control can become seriously impaired. This impairment in self-control is the hallmark of addiction.
Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control.12 These changes help explain the compulsive nature of addiction.
How Long Does It Take The Brain To Recover From Addiction
The brain has billions of neurons, which connect via neural pathways. As children develop and learn, their brains create and change these pathways, a process known as neuroplasticity, with relative ease. At approximately age twenty-five, the brain has developed the majority of its neural pathways its plasticity is significantly reduced.
The brain uses neural pathways as efficiently as possible, allowing repetitive tasks to become automatic or habitual. The frequent use of the same circuits embeds them deeper into the brain, making it more difficult to alter their routes. Imagine dragging a scissors blade across cardboard along the same line over and over the groove gets more pronounced. Fortunately, the brain is more flexible than cardboard. Although adults need more time and effort to change neural pathways than a child does, adults can change their brains.
Changing the adult brain is essential for individuals who engage in addictive behaviors. Even in a high-tech society, humans still behave on the pleasure-reward system our early ancestors used for survival. The brain releases dopamine, the feel-good neurotransmitter when an action, event, or emotion is satisfying or pleasurable. To get more of that good feeling, humans repeat that stimulating action or thought.
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Speak To An Addiction Recovery Expert Now Available & Answered 24 Hours:
Drug use can affect every part of your life. Addiction may impair the health of your body, interfere with your relationships, and change the way you perceive the outside world. One of the most damaging side effects of drug abuse is damage to your brain. If youve misused prescription drugs, heroin, cocaine, stimulants, depressants, hallucinogens, or other types of drugs, your brain may have sustained a considerable amount of harm. The good news is that your brain can heal itself when you stop using drugs but you must create the right conditions to do so. When you do, the brain can re-establish its chemical balance. Once balanced, your brain can begin to regain control of your impulses, emotions, memory, thinking patterns, and mental health.
How Opioids Affect The Brain
Prescription opioids activate receptors in the brain and decrease its pain signals. This receptor interaction is also associated with a release of dopamine into the brain. This can result in feelings of euphoria, elation, or pleasure. When dopamine is released, other areas of the brain react, creates a memory and associates it with pleasure. This is one of the key reasons why many peopleeven those who begin taking these drugs according to a prescriptionmay start to use them in increasing doses. Over the medium and long term, users may need to take higher and higher doses in order to elicit the same high. Eventually, this can help lead to users being addicted to prescription drugs.
Some potential short-term, neurological effects of opioids include:
- Mood changes.
- Impaired memory, judgement, and attention.
Over the long term, prescription drug abuse will affect the brain in the following ways:
- Tolerance: Higher and more doses will need to be taken to achieve the same effects.
- Drug dependence: Withdrawal symptoms such as depression, insomnia, anxiety, restlessness, and irritability can be unpleasant. The individual may decide to continue taking the drugs to avoid these withdrawal symptoms in an attempt to appear to function normally.
However, there are two ways to stop opioid use comfortably and safely formal detox and substance abuse treatment.
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Opioid Tolerance Dependence And Withdrawal
From a clinical standpoint, opioid withdrawal is one of the most powerful factors driving opioid dependence and addictive behaviors. Treatment of the patients withdrawal symptoms is based on understanding how withdrawal is related to the brains adjustment to opioids.
Repeated exposure to escalating dosages of opioids alters the brain so that it functions more or less normally when the drugs are present and abnormally when they are not. Two clinically important results of this alteration are opioid tolerance and drug dependence . Withdrawal symptoms occur only in patients who have developed tolerance.
Opioid tolerance occurs because the brain cells that have opioid receptors on them gradually become less responsive to the opioid stimulation. For example, more opioid is needed to stimulate the VTA brain cells of the mesolimbic reward system to release the same amount of DA in the NAc. Therefore, more opioid is needed to produce pleasure comparable to that provided in previous drug-taking episodes.
The Neurobiological Basis of Dependence and Withdrawal
The locus ceruleus is an area of the brain that is critically involved in the production of opioid dependence and withdrawal. The diagrams show how opioid drugs affect processes in the LC that control the release of noradrenaline , a brain chemical that stimulates wakefulness, muscle tone, and respiration, among other functions.
How Does The Brain Work
The brain is often likened to an incredibly complex and intricate computer. Instead of electrical circuits on the silicon chips that control our electronic devices, the brain consists of billions of cells, called neurons, which are organized into circuits and networks. Each neuron acts as a switch controlling the flow of information. If a neuron receives enough signals from other neurons that it is connected to, it fires, sending its own signal on to other neurons in the circuit.
The brain is made up of many parts with interconnected circuits that all work together as a team. Different brain circuits are responsible for coordinating and performing specific functions. Networks of neurons send signals back and forth to each other and among different parts of the brain, the spinal cord, and nerves in the rest of the body .
To send a message, a neuron releases a neurotransmitter into the gap between it and the next cell. The neurotransmitter crosses the synapse and attaches to receptors on the receiving neuron, like a key into a lock. This causes changes in the receiving cell. Other molecules called transporters recycle neurotransmitters , thereby limiting or shutting off the signal between neurons.
Different Classes Of Substances Affect The Brain And Behavior In Different Ways
Although the three stages of addiction generally apply to all addictive substances, different substances affect the brain and behavior in different ways during each stage of the addiction cycle. Differences in the pharmacokinetics of various substances determine the duration of their effects on the body and partly account for the differences in their patterns of use. For example, nicotine has a short half-life, which means smokers need to smoke often to maintain the effect. In contrast, THC, the primary psychoactive compound in marijuana, has a much longer half-life. As a result, marijuana smokers do not typically smoke as frequently as tobacco smokers. Typical patterns of use are described below for the major classes of addictive substances. However, people often use these substances in combination. Additional research is needed to understand how using more than one substance affects the brain and the development and progression of addiction, as well as how use of one substance affects the use of others.
Effects Of Stimulant Drugs On The Brain
Stimulants include illicit drugs like cocaine or methamphetamine, and prescription amphetamines, such as Adderall and Ritalin.
This collection of drugs affects the brain by acting as central nervous system stimulants. Stimulants increase the activity of the brain chemicals dopamine and norepinephrine.
While the increase in dopamine causes a rush of pleasure among uses, the hyperstimulation of norepinephrine can cause:
- Increased heart rate
- Increased blood sugar levels
When taken in high dosages, the irregular chemical balance in the brain caused by stimulants can lead to a dangerously high body temperature, an irregular heartbeat, seizures and heart failure. Over a long period of time, this chemical imbalance could also cause you to develop depression, anxiety, psychosis or extreme paranoia.
Additionally, the hyperstimulation throughout the brain and body makes you feel stronger, more self-assured and energized. The extra confidence and energy allow those who abuse stimulants to accomplish more than they usually would without the drug. The feeling of accomplishment leads many back to the use of stimulants time and time again.
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The Communications Center: A Primer
Your brain contains billions and billions of nerve cells known as neurons. Groups of neurons send and receive messages to and from the various brain structures, the spinal cord and the bodys complex system of nerves. These messages contain instructions for virtually everything we do: scratch an itch, create art, or experience emotions.
The messages are sent and received as chemical and electrical signals that are carried by chemicals called neurotransmitters. A neurotransmitter is like a key, and it fits perfectly into the receiving neurons receptor, which is like a lock. Once the message is received, a transporter located on the neuron that sent the message takes the neurotransmitter back, shutting off the signal between the neurons.
In Summary: The Withdrawal/negative Affect Stage And The Extended Amygdala
This stage of addiction involves a decrease in the function of the brain reward systems and an activation of stress neurotransmitters, such as CRF and dynorphin, in the extended amygdala. Together, these phenomena provide a powerful neurochemical basis for the negative emotional state associated with withdrawal. The drive to alleviate these negative feelings negatively reinforces alcohol or drug use and drives compulsive substance taking.
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Making Mental Health Essential Health
Despite improvements in the Affordable Care Act, the reality remains that mental health treatment accessibility is still not on par with access to physical health services. That was the point made in the closing keynote address by Patrick J. Kennedy, former U.S. Representative from Rhode Island.
The biggest challenges to achieving improvements in mental health care are politics and bringing together disparate groups of clinicians, said Kennedy, who has struggled with addiction, the brief explains. No one in Washington is sounding the alarm about problems with mental health care, such as not having enough doctors, and poor reimbursement rates and prescribing restrictions for doctors that do provide care, he said.
While some may judge Kennedy due to some of his views, such as favoring drug court over incarceration for people with addiction, he actually opposes the legalization of marijuana. He closed the forum with this comment: If you are a progressive liberal who cares about public health, you cannot stand by and watch a new industry like big tobacco take over and addict poor people who dont have access to like I do, and they are going to be out there struggling.
Informing Drug Prevention And Treatment With Brain Development Science
We contend that brain development science provides a valuable framework for optimizing the effectiveness of prevention and treatment programs and practices. This movement has already started in the context of how this science may help parents be more prevention smart when raising a child . We address some possible applications of brain development science to prevention and treatment, including the parenting issue, below.
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A Basic Primer On The Human Brain
To understand how addictive substances affect the brain, it is important to first understand the basic biology of healthy brain function. The brain is an amazingly complex organ that is constantly at work. Within the brain, a mix of chemical and electrical processes controls the body’s most basic functions, like breathing and digestion. These processes also control how people react to the multitudes of sounds, smells, and other sensory stimuli around them, and they organize and direct individuals’ highest thinking and emotive powers so that they can interact with other people, carry out daily activities, and make complex decisions.
The brain is made of an estimated 86 billion nerve cellscalled neuronsas well as other cell types. Each neuron has a cell body, an axon, and dendrites . The cell body and its nucleus control the neuron’s activities. The axon extends out from the cell body and transmits messages to other neurons. Dendrites branch out from the cell body and receive messages from the axons of other neurons.
Neurons communicate with one another through chemical messengers called neurotransmitters. The neurotransmitters cross a tiny gap, or synapse, between neurons and attach to receptors on the receiving neuron. Some neurotransmitters are inhibitorythey make it less likely that the receiving neuron will carry out some action. Others are excitatory, meaning that they stimulate neuronal function, priming it to send signals to other neurons.
A Neuron and its Parts.
Alcohol And The Brain
Neuroimaging studies have revealed the following about the brain’s of alcoholics1,2,3,4:
- Reduction in white matter throughout the brain.
- Damage to white matter appears to happen during alcohol consumption, not the withdrawal or recovery period.
- In fact, it appears as though the brain will begin to heal itself during the recovery phase.
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Preoccupation/anticipation Stage: Prefrontal Cortex
The preoccupation/anticipation stage of the addiction cycle is the stage in which a person may begin to seek substances again after a period of abstinence. In people with severe substance use disorders, that period of abstinence may be quite short . In this stage, an addicted person becomes preoccupied with using substances again. This is commonly called craving. Craving has been difficult to measure in human studies and often does not directly link with relapse.
This stage of addiction involves the brain’s prefrontal cortex the region that controls executive function: the ability to organize thoughts and activities, prioritize tasks, manage time, make decisions, and regulate one’s own actions, emotions, and impulses. Executive function is essential for a person to make appropriate choices about whether or not to use a substance and to override often strong urges to use, especially when the person experiences triggers, such as stimuli associated with that substance or stressful experiences.
The Preoccupation/Anticipation Stage and the Prefrontal Cortex.
Major Neurotransmitter Systems Implicated in the Neuroadaptations Associated with the Preoccupation/Anticipation Stage of Addiction. Abbreviations: PFC – prefrontal cortex, DS – dorsal striatum, NAc – nucleus accumbens, BNST – bed nucleus of the stria