Why Do Some People Become Addicted While Others Do Not?
No single factor can predict whether a person will become addicted to drugs. Risk for addiction is influenced by a combination of factors that include individual biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. For example:
Biology: The genes that people are born with—in combination with environmental influences—account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental disorders may influence risk for drug abuse and addiction.
Environment: A person’s environment includes many different influences, from family and friends to socioeconomic status and quality of life in general. Factors such as peer pressure, physical and sexual abuse, stress, and quality of parenting can greatly influence the occurrence of drug abuse and the escalation to addiction in a person’s life.
Development: Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction vulnerability. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to more serious abuse, which poses a special challenge to adolescents. Because areas in their brains that govern decision-making, judgment, and self-control are still developing, adolescents may be especially prone to risk-taking behaviors, including trying drugs of abuse.
Why Can't Addicts Stop Using Drugs on Their Own?
Repeated drug use changes the brain, including parts of the brain that give person self-control. These and other changes can be seen clearly in brain imaging studies of people with a drug addiction. These brain changes explain why quitting is so difficult, even when an addicted person feels ready. NIDA has an excellent video, "Why Are Drugs So Hard to Quit?"
What is Addiction?
Addiction knows no boundaries. Opiate addiction can happen to people of every race, ethnicity, income level, and religious background. The National Institute on Drug Abuse’s video "Anyone Can Become Addicted to Drugs" helps to explain addiction.
Addiction is a chronic, often relapsing, brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. When a person who uses drugs can't stop taking a drug even if they want to, it's called addiction. The urge is too strong to control, even if you know the drug is causing harm.
When people start taking drugs, they don't plan to get addicted. They like how the drug makes them feel. They believe they can control how much and how often they take the drug. However, addiction changes the brain. Those who use drugs start to need the drug just to feel normal. Addiction challenges a person’s self-control and hampers his or her ability to resist intense impulses to take drugs. It has nothing to do with lack of willpower.
Addiction can quickly take over a person's life. Addiction can become more important than the need to eat or sleep. The urge to get and use the drug can fill every moment of a person's life. The addiction replaces all the things the person used to enjoy. A person who is addicted might do almost anything—lying, stealing, or hurting people—to keep taking the drug. This could get the person arrested.
Addiction is a brain disease.
Drugs change how the brain works.
These brain changes can last for a long time.
They can cause problems like mood swings, memory loss, even trouble thinking and making decisions.
Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal treatment failure—rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover.
What Happens to Your Brain When You Take Drugs?
Drugs are chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs cause this disruption: By imitating the brain’s natural chemical messengers and/or by overstimulating the “reward circuit” of the brain.
Some drugs, such as marijuana and heroin, have a similar structure to chemical messengers called neurotransmitters, which are naturally produced by the brain. This similarity allows the drugs to “fool” the brain’s receptors and activate nerve cells to send abnormal messages.
Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters or to prevent the normal recycling of these brain chemicals, which is needed to shut off the signal between neurons. This disruption produces a greatly amplified message that ultimately disrupts normal communication patterns.
Nearly all drugs, directly or indirectly, target the brain's reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that control movement, emotion, motivation, and feelings of pleasure.
The overstimulation of this system, which normally responds to natural behaviors that are linked to survival (eating, spending time with loved ones, etc), produces euphoric effects in response to the drugs. This reaction sets in motion a pattern that "teaches" people to repeat the behavior of abusing drugs.
As a person continues to abuse drugs, the brain adapts to the dopamine surges by producing less dopamine or reducing the number of dopamine receptors. The user must therefore keep abusing drugs to bring his or her dopamine function back to ''normal'' or use more drugs to achieve a dopamine high.
Long-term drug abuse causes changes in other brain chemical systems and circuits, as well. Brain imaging studies of drug-addicted individuals show changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs compulsively -- in other words, to become addicted to drugs.
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NIDA/ Drs. N. Volkow and H. Schelbert