Understanding  Drug  Abuse  and  Addiction  

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

Understanding Drug Abuse and Addiction • November 2012 • Page 1

son  to  relapse  and  begin  abusing  drugs   As  a  person  continues  to  abuse  drugs,  
again.  Relapse,  however,  does  not  signal   the  brain  adapts  to  the  overwhelming  
treatment  failure—rather,  it  indicates   surges  in  dopamine  by  producing  less  
that  treatment  should  be  reinstated  or   dopamine  or  by  reducing  the  number  of  
adjusted  or  that  an  alternative  treatment   dopamine  receptors  in  the  reward  cir-­‐
is  needed  to  help  the  individual  regain   cuit.  The  result  is  a  lessening  of  dopa-­‐
control  and  recover.   mine’s  impact  on  the  reward  circuit,  
  which  reduces  the  abuser’s  ability  to  en-­‐
What  Happens  to  Your  Brain  When   joy  not  only  the  drugs  but  also  other  
You  Take  Drugs?   events  in  life  that  previously  brought  
  pleasure.  This  decrease  compels  the  ad-­‐
Drugs  contain  chemicals  that  tap  into  the   dicted  person  to  keep  abusing  drugs  in  
brain’s  communication  system  and  dis-­‐ an  attempt  to  bring  the  dopamine  func-­‐
rupt  the  way  nerve  cells  normally  send,   tion  back  to  normal,  but  now  larger  
receive,  and  process  information.  There   amounts  of  the  drug  are  required  to  
are  at  least  two  ways  that  drugs  cause   achieve  the  same  dopamine  high—an  ef-­‐
this  disruption:  (1)  by  imitating  the   fect  known  as  tolerance.  
brain’s  natural  chemical  messengers  and    
(2)  by  overstimulating  the  “reward  cir-­‐ Long-­‐term  abuse  causes  changes  in  oth-­‐
cuit”  of  the  brain.   er  brain  chemical  systems  and  circuits  as  
  well.  Glutamate  is  a  neurotransmitter  
Some  drugs  (e.g.,  marijuana  and  heroin)   that  influences  the  reward  circuit  and  
have  a  similar  structure  to  chemical   the  ability  to  learn.  When  the  optimal  
messengers  called  neurotransmitters,   concentration  of  glutamate  is  altered  by  
which  are  naturally  produced  by  the   drug  abuse,  the  brain  attempts  to  com-­‐
brain.  This  similarity  allows  the  drugs  to   pensate,  which  can  impair  cognitive  
“fool”  the  brain’s  receptors  and  activate   function.  Brain  imaging  studies  of  drug-­‐
nerve  cells  to  send  abnormal  messages.   addicted  individuals  show  changes  in  ar-­‐
  eas  of  the  brain  that  are  critical  to  judg-­‐
Other  drugs,  such  as  cocaine  or  metham-­‐ ment,  decision  making,  learning  and  
phetamine,  can  cause  the  nerve  cells  to   memory,  and  behavior  control.  Together,  
release  abnormally  large  amounts  of   these  changes  can  drive  an  abuser  to  
natural  neurotransmitters  (mainly  do-­‐ seek  out  and  take  drugs  compulsively  
pamine)  or  to  prevent  the  normal  recy-­‐ despite  adverse,  even  devastating  con-­‐
cling  of  these  brain  chemicals,  which  is   sequences—that  is  the  nature  of  addic-­‐
needed  to  shut  off  the  signaling  between   tion.  
neurons.  The  result  is  a  brain  awash  in    
dopamine,  a  neurotransmitter  present  in   Why  Do  Some  People  Become  Addict-­‐
brain  regions  that  control  movement,   ed  While  Others  Do  Not?  
emotion,  motivation,  and  feelings  of    
pleasure.  The  overstimulation  of  this  re-­‐ No  single  factor  can  predict  whether  a  
ward  system,  which  normally  responds   person  will  become  addicted  to  drugs.  
to  natural  behaviors  linked  to  survival   Risk  for  addiction  is  influenced  by  a  
(eating,  spending  time  with  loved  ones,   combination  of  factors  that  include  indi-­‐
etc.),  produces  euphoric  effects  in  re-­‐ vidual  biology,  social  environment,  and  
sponse  to  psychoactive  drugs.  This  reac-­‐ age  or  stage  of  development.  The  more  
tion  sets  in  motion  a  reinforcing  pattern   risk  factors  an  individual  has,  the  greater  
that  “teaches”  people  to  repeat  the  re-­‐ the  chance  that  taking  drugs  can  lead  to  
warding  behavior  of  abusing  drugs.   addiction.  For  example:  
   

Understanding Drug Abuse and Addiction • November 2012 • Page 2

 • Biology.  The  genes  that  people  are   professionals  must  keep  sending  the  
born  with—in  combination  with   message  that  drug  addiction  can  be  pre-­‐
environmental  influences—account   vented  if  one  never  abuses  drugs.  
for  about  half  of  their  addiction    
vulnerability.  Additionally,  gender,   Other  Information  Sources  
ethnicity,  and  the  presence  of  other    
mental  disorders  may  influence   For  information  on  understanding  drug  
risk  for  drug  abuse  and  addiction.   abuse  and  addiction,  please  see  our  
• Environment.  A  person’s  environ-­‐ booklet,  Drugs,  Brains,  and  Behavior—
ment  includes  many  different  influ-­‐ The  Science  of  Addiction.  
ences,  from  family  and  friends  to    
socioeconomic  status  and  quality  of   For  more  information  on  prevention,  
life  in  general.  Factors  such  as  peer   please  visit  our  Prevention  Research  in-­‐
pressure,  physical  and  sexual   formation  page.  
abuse,  stress,  and  quality  of  parent-­‐  
ing  can  greatly  influence  the  occur-­‐ For  more  information  on  treatment,  
rence  of  drug  abuse  and  the  escala-­‐ please  visit  our  Treatment  Research  in-­‐
tion  to  addiction  in  a  person’s  life.   formation  page.  
• Development.  Genetic  and  envi-­‐  
ronmental  factors  interact  with   To  find  a  publicly  funded  treatment  cen-­‐
critical  developmental  stages  in  a   ter  in  your  State,  please  call  1-­‐800-­‐662-­‐
person’s  life  to  affect  addiction  vul-­‐ HELP  or  visit  
nerability.  Although  taking  drugs  at   www.findtreatment.samhsa.gov.  
any  age  can  lead  to  addiction,  the    
earlier  that  drug  use  begins,  the   References  
more  likely  it  will  progress  to  more   1. National  Drug  Intelligence  Center  
serious  abuse,  which  poses  a  spe-­‐ (2011).  The  Economic  Impact  of  Il-­‐
cial  challenge  to  adolescents.  Be-­‐ licit  Drug  Use  on  American  Society.  
cause  areas  in  their  brains  that   Washington  D.C.:  United  States  De-­‐
govern  decision  making,  judgment,   partment  of  Justice.  Available  at  
and  self-­‐control  are  still  developing,   http://www.justice.gov/archive/nd
adolescents  may  be  especially   ic/pubs44/44731/44731p.pdf    
prone  to  risk-­‐taking  behaviors,  in-­‐ 2. Centers  for  Disease  Control  and  
cluding  trying  drugs  of  abuse.   Prevention.  Smoking-­‐Attributable  
  Mortality,  Years  of  Potential  Life  
Prevention  Is  the  Key   Lost,  and  Productivity  Losses—
  United  States,  2000–2004.  Morbidi-­‐
Drug  addiction  is  a  preventable  disease.   ty  and  Mortality  Weekly  Report,  
Results  from  NIDA-­‐funded  research  have   57(45);1226-­‐1228,  2008  (Novem-­‐
shown  that  prevention  programs  involv-­‐ ber  14).  Available  at:  
ing  families,  schools,  communities,  and   http://www.cdc.gov/mmwr/previe
the  media  are  effective  in  reducing  drug   w/mmwrhtml/mm5745a3.htm.  
abuse.  Although  many  events  and  cul-­‐ 3. Rehm,  J.,  Mathers,  C.,  Popova,  S.,  
tural  factors  affect  drug  abuse  trends,   Thavorncharoensap,  M.,  Teerawat-­‐
when  youths  perceive  drug  abuse  as   tananon  Y.,  Patra,  J.  Global  burden  
harmful,  they  reduce  their  drug  taking.   of  disease  and  injury  and  economic  
Thus,  education  and  outreach  are  key  in   cost  attributable  to  alcohol  use  and  
helping  youth  and  the  general  public  un-­‐ alcohol-­‐use  disorders.  Lancet,  
derstand  the  risks  of  drug  abuse.  Teach-­‐ 373(9682):2223–2233,  2009.  
ers,  parents,  medical  and  public  health    

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