Neurosurgery and Brain Health How Drug Addiction Happens By Neurosurgery, December 11, 2015 Understanding how people become addicted to drugs is an essential first step in confronting what has become a national crisis. For the individual, it is a compelling need, regardless of its destructive potential. For families and society as a whole, it is among the most serious of challenges. Overdose, poor health, broken homes, violence, and child abuse are just some of its negative impact. In addition, the economic burden from alcohol, illicit drugs, and nicotine cost the nation over $600 billion every year, says the National Institute on Drug Abuse (NIDA). Addiction and the Brain How do people get hooked on drugs? At its most basic level, it is a disease affecting how the brain communicates with itself. Drugs do this in two ways. Some — like narcotics and cannabis — mimic the brain’s neurotransmitters. Methamphetamine, cocaine, and other stimulates overstimulate the brain’s reward system, causing it to produce excessive dopamine — its pleasure neurotransmitter. Either way, the brain reinforces behavior — drug use — with dopamine-induced pleasure. Once a person is addicted, the brain believes it “needs” this pleasure. Over time, it takes more drugs to achieve the desired effect. Believing it is supplying too much dopamine, the brain cuts back on its own production. Yet the reward system expects the same amount of this neurotransmitter, and the result is tolerance — where more of the drug is needed to maintain pleasurable dopamine levels. Drug addiction affects the brain in other ways. For example, another neurotransmitter called glutamate is also important in the brain’s pleasure/reward system. Glutamate is important to the brain’s learning abilities, and drug-induced glutamate imbalances partly explain why addicts suffer cognitive damage over time. The brain’s reward system isn’t the only area harmed by drugs. The NIDA says that images of the brain reveal areas responsible for judgment, decision-making, and behavior control are all damaged among drug addicts. Beyond the Brain Addiction is more than a chemical process in the brain. A number of combined risk factors increase the likelihood of abusing drugs in the first place while reinforcing their ongoing use. Such biological factors as genetic predisposition, gender, ethnicity, or having a mental disorder affect an individual’s vulnerability to drug abuse. Stress, a person’s peer groups, a history of physical and sexual abuse, or socioeconomic status are among many environmental effects. Early drug addiction adversely influences adolescent brain development, and the younger a person begins the worse the drug problem becomes. Like many other chronic diseases, drug addiction is preventable. Prevention is in fact the single most effective approach. Ongoing outreach and education among vulnerable populations is essential. In spite of all of these compelling factors, drug addiction is a treatable disease. Whether it is nicotine, alcohol, heroin, or any other drug, help is available to those who want to quit. Contact Western Psychiatric Institute and Clinic at 412-624-1000 for more information on addiction medicine, rehabilitation, and recovery.