Drug abuse and drug addiction
What is a substance, anyway?
- Alcohol: beer, wine, liquor
- Caffeine: coffee, tea, kola nut
- Cannabis: marijuana, hashish, hash oil
- Hallucinogens: phencyclidine (PCP), d-lysergic acid diethylamide (LSD), psilocybin (magic mushrooms), peyote
- Inhalants: inhaled spray paints, markers, glues
- Opioids heroin, prescription pain-killers, methadone
- Sedatives, hypnotics, or anxiolytics: barbiturates, benzodiazepines, antihistamines
- Stimulants: cocaine, amphetamines, other stimulants
- Tobacco: cigarettes, cigars, snuff, chewing tobacco, e-cigarettes
- Other (or unknown)
What makes a substance addictive?
- Amygdala: sensing and expressing emotions
- Nucleus accumbens: motor control
- Hippocampus: memory formation
- Prefrontal cortex: attention and planning behavior
What are the symptoms of substance use disorders?
|Example Substance||Substance-specific negative consequences (not necessarily a sign of substance use disorder)||Substance use disorder|
|Tobacco||Heart and lung disease||Continuing to use a substance (due to being unwilling or unable to stop) despite having significant negative physical, mental, or social consequences as a result of substance use. This applies to all substances listed.|
|Lost productivity at work due to needing smoke breaks|
|Turned down for a date because you smoke|
|Embarrassing yourself while drunk at a party|
|Intoxication-related injury (falling down, drunk-driving accident, etc.)|
|Cannabis||Problems with work, school, or police as a result of use|
|Intoxication-related injury (falling down, high driving accident, etc.)|
|Depression; lack of motivation|
Impaired control over substance use
- Taking a substance in larger amounts or for a longer period of time than was originally intended
- Persistent desire or unsuccessful efforts to cut down or control substance use
- Spending a large amount of time obtaining, using, or recovering from the effects of substance use
- Intense desire or urge to use a substance (craving), especially while in places where the substance was previously obtained or used
- Recurrent substance use resulting in a failure to fulfill duties at work, school, or home
- Continued substance use despite persistent or recurrent social problems caused or made worse by the effects of substance use
- Giving up or reducing important social, occupational, or recreational activities because of substance use
- Recurrent substance use in situations where it is physically hazardous
- Continued substance use despite persistent or recurrent physical or psychological health problems likely resulting from substance use
- Needing to use an increased amount of a substance to achieve the same effects
- Having diminished effects with continued use of the same amount of a substance
- The characteristic withdrawal syndrome for the particular substance (the exact presentation of withdrawal is different for various substances)
- Taking the substance to relieve or avoid the symptoms of withdrawal
What causes substance use disorders?
- Genetics/biological: It is estimated that genes account for 40-60% of a person’s vulnerability to developing a substance use disorder. However, this doesn’t mean that there is an addiction gene, but rather that combinations of many genes (as well as other biological factors) may work together to result in a person being more likely to use substances in excess. For example, a person who is biologically predisposed to have a weak dopamine-reward response may be more likely to overuse drugs that cause intense dopamine release.
- Environmental: Growing up in a chaotic home; living in a neighborhood where drugs are easily available; and having family members, friends, or peers who abuse alcohol or other drugs have all been linked to the development of substance use disorders. As is the case with genetic factors, these environmental factors likely don’t directly cause a disorder, but instead may increase a person’s vulnerability.
- Developmental: A person’s stage of physical and mental development plays a large role in their vulnerability to developing a substance use disorder. While drug use at any age can be risky, people who begin using drugs before or during adolescence (when the brain is still developing) are at a much higher risk for developing a substance use disorder.