THE NEUROBIOLOGY OF SUBSTANCE USE, MISUSE, AND ADDICTION Facing Addiction in America NCBI Bookshelf

Unlike other organs, the brain is designed to change, because its mission is to keep us alive, and in order to safeguard us, it needs to be able to detect and respond to the ever-changing dynamics of the real world. This is why a person who misuses drugs eventually feels flat, without motivation, lifeless, and/or depressed, and is unable to enjoy things that were previously pleasurable. Now, the person needs to keep taking drugs to experience even a normal level of reward—which only makes the problem worse, like a vicious cycle. Also, the person will often need to take larger amounts of the drug to produce the familiar high—an effect known as tolerance. For the brain, the difference between normal rewards and drug rewards can be likened to the difference between someone whispering into your ear and someone shouting into a microphone.

• As with most other chronic diseases, such as diabetes, asthma, or heart disease, treatment for drug addiction generally isn’t a cure.
• Medical professionals previously used the term “drug abuse” to describe substance use disorder.
• People who purposefully overdose on medications frequently have mental health conditions.
• Overcoming drug misuse is a journey, but you don’t need to take it alone.
• After a drug overdose, you’ll need immediate and accurate information about the specific name of the drug, the amount of the drug ingested, and the time when the drug was taken.

Conducting Research on the Neurobiology of Substance Use, Misuse, and Addiction

Studies show that once drug use stops, and once people explore new interests or resume interrupted ones, there is a gradual restoration of thickness to key areas of the cortex and renewal of circuitry paving pathways for responding to other sources of reward and pleasure. The capacity to respond to drug cues doesn’t necessarily vanish entirely, but it is deactivated; it is overridden, no longer the only goal capable of firing up the brain, and it diminishes in importance. Craving peaks at 60 days of abstinence among alcoholics, studies show.

What You Need to Know About Substance Use Disorder

It is important to know that recovery from addiction also relies on neuroplasticity. 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. The brain is made up of many parts with interconnected circuits that all work together as a team.

In Summary: The Withdrawal/Negative Affect Stage and the Extended Amygdala

• In spite of this progress, our understanding of how substance use affects the brain and behavior is far from complete.
• It can also be a dangerous hurdle standing between them and the rest of their recovery journey.
• New NIDA animation tackles a common question and explains the science behind drug use and addiction to help light the…
• Clinically, alcohol consumption that exceeds guidelines for moderate drinking has been used to prompt brief interventions or referral for specialist care 112.
• Indeed, brain imaging findings in addiction (perhaps with the exception of extensive neurotoxic gray matter loss in advanced alcohol addiction) are nowhere near the level of specificity and sensitivity required of clinical diagnostic tests.

There’s no cure, but treatment can help you stop using drugs and stay drug-free. Drug addiction isn’t about just heroin, cocaine, or other illegal drugs. You can get addicted to alcohol, nicotine, sleep and anti-anxiety medications, and other legal substances. Consider how a social drinker can become intoxicated, get behind the wheel of a car, and quickly turn a pleasurable activity into a tragedy that affects many lives. Occasional drug use, such what is drug addiction as misusing an opioid to get high, can have similarly disastrous effects, including impaired driving and overdose. The following are examples of common drugs, their short-term physical effects, and potential health risks due to SUD.

The Human Brain: Major Structures and Functions

Research shows that combining addiction treatment medicines with behavioral therapy ensures the best chance of success for most patients. Treatment approaches tailored to each patient’s drug use patterns and any co-occurring medical, mental, and social problems can lead to continued recovery. Drug addiction, also called substance use disorder, is a disease that affects a person’s brain and behavior and leads to an inability to control the use of a legal or illegal drug or medicine. Substances such as alcohol, marijuana and nicotine also are considered drugs.

• Even after you’ve completed initial treatment, ongoing treatment and support can help prevent a relapse.
• HT drafted the nicotine literature review, the “Future Directions” section, and Figure 1, as well as helped format Supplementary Tables S1–S5.
• The temporal overlap between substance use initiation and the vulnerable neurodevelopmental windows makes this an important period to study (Spear, 2000; Thorpe et al., 2020).
• This stage heavily involves the basal ganglia (Figure 2.4) and its two key brain sub-regions, the nucleus accumbens and the dorsal striatum.
• The notion of addiction as a brain disease is commonly criticized with the argument that a specific pathognomonic brain lesion has not been identified.
• Although young people are particularly vulnerable to the adverse effects of substance use, not all adolescents who experiment with alcohol or drugs go on to develop a substance use disorder.

• the nucleus accumbens, a cluster of cells below the cortex in the basal forebrain that produces the urge to pursue a goal. Sometimes called the “pleasure center” of the brain, it is a key player in the reward circuitry of the brain and releases dopamine in response to positive experiences and the anticipation of such experiences. In response to repeated use of a highly pleasurable experience—drugs, gambling—neurons adjust their wiring to become increasingly efficient at relaying the underlying signals. And neural connection to the brain centers of impulse control and decision-making is weakened.

Together, these findings suggest that neural vulnerabilities in regions implicated in inhibitory control predict alcohol use, and heavy drinking subsequently may lead to additional alterations. Another study has demonstrated the reverse relationship between alcohol use and morphological differences, whereby smaller left dorsal and rostral paralimbic ACC volumes predicted later alcohol-related problems (Cheetham et al., 2014). The association between early alcohol use and subsequent alcohol-related problems has been further supported by data drawn from two large population studies conducted in two countries with distinct alcohol use policies and cultures. After controlling for a comprehensive number of potential confounders, both early-onset drinking and early onset of excessive drinking in adolescence (aged 14–16) were related to increased risk of alcohol-related problems when assessed at 18- to 25-years-old (Enstad et al., 2019). Impaired decision-making and underlying neural mechanisms in adolescent alcohol users may mediate the relationship between alcohol use and future substance use vulnerability. Similarly, connectivity between the OFC and amygdala predicted increases in alcohol use and increased connectivity between these regions has previously been shown to be protective against risk-taking (Peters et al., 2017).