Drugs and alcohol can hijack your brain
Illustration of circuits and arrows inside a man’s brain. People with addictions lose control of their actions. They feel a compulsion to consume and look for drugs, alcohol or other substances regardless of cost – even putting friendships at risk, hurting their families or losing their jobs. Why does addiction cause people to behave in such destructive ways? And why is it so difficult to leave them?
Scientists funded by the NIH work to learn more about the biology of addiction. They have shown that addiction is a complex and long-lasting brain disease, and that the treatments currently available can help people control their addictions. But even for those who manage to stop using, there will always be a risk that the addiction will return, which is known as recidivism.
The biological basis of addiction helps explain why people need much more than good intentions or willpower to break their addictions.
“A common and mistaken idea is that addiction is a choice or a moral problem, and that all you have to do is stop using, but nothing is further from the truth,” says Dr. George Koob, director of the Institute. National Alcohol and Alcohol Abuse Survey (NIAAA) of the NIH. “In fact, the brain changes with addiction, and a lot of work is needed to get it back to its normal state.The more alcohol or drugs you have consumed, the more the brain will be affected.”
The researchers discovered that a good part of the power of addiction lies in its ability to hijack and even destroy fundamental brain regions that are responsible for helping us to survive.
A healthy brain will reward healthy behaviours, such as exercising, feeding or bonding with loved ones. To do this, turn on brain circuits that make you feel wonderfully well, which motivates you to repeat those behaviours. On the contrary, when you are in danger, a healthy brain pushes the body to react quickly with fear or alarm, so that you move away from harmful sources. If you feel tempted by something questionable – like eating ice cream before dinner or buying things you can not afford – the frontal regions of the brain will help you decide if the consequences of those acts are worth it.
But when you are becoming addicted to a substance, that normal “wiring” of brain processes that come to your aid, may begin to work against you. Drugs and alcohol can hijack the pleasure / reward circuits of the brain and “hook” it so that it wants more and more. The addiction can also overload the emotional circuits that activate the feeling of danger, which causes feelings of anxiety and stress when you are not consuming alcohol or drugs. In this stage, people often use drugs or alcohol to not feel bad, instead of using them to find pleasurable effects.
In addition, repeated drug use can damage the essential decision-making center in the front of the brain. This area, known as the prefrontal cortex, is precisely the area that should help you recognize the damage caused by the use of addictive substances.
“Imaging studies of the brain of people addicted to drugs or alcohol show less activity in the frontal cortex,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA for its acronym in English) of the NIH. “When the frontal cortex does not work correctly, people can not make the decision to stop using the drug – even if they realize that the price they must pay to consume it is extremely high, and that they could lose custody of their children or ending up in jail, even so, they consume it. ”
Scientists still do not understand why some people become addicted and others do not. The addiction tends to be hereditary, and certain types of genes have been related to different forms of addiction. But not all members of an affected family are necessarily prone to addiction. “As with heart disease or diabetes, there is no particular gene that makes you vulnerable,” says Koob.
Other factors can also increase your likelihood of becoming addicted. “Growing up with an alcoholic, having suffered child abuse, being exposed to an extremely high stress level – all these social factors can contribute to the risk of alcohol addiction or drug abuse,” says Koob. “And when it comes to the use of drugs and alcohol in children, the sooner you start, the higher your chances of having an alcohol abuse disorder or an addiction later in life.”
Adolescents are especially vulnerable to a possible addiction because their brains have not yet fully developed – particularly the frontal regions that help control impulses and assess risk. Pleasure circuits in the brains of adolescents also operate at a higher speed, which makes the consumption of alcohol and drugs even more rewarding and tempting.
The NIH is launching a new study nationwide to learn more about how adolescent brains are altered by alcohol, tobacco, marijuana and other drugs. The researchers will use brain scans and other tools to evaluate more than 10,000 young people over a 10-year period. The study will track the relationships between substance use and brain changes, academic achievement, IQ, reasoning skills and mental health over time.
Although there is still much more to learn, we know that prevention is essential to reduce the damage of addiction. “Children and adolescents are moments in which parents can get involved and teach their children a lifestyle and healthy activities that can protect them against drug use,” says Volkow. “Physical activity is important, as well as getting involved in a job, in science or art projects, and in social networks that do not promote drug use.”
To treat addiction, scientists have identified several medications and behavioural therapies-especially when used in combination-that can help people stop using specific substances and prevent recidivism. Unfortunately, there is currently no medication to treat addiction to stimulants such as cocaine or methamphetamine, but behavioural therapies can help.
“The treatment depends largely on the severity of the addiction and the individual in particular,” adds Koob. “Some people can stop smoking or consuming alcohol on their own.The most serious cases may require months or even years of treatment and follow-up, through a real effort on the part of the person, and usually a complete abstinence from the substance . ”
Researchers funded by the NIH are also evaluating experimental therapies that could improve the effectiveness of treatments already in operation. The conscious meditation (mindfulness) and the magnetic stimulation of the brain are two techniques whose capacity to strengthen the circuits of the brain damaged by the addiction is being evaluated. Scientists are also studying possible vaccines against nicotine, cocaine and other drugs, which could prevent the drug from entering the brain.
“Addiction is a devastating disease, with a relatively high death rate and serious social consequences,” says Volkow. “We are exploring different strategies so that people finally have more treatment options, which will increase their chances of success when they try to stop using the drug.”