One of the most common questions we are asked is, “How do drug addictions start?”
Drug addiction, or substance abuse, is formally known as substance use disorder (SUD). The clinical descriptor for alcoholism, by contrast, is alcohol use disorder. These addictions are diagnosed using the criteria laid out in DSM-5, the most current edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders).
The sustained abuse of addictive substances triggers functional and structural brain changes. In addition to disrupting the way your brain responds to pleasure, addiction also impacts areas of the brain associated with learning and motivation.
Addiction affects the brain in the following ways:
- Cravings in the absence of the substance.
- Diminished control over substance use.
- Ongoing substance use despite negative outcomes.
Researchers have been probing the causes of addiction and addictive behaviors since the 1930s.
For many decades, addiction was widely viewed as a moral failing or a simple lack of willpower. A punitive approach prevailed in place of today’s rehabilitative approach to addiction treatment.
Robust research in this area led to the scientific consensus on addiction shifting. Today, NIDA (the National Institute on Drug Abuse) and the CDC (Centers for Disease Control and Prevention) recognize addiction as a chronic, relapsing disease that changes brain structure and function.
How, then, do these brain changes unfold, and how does this further drive compulsive behaviors like substance use?
The brain registers all pleasure equally, whatever the source. Whether pleasure comes from a sexual encounter, a tasty meal, or ingesting psychoactive substances, your brain reacts by releasing dopamine, a neurotransmitter or chemical messenger.
All addictive substances cause powerful surges of dopamine to flood the nucleus accumbens.
Substances have different risk profiles for addiction based on the following variables:
- Intensity of dopamine release.
- Reliability of dopamine production.
- Speed of dopamine release.
Dopamine plays a powerful role in your experience of pleasure. Beyond this, the neurotransmitter impacts both learning and memory. Both of these functions can influence the progression from liking and desiring a substance to becoming addicted to that substance.
How do most drug addictions start in the brain, then?
How Does Drug Addiction Start in the Brain?
Humans are hedonistic by nature, naturally pursuing things that make us feel good.
As outlined above, any pleasurable experience leads to the release of dopamine in the brain.
Over the course of your development into an adult, your brain will store memories of pleasurable feelings, and it will also store the source of the feelings. Healthy brains store those memories and associate them with future pleasurable experiences.
If you abuse alcohol or drugs, though, the brain does not respond in a healthy manner. Rather, the brain releases even more dopamine than usual. Additionally, addictive substances cause changes in brain chemistry, preventing dopamine from being efficiently reabsorbed. As a result, taking addictive substances triggers an extended euphoria that is naturally unattainable.
As the brain is rewarded with the euphoric feelings delivered by substance use, it starts demanding more of those pleasurable feelings. Tolerance to the substance starts building, causing you to require more of the substance to achieve the same effects. It doesn’t typically take long before nothing can induce happiness except substance abuse. The everyday starts to become dull with substance use prioritized above all else.
By this point, the vicious cycle of addiction has already set in. This simplified version of the standard route to addiction shows that substance use alters brain chemistry, and that the reward of the system of the brain continues to mutate with sustained substance abuse.
The following variables can all influence your risk profile of developing an addiction:
- Drug of choice
- Method of delivery
- Underlying medical conditions
- Co-occurring disorders
- Environmental factors
- Peer pressure
1) Drug of choice
The rate at which addiction develops varies from substance to substance.
Some illicit drugs – heroin, cocaine, and meth, for instance – can be more physically addictive than marijuana or alcohol. Detox and withdrawal from substances like heroin, cocaine, and meth is usually physically painful. This prompts many people to return to substance use to alleviate withdrawal symptoms.
In addition to accelerating the process of addiction, more addictive drugs also lead to more serious complications like overdose at a greater rate than less addictive drugs.
2) Method of delivery
Similarly, the route of delivery impacts the risk of addiction.
Smoking or injecting substances usually leads to addiction developing more rapidly than swallowing substances. When you swallow substances, they first pass through organs like your liver before entering the bloodstream.
NIDA reports that around half of your risk profile for developing addiction is genetic.
If you have a close family member with experiences of addiction, you are more likely to develop an addiction yourself. This is sometimes informally expressed as the concept of an addictive personality, a hereditary predisposition to addiction.
4) Underlying medical conditions
Certain physical medical conditions can also increase the risk of addiction.
During the ongoing opioid epidemic, many people prescribed opioid painkillers to soothe post-operative pain developed a tolerance and addiction to those medications, sometimes developing full-blown opioid use disorder.
Others self-medicate the effects of physical illnesses by using alcohol or drugs as a coping mechanism. While self-medication can offer some fleeting relief, the root cause of the problem remains unaddressed, leading to the issue being inflamed over time.
5) Co-occurring disorders
When an alcohol use disorder or substance use disorder co-occurs with a mental health condition, this is known as co-occurring disorder or dual diagnosis.
Some common examples of co-occurring disorders are:
- PTSD and alcohol use disorder
- Substance use disorder and depression
- Anxiety disorder and benzodiazepine addiction
As above, many people in these scenarios make the inadvisable choice of self-medicating symptoms. Instead, simultaneous dual diagnosis treatment is recommended for co-occurring disorders.
6) Environmental factors
Environmental factors often contribute toward addiction.
Many kids with absent or unengaged parents experiment more liberally with alcohol and other substances.
If someone has easy access to prescription medications or illicit drugs, this can also heighten the risk of experimentation leading to tolerance, dependence, and addiction.
Neglect, trauma, and abuse can lead to the use of substances as a coping mechanism.
7) Peer pressure
Peer pressure, whether direct or indirect, is a common cause of young people experimenting with alcohol or drugs.
When peer pressure is combined with easy availability – kegs in a college environment, for example – this can often kickstart abusive patterns of substance use that develop into addiction in later life.
How to Get Started with Addiction Recovery at Renaissance
Now for the good news. While there is no cure for addiction, there are many evidence-based treatment programs here at Renaissance Recovery.
The most crucial thing to understand is that recovery is not a single, time-limited event like detox. Rather, it is an ongoing process, and a process that may not unfold in a linear fashion. Indeed, 40% to 60% of those in recovery relapse.
Regrettably, there is a significant treatment gap. Researchers estimate that fewer than 10% of those with substance use disorders receive professional treatment.
Discover as much as you can about the different forms of inpatient and outpatient treatment available.
Assemble a shortlist of suitable facilities and start preparing yourself to unpack the physical component of addiction with detox. Once you have detoxed, you will ready to attack the psychological component of addiction through the following therapies:
- Medication-assisted treatment
- Psychotherapy – CBT (cognitive behavioral therapy) or DBT (dialectical behavior therapy)
- Counseling (individual and group)
- Holistic therapies
- Family therapy
Call our friendly team today at 866.330.9449 to find out how you or your loved one can get help. We are available to speak on the phone day and night, so please don’t hesitate to reach out.