Advising psychologist Niamh Delmar on why we need to understand the neuroscience of addiction in order to help those in need.
Drug addiction, called substance abuse disorder, negatively affects the brain and behavior of the individual. Once addicted, the user continues to use the drug despite the adverse risks.
Symptoms and behaviors include needing to use the drug regularly, cravings for it, needing more for the same effect, spending money, engaging in other behaviors to risk, not stopping using and withdrawing from trying to quit the drug.
There is a wide range of drugs that people become addicted to, including prescription drugs, stimulants, club drugs, hallucinogens, and opioids.
Drugs are misused to relax, shut down, calm down, forget, for a high, to increase energy, or to improve performance. Polydrug use refers to the simultaneous use of various drugs and can involve both illicit and legal drugs.
The Neurosciences of Addiction
Pleasure activities infiltrate our daily lives, such as buying new clothes, going on vacation, going to the gym, or dining out. For some, this pursuit of pleasure spirals out of control and turns into addiction to pornography, alcohol, food, drugs, and other self-destructive activities.
Understanding the neuroscience of addiction is an essential part of responding to and treating addicts. The ventral tegmental in the brain is the center of reward seeking. When something feels good, dopamine is released here, creating euphoria. The behavior is repeated to relive this state.
As the addiction deepens, the descent of the “high” causes dopamine levels to plummet, causing nausea, heart palpitations, tremors, and other distressing symptoms. The brain associates other aspects of a person’s life with getting high, such as who to drink with and where to drink. Reminders of the drug become overwhelming and take up the mind, money, time and life of the person. Drugs come first. Addicted people don’t have fun and are turned away by drugs.
Drug addiction symptoms
Symptoms of drug addiction include psychological, behavioral and physical effects and vary depending on the type of drug used. These range from feelings of euphoria, excitement, paranoia, sedation, slow or accelerated speech and movement to altered states and hallucinations. Psychological symptoms include mood swings, outbursts of anger, restlessness, poor judgment, inability to focus or concentrate, memory problems, and exacerbation of mental health issues.
Behavioral and social signs include lying, declining school or job performance, giving up favorite activities, money problems, engaging in risky or illegal activities, and withdrawal.
Physical signs include decreased self-care, unkempt appearance, changes in appetite, and disturbed sleep. Eyes, nose, blood pressure, heart rate and a wide range of physiological changes ensue.
Risk factors for becoming dependent
What are the risk factors for becoming dependent? It is multifactorial, involving biological, psychological and social contributing factors. According to the Mayo Clinic, there may be a genetic predisposition, family history, and/or mental health disorder. It can start with experimental use in social situations and quickly escalate depending on the type of drug.
A family history of drug addiction increases the risk of becoming dependent. The influence of the person’s social circle has been shown to be an important factor in drug abuse, particularly among younger cohorts. Stressful family dynamics, lack of supervision and early drug use increase vulnerability.
Poverty, multi-generational unemployment and lack of community facilities have been associated with drug abuse in some areas. However, drug addiction among the middle class has escalated and is evident, and sometimes deadly, among the rich and famous.
The availability of drugs is increasing use, as the period of Covid-19 restrictions shows. An HSE survey carried out during this period reveals changes in the consumption of illicit drugs. While cannabis use has increased, other drugs have been used less due to fewer opportunities.
The Behavioral and Clinical Neuroscience Institute in Cambridge has conducted addiction research on the consequences of chronic drug use on mental performance and brain activity.
Use of a highly addictive drug can lead to psychosis, seizures, death, brain damage, unprotected sex, physical health problems, increased risk of suicide, family and relationship problems, school problems and professionals, lawsuits, drug trafficking, custodial sentences and financial loss. .
A mental health disorder, such as depression or PTSD, is another risk factor for substance abuse disorder. The person uses the drug to relieve distressing symptomatology. Exposure to traumatic experiences, particularly during childhood, has been linked to substance abuse.
Research data has shown a strong correlation between trauma and substance abuse in adolescents. Addiction expert Gabor Maté advocates a compassionate approach to addiction and sees it as an escape from the emotional distress of past trauma.
He asserts that no one chooses to be an addict and that self-awareness, openness and processing traumatic childhood experiences are key to recovery.
Drug policy and social attitudes
With all of this latest addiction research involving neuroscience and psychology, there is still a long way to go. Drug policy cannot focus solely on methadone treatment programs and counseling alone may not be enough.
Societal attitudes toward heroin addicts from lower socioeconomic groups may differ from how rock stars, movie stars, or celebrities are perceived. Negative opinions of drug addicts and references to “crackheads” and “junkies” will not be part of the solution, nor will the glorification of drug use by famous role models. The way people are referred to can create or sustain stigma.
While the behaviors of addicted people can be problematic, we cannot dehumanize those with substance abuse disorders. Drug addiction is a serious and complex public health problem that cannot be addressed by reactive measures alone. Trauma screening and trauma-informed therapy are essential.
Many people in recovery report interventions that have helped them, such as motivational interviewing, evidence-based individualized treatment, addressing childhood trauma and mental health issues, developing a new social circle, coping strategies, life skills, support, education, work opportunities and compassion.
Cuan Mhuire has treatment centers across the country and offers educational and aftercare programs. Tiglin offers rehabilitation programs for people with addictions or homelessness. They provide training to reintegrate people into society.
An example of this is The Rise at the Cove Cafe at Greystones, a social enterprise cafe. Initiatives like these work. Along with effective treatment programs like these, preventive measures are needed.
The high rates of traumatic childhood experiences in addiction research indicate how essential multidisciplinary services for children and adolescents are. If they don’t have support to turn to, they may turn to drugs.
If you have been affected by the issues raised in this story, please visit: www.rte.ie/helplines