Drug Abuse
Teenagers and young adults who abuse drugs often display problem behaviors such as poor academic performance and dropping out of school. They also are at an increased risk of unplanned pregnancies, violence, and infectious diseases.
For most young people, the initial decision to take drugs is voluntary. However, the repeated use of substances such as drugs, alcohol, and tobacco causes changes in the brain that affect one’s self-control and ability to make sound decisions. Drugs also cause the brain to send intense impulses that compel the user to take more drugs. Because of this, drug abuse can result in addiction.
The teen brain is still developing, making the effects of drug abuse even more complex for this population. One area of the brain still maturing during adolescence is the prefrontal cortex, which enables a person to consider situations fully, make solid decisions, and keep emotions and desires under control. Because this critical part of an adolescent’s brain is still a work in progress, adolescents are at greater risk for poor decision-making (such as trying drugs or continued use). Also, using drugs while the brain is still developing may lead to profound and long-lasting consequences.
No single factor determines whether a person will become addicted to drugs. The overall risk for addiction is affected by the person’s biological makeup and his or her environment. It can even be influenced by gender or ethnicity, a person’s developmental stage, and the surrounding social environment (such as conditions at home, at school, and in the neighborhood). Scientists estimate that genetic factors account for 40 to 60 percent of a person’s vulnerability to addiction, including the effects of environment on gene expression and function.
Adolescents and persons with mental disorders are at greater risk of drug abuse and addiction than the general population, making drug abuse prevention programs for teens critically important. Alcohol, tobacco, and illicit drug abuse are reduced when science-validated drug-abuse prevention programs are properly implemented by schools and communities. Such programs help teachers, parents, and health care professionals shape teens’ perceptions about the dangers of drug abuse. While many events and cultural factors affect drug abuse trends, levels of abuse are reduced when teens and young adults learn that such abuse is harmful.
Commonly Abused Drugs
Drug use in teenagers and young adults varies between ages thirteen and nineteen years. Younger teens are less likely to use most drugs than older teens. An exception is the use of inhalants, which is seen more in younger teens and less in older ones, in part because inhalants are readily accessible to teens. An average home has between thirty and fifty products with abuse potential. Also, inhalants are inexpensive and are legal to buy and possess. Additionally, the perceived risk of use is low.
More and more teens are abusing prescription drugs. Use of marijuana has remained stable but is more common. About 4.8 percent of high school seniors report having abused Vicodin and about 21.2 percent report having used marijuana in the last year. According to the 2014 Monitoring the Future survey, prescription and over-the-counter drugs are among the most commonly abused drugs by twelfth graders; only alcohol, marijuana, and tobacco are used more often. Youth who abuse prescription medications also are more likely to report using other drugs.
Other drugs that are abused by teens and young adults include opioids (heroin, opium), stimulants (cocaine, amphetamine, methamphetamine), club drugs (methylenedioxy-methamphetamine, flunitrazepam, gamma-hydroxybutyrate), dissociative drugs (ketamine, PCP and analogs, Salvia divinorum, dextromethorphan), hallucinogens (lysergic acid diethylamide, mescaline, psilocybin), and anabolic steroids.
Drug Abuse and Its Effects on the Brain
Drugs contain chemicals that interfere with the brain’s communication system and change the way nerve cells normally send, receive, and process information. Drugs cause this interruption by imitating the brain’s natural chemical messengers and by overstimulating the reward circuit of the brain.
Some drugs (such as marijuana and heroin) have a structure that is similar to chemical messengers called neurotransmitters, which are naturally produced by the brain. This similarity allows the drugs to fool the brain’s receptors and activate nerve cells to send abnormal messages.
Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release large amounts of natural neurotransmitters (mainly dopamine) or to prevent the normal recycling of these brain chemicals, which is needed to shut off the signaling between neurons. The result is a brain full of dopamine, a neurotransmitter present in brain regions that controls movement, emotion, motivation, and feelings of pleasure. The overstimulation of this reward system, which normally responds to natural behaviors linked to survival (for example, eating and spending time with loved ones), produces euphoric effects in response to psychoactive drugs. This reaction sets in motion a reinforcing pattern that “teaches” a person to repeat the rewarding behavior of abusing drugs.
As a person continues to abuse drugs, the brain adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. The result is a lessening of dopamine’s effect on the reward circuit, which reduces the abuser’s ability to enjoy the drugs, as well as the events in life that previously brought pleasure. This decrease compels the addict to keep abusing drugs to bring the dopamine function back to normal; however, larger amounts of the drug will be required to achieve the same dopamine high—an effect known as tolerance.
Long-term abuse also causes changes in other brain-chemical systems and circuits. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate, which can impair cognitive function.
Brain imaging studies of drug addicts show changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Together, these changes can drive an abuser to seek and take drugs compulsively despite adverse, even devastating consequences; this is the nature of addiction.
Treatment
Drug abuse is a treatable disease with many effective treatments available. Some important points about drug abuse treatment include the following: Medical and behavioral therapy, alone or together, are used to treat drug abuse. Treatment can sometimes be done on an outpatient basis, but severe drug abuse usually requires residential treatment, in which the patient sleeps at the treatment center.
Treatment can take place within the criminal justice system, which can help to prevent a convicted person from returning to criminal behavior. Furthermore, studies show that treatment does not need to be voluntary to work.
Addiction is a difficult disorder to treat, especially if diagnosed late into the condition, although remissions can be achieved in up to 60 percent of patients. Whether or not treatment works depends on the patient’s level of functioning at entry into treatment, premorbid functioning, comorbid conditions, and the support systems and resources available to the patient. Treating a substance abuser is not a hopeless process, but it can be a long and difficult one, similar to the treatment of any chronic disorder.
Bibliography
Gogtay, N., et al. “Dynamic Mapping of Human Cortical Development during Childhood through Early Adulthood.” Proceedings of the National Academy of Sciences 101 (2004): 8174–79. Print.
Graham, A. W., and T. K. Shultz, eds. Principles of Addiction Medicine. 3rd ed. Chevy Chase: Amer. Soc. of Addiction Medicine, 2003. Print.
National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction. Bethesda: NIDA, 2010. Print.
National Institute on Drug Abuse. Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders. Bethesda: NIDA, 2003. Print.
Rehm, J., et al. “Global Burden of Disease and Injury and Economic Cost Attributable to Alcohol Use and Alcohol-Use Disorders.” Lancet 373 (2009): 2223–33. Print.
United States. Natl. Inst. on Drug Abuse. "DrugFacts: High School and Youth Trends." NIDA, Dec. 2014. Web. 10 Nov. 2015.
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