Category Archives: Addiction Facts

Why people develop a drug of choice

This is the last installment of a five part series on the neurobiology of addiction by Jennifer Fernández, PhD.

Drugs and compulsive behaviors are used to cope with a variety of problems.

Drug of choice can say a lot about a person or what they’re coping with. People choose drugs that will best help them cope with underlying problems. Sometimes these problems include severe mental illness. Addiction can occur when drugs or compulsive behaviors are relied upon for alleviation from multiple or serious problems.

Alcohol is often sought out by those who have a hard time expressing themselves, especially if coupled with social anxiety. It makes you feel loose and carefree by releasing GABA and suppressing glutamate in the brain. The soothing and disinhibiting effects are also helpful to people in emotional pain, such as someone suffering from grief. Sometimes people with trauma histories turn to alcohol to soothe their psychic wounds. People with schizophrenia sometimes use alcohol to quiet auditory hallucinations.

Amphetamines give you a rush of pleasure and boost energy and focus by altering norepinephrine and dopamine in the brain. They may be sought out by someone who is depressed and has been unable to feel pleasure for some time. Improved focus may be sought after by someone with ADHD. Anti-psychotic medication can have dulling and flattening side effects and sometimes people with schizophrenia seek out the alertness and energy of stimulants. Nicotine is used by 95% of people with schizophrenia because of its ability to increase concentration and focus.

Opiates may help someone who is feeling irritable, stressed, or moody by blocking endorphin receptor sites in the brain and increasing feelings of euphoria. People who have experienced trauma or are in significant emotional pain may also turn to opiates to help soothe and forget their painful memories. Traumatized people may also turn to dissociatives for their ability to induce out of body experiences.

Hallucinogens and ecstasy create a sense of connection and feelings of warmth and empathy by altering serotonin and norepinephrine receptor sites. Someone with anxiety or an inability to feel pleasure may turn to these drugs for comfort.

Recreational and pharmaceutical drugs work on the same systems in the brain. So if your drug use is an attempt to self-medicate an underlying problem, speaking to a trained professional can help you find healthier alternatives to cope.

Photo credit: Marrinc

Neurotransmitters and Addiction

This is the fourth installment of a five part series on the neurobiology of addiction by Jennifer Fernández, PhD.

Drugs act on neurotransmitters to increase, decrease, or alter their release or reuptake.

In the previous installment of this series, we learned that dopamine is responsible for feelings of pleasure and euphoria, but it has other functions as well. And dopamine isn’t the only chemical messenger in the brain.

Dopamine is just one of dozens of neurotransmitters. It is the most well known chemical messenger and is responsible for feelings of pleasure, coordination of movement, and logical thinking. It is responsible for “the rush” one feels when they use a recreational drug and it also influences the addictive potential of a drug. It is released when we do things that are important for survival, like sleeping, eating, and having sex. Dopamine sends the message “That feels good! Do it again!”

Norepinephine is one of the brain’s natural stimulants. It is responsible for increased alertness and focus and is involved with learning and memory processes. Norepinephrine is also involved in the fight or flight response. It signals the release of adrenaline in your body to prepare you for survival in the face of imminent danger. It sends the message “Fight!” or “Run!”

GABA (gamma-aminobutyric acid) is the brain’s Valium. It relaxes the brain by suppressing overexcitement or hyperactivity, while allowing us to remain alert and focused. Low levels of GABA are associated with anxiety and seizure.

Glutamate stimulates various activities throughout the brain. We don’t know much about how it is involved in mood regulation.

Serotonin plays several complex roles in the brain. It is involved in regulating mood, sleep, appetite, and sex drive. Low levels of serotonin are associated with aggression, irritability, and depression. Serotonin is also responsible for hallucinations and regulating other neurotransmitters.

Endorphins are the brain’s natural opiates. They influence the perception and control of physical and emotional pain. In addition to pain relief, they are responsible for feelings of well-being, happiness, and euphoria.

Drugs act on these messenger chemicals to increase, decrease, or alter their release or reuptake. Our brain is wired to recognize these chemicals and accept their messages. The difference is that drugs relay the message better, faster, and in a much more intense way. Research shows us that life experiences affect the development of the brain, including how neurotransmitters work. For example, someone who has experienced trauma may find it difficult to feel pleasure or regulate their mood due to low levels of dopamine and serotonin. This may cause them to turn to externally supplied chemicals to balance the levels of neurotransmitters in their brain.

The next, and final, installment of this series will explain why some people turn to recreational drugs in an attempt to balance the chemical messengers of the brain.

Photo credit: Life Mental Health

This is your brain on drugs. For real.

This is the third installment of a five part series on the neurobiology of addiction by Jennifer Fernández, PhD.

This is not your brain on drugs. These are burnt eggs.

Addiction is scary. It has caused pain in many people’s lives and has cost families and governments trillions of dollars to treat and prevent. It’s no surprise that social service agencies want to educate the general population about the harms of addiction. You may have seen this public service announcement comparing the addicted brain to fried eggs. The image is powerful, yes, but it is not educational. This is what actually happens in your brain when you take drugs.

Neurons generate messages that travel between cells in the brain.

Above is an image of a neuron. Our brain is filled with billions of these nerve cells and fibers. They contain genetic information and also serve as messengers. They transmit information through fibers from one cell to another via electrical charges. Neurons generate messenger chemicals, or neurotransmitters, to transmit information from cell to cell. The electrical charge travels through the dendrites, cell body (or soma), axon, and terminal bud down to the synapse, the gap between neurons where the magic happens. Neurotransmitters live in the terminal bud of neurons. An electrical charge comes through the neuron and releases the messenger chemicals. The chemicals then float across the synapse and attach to the neighboring cell for a short amount of time in a process called neurotransmission. Once the message has been relayed, they return to their home cell. This process is called reuptake. For example, if you were to burn your hand on the stove, nerve cells in your muscles would send a message to the neurons in your brain saying, “Ouch!” Your brain sends a message back down to the muscles in your arm to pull your hand back. At the same time, the message from your burning hand also alerts your brain to release endorphins, the brain’s natural pain reliever. The endorphins do their job and relieve the pain long enough so you can think to run cold water over your hand. Once the message has been communicated, the endorphins return to their home cell until the next electrical charge commands them to be released.

THIS is your brain on drugs.

Above we have a close up of the synapse, the gap between neurons, and what happens when cocaine is present in the brain. The red arrows show the process of reuptake. The neurotransmitter dopamine has been released into the synapse to send a message to the neighboring cell. Once dopamine has completed its task, it attempts to go back home, but cocaine is blocking the way. Since dopamine can’t go back home it goes back to doing it’s job, binding to the neighboring cell. Dopamine’s loitering, so to speak, is what causes feelings of intense pleasure and euphoria.

Dopamine is only one of dozens of neurotransmitters in the brain. In the next installment, we identify the major neurotransmitters involved with drug use.

Photo credits: burnt eggs by incredibledictu, neuron, and neurotransmission by NIH.

The Neurocircuitry of Addiction

Drugs and compulsive behaviors have an impact on the reward center of the brain.

This is the second installment of a five part series on the neurobiology of addiction by Jennifer Fernández, PhD.

Addiction causes changes to brain structures that regulate pleasure, motivation, and decision making. Depending on the type of drug abused and the length of the abuse, these changes can be permanent. Other factors, such as pre-existing abnormalities in brain structure (like depression, schizophrenia, or ADHD) can also make the effects of drug misuse irreversible. The primary brain structures affected by drug use and compulsive behaviors are the ventral tegmental area (VTA), the nucleus accumbens, and the prefrontal cortex.

This is your brain

The VTA is the birthplace of dopamine, a chemical that signals the brain about pleasure. It is involved in cognition, motivation, intense feelings of love, addiction, and psychiatric disorders like schizophrenia and ADHD.

The nucleus accumbens (NA) is the reward and pleasure center of the brain. It sends the chemical messenger of pleasure, dopamine, to various areas of the brain, depending on the message. Permanent changes occur to this brain structure with repeated drug use. These changes explain drug tolerance (needing to take more drugs to feel high) and drug withdrawal (physical and psychological discomfort when drug use stops abruptly). The NA is also involved in fear, aggression, laughter, impulsivity, and learning.

The prefrontal cortex (PFC) is the part of the brain that separates us from other animals. It is involved in executive functioning, complex brain functions that include differentiating from good and bad or same and different, future consequences, predicting expectations based on actions, working towards a goal, and suppressing urges that might be deemed socially unacceptable. In the brain of addicted individuals, the PFC is thought to be involved in anticipation of the drug, motivation to seek out the drug, craving, automatic responses to emotions, and reduced self-control. Once a person becomes addicted, their attention narrows to focus on drug-related cues over all other reinforcers, impulsivity increases, and basic emotions become unregulated.

In the next installment, we’ll dive even deeper into the brain to look at the role drugs have in neurotransmission.

Photo credit: Lydia Kibiuk and BrainFacts.org

The Neurobiology of Addiction

This is the first installment of a five part series on the neurobiology of addiction by Jennifer Fernández, PhD.

Addiction is a biopsychosocial phenomenon that affects over 20 million people in the United States. The factors that cause addiction are not yet well understood, with some arguing that it is a disease and others suggesting it’s more complicated than that.

But we can identify some predictors for addiction and we do understand the impact it has on the brain.

This five part series will primarily focus on current understanding about the brain structures and neurotransmitters involved in addiction. We’ll also look at the interaction specific drugs have with neurotransmitters in the brain and how this accounts for preferences in drug selection. We’ll start with an overview of addiction theories then dive into the neurocircuitry and neurobiology of addiction. We’ll conclude by looking at the effect of drugs on neurotransmitters in the brain and discuss why one develops a drug of choice.

Theories of addiction

Although we don’t fully understand addiction, there are lots of theories that attempt to explain it. The most popular one is the disease model. It explains that addiction has a biological origin that causes changes in the brain. This model also accounts for the heredity of addiction, or genetic predisposition. Studies of twins who have been separated at birth show that they are likely to develop addictions, despite growing up in different home environments.

You may have also heard addiction described as a hijacker of the reward center of the brain. Brain imaging studies show that overuse of drugs or compulsive behaviors “hijack” the reward system and can lead to changes in the brain that make it difficult to experience pleasure as one did before.

Then there’s the self-medication hypothesis. It posits that people use drugs to help them cope with physical and/or emotional pain. It helps explain why people turn to specific drugs or compulsive behaviors to help them deal with things like depression, chronic pain, trauma, or grief.

But the best way to explain addiction is as a biopsychosocial phenomenon. We know that addiction has a biological component. It causes temporary and permanent changes in the brain and body. We also know there is a psychological component: an inability to cope with distressing emotions. The social component of addiction is related to peer culture, as they influence what you use, how you use it, or how (not) to deal with your emotions.

In the question about nature versus nurture, the answer might just be nature and nurture. Drugs affect us biologically and we may even be genetically predisposed to those effects. Your parents, family, friends, or lovers may have modeled addictive behaviors or inability to cope with emotions in a healthy manner.

The next installment of this series will focus on the neurocircuitry of addiction.

Photo credit: Faiize

Is internet addiction real?

If internet use interferes with one’s life and ability to function, internet addiction or compulsive internet use may be a concern.

Although there is debate in the academic world about the authenticity of internet addiction there is no dispute that, for some people, excessive internet use can cause distress, strife, and disruption in their ability to function. Internet addiction is somewhat of a misnomer and compulsive internet use seems to capture the nature of the disorder more accurately. It’s compulsive because use of the internet acts as a substitute for an unmet lifestyle need. For example, someone who suffers from depression or anxiety may turn to the fantasy world of the internet to escape those uncomfortable emotions. Obviously this is also true of drug addictions, and although a recent study shows differences in the brain anatomy of excessive internet users, the results are inconclusive.

The Center for Internet Addictions proposes the following diagnostic criteria for internet addiction for users who have experienced four or more of the following symptoms in the last month:

Feeling preoccupied with the Internet or online services and thinking about it while off line
Feeling a need to spend more and more time online to achieve satisfaction
Inability to control online use
Feeling restless or irritable when attempting to cut down or stop online use
Going online to escape problems or relieve feelings such as helplessness, guilt, anxiety or depression
Lying to family members or friends to conceal how often and how long you stay online
Risking the loss of a significant relationship, job, or educational or career opportunity because of online use
Continuing use even after spending too much money on online fees
Going through withdrawal when offline, displaying symptoms such as increased depression, moodiness, or irritability
Staying online longer than originally intended

Compulsive internet use can take on several forms:

cybersex & pornography
online relationships
gaming
compulsive shopping

Regardless of the biological underpinnings of excessive internet use, it is clear that people experience distress and disruption to their lives when they compulsively turn to the internet for relief. If you think your internet usage is compulsive, contact a mental health professional for an evaluation. It is highly likely that you are using the internet to cope with an underlying issue.

Photo credit: Federico Morando

Jennifer Fernández, Ph.D. and Associates

Substance Abuse Treatment in San Francisco