Category Archives: self-medication hypothesis

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.

representation of addiction

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

The Neurobiology of Addiction

Brain_Broccoli_by_faiizeThis 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