Drug Use and Addiction

Drug Use in the United States: Trends and Effects

• Illicit drug use among 8th graders, excluding marijuana, remains at 10%
• Cannabis, cocaine, and hallucinogen use is on the rise, while painkillers and opioids are decreasing
• Methamphetamine use has remained stable, with an increase in the use of more potent crystalline form
• Male ecstasy use has increased in the 20-29 age group and older males
• Methamphetamine use is associated with psychotic episodes
• Cannabis remains the most commonly used illicit drug
• Curiosity and peer pressure are primary reasons for drug use
• The brain regions involved in drug use include the occipital, parietal, frontal lobes, cerebellum, brain stem, thalamus, hippocampus, and nucleus accumbens
• The mesolimbic dopamine system is involved in drug abuse and addiction
• Dopamine is central to the brain's reward system and is involved in substance use disorder
• Dopamine is involved in rewarding behavior and is affected by natural rewards, drugs of abuse, and nurturing behavior
• Pharmacology of drugs can increase dopamine levels and reinforce behavior, leading to addiction and substance use disorder

Understanding Substance Use Disorders and Addiction

• Most drugs affect the brain's reward system by increasing dopamine levels, influencing the individual's physical and mental health.
• Overdose from drug use poses serious risks, leading to coma, brain damage, or death, and may require treatment involving medication, therapy, or hospitalization.
• Substance use disorder, or addiction, is characterized by compulsive drug use despite negative consequences and can significantly impact physical and mental health, relationships, and daily functioning.
• Addiction is influenced by genetics, environment, and individual characteristics, and effective treatment involves medication, therapy, and support from healthcare professionals and peers.
• The brain's reward system, involved in pleasure and motivation, plays a crucial role in substance use, with all drugs of abuse increasing dopamine levels in the nucleus accumbens.
• Chronic drug use can lead to changes in the brain's reward system, making it difficult for individuals to experience pleasure from natural rewards and leading to a compulsion to seek and use drugs despite negative consequences.
• Substance use disorder is associated with changes in brain function, particularly in the mesolimbic dopamine system, and can result in physical and psychological dependence, as well as withdrawal symptoms and tolerance to the rewarding effects of the drug.
• Addiction is a result of learned associations of brain changes driving the craving aspect, and substance use disorders are categorized on a continuum, with DSM-4 and DSM-5 addressing these as a single category.
• Withdrawal symptoms occur when the drug is stopped, and tolerance to the rewarding effects of the drug is developed with repeated administration, while sensitization causes an increased response to the drug.
• All addictive drugs can cause neural adaptations in regions involved in motivational processes, promoting maladapted behavior where taking the drug takes precedence over anything else.
• The potency of a drug depends on the route of administration, with intravenous administration being the fastest and most potent, while oral administration is the least addictive.
• Heroin, alcohol, and benzodiazepine withdrawal can cause various symptoms, and the speed and magnitude of dopamine increase determine the rush of the drug, with different routes of administration affecting addiction likelihood.