Drug use or abuse crosses the line into drug addiction when you feel you
have to have the drug, and you increase the amount of the drug you take.
Various factors, such as your personality, your genetic makeup and peer
pressure, affect your likelihood of becoming addicted to a drug. In
addition, some drugs such as heroin and cocaine more quickly produce a
physical addiction than other drugs do for many people.
Physical addiction appears to occur when repeated use of a drug alters
reward pathways in your brain. The addicting drug causes physical
changes to some nerve cells (neurons) in your brain.
Neurons use chemicals called neurotransmitters to communicate. Neurons
release neurotransmitters into the gaps (synapses) between nerve cells
and are received by receptors on other neurons and on their own cell
bodies. The changes that occur in this communication process vary with
the type of drug to which you're addicted, though researchers have
discovered that addictive drugs, such as cocaine and morphine, all
affect some nerve endings in the brain in the same manner. If further
research confirms this finding, it may be possible to develop a
universal drug that could be used to treat all addictions.
Here are some of the ways specific drugs may contribute to addiction:
The main active agent in cannabis compounds,
delta-9-tetrahydrocannabinol (THC), affects the neurotransmitter
communication process. Some people perceive the effects of THC as
enjoyable, and this sensation reinforces use of the drug. Other
people experience anxiety or uncomfortable feelings, which do not
reinforce use of the drug.
Benzodiazepines and barbiturates produce long-term cellular changes
partly by enhancing the actions of the inhibitory neurotransmitter
gamma-aminobutyric acid (GABA). Released into the synapses, GABA
binds to receptors and ultimately lowers cell excitability, which
slows down brain activity.
These drugs raise the levels of dopamine, norepinephrine and
serotonin in the synapses. Brain cells release dopamine as part of
the reward system through which you learn to seek stimuli, such as
food and sex. Norepinephrine is a hormone released in response to
stress. Serotonin is a chemical in the brain that regulates mood.
Stimulants block the reabsorption of dopamine after its release and
can physically alter the sensitivities of some dopamine and
These drugs affect the nerve cells of the reward pathways in your
brain in ways similar to that of stimulants, producing positive
reinforcement for the use of these drugs. There are opioid receptors
in the brain, spinal cord and gastrointestinal tract.
These factors increase the likelihood of your having an addiction to a
legal or an illegal drug:
If you're a thrill seeker, impulsive and resistant to social norms,
you run a greater risk of drug abuse and dependence. As many as half
the people addicted to drugs have another psychological problem such
as depression, attention deficit disorder and post-traumatic stress
disorder. Children who exhibit aggression, a lack of self-control
and a difficult temperament may be at greater risk of drug
Particularly for young people, peer pressure is a strong factor in
starting to use and abuse drugs. A lack of attachment with your
parents may increase the risk of addiction.
depression and loneliness.
Using drugs can become a way of coping with these painful
Drug addiction is more common in some families and likely involves
the effects of many genes. If you have family members with alcohol
or drug problems, you're at greater risk of developing a drug
Type of drug.
Some drugs, such as heroin and cocaine, more quickly result in
physical addiction than do others.
Addiction is a chronic relapsing disorder, meaning you tend to fall back
into old addictive behaviors, including drug use, even after treatment.
The sooner you seek help, the greater your chances for a long-term
recovery. If you're initially reluctant to approach a doctor, help lines
or hot lines may be a good place to start to learn about treatment. You
can find help lines listed in the phone book or on the Internet.
Because denial is nearly always a characteristic of addiction, people
who are addicted to or who abuse drugs often won't seek medical
treatment on their own. Family members, friends or co-workers may need
to persuade someone to undergo screening for drug addiction. Breaking a
drug addiction may involve counseling, an outpatient treatment program
or residential treatment.
Screening and diagnosis
Diagnosing a drug addiction often starts at the family doctor level,
perhaps after one family member has raised concerns about another family
member's behavior. Your doctor may ask questions about your frequency of
drug use, whether any family member has criticized your drug use or
whether you've ever felt you might have a problem.
definitive diagnosis of drug addiction usually occurs after an
evaluation by a psychiatrist, psychologist or a specialized addiction
counselor. Blood tests often aren't able to result in a diagnosis of a
drug addiction, but these tests can help a doctor detect the presence of
a drug when its use has been denied.
Aside from the physical and psychological problems they cause,
dependence on drugs can create a number of other disruptions in your
Behavioral changes may cause marital or family strife.
Work performance may decline, and you may be absent from work more
You may lose or alienate longtime friends.
Academic performance and motivation to do well in school may suffer.
Stealing to support your drug addiction and driving while impaired
are just two of the potential legal problems drug addiction can
Spending money to support your habit takes away money from your
other needs, could put you into debt, and could lead you into
behaviors that are contrary to your values.
Drug use and addiction has many physical consequences that vary
depending on which drug you use. Using drugs may make you more
likely to participate in other unsafe behaviors, such as sharing
needles or having unprotected sex, which can increase your chances
of contracting HIV or hepatitis. People who are addicted to drugs
are also at a higher risk of overdosing because addicts need more
and more of the drug to achieve the same feeling.