About Addiction…

Most people use alcohol and other potentially addictive drugs without becoming addicted. Genetic, psychiatric and social factors influence an individual’s risk of developing a substance use disorder. Anxiety and depression are risk factors, because substances can provide immediate and profound temporary relief of these symptoms. Social factors include lack of meaningful activities and relationships, and friends or neighbours who use substances.

Exposure to drugs or alcohol is the only necessary factor to create an addiction – without exposure, there can be no substance use disorder.

When people engage in behaviours that are essential for survival, such as eating or sex, there is a release of dopamine in the “reward pathway” located in the mid-brain. The dopamine release produces pleasure, or euphoria. The reward pathway is closely connected to the memory center of the brain, which vividly remembers the activities which produced this euphoria, The memory center is connected to the executive function in the prefrontal lobes, which directs the person to repeat these activities.

All addictive drugs act on the reward pathway, often producing a more intense and sustained euphoria than is produced by non-drug behaviours. Addictive drugs, in essence, “hijack” the reward pathway so that the person with a substance use disorder feels a compulsive need to seek out the drug, sometimes to the detriment of their well being.

With heavy, daily use of a substance, the brain adapts to resist the drug’s effects, a phenomenon known as tolerance. Increasing tolerance to substances results in people needing higher and higher doses to achieve the same effect. If highly tolerant people abruptly stop their substance use, the altered receptors can take days or weeks to reset back to normal; during this period people will experience symptoms very uncomfortable symptoms of withdrawal.

Both tolerance and withdrawal can maintain and exacerbate substance use disorders. People with substance use disorders often escalate their dose to overcome tolerance and experience euphoria. People will continue to seek out substances in order to relieve or avoid distressing withdrawal symptoms.

Most people use alcohol and other potentially addictive drugs without becoming addicted. Genetic, psychiatric and social factors influence an individual’s risk of developing a substance use disorder. Anxiety and depression are risk factors, as substances can provide immediate and profound temporary relief of these symptoms. Social factors include the lack of meaningful activities and relationships, and friends or neighbours who use substances.

Public Health should educate the public, and especially students, about the risks of occasional drug use (especially as counterfeit pills may contain fentanyl) and the risks of alcohol poisoning from heavy binge drinking.