- Drug Misuse and Addiction | National Institute on Drug Abuse
- Why do people take drugs?
- If taking drugs makes people feel good or better, what's the problem?
- Do people choose to keep using drugs?
- Why do some people become addicted to drugs, while others do not?
- What biological factors increase risk of addiction?
- What environmental factors increase the risk of addiction?
- What other factors increase the risk of addiction?
- Images of Brain Development in Healthy Children and Teens (Ages 5-20)
- The brain continues to develop into adulthood and undergoes dramatic changes during adolescence
- † The term addiction as used in this booklet is equivalent to a severe substance use disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, 2013)
- Is Substance Use a Part of “Normal” Teen Behavior?
- Fitting in
- What parents can do:
- Life transitions
- What Parents Can Do:
- Emotional & psychological pain
Drug Misuse and Addiction | National Institute on Drug Abuse
Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.† It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs.11
Addiction is a lot other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects, and both are, in many cases, preventable and treatable. If left untreated, they can last a lifetime and may lead to death.
Modified with permission from Volkow et al. 1993.
Note: These PET scans compare the brain of an individual with a history of cocaine use disorder (middle and right) to the brain of an individual without a history of cocaine use (left).
The person who has had a cocaine use disorder has lower levels of the D2 dopamine receptor (depicted in red) in the striatum one month (middle) and four months (right) after stopping cocaine use compared to the non-user.
The level of dopamine receptors in the brain of the cocaine user are higher at the 4-month mark (right), but have not returned to the levels observed in the non-user (left).
Why do people take drugs?
In general, people take drugs for a few reasons:
- To feel good. Drugs can produce intense feelings of pleasure. This initial euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the high is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opioids such as heroin is followed by feelings of relaxation and satisfaction.
- To feel better. Some people who suffer from social anxiety, stress, and depression start using drugs to try to feel less anxious. Stress can play a major role in starting and continuing drug use as well as relapse (return to drug use) in patients recovering from addiction.
- To do better. Some people feel pressure to improve their focus in school or at work or their abilities in sports. This can play a role in trying or continuing to use drugs, such as prescription stimulants or cocaine.
- Curiosity and social pressure. In this respect, teens are particularly at risk because peer pressure can be very strong. Adolescence is a developmental period during which the presence of risk factors, such as peers who use drugs, may lead to substance use.
If taking drugs makes people feel good or better, what's the problem?
When they first use a drug, people may perceive what seem to be positive effects. They also may believe they can control their use. But drugs can quickly take over a person's life.
Over time, if drug use continues, other pleasurable activities become less pleasurable, and the person has to take the drug just to feel “normal.” They have a hard time controlling their need to take drugs even though it causes many problems for themselves and their loved ones.
Some people may start to feel the need to take more of a drug or take it more often, even in the early stages of their drug use. These are the signs of an addiction.
Even relatively moderate drug use poses dangers. Consider how a social drinker can become intoxicated, get behind the wheel of a car, and quickly turn a pleasurable activity into a tragedy that affects many lives. Occasional drug use, such as misusing an opioid to get high, can have similarly disastrous effects, including impaired driving and overdose.
Do people choose to keep using drugs?
The initial decision to take drugs is typically voluntary. But with continued use, a person's ability to exert self-control can become seriously impaired. This impairment in self-control is the hallmark of addiction.
Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control.12 These changes help explain the compulsive nature of addiction.
No single factor determines whether a person will become addicted to drugs.
Why do some people become addicted to drugs, while others do not?
As with other diseases and disorders, the lihood of developing an addiction differs from person to person, and no single factor determines whether a person will become addicted to drugs.
In general, the more risk factors a person has, the greater the chance that taking drugs will lead to drug use and addiction. Protective factors, on the other hand, reduce a person's risk.
Risk and protective factors may be either environmental or biological.
|Aggressive behavior in childhood13,14||Self-efficacy (belief in self-control)15|
|Lack of parental supervision14,16||Parental monitoring and support16-18|
|Low peer refusal skills13,17,18||Positive relationships17,19|
|Drug experimentation14,20,21||Good grades17,22|
|Availability of drugs at school21,23||School anti-drug policies17|
|Community poverty24,25||Neighborhood resources26|
What biological factors increase risk of addiction?
Biological factors that can affect a person's risk of addiction include their genes, stage of development, and even gender or ethnicity.
Scientists estimate that genes, including the effects environmental factors have on a person's gene expression, called epigenetics, account for between 40 and 60 percent of a person's risk of addiction.
27 Also, teens and people with mental disorders are at greater risk of drug use and addiction than others.28
Children's earliest interactions within the family are crucial to their healthy development and risk for drug use.
What environmental factors increase the risk of addiction?
Environmental factors are those related to the family, school, and neighborhood. Factors that can increase a person's risk include the following:
- Home and Family. The home environment, especially during childhood, is a very important factor. Parents or older family members who use drugs or misuse alcohol, or who break the law, can increase children's risk of future drug problems.29
- Peer and School. Friends and other peers can have an increasingly strong influence during the teen years. Teens who use drugs can sway even those without risk factors to try drugs for the first time. Struggling in school or having poor social skills can put a child at further risk for using or becoming addicted to drugs.30
What other factors increase the risk of addiction?
- Early use. Although taking drugs at any age can lead to addiction, research shows that the earlier people begin to use drugs, the more ly they are to develop serious problems.31 This may be due to the harmful effect that drugs can have on the developing brain.32 It also may result from a mix of early social and biological risk factors, including lack of a stable home or family, exposure to physical or sexual abuse, genes, or mental illness. Still, the fact remains that early use is a strong indicator of problems ahead, including addiction.
- How the drug is taken. Smoking a drug or injecting it into a vein increases its addictive potential.33,34 Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes. Scientists believe this powerful contrast drives some people to repeatedly use drugs to recapture the fleeting pleasurable state.
Images of Brain Development in Healthy Children and Teens (Ages 5-20)
As the brain matures, experiences prune excess neural connections while strengthening those that are used more often.
Many scientists think that this process contributes to the steady reduction in gray matter volume seen during adolescence (depicted as the yellow to blue transition in the figure).
As environmental forces help determine which connections will wither and which will thrive, the brain circuits that emerge become more efficient. However, this is a process that can cut both ways because not all patterns of behavior are desirable or healthy.
The environment is an artist who creates a sculpture by chipping away excess marble; and just bad artists can produce bad art, environments with negative factors ( drugs, malnutrition, bullying, or sleep deprivation) can lead to efficient but potentially harmful circuits that conspire against a person’s well-being.
The brain continues to develop into adulthood and undergoes dramatic changes during adolescence
One of the brain areas still maturing during adolescence is the prefrontal cortex—the part of the brain that allows people to assess situations, make sound decisions, and keep emotions and desires under control.
The fact that this critical part of a teen’s brain is still a work in progress puts them at increased risk for trying drugs or continuing to take them.
Introducing drugs during this period of development may cause brain changes that have profound and long-lasting consequences.
† The term addiction as used in this booklet is equivalent to a severe substance use disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, 2013)
NIDA. 2020, July 13. Drug Misuse and Addiction. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction
NIDA. «Drug Misuse and Addiction.» National Institute on Drug Abuse, 13 Jul. 2020, https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction
NIDA. Drug Misuse and Addiction. National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction. July 13, 2020
Is Substance Use a Part of “Normal” Teen Behavior?
It’s easy to recognize the obvious risks of drug, alcohol or nicotine use – that is, that it can result in negative consequences car accidents, personal injury and in some cases may even lead to addiction. But less obvious is the impact substance use has on the still-developing teen brain.
In the same way we’ve come to recognize the negative consequences that a mother’s drinking or smoking can have on a developing fetus, we now know there are distinct risks to brain development with teen substance use.
Consider the construction of a house as a metaphor. First the foundation is poured, followed by framing, wiring and plumbing over the course of time.
The brain develops in a similar way, with the foundation being laid before birth and into the early years of childhood.
Adolescence is another time of rapid brain development where the brain’s framing and wiring become more efficient and the brain develops skills to focus, prioritize and problem-solve.
Vaping, drinking or using substances can damage the brain’s wiring, increasing the lihood of learning difficulties and physical and mental health problems during the teen years and well into adulthood. Just as a house is still functional with a cracked foundation and faulty wiring, so is the human brain, but neither is optimal.
From mood swings to rebellion, many types of challenging behavior are normal during the teen years, but experimenting with substance use isn’t one of them. We also need to rethink our perception of norms. It’s not true that “everyone vapes” or “everyone drinks.”
That said, a variety of common teen experiences can become an excuse or reason for substance use. Understanding why some teens drink or use substances is a valuable step toward keeping them healthy and safe.
Feelings of being an outsider and longing to be included and d by others are pretty pronounced during the teen years.
If the kids your teen wants to be friends with, or is hanging out with, are drinking or using substances, they may feel that they need to participate as well or risk being left out.
Some teens see substance use as an easy path to making friends, fitting in or being accepted with the “right” crowd.
What parents can do:
- Get to know your kid’s friends and their parents, and talk with those parents about their approach to supervision and their stance on substance use.
- Encourage your teen to use your home for socializing. Give them a private space if possible but keep an eye on them.
- Assure your child that they can call you to be picked up whenever needed, no questions asked.
- Talk about their need for acceptance and to fit in. Explain that real friends will give them space to be themselves and won’t make them do anything they’re uncomfortable with.
Some teens use drugs and alcohol to overcome insecurities, let their guard down and feel socially confident. Substance use may make them feel they are really open and connecting with others. In addition to more obvious risks, this can lead teens to feel substance use is necessary to achieve a certain level of interaction.
Periods of transition in teens’ lives — moving, divorce, puberty, changing schools, an illness or death in the family — can become a time of upheaval, leading some to attempt to find solace in alcohol or drugs.
What Parents Can Do:
- Ramp up the monitoring and communication during and after transitions.
- Encourage an open dialogue with your teen about their experiences.
- Set aside regular one-on-one time with your teen to bond and have fun together.
Emotional & psychological pain
Whether it’s the pressure of everyday teen drama or the emotional toll of family problems, stress or trauma, some teens use substances to dull the very real pain in their lives.
Loneliness, low self-esteem, depression, anxiety disorder and other mental health issues are commonly associated with teen substance use.
Furthermore, many of these issues occur in combination with one another, each compounding the intensity of the others.