The Reward System’s Slippery Slope
A substance use disorder is a psychological disorder in which a person continues to use a substance despite the negative consequences. Substances are groups of drugs that have similar effects on your brain, body and behavior. The worldwide prevalence is around 16% and men are more likely to be diagnosed.
Examples of substances:
- Alcohol (beer, wine, liquor)
- Tobacco (cigarettes, snuff, cigars, e-cigarettes )
- Caffeine (coffee, tea)
- Stimulants (cocaine, amphetamine, methamphetamine)
- Cannabis (marijuana, hash oil)
- Sedatives (benzodiazepines, barbiturates)
- Hallucinogens (LSD, PCP, psilocybin, peyote)
- Opioids (heroin, methadone)
- Inhalants (markers, glues)
Substances are addictive because they activate the brain’s reward system. Your reward system makes you feel pleasure by releasing a neurotransmitter called dopamine from the ventral tegmental area when you perform activities necessary for survival, such as eating, drinking and having sex.
When you begin to use a substance, your reward system releases much greater quantities of dopamine, hijacking your reward system and motivating you to use the substance again. Once a person’s reward system is hijacked and he or she turns into an addict, other important needs such as sleep, saving money and being responsible no longer matter as much.
Examples of negative consequences:
- Tobacco (cancer, heart disease, lung disease, smoke breaks interfering with work)
- Alcohol (liver disease, drunk-driving, embarrassments and hangovers)
- Cannabis (lack of motivation, psychosis, social isolation)
Impaired control over substance use means that a person is taking a substance in larger amounts, has unsuccessful efforts to cut down, spends a large amount of time obtaining and using the substance and experiences cravings.
Social impairment means that a person may start to fail at work or school, have recurrent use despite social consequences and give up on recreational or occupational activities because of substance use.
Risky use means that a person uses a substance in dangerous situations and continues to use despite physical or psychological health problems.
Tolerance to a substance means that a person experiences diminished effects with use of the same amount and needs an increased amount to achieve the same effects.
Withdrawal to a substance means that a person experiences physical or psychological side effects when the substance is no longer in the body.
The causes of substance use disorder:
- Genes (account for 60% of a person’s vulnerability)
- Environmental (growing up in a drug-infested neighborhood, poor parenting, peer pressure)
- Developmental (children or adolescents who use drugs have a greater risk because their brain is still developing until approximately age 25)
There is no cure for substance use disorder. The treatment is tailored to the individual depending on which substance he or she uses and what support is available. Examples include medication assisted treatments such as 12-step meetings, naltrexone for alcoholics, Suboxone for heroin addicts, nicotine replacement for cigarette smokers, inpatient rehabilitation and individual therapy with counselors and psychiatrists.
The goals for a drug addict are to establish a functioning role in society, maintain a drug-free lifestyle and most importantly, to stop using drugs! Because the disorder is chronic, most people require long-term or recurrent treatment to maintain sobriety.
Are you Ready? (This is Defeating Stigma Mindfully)