Understanding Drug Abuse and Addiction

Many people do not understand why or drug abuse and addiction, such as family
how other people become addicted to disintegration, loss of employment, failure in
drugs. It can be wrongfully assumed that school, domestic violence, and child abuse.
drug abusers lack moral principles or
willpower and that they could stop using What Is Drug Addiction?
drugs simply by choosing to change their Addiction is a chronic, often relapsing brain
behavior. In reality, drug addiction is a disease that causes compulsive drug seeking
complex disease, and quitting takes more and use, despite harmful consequences to
than good intentions. In fact, because the addicted individual and to those around
drugs change the brain in ways that foster him or her. Although the initial decision to
compulsive drug abuse, quitting is difficult, take drugs is voluntary for most people, the
even for those who are ready to do so. brain changes that occur over time challenge
Through scientific advances, we know more a person’s self control and ability to resist
about how drugs work in the brain than intense impulses urging them to take drugs.
ever, and we also know that drug addiction
can be successfully treated to help people
Fortunately, treatments are available to
stop abusing drugs and lead productive
help people counter addiction’s powerful
lives.
disruptive effects. Research shows that
combining addiction treatment medications
Drug abuse and addiction have negative
with behavioral therapy is the best way to
consequences for individuals and for
ensure success for most patients. Treatment
society. Estimates of the total overall costs
approaches that are tailored to each patient’s
of substance abuse in the United States,
drug abuse patterns and any co-occurring
including productivity and health- and
medical, psychiatric, and social problems can
crime-related costs, exceed $600 billion
lead to sustained recovery and a life without
annually. This includes approximately $181
drug abuse.
billion for illicit drugs,1 $193 billion for
tobacco,2 and $235 billion for alcohol.3 As
Similar to other chronic, relapsing diseases,
staggering as these numbers are, they do
such as diabetes, asthma, or heart disease,
not fully describe the breadth of destructive
drug addiction can be managed successfully.
public health and safety implications of
And as with other chronic diseases, it is not

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 uncommon for a person to relapse and begin present in brain regions that control
abusing drugs again. Relapse, however, does movement, emotion, motivation, and
not signal treatment failure—rather, it indicates feelings of pleasure. The overstimulation of
that treatment should be reinstated, adjusted, this reward system, which normally responds
or that an alternative treatment is needed to to natural behaviors linked to survival
help the individual regain control and recover. (eating, spending time with loved ones,
etc.), produces euphoric effects in response
What Happens to Your Brain to psychoactive drugs. This reaction sets in
motion a reinforcing pattern that “teaches”
When You Take Drugs? people to repeat the rewarding behavior of
Drugs contain chemicals that tap into the abusing drugs.
brain’s communication system and disrupt
As a person continues to abuse drugs, the
the way nerve cells normally send, receive,
brain adapts to the overwhelming surges
and process information. There are at least
in dopamine by producing less dopamine
two ways that drugs cause this disruption:
or by reducing the number of dopamine
(1) by imitating the brain’s natural chemical
receptors in the reward circuit. The result
messengers and (2) by overstimulating the
is a lessening of dopamine’s impact on
“reward circuit” of the brain.
the reward circuit, which reduces the
abuser’s ability to enjoy the drugs, as well
Some drugs (e.g., marijuana and heroin) have as the events in life that previously brought
a similar structure to chemical messengers pleasure. This decrease compels the
called neurotransmitters, which are naturally addicted person to keep abusing drugs in
produced by the brain. This similarity allows an attempt to bring the dopamine function
the drugs to “fool” the brain’s receptors back to normal, except now larger amounts
and activate nerve cells to send abnormal of the drug are required to achieve the
messages. same dopamine high—an effect known as
tolerance.
Other drugs, such as cocaine or
methamphetamine, can cause the nerve Long-term abuse causes changes in other
cells to release abnormally large amounts of brain chemical systems and circuits as
natural neurotransmitters (mainly dopamine) well. Glutamate is a neurotransmitter that
or to prevent the normal recycling of these influences the reward circuit and the ability
brain chemicals, which is needed to shut off to learn. When the optimal concentration
the signaling between neurons. The result is a of glutamate is altered by drug abuse, the
brain awash in dopamine, a neurotransmitter brain attempts to compensate, which can

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 impair cognitive function. Brain imaging as peer pressure, physical and sexual
studies of drug-addicted individuals show abuse, stress, and quality of parenting
changes in areas of the brain that are critical can greatly influence the occurrence
to judgment, decisionmaking, learning and of drug abuse and the escalation to
memory, and behavior control. Together, addiction in a person’s life.
these changes can drive an abuser to seek
out and take drugs compulsively despite • Development. Genetic and
adverse, even devastating consequences— environmental factors interact with critical
that is the nature of addiction. developmental stages in a person’s life
to affect addiction vulnerability. Although
taking drugs at any age can lead to
Why Do Some People addiction, the earlier that drug use
Become Addicted While begins, the more likely it will progress
Others Do Not? to more serious abuse, which poses
a special challenge to adolescents.
No single factor can predict whether a
Because their brains are still developing
person will become addicted to drugs. Risk
in the areas that govern decisionmaking,
for addiction is influenced by a combination
judgment, and self-control, adolescents
of factors that include individual biology,
may be especially prone to risk-taking
social environment, and age or stage of
behaviors, including trying drugs of
development. The more risk factors an
abuse.
individual has, the greater the chance that
taking drugs can lead to addiction. For
example: Prevention Is the Key
• Biology. The genes that people are born Drug addiction is a preventable disease.
with––in combination with environmental Results from NIDA-funded research have
influences––account for about half of shown that prevention programs involving
their addiction vulnerability. Additionally, families, schools, communities, and the
gender, ethnicity, and the presence of media are effective in reducing drug abuse.
other mental disorders may influence risk Although many events and cultural factors
for drug abuse and addiction. affect drug abuse trends, when youths
perceive drug abuse as harmful, they
• Environment. A person’s environment reduce their drug taking. Thus, education
includes many different influences, from and outreach are key in helping youth and
family and friends to socioeconomic status the general public understand the risks of
and quality of life in general. Factors such drug abuse. Teachers, parents, medical and

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 public health professionals must keep sending For more information on prevention, please
the message that drug addiction can be visit www.nida.nih.gov/drugpages/
prevented if one never abuses drugs. prevention.html.

For more information on treatment, please

Other Information Sources visit www.nida.nih.gov/drugpages/
For information on understanding drug treatment.html. To find a publicly funded
abuse and addiction, please see our booklet, treatment center in your State, please call
Drugs, Brains, and Behavior—The Science 1-800-662-HELP or visit
of Addiction, at www.nida.nih.gov/ www.findtreatment.samhsa.gov.
scienceofaddiction.

References
1
Office of National Drug Control Policy. The Economic Costs of Drug Abuse in the United States, 1992–2002.
Washington, DC: Executive Office of the President (Publication No. 207303), 2004.

2
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion,
Office on Smoking and Health, U.S. Department of Health and Human Services. Best Practices for Comprehensive
Tobacco Control Programs—2007. Available at: http://www.cdc.gov/tobacco/stateandcommunity/best_practices/
pdfs/2007/bestpractices_complete.pdf.

3
Rehm, J., Mathers, C., Popova, S., Thavorncharoensap, M., Teerawattananon Y., Patra, J. Global burden of disease
and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet, 373(9682):2223–2233,
2009.

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