Why do people become addicted to medications?

Most people who drink alcohol and use other over the counter or prescription drugs, such as pain killers, do so infrequently and/or at levels that do not pose a danger to themselves or others.  Although in the case of prescription medicine or over the counter medicine, there are always instructions for the novice user such as how best to use, when not to use the drug and signs to look out for that might indicate an acute problem.  Dependence rarely occurs in these instances and/or for these people.  However, there is a percentage of the population for whom reducing usage can be difficult and staying away from them completely, a real problem. Why is this so?

The answer lies in the brain, that most complex of organs.  Drugs of any kind, affect how messages are sent and received in the brain.

Drugs, regardless of how they are taken e.g. tablet form or injection, make their way into the brain via the blood.  Once in the brain, drugs affect how messages are sent and received. 

As the body’s communication centre, with messages being passed back and forth regulating what we feel, think and do, the brain needs a way of achieving this communication via a communicator.  This is achieved by chemicals called ‘neurotransmitters’  or chemical messenger systems.  There are many neurotransmitters but for the purpose of clarity and brevity we will limit the discussion to the major three of which most people may have heard – dopamine, noradrenaline and serotonin.  Drugs can increase or decrease the production of these neurotransmitters such as dopamine, which increases or decreases pleasure, noradrenaline, the fight or flight system, and serotonin which enhances, evens out or diminishes our mood.  Drugs can regulate how much of a certain neurotransmitter stays active and for how long, or they bind to receptors in the brain to mimic the action of a particular neurotransmitter.

Most drugs affect the system of dopamine in one way or another.  Dopamine is known to regulate emotion, feelings of pleasure and also motivation, in other words dopamine is the brain’s reward system.  We are wired to ensure that we repeat actions and activities which bring us pleasure and these are the feelings to which we become addicted.  Our brain is signalled to do something again when there is a burst of dopamine after doing something pleasant.  Activities such as eating are felt as rewarding, therefore dopamine is released and activated in the brain when we eat.  Drugs do exactly the same thing, but on a much larger and more intense scale.  Therefore, some people are driven to take more of the drug in order to feel the burst of dopamine, the sense of pleasure.  The brain becomes primed to repeat the drug taking over and over again without thinking about cause and effect.

Think about a food you love and that you would actually make the effort of getting into the car to drive and get some of this food.  The person craving the reward feeling for certain drugs, feels this ten times as strongly as you would for that food.  They are simply addicted to the drug.  Thought of this way, it is possible then to imagine the difficulty with which drug addicted persons have to overcome their addiction and how they find themselves in a terrible predicament when it comes to stopping the drug.

The brain has trouble keeping up production of dopamine over time, especially when large amounts have been released.  It is possible for the brain to run out of dopamine, for stores to become depleted.  This is why, after a day or two of not having a particular drug, the person may seem flat and out of sorts, may feel sick, have body aches and feel general malaise as well as changes to their mood.  The body is trying to function without dopamine.  The mood and physical ailments return to normal when dopamine production and storage are naturally replenished or they are given more of the drug to which they are addicted.  Warning! Withdrawal from some of these drugs is complex and can be dangerous in some circumstances and should not be undertaken without a doctor’s supervision for example, benzodiazepines (Valium).

This is only the briefest of explanations and the very tip of the iceberg of physiological and psychological addiction processes.  More articles will be forthcoming here over time, but this gives you some food for thought even if it allows you to judge less harshly those who are addicted and perhaps may want to offer them a helping hand in the face of their addiction.  It is not an easy road by any means – not for the person who is addicted, not for their family and not for their friends.  It is even difficult for the medical profession to treat although coming to increased understandings through research goes some way toward offering more suitable forms of therapy.

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