It is an
all-too-common scenario: A person experiments with an addictive drug like
cocaine. Perhaps he intends to try it just once, for "the experience" of it.
It turns out, though, that he enjoys the drug's euphoric effect so much that
in ensuing weeks and months he uses it again -- and again.
But in due time, he decides he really
should quit. He knows that despite the incomparable short-term high he gets
from using cocaine, the long-term consequences of its use are perilous. So
he vows to stop using it. His brain, however, has a different agenda. It now
demands cocaine. While his rational mind knows full well that he shouldn't
use it again, his brain overrides such warnings. Unbeknown to him, repeated
use of cocaine has brought about dramatic changes in both the structure and
function of his brain.
In fact, if he'd known the danger
signs for which to be on the lookout, he would have realized that the
euphoric effect derived from cocaine use is itself a sure sign that the drug
is inducing a change in the brain -- just as he would have known that as
time passes, and the drug is used with increasing regularity, this change
becomes more pronounced, and indelible, until finally his brain has become
addicted to the drug. And so, despite his heartfelt vow never again to use
cocaine, he continues using it. Again and again.
His drug use is now beyond his
control. It is compulsive. He is addicted. While this turn of events is a
shock to the drug user, it is no surprise at all to researchers who study
the effects of addictive drugs. To them, it is a predictable outcome. To be
sure, no one ever starts out using drugs intending to become a drug addict.
All drug users are just trying it. Every drug user starts out as an
occasional user, and that initial use is a voluntary and controllable
But as time passes and drug use
continues, a person goes from being a voluntary to a compulsive drug user.
This change occurs because over time, use of addictive drugs changes the
brain -- at times in big dramatic toxic ways, at others in more subtle ways.
The fact is, drug addiction is a brain disease. While every type of drug of
abuse has its own individual "trigger" for affecting or transforming the
brain, many of the results of the transformation are strikingly similar
regardless of the addictive drug that is used -- and of course in each
instance the result is compulsive use.
The brain changes range from
fundamental and long-lasting changes in the biochemical makeup of the brain,
to mood changes, to changes in memory processes and motor skills. These
changes have a tremendous impact on a person's behavior. In fact, in
addiction the drug becomes the single most powerful motivator in the life of
the drug user. He will do virtually anything for the drug.
While we haven't yet identified all
the triggers for the changes in the brain's structure and function that
culminate in addiction, It is virtually inevitable that prolonged drug use
will lead to addiction. From this we can soundly conclude that drug
addiction is indeed a brain disease. It should be stressed, however, that to
assert that drug addiction is a brain disease is not the same as saying that
those addicted to drugs are not accountable for their actions, or that they
are hapless victims of the harmful effects that use of addictive drugs has
on their brains, and in every facet of their lives.
Just as their behavior at the outset
was pivotal in putting them on a collision course with compulsive drug use,
their behavior after becoming addicted is just as critical if they are to be
effectively treated and to recover. But this can pose an enormous challenge.
The changes in their brain that turned them into compulsive users make it a
daunting enough task to control their actions and complete treatment.
Preventing addiction is easier than
curing it. The same chemical processes that make people want to experiment
with drugs are responsible for the biological changes that lead to