Youth Community Center: March 2007

DRUGS a sensitive topic I guess, however I have some information and facts to show you, which will make you realize the consequence of how bad it can ever be…We live in a Society where Drugs has just been a part of our lives. Most of us use drugs every day, caffeine, nicotine and alcohol are just a few of the 'tend altering' drugs we like but they are just as much drugs as are heroin, cannabis and cocaine. All commonly used drugs are a mixture of some good and bad in them…they have both benefits and problems associated with them. Most of us manage to make the benefits of the drugs we use outweigh the problems.

Like…

Give us more energy when we need it, help us to feel good about ourselves, help us to socialize and give us "time out" when we want it.

The bad news about drug use involves everything from hangovers to permanent ill health, from public nuisance to violence and other serious crime.

Young people are using more drugs now than they have before both legal and illegal. Concern about the growth of recreational drug use is justified but while it is indeed worrying, we ought to remember that growing out of drug problems is normal. Anyone who takes drugs does it to get rid of some pain or unwanted feelings, including boredom to understand why someone takes drugs, you need to know what was wrong before he or she took them.

Drug addiction is a brain disease. Although initial drug use might be voluntary, drugs of abuse have been shown to alter gene expression and brain circuitry, which in turn affect human behavior. Once addiction develops, these brain changes interfere with an individual’s ability to make voluntary decisions, leading to compulsive drug craving, seeking and use. The impact of addiction can be far reaching. Cardiovascular disease, stroke, cancer, HIV/AIDS, hepatitis, and lung disease can all be affected by drug abuse. Some of these effects occur when drugs are used at high doses or after prolonged use; however, some may occur after just one use.

Throughout much of the last century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When science began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society's responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punitive rather than preventative and therapeutic actions. Today, thanks to science, our views and our responses to drug abuse have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of drug addiction, enabling us to respond effectively to the problem.

"I want every parent in the world to know and understand teenagers. If I can only stop one child taking drugs or help a parent to understand their child on drugs, I would be happy." - Gor (former drug addict) http://www.thaidrugaddict.com/

As a result of scientific research, we know that addiction is a disease that affects both brain and behavior. We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease. Scientists use this knowledge to develop effective prevention and treatment approaches that reduce the toll drug abuse takes on individuals, families, and communities.

Despite these advances, many people today do not understand why individuals become addicted to drugs or how drugs change the brain to foster compulsive drug abuse. This booklet aims to fill that knowledge gap by providing scientific information about the disease of drug addiction, including the many harmful consequences of drug abuse and the basic approaches that have been developed to prevent and treat the disease. At the National Institute on Drug Abuse (NIDA), we believe that increased understanding of the basics of addiction will empower people to make informed choices in their own lives, adopt science-based policies and programs that reduce drug abuse and addiction in their communities, and support scientific research that improves the Nation's well-being.

How do drugs work in the brain?

Drugs are chemicals. They work in the brain by tapping into the brain's communication system and interfering with the way nerve cells normally send, receive, and process information. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter. This similarity in structure "fools" receptors and allows the drugs to lock onto and activate the nerve cells. Although these drugs mimic brain chemicals, they don't activate nerve cells in the same way as a natural neurotransmitter, and they lead to abnormal messages being transmitted through the network.

Other drugs, such as amphetamine or cocaine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals, which is needed to shut off the signal between neurons. This disruption produces a greatly amplified message, ultimately disrupting communication channels. The difference in effect can be described as the difference between someone whispering into your ear and someone shouting into a microphone.

All drugs of abuse directly or indirectly target the brain's reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and feelings of pleasure. The overstimulation of this system, which rewards our natural behaviors, produces the euphoric effects sought by people who abuse drugs and teaches them to repeat the behavior.

What happens to the brain if you keep taking drugs?

Our brains are wired to ensure that we will repeat life-sustaining activities by associating those activities with pleasure or reward. Whenever this reward circuit is activated, the brain notes that something important is happening that needs to be remembered, and teaches us to do it again and again, without thinking about it. Because drugs of abuse stimulate the same circuit, we learn to abuse drugs in the same way. When some drugs of abuse are taken, they can release 2 to 10 times the amount of dopamine that natural rewards do. In some cases, this occurs almost immediately (as when drugs are smoked or injected), and the effects can last much longer than those produced by natural rewards. The resulting effects on the brain's pleasure circuit dwarfs those produced by naturally rewarding behaviors such as eating and sex. The effect of such a powerful reward strongly motivates people to take drugs again and again. This is why scientists sometimes say that drug abuse is something we learn to do very, very well.

Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine (and other neurotransmitters) by producing less dopamine or by reducing the number of receptors that can receive and transmit signals. As a result, dopamine's impact on the reward circuit of a drug abuser's brain can become abnormally low, and the ability to experience any pleasure is reduced. This is why the abuser eventually feels flat, lifeless, and depressed, and is unable to enjoy things that previously brought them pleasure. Now, they need to take drugs just to bring their dopamine function back up to normal. And, they must take larger amounts of the drug than they first did to create the dopamine high - an effect known as tolerance.

What are the medical consequences of drug addiction?

Individuals who suffer from addiction often have one or more accompanying medical issues, including lung and cardiovascular disease, stroke, cancer, and mental disorders. Imaging scans, chest x-rays, and blood tests show the damaging effects of drug abuse throughout the body. For example, tests show that tobacco smoke causes cancer of the mouth, throat, larynx, blood, lungs, stomach, pancreas, kidney, bladder, and cervix. In addition, some drugs of abuse, such as inhalants, are toxic to nerve cells and may damage or destroy them either in the brain or the peripheral nervous system. Drug abuse and mental disorders often co-exist. In some cases, mental diseases may precede addiction; in other cases, drug abuse may trigger or exacerbate mental disorders, particularly in individuals with specific vulnerabilities.

"It is easy to start taking drugs, but it is very difficult to quit. Believe me I know it well. Your life will never be the same again. Please don't try it even one time. Don't ruin all your future by experimenting with drugs like me." - Gor (four months after first taking drugs) http://www.thaidrugaddict.com/

Can addiction be treated successfully?

Yes. Addiction is a treatable disease. Discoveries in the science of addiction have led to advances in drug abuse treatment that help people stop abusing drugs and start leading productive lives. Addiction need not be a life sentence. Like other chronic diseases, addiction can be managed successfully. Treatment enables people to counteract addiction's powerful disruptive effects on brain and behavior and regain control of their lives.

The chronic nature of the disease means that relapsing to drug abuse is not only possible, but likely, with relapse rates similar to those for other well-characterized chronic medical illnesses such as diabetes, hypertension, and asthma, which also have both physiological and behavioral components. Treatment of chronic diseases involves changing deeply imbedded behaviors, and relapse does not mean treatment failure. For the addicted patient, lapses back to drug abuse indicate that treatment needs to be reinstated or adjusted, or that alternate treatment is needed.

Research shows that combining treatment medications, where available, with behavioral therapy is the best way to ensure success for most patients. Treatment approaches must be tailored to address each patient's drug abuse patterns and drug-related medical, psychiatric, and social problems. Different types of medications may be useful at different stages of treatment to help a patient stop abusing drugs, stay in treatment, and avoid relapse.

Treating withdrawal: When patients first stop abusing drugs, they can experience a variety of physical and emotional symptoms, including depression, anxiety, and other mood disorders; restlessness; and sleeplessness. Certain treatment medications are designed to reduce these symptoms, which makes it easier to stop the abuse.

Staying in Treatment: Some treatment medications are used to help the brain adapt gradually to the absence of the abused drug. These medications act slowly to stave off drug cravings, and have a calming effect on body systems. They can help patients focus on counseling and other psychotherapies related to their drug treatment.

Preventing Relapse: Science has taught us that stress, cues linked to the drug experience (e.g., people, places, things, moods), and exposure to drugs are the most common triggers for relapse. Medications are being developed to interfere with these triggers to help patients sustain recovery.

Behavioral treatments help engage people in drug abuse treatment, modifying their attitudes and behaviors related to drug abuse and increasing their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive abuse. Moreover, behavioral therapies can enhance the effectiveness of medications and help people remain in treatment longer.

Getting an addicted person to stop abusing drugs is just one part of a long and complex recovery process. When people enter treatment, addiction has literally taken over their lives. The compulsion to get drugs, take drugs, and experience the effects of drugs has dominated their every waking moment, and drug abuse has taken the place of all the things they used to enjoy doing. It has disrupted how they function in their family lives, at work, and in the community, and has made them more likely to suffer from other serious illnesses. Because addiction can affect so many aspects of a person's life, treatment must address the needs of the whole person to be successful. This is why the best programs incorporate a variety of rehabilitative services into their comprehensive treatment regimens. Treatment counselors select from a menu of services for meeting the individual medical, psychological, social, vocational, and legal needs of their patients to foster their recovery from addiction.

Cognitive Behavioral Therapy. Seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs.

Motivational Incentives. Uses positive reinforcement such as providing rewards or privileges for remaining drug free, for attending and participating in counseling sessions, or for taking treatment medications as prescribed.

Motivational Interviewing. Employs strategies to evoke rapid and internally motivated behavior change to stop drug use and facilitate treatment entry.

Group therapy helps patients face their drug abuse realistically, come to terms with its harmful consequences, and boost their motivation to stay drug free. Patients learn effective ways to solve their emotional and interpersonal problems without resorting to drugs.

How about a real life Experience from an Ex-Drug Addict…

I was 17-years-old when I first smoked heroin. The friend who introduced me to this died on Christmas Eve 1987 when he, and another nine people, accidentally shot up ajax.

It seemed so innocent to me at the time, many years before these things were to happen. It all seemed so friendly. I had never felt so good before - it was as if I didn't belong to this world any more, but had stepped into another. I felt so free, so alive, so in control, so happy and carefree, like a child again. I had met my partner for life, I thought. No-one or nothing would ever wrestle for my affection - for all my affection was lost in this.

My heart became detached from all human love; it was totally in love with heroin and how it treated me. It caressed my soul with gentle floods of warmth in an ecstatic union of love. I would run after it like honey, as one runs after the person one loves. It took all of my attention and I gave it the best years of my life.

In reality, my life was ruined as I became a relentless chaser of my own lost life. It had me completely in its fix by the age of 19 and then after that for another nine years. I felt as if I had lost my soul all of those years - as if I were dead. The only life I had in me was for that, and when I did not have that I had only deep, deep depression. A darkness would straightaway engulf me and leave me only what could alleviate my pain - heroin.

I began to see myself as a totally hopeless case. I would inject heroin twelve times a day from whatever time I awoke to about midnight every few hours. No-one's worries for me, no-one's good advice, no-one's sleepless nights could help or cure me.

During the last four years of my use of heroin, I used to pray to God every time I injected myself. With tears in my eyes I would ask God to forgive me and not let me die - for I knew I had lost my free will.

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