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.
Most 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.
When some drugs of abuse are taken, they can release up 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.
Drug abusers eventually feel lifeless and depressed, and take drugs just to try and bring their dopamine function back up to normal.
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 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 drug abusers eventually feel flat, lifeless and depressed, and are unable to enjoy things that previously brought them pleasure. Now, they need to take drugs just to try and 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.
We know that the same sort of mechanisms involved in the development of tolerance can eventually lead to profound changes in neurons and brain circuits, with the potential to severely compromise the long-term health of the brain and impair brain functioning. Chronic exposure to drugs of abuse disrupts the way critical brain structures interact to control and inhibit behaviors related to drug abuse. Drug addiction erodes a person’s self-control and ability to make sound decisions, while sending intense impulses to take drugs.
Individuals who suffer from addiction often have one or more accompanying medical issues, including lung and cardiovascular disease, stroke, cancer and/or mental disorders. Imaging scans, chest X-rays, and blood tests show the damaging effects of drug abuse throughout the body. In some cases, mental diseases may precede addiction; in other cases, drug abuse may trigger them.