• Aakash Chowdhary

The Science Behind Substance Abuse

Many might recall the plethora of memes about a homeless Indian boy, talking to a news anchor about substance abuse. While the Internet mocked and trivialized the horrid tragedy of youngsters becoming prisoners of substance abuse, for those in the medical profession, it was a wake up call. Substance abuse is increasingly becoming a matter of concern among adolescents and young adults. A rise in cases of drug abuse and alcohol, can be attributed primarily to stress, boredom, and social recognition and associated peer pressure.

Addiction of a substance starts with experimentation — the urge to "try". It usually begins out of curiosity, imitation of peers, or in some cases, due to severe underlying stress. Initially, the use of the substance seems to solve the problem — makes life better. But with time, the use of the substance becomes a habit without which one feels restless, uneasy, and finds it extremely hard to concentrate on anything other than using the substance. What begins as a voluntary choice, turns into a physical and psychological need- a pathological obsession. Anyone who uses a drug for the first time, experiences an unnaturally intense feeling of pleasure. Reward circuitry of our brain is activated, with dopamine stimulating the pleasure centers of the brain incentivizing the behavior more. The brain starts changing as a result of this unnatural flood of neurotransmitters.

Since these neurotransmitters sense more than enough dopamine, neurons may begin to reduce number of dopamine receptors, or simply, make less dopamine. As a result, dopamine's ability to activate circuits to cause pleasure is severely weakened. Person feels flat, lifeless, and depressed without the drug—the withdrawal symptoms. Now, the person needs more of the drug to bring the dopamine levels up to normal. These brain changes drive a person to seek out and use drugs compulsively, despite negative consequences. Signs of drug abuse include-

-Bloodshot eyes, or pupils that are smaller/larger than usual. -Changes in appetite, or sleep patterns. -‎Sudden weight loss/gain. -Tremors, slurred speech, and impaired motor skills coordination. -Compulsive need for the drug leading to a collapse of ability to distinguish between right and wrong, leading to larceny, anger etc.

Substance abuse, or addiction, is a developmental disease. The pre-frontal cortex of brain (which lies just behind the forehead) governs judgement and decision-making functions of the brain, and is the last part of the brain to develop. This explains why young adults and teens are more prone to risk-taking, and particularly vulnerable to substance abuse. Mental illness, physical or sexual abuse, aggressiveness, academic problems, or parent-child relations might predispose one to substance abuse.

Prevention and early intervention works best. Motivation, counseling, and therapies could provide the required help. It is important to identify the substance which is the underlying cause for the addiction (people, place, things, events, activities, emotions, times, dates), and avoid exposure to them. Learning about substances and their risks is very useful. One should be made aware of the consequences that could result from drug abuse (bullying, flghting, unprotected/unintended physical relationship, criminal activities, etc.). Youngsters, in particular, should be advised that coping with stress requires a happy lifestyle, not substance overdoses. Exercise, meditation, socialization, positive influences often help raise self-esteem while maintaining a balance between mental and physical activities also prove helpful.

​One shouldn't risk experimenting with substance abuse. It is important to be aware of family history in cases of substance abuse- predisposition towards addiction is often hereditary. One should also try to reduce influences that enable substance abuse in life. Avoid relying on someone to stop "doing drugs" with you, as (s)he may not have willingness to change. Learn to walk away from those that insist on using drugs. Friendships are healthier when you stop "using drugs" to smooth out rough spots.

Withdrawal requires patience, will power, and motivation. Get in touch with family or friends who can prove to be reliable counsel. Take medical advice if needed. No matter what your background or current situation is, it is possible to avoid slipping into danger of substance abuse. The secret to a happy life lies in organic happiness from everyday events, not in artificially enhanced dopamine levels.

Views expressed should not be construed as medical advice.

About The Author

Aakash Chowdhary is a fifth year student of MBBS in Jammu & Kashmir. Aakash has a keen interest in ocular genomics and tele-medicine. He is member at the Global Alliance for Genomics and Health, a Foundation and Student Member of the Royal College of Physicians (Edinburgh), and a Medical Student Member of the American Academy of Neurology, American College of Physicians, and the AAEM Resident and Student Association. In addition, Aakash also runs a successful IT forum by the name of Crooked Computing Inc.

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