Advancing Understanding of Drug Addiction and Treatment

By Miller, Roxanne Greitz | Science Scope, February 2009 | Go to article overview

Advancing Understanding of Drug Addiction and Treatment


Miller, Roxanne Greitz, Science Scope


While most school districts utilize a drug abuse resistance curriculum, as science teachers, it is our responsibility to understand the science behind drug addiction in order to most effectively educate our students against drug abuse. In the last two decades, increases in scientific technology have permitted significant discoveries surrounding the neurobiology, genetic components, and treatment of drug addiction. This article addresses the latest scientific knowledge about drug addiction and treatment with information that can be used in the middle school setting, focusing on cocaine addiction to illustrate the points discussed.

What is drug addiction?

Most scientists now consider drug addiction a biomedical rather than a psychological condition, or a failure of will, as many laypersons still believe. The American Medical Association, American Psychiatric Association, and other organizations now describe drug addiction as a brain disease that causes an uncontrollable, compulsive drug craving, seeking, and use even in the face of negative health and social consequences. Addiction must be distinguished from the term dependence, which refers to whether physical or psychological withdrawal symptoms will occur if drug use is discontinued. Certain drugs, such as heroin and alcohol, create physical dependence, while other drugs, such as cocaine, produce very few symptoms of physical dependence and are therefore referred to as primarily creating psychological dependence.

Drug education programs of the past, particularly in the 1970s and 1980s, highlighted physical versus psychological addiction, an emphasis that is now seen as archaic in the drug treatment world. Addiction can occur whether the drug used creates physical or psychological dependence, and the compulsion to use the two classes of drugs can be equal. Addiction causes physical changes in the brain, regardless of whether the drug used causes physical withdrawal symptoms upon discontinuance, and it is these changes in brain function that result in the addict's compulsion to continue drug use.

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An analogy used to illustrate how addiction occurs is that "after a certain amount of a drug is consumed, it is as if a switch in the brain is flipped from normal to addict" (Leshner 2001). The amount of drugs that must be consumed to cause these brain changes is different for everyone, which helps to explain why some people become addicted after low to moderate drug use when others can use higher levels of drugs or use them for longer periods of time and not show symptoms of addiction (Leshner 2001). Specifically, in the case of cocaine and related stimulant drugs (such as crystal methamphetamine), some addicts report that craving began after as few as one to two incidents of use.

Recent scientific evidence suggests that between 50-70% of the variability in susceptibility to becoming addicted is due to genetic factors, while environmental and biological factors also play a role (Leshner 2001). Therefore, while it is accurate to state that addiction can run in families due to their shared genetic makeup, an absence of addicts in a family does not remove the possibility of genetic predisposition to addiction. This is why the phrase "be smart, don't start" represents the most effective way to prevent addiction. Abstaining entirely from drug use will prevent addiction from occurring, regardless of whether or not a genetic predisposition to addiction is present.

For those who do not heed this advice and become addicted, even if their brain function is returned to normal after treatment, it is possible that the psychological effects of addiction, including the compulsion to use drugs, can continue for years after drug use has stopped. Stressing these points--that one cannot predict when addiction will develop, that one can carry a genetic predisposition to addiction without knowing it, that addiction can develop even after only low levels of drug use, and that the effects of addiction can last long after treatment--when educating students strengthens the argument that prevention and abstinence from all drug use are the most effective treatment. …

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