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In this age of paranoia about drug use, an age during which we are more afraid than ever that a loved one may fall under the thrall of a harmful drug, you'd think that we'd all take responsibility for our own education about drug use. Surely every parent should understand the effects of popular mainstream drugs, know about the health risks, the law and the terrible effects it can have on a young life. After all, how can we be expected to teach our children about the dangers of drugs if we don't know about them?
In truth, very few people uninvolved with the drug scene understand more than what they've gleaned from the movies, TV and the news. In fact, very few people understand the mechanisms of addiction itself. We don't know why it happens, why certain people seem more susceptible to it and what are the best ways to combat addiction.
If we don't understand these things, how can we possibly teach our children?
The definition for drug addiction is by no means clear cut. The DSM-IV (the Diagnostic and Statistics Manual of Mental Disorders) is the Bible of the medical profession, detailing every disease and disorder recognized by the medical profession. However, in the DSM definition for drug addiction the word 'addiction' itself does not appear.
Instead, the DSM refers to addiction as a dependence on a substance the use of which persists despite problems related to the use of that substance. It goes on to describe the mechanism by which a tolerance to the substance may develop over time, and explains that when use is stopped the user may suffer symptoms of withdrawal.
This technical definition does not help explain the mechanisms of addiction. It doesn't differentiate between physical and psychological dependence, and nor does it include the notion that an addiction can be present, no matter how rarely, in which problems do not occur.
All drugs work on the body and mind in different ways, and there is no one narcotic that can be used as an exemplar for the mechanism of physical addiction. However, most drugs follow the same pathway to physical dependence that can be boiled down to the way they act on the brain.
The majority of drugs have some sort of effect on neurotransmitters in the brain. Everything from alcohol to paint thinner to heroin upsets the delicate chemical balance of the mind, producing the high that drug users seek. Even those narcotics that do not produce a true high (including prescribed pain killers that were initially used for therapeutic purposes) alter brain chemistry.
The use of the word 'addiction' is actually unhelpful when trying to understand the mechanisms at work. A better word would be 'dependence'. With prolonged use almost all drugs permanently alter brain chemistry to the extent that the chemistry in action while an user is 'high' is actually the new norm. With time, any positive effects of the drug will now be countered by the skewed brain chemistry, so when the drug is taken away the user will experience a crash that can only be halted and reversed by another dose.
This is how dependence starts. Once the brain has adjusted to the effects of a drug it will require an ever greater dose to achieve the desired effect. Users will be forced to seek out and take larger doses of the drug simply to avoid the terrible symptoms of withdrawal.
Psychological addiction is an entirely separate mechanism. Drug users become accustomed through use to the schedule and the experience of getting high. Just as tobacco smokers may automatically reach for a cigarette at certain times at which they have become accustomed to smoking, drug users will become fixed into a schedule of drug use that can prove a more powerful motivator to continue than even the physical need.
The physical dependence on most drugs can be destroyed by simply evacuating the drug from the bloodstream and suffering through the symptoms of withdrawal until the chemistry of the brain finds a new balance. However, psychological addiction may never truly be flushed from the system. Chronic addicts may experience the desire to use drugs for the rest of their lives, despite the fact that their body no longer craves them.
The definition for drug addiction is notoriously difficult to pin down, and addiction is poorly understood by anyone but addicts themselves. However, if we are to protect our loved ones from the ravages of drugs it's vital that we try to learn about them; that we learn how they can so easily take us under their influence and lead us down the path to destruction. Education is the only true cure for addiction.
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