Drug Addiction and our Youth

There’s ample evidence that many youth use drugs to self-medicate for depression, anxiety, and fear, not to mention a host of mental-health disorders. The drugs they take may become the focal point for both kids and their parents, but they may be masking deeper problems. How can a parent know? Parents consult expert after expert, but even the experts don’t necessarily know either. Diagnosis isn’t an exact science, and it’s complicated, particularly for adolescents and young adults, for whom mood changes, including depression, are common. Many symptoms of these disorders appear to be identical to some of the symptoms of drug abuse. Also, by the time experts finally figure out that there’s a problem, drug addiction may have exacerbated the underlying mental health ailment and fused with it. It becomes impossible to know where one leaves off and the other begins. This is frequently referred to by professionals as “double trouble.”

“Considering the level of maturity of young adolescents, the availability of drugs, and the age at which drugs are first used, it is not surprising that a substantial number of them develop serious drug problems,” writes Robert Schwebel, PhD, in Saying No is Not Enough. “Once this happens, the effects are devastating. Drugs shield children from dealing with reality and mastering developmental tasks crucial to their future. The skills they lacked that left them vulnerable to drug abuse in the first place are the very ones that are stunted by drugs. They will have difficulty establishing a clear sense of identity, mastering intellectual skills, and learning self-control. The adolescent period is when individuals are supposed to make the transition from childhood to adulthood. Teenagers with drug problems will not be prepared for adult roles. They will chronologically mature while remaining emotional adolescents.”

My exposure to theories of development while studying psychology at the University of Scranton in the early 1980s, as well as in current psychology courses at Colorado Christian University, tells me that children’s brains are at their most malleable – that is, the greatest change takes place – before they are two years old and then again when they are teenagers. The worst time for a person to be tampering with their brain is when they are a teenager. Drugs radically alter the way teenagers’ brains develop. Experience and behavior help to set up a cycle that may deepen emotional problems. The biological infrastructure that develops as a result may become more acute and more intractable. It enforces and reinforces the psychological problems, which become more firmly established. Treating people whose drug use began when the were teenagers, as did mine, is further complicated because deconstructing or rerouting established pathways have biological as well as emotional and behavioral roots.

To understand the risks associated with psychoactive substances in adolescents, it helps to understand that teenagers are not just less-experienced adults; they are undergoing an important yet challenging developmental stage in which they are prone to errors of judgment, and sensitive to neurological assault by drugs and psychoactive substances. More than any other age group, adolescents are at risk for substance addiction, and, more than any other age group, they risk permanent intellectual and emotional damage due to the effects of drugs.

Obviously, the human brain is sculpted by experience, which is processed primarily by the pre-frontal cortex. This area of the brain executes such skills as setting priorities, formulating strategies, allocating attention, and controlling impulses. The outer mantle of the cortex is involved with processing abstract information and understanding rules, laws and codes of social interaction. Teenagers are notorious for their obsession with social interaction, as well as for making up social rules and breaking them. They are merely testing limits. As teenagers grow into young adults, they often exhibit a fascination with abstract thinking on topics like history, culture, and media, which demonstrates their growing ability to understand the larger world. While the teenage brain is in some ways ill-equipped to make decisions and choices without the help of trusted adults, it is perfectly designed for the types of intellectual and social challenges teenagers most need to master.

Still, development of fully mature complex thinking takes a long time. MRI studies show that the development of the pre-frontal cortex and outer mantle of the brain continues into the early 20s, and may not be completed until the mid 20s. There are many ways that psychoactive substances can alter or damage the development of the adolescent brain. Psychoactive substances often target and alter the function of neurotransmitters, which are chemical messengers that allow nerves to communicate with each other. Interference with neurotransmitters can directly damage fragile developing neural connections. More importantly, drug and alcohol use alters perception, and may interfere with developing perceptual skills. Habits and choices associated with the use of drugs and alcohol slowly become ingrained into the wiring of the brain. Repeated action becomes habit, and the habits of thought, perception, and reasoning developed in childhood and adolescence can stay with a person throughout his or her lifetime. My addiction began at the vulnerable young age of 18. I continued to abuse drugs and alcohol throughout nearly forty years of my life.

As many mental health professionals are quick to point out, if you do something for long enough it becomes automatic. Nowhere does this wisdom more hold true than in teens and young adults. Though teens may change clothes, ideas, friends and hobbies with maddening frequency, they are busily developing ideas about themselves, their world, and their place in it that will follow them for the rest of their lives. Adults may spend years trying to create or break even the simplest habit, yet most adults find that their most profound ideas about themselves and the world were developed in high school or college. This is because, by age 25 or so, the brain is fully developed, and building new neural connections is a much slower process.

Early detection and treatment is essential to heading off the development of substance addiction in adolescents. Given their brain development, teenagers cannot be expected to understand the full range of consequences in their choices regarding drugs and alcohol. The disease must be prevented, and where it cannot be prevented it must be arrested while there is still time for a full recovery.

O God, that men should put an enemy in their mouths to steal away their brains! That we should, with joy, pleasance, revel, and applause, transform ourselves into beasts. – Wm. Shakespeare.

Drugs and the Brain

The human brain is the most complex organ in the body. We need it in order to drive a car, enjoy a meal, breathe, create a work of art, and enjoy everyday activities. It regulates our basic body functions. It enables us to interpret and respond to everything we experience, and it shapes our thoughts, emotions and behavior. The brain is made up of many parts that work together as a team. Drugs can alter or change important brain areas that are necessary for life-sustaining functions, and can drive the compulsive drug abuse that marks addiction.

The brain stem controls basic functions critical to life, such as heart rate, breathing, and sleeping. The limbic system contains the brain’s reward circuit. It links together a number of brain structures that control and regulate our ability to feel pleasure. Being able to experience pleasure motivates us to repeat behaviors, such as eating and sex, that are critical to our existence. The limbic system is also activated when we take mood-altering drugs. The cerebral cortex contains areas that enable us to see, feel, hear and taste. The front part of the cortex, the forebrain, is our thinking center. It allows us to plan, solve problems, and make decisions. Judgment resides in the forebrain.

The brain is literally a communications center consisting of billions of neurons. Networks of neurons pass messages back and forth to different structures within the brain, the spinal column, and the peripheral nervous system. These nerve networks coordinate and regulate everything we feel, think, and do. Each nerve cell in the brain sends and receives messages in the form of electrical impulses. Once a cell receives and processes a message, it sends it on to other neurons. Neurotransmitters are the brain’s chemical messages. Receptors are the brain’s chemical receivers.

Mood-altering drugs tap in to the brain’s communications system and interfere with the way nerve cells normally send, receive and process information. Some drugs, such as marijuana and heroin, have a chemical structure that mimics natural neurotransmitters. This “fools” the receptors and activates our nerve cells. Although these drugs mimic brain chemistry, they don’t activate nerve cells in the same manner as natural our neurotransmitters. Rather, they lead to abnormal messages being transmitted throughout the brain.

Drugs like amphetamine and cocaine can cause the nerve cells to release abnormally large amounts of natural neurotransmitters, and may prevent the normal recycling of these brain chemicals. This disruption produces a greatly amplified message, ultimately disrupting communication channels. The contrast between natural neurotransmitters and the ones mimicked by mood-altering drugs is like the difference between someone whispering into your ear and someone shouting into a microphone. Abuse of mood-altering drugs targets the brain’s reward system by flooding the circuit with dopamine. Dopamine is a natural neurotransmitter which is present in all regions of the brain. It regulates movement, emotion, cognition, motivation, and feelings of pleasure.

Drugs are more addictive than natural rewards. This is because when these drugs are taken, they release 2 to 10 times the amount of dopamine that natural rewards do. In some cases, this occurs almost immediately (as when the drug is smoked or injected). The effects can last much longer than those produced by natural rewards. The effects these drugs have on the brain’s pleasure circuit dwarfs in comparison to those produced by naturally occurring neurotransmitters. The effect of such a powerful reward strongly motivates people to take drugs again and again.

Just as we turn down the volume on a radio that is too loud, the brain adjusts to 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, the impact dopamine has on the reward circuit of a drug abuser’s brain can become abnormally low. When this happens, the ability to experience any pleasure is reduced. This is why the addict eventually feels flat, lifeless and depressed. They are unable to enjoy the things that previously brought them pleasure. They need to take drugs just to bring their dopamine function back to normal. What’s worse, they need to take larger amounts of the drug than they first did to create the dopamine high.

I was aware of the impact drug abuse can have on brain chemistry, but I was in denial as to whether I had reached the level of tolerance. I was surprised to learn that drug abuse can lead to profound changes in our actual circuitry. Long-term health of the brain is also severely compromised. Interestingly, long-term drug abuse can trigger adaptations in habits and non-conscious memory systems, resulting in a type of conditioning known as “triggers.” I found this to be true after long-term abuse of narcotic pain killers. I associated the smells inside a pharmacy with taking oxycodone. My drug and alcohol counselor told me that familiar smells are the source of triggering memory. Even if it’s the smell of Snickerdoodles at Christmastime.

Chronic long-term use of mood-altering drugs can cause disruption in the way critical brain structures interact to control behavior. Continued abuse usually leads to the need for higher amounts of the drug in order to produce the desired effect. This, of course, is what we call addiction. Drug use becomes compulsive. The addict no longer has a choice. Self-control and the ability to make sound decisions are gone. The addict now feels intense impulses to get high.

If someone relapses after starting on a journey to recovery, does that mean treatment has failed? No. The chronic nature of the disease means that relapsing is not only possible, it is likely. The longer the addiction has been continuing, the harder it is to reset the brain’s chemistry. When production of natural neurotransmitters such as dopamine and serotonin is crippled, the addict craves drugs just to feel “normal” again. Relapse merely indicates that treatment needs to be reinstated or adjusted, or that alternative treatment is needed (such as being admitted to a rehab).

If you are struggling with relapse, get in touch with someone from AA or NA. I’ll be praying for you.

But What If I Can’t Be Fixed?

I’m so down the scale from where I want to be. If I’m not careful, I can buy into a back story that I come from pain and badness and dishonesty and using people. A place where forgiveness can never be had. Second changes are just words in a country song. Where people say, “We’ve heard it all before Steve.” To them, nothing sounds different. And I don’t blame them. They HAVE heard many versions of this “apology.” I don’t want to hear it again, they say. Nothing’s changed.

Oh, but I have changed! I’m completely different now. First, this is not true. For the moment, your attitude has changed. You’re speaking the words of apology, but there has not been a core change down in your soul. The rewiring in your brain that tends to get you thinking and obsessing over drugs and drinking has not changed. It cant’! Not that soon. It took years to rewire your brain to behave in a certain way. Years! Your brain has been hard wired and that’s a big thing. It’s the only thing. The sound of a lighter flicking, the smell of a match burning, the gurgling of a bong, the crackle of a rock of crack, hell, even the smell inside your favorite drug store (if you are into pills) will bring you face-to-face with the desire to get high. These memories are jammed full of memory. Of experience.

This is why the newcomer is told to stay away from all situations that remind him or her of using drugs or getting drunk. Your mood changes when  you’re triggered. Perhaps you’re mad at someone, and may feel completely justified in your anger. You’re ready to walk away from everyone just to be right. It is those positions that tear at your sobriety. It eats at the last bit of self-control you have, and you’re off on a tangent. Sobriety is the least thing you have on your mind right now.  You’re in dangerous territory. The land of primal hatred and total meltdown. This is the type of anger that will make you run red lights with your kids in the back seat. It’s the kind of anger that will build in to a resentment.

This change in brain wiring is so subtle, we don’t realize it happened. Certain chemical reactions are already being set up. Repeating the behavior tends to make certain the same neuronal firing will happen again. As this pattern gets stronger, the habit gets stronger. It becomes harder to pick up the phone and call someone to talk about what’s up. I know the analogy that the phone becomes twelve-hundred pounds, but it’s worse than that. The desire to even try to pick it up is not there. In fact, the phone is not even on your mind. Nerves, fear of rejection, sweaty palms, shortness of breath, and even chest palpitations. All designed to keep you from using the phone.

This cycle has to be broken or you will live a sad life of using and lying and breaking hearts and ruining relationships, You see, people get tired of hearing the same old excuses. Interpersonal relationship are a funny thing. They form in any situation. Eventually, the feeling comes that you are being objectified and lied to by your addict loved one. That you are not hearing what the person is actually up to. Instead, you’re hearing him or her read from a one-act play where he or she is in the leading role and is also directing the action. This type of dialog never leads to growth.

What is the key? Willingness. If the addict is not willing to change, everything you say is bullshit. It’s all part of a play you wrote called “I’m okay now. Everything is different.” In fact, everything is wrong. You are struggling with cravings. Things you think about or people you run into are triggering you to want to use. Hell, even songs on the radio and smells in the pharmacy can trigger you. It is during this period that you must use the phone. You have to call and tell on yourself. Get in tight with God. Go to him when you are tempted in this way. There is no amount of human power that can relieve this suffering. Only God can. And He will if you call upon him.

It’s simple, just get on your knees and ask Him for His help and protection. And get to a meeting.