Many people don't understand why
or how other people become addicted to
drugs. They may mistakenly think that
those who use drugs lack moral
principles or willpower and that they
could stop their drug use simply by
choosing to. In reality, drug
addiction is a complex disease, and
quitting usually takes more than good
intentions or a strong will. Drugs
change the brain in ways that make
quitting hard, even for those who want
to. Fortunately, researchers know more
than ever about how drugs affect the
brain and have found treatments that
can help people recover from drug
addiction and lead productive lives.
What is drug addiction?
Addiction is a chronic disease
characterized by drug seeking and use
that is compulsive, or difficult to
control, despite harmful consequences.
The initial decision to take drugs is
voluntary for most people, but
repeated drug use can lead to brain
changes that challenge an addicted
person’s self-control and interfere
with their ability to resist intense
urges to take drugs. These brain
changes can be persistent, which is
why drug addiction is considered a
"relapsing" disease—people in recovery
from drug use disorders are at
increased risk for returning to drug
use even after years of not taking the
drug.
It's common for a person to relapse,
but relapse doesn't mean that
treatment doesn’t work. As with other
chronic health conditions, treatment
should be ongoing and should be
adjusted based on how the patient
responds. Treatment plans need to be
reviewed often and modified to fit the
patient’s changing needs.
What happens to the brain
when a person takes drugs?
Most drugs affect the brain's "reward
circuit," causing euphoria as well as
flooding it with the chemical
messenger dopamine. A properly
functioning reward system motivates a
person to repeat behaviors needed to
thrive, such as eating and spending
time with loved ones. Surges of
dopamine in the reward circuit cause
the reinforcement of pleasurable but
unhealthy behaviors like taking drugs,
leading people to repeat the behavior
again and again.
As a person continues to use drugs,
the brain adapts by reducing the
ability of cells in the reward circuit
to respond to it. This reduces the
high that the person feels compared to
the high they felt when first taking
the drug—an effect known as tolerance.
They might take more of the drug to
try and achieve the same high.
These brain adaptations often lead to
the person becoming less and less able
to derive pleasure from other things
they once enjoyed, like food, sex, or
social activities.
Long-term use also causes changes in
other brain chemical systems and
circuits as well, affecting functions
that include:
 learning
 judgment
 decision-making
 stress
 memory
 behavior
Despite being aware of these harmful
outcomes, many people who use drugs
continue to take them, which is the
nature of addiction.
Why do some people become
addicted to drugs while others
don't?
No one factor can predict if a person
will become addicted to drugs. A
combination of factors influences risk
for addiction. The more risk factors a
person has, the greater the chance
that taking drugs can lead to
addiction.
Biology. The genes that people are
born with account for about half of a
person's risk for addiction. Gender,
ethnicity, and the presence of other
mental disorders may also influence
risk for drug use and addiction.
Environment. A person’s environment
includes many different influences,
from family and friends to economic
status and general quality of life.
Factors such as peer pressure,
physical and sexual abuse, early
exposure to drugs, stress, and
parental guidance can greatly affect a
person’s likelihood of drug use and
addiction.
Development. Genetic and environmental
factors interact with
developmental stages in a person’s
critical
life to affect addiction
Although taking drugs at any age can
lead to addiction, the earlier that
drug use begins, the more likely it
will progress to addiction. This is
particularly problematic for teens.
Because areas in their brains that
control decision-making, judgment, and
self-control are still developing,
teens may be especially prone to risky
behaviors, including trying drugs.
Can drug addiction be cured or
prevented?
As with most other chronic diseases,
such as diabetes, asthma, or heart
disease, treatment for drug addiction
generally isn’t a cure. However,
addiction is treatable and can be
successfully managed. People who are
recovering from an addiction will be
at risk for relapse for years and
possibly for their whole lives.
Research shows that combining
addiction treatment medicines with
behavioral therapy ensures the best
chance of success for most patients.
Treatment approaches tailored to each
patient’s drug use patterns and any
co-occurring medical, mental, and
social problems can lead to continued
recovery.
More good news is that drug use and
addiction are preventable. Results
from NIDA-funded research have shown
that prevention programs involving
families, schools, communities, and
the media are effective for preventing
or reducing drug use and addiction.
Although personal events and cultural
factors affect drug use trends, when
young people view drug use as harmful,
they tend to decrease their drug
taking. Therefore, education and
outreach are key in helping people
understand the possible risks of drug
use. Teachers, parents, and health
care providers have crucial roles in
educating young people and preventing
drug use and addiction.
Addiction vs. Abuse and
risk. Tolerance
Drug abuse is when you use legal or
illegal substances in ways you
shouldn’t. You might take more than
the regular dose of pills or use
someone else’s prescription. You may
abuse drugs to feel good, ease stress,
or avoid reality. But usually, you’re
able to change your unhealthy habits
or stop using altogether.
Addiction is when you can’t stop. Not
when it puts your health in danger.
Not when it causes financial,
emotional, and other problems for you
or your loved ones. That urge to get
and use drugs can fill up every minute
of the day, even if you want to quit.
Addiction also is different from
physical dependence or tolerance. In
cases of physical dependence,
withdrawal symptoms happen when you
suddenly stop a substance. Tolerance
happens when a dose of a substance
becomes less effective over time.
When you use opioids for pain for a
long time, for example, you may
develop tolerance and even physical
dependence. This doesn’t mean you’re
addicted. In general, when narcotics
are used under proper medical
supervision, addiction happens in only
a small percentage of people.
Effect on Your Brain
Your brain is wired to make you want
to repeat experiences that make you
feel good. So you’re motivated to do
them again and again.
The drugs that may be addictive target
your brain’s reward system. They flood
your brain with a chemical called
dopamine. This triggers a feeling of
intense pleasure. You keep taking the
drug to chase that high.
Over time, your brain gets used to the
extra dopamine. So you might need to
take more of the drug to get the same
good feeling. And other things you
enjoyed, like food and hanging out
with family, may give you less
pleasure.
When you use drugs for a long time, it
can cause changes in other brain
chemical systems and circuits as well.
They can hurt your:
 Judgment
 Decision-making
 Memory
 Ability to learn
Together, these brain changes can
drive you to seek out and take drugs
in ways that are beyond your control.
Who’s Most Likely to
Become Addicted?
Each person’s body and brain are
different. People also react
differently to drugs. Some love the
feeling the first time they try it and
want more. Others hate it and never
try again.
Not everyone who uses drugs becomes
addicted. But it can happen to anyone
and at any age. Some things may raise
your chances of addiction, including:
 Family history. Your genes are
responsible for about half of
your odds. If your parents or
siblings have problems with
alcohol or drugs, you’re more
likely as well. Women and men
are equally likely to become
addicted.
 Early drug use. Children’s
brains are still growing, and
drug use can change that. So
taking drugs at an early age may
make you more likely to get
addicted when you get older.
 Mental disorders. If you’re
depressed, have trouble paying
attention, or worry constantly,
you have a higher chance of
addiction. You may turn to drugs
as a way to try to feel better.
A history of trauma in your life
also makes you more likely to
have addiction.
 Troubled relationships. If you
grew up with family troubles and
aren’t close to your parents or
siblings, it may raise your
chances of addiction.
Signs of Addiction
You may have one or more of these
warning signs:
 An urge to use the drug every
day, or many times a day
 Taking more drugs than you want
to, and for longer than you
thought you would
 Always having the drug with you,
and buying it even if you can’t
afford it
 Using drugs even if they cause
you trouble at work or make you
lash out at family and friends
 Spending more time alone.
 Not taking care of yourself or
caring how you look
 Stealing, lying, or doing
dangerous things, like driving
while high or having unsafe sex
 Spending most of your time
getting, using, or recovering
from the effects of the drug
  Feeling sick when you try to Symptoms and signs of drug abuse vary
quit depending on the specific drug, but
typically seen across all drugs is the
Symptoms of drug use can often be exclusion of activities in order to
spotted if risk factors for drug use use the drug. When the person no
have been identified. Risk factors for longer participates in anything but
drug use include: drug use, it is a clear sign of drug
abuse. Further decreased performance
 Easy availability of drugs in work or school and a vast change in
 Drug users in the family mood and sleep are also signs of drug
 Friends who are drug users abuse.
 An unhappy home life
Additional signs and symptoms of drug
 A mental illness
abuse include:
If a person has these risk factors,
it's reasonable to look for symptoms  Unusual, bizarre behavior
of drug use.  Abnormal vital signs like
respiration, heart rate and
The first sign of drug use is often a blood pressure
change in behavior. The user may lose  Confusion
interest in activities and hobbies and  Chest or lung pain
spend more time with friends than at  Nausea, vomiting, diarrhea,
home. Another symptom of drug use is stomach pain
sleeping changes and decreased  Diseases such as hepatitis B or
performance at work or school. These C, or HIV from needle-sharing
symptoms of drug use may indicate  Frequent hangovers
another problem; however, so it's  Hiding drugs
important to talk to the individual
directly to confirm what you're really
seeing are symptoms of drug use. 1
(read about drug abuse effects)
How to Prevent Addiction to
Other signs and symptoms of Prescribed Painkillers
drug use include:
Most people who take their pain
 Smell of drugs on person and medicine as directed by their doctor
clothing do not become addicted, even if they
 Constant discussion of drugs take the medicine for a long time.
 Pressuring others to do drugs Fears about addiction should not
 Frequent washing of clothes, prevent you from using narcotics to
showering or spraying room relieve your pain.
deodorizer to remove drug smells
 Presence of drug paraphernalia But if you’ve abused drugs or alcohol
like a pipe, bong or rolling in the past or have family members who
papers have, you may be at a higher risk.
 Changes in mood such as anxiety
or depression To avoid pain medicine addiction:
 Skin that is cool and sweaty or
hot and dry  Take the drug exactly as your
doctor prescribes.
 Needing more money or
unexplained expenses  Tell your doctor about any
personal or family history of
drug abuse or addiction; this
Drug Abuse Symptoms will help them prescribe the
medicines that will work best
While the above are signs and symptoms for you.
of drug use, the signs and symptoms of
drug abuse tend to be more severe. Remember, it’s common for people to
Signs of drug abuse are more develop a tolerance to pain medication
pronounced as the user now has an and to need higher doses to get the
extreme urge (craving) to use the same level of pain relief. This is
drug. The user is no longer normal and is not a sign of addiction.
experimenting with the drug; they now With addiction, you may need to use
feel a need to use it. higher doses, but it’s not for pain
relief. Still, talk to your doctor if
this effect becomes troubling.

Don't Wait; Get Help Now

If your drug use is out of control or
causing problems, talk to your doctor.

Getting better from drug addiction can

take time. There’s no cure, but
treatment can help you stop using
drugs and stay drug-free. Your
treatment may include counseling,
medicine, or both. Talk to your doctor
to figure out the best plan for you.