Drug use and Abuse
Addiction is not a choice; it is a mental illness.
In recent years, there has been a growing worry about the incidence of alcohol and drug usage among Generation Z. According to the “Monitoring the Future” survey, approximately 30% of high school seniors reported using an illicit drug in the previous year, with marijuana being the most popular substance. Similarly, alcohol use is high, with more than 40% of seniors reporting consuming it in the previous month. The “Comprehensive National Survey on the Extent and Pattern of Substance Use” in India found that Indian youth use substances at high rates, with cannabis and opiate usage growing over the years. While experimenting with substances is a normal part of growing up, the boundary between use and abuse is blurry, resulting in negative consequences for individuals and society. In this blog today I’m going to be talking about the reasons and psychology behind drug and alcohol use, the neuroscience behind addiction, and helpful resources avaliable.
Firstly, understanding why young people turn to drugs and alcohol is crucial because this helps us identify triggers faced by adolescents. Several factors may contribute to this behavior, reflecting a mix of personal, social, and environmental influences. Some of the common factors are:
Relationship Stress: Romantic relationships during adolescence and early adulthood are emotionally charged. Breakups, conflicts, and the pressure to fit in can contribute to emotional distress, prompting substance use as a coping mechanism to relieve feelings of heartache.
Peer Pressure: The influence of peers plays a significant role in the decision to experiment with drugs and alcohol. The desire to fit in and be accepted can lead young people to engage in risky behaviors to be “cool” or liked by their peers.
Academic Stress: The competitive nature of the education system places immense stress on students. The pressure to perform well in exams and be in the top 1% to hopefully secure a promising future can drive some to use substances to manage their stress. Parental pressure to excel academically often intensifies this stress, making substances seem like a tempting escape.
Behavioral Self-Handicapping and Low Self-Esteem: Behavioral self-handicapping involves acting in ways that reduce the likelihood of success on a task, allowing individuals to blame obstacles, such as drug and alcohol use, for their failures instead of their lack of ability. This behavior serves as a protective mechanism for their self-esteem. Low self-esteem, coupled with feelings of social rejection and parental disappointment, can drive teens to use substances as a means of coping.
Family History and Traumatic Events: A family history of substance abuse increases the risk of addiction due to its genetic component. Additionally, experiences of trauma, such as being in a car accident or experiencing abuse, can drive teens to use substances as a means of coping with emotional pain and silencing their inner demons.
Mental Health Conditions: Mental or behavioral health conditions such as depression, anxiety, or ADHD make teens more susceptible to substance use as a form of self-medication. Many times this is due to them not having familial support who can help them find healthy coping mechanisms or take them to professionals. These conditions often lead individuals to seek out drugs and alcohol as a way to alleviate their symptoms temporarily.
Impulsive or Risk-Taking Behavior: Adolescents naturally exhibit more impulsive and risk-taking behaviors because their pre-frontal cortex is still not developed, which can lead to experimentation with drugs and alcohol. The stress of meeting parental expectations can further enhance these risk-taking behaviors as a form of rebellion or escape.
Initially, many young people turn to drugs and alcohol as a way to cope with stress, anxiety, and other negative emotions. However, what starts as occasional use can quickly spiral into addiction. Substance abuse often masks underlying mental health issues, such as depression, anxiety, and bipolar disorder. Rather than addressing these problems head-on, young people use drugs and alcohol to numb their pain, which only exacerbates their mental health struggles, leading to a vicious cycle of substance use and worsening mental health. A study published in the Canadian Journal of Clinical Psychiatry highlighted the link between substance abuse and mental health disorders, noting that individuals who use substances are more likely to suffer from these conditions. Additionally, the developing brain of a young person is particularly vulnerable to the effects of drugs and alcohol. Studies have shown that substance use during adolescence can interfere with brain development, leading to cognitive impairments and increased susceptibility to mental health disorders. For instance, a study published in The Lancet Psychiatry found that heavy cannabis use in adolescence was associated with a higher risk of developing psychosis and schizophrenia.
To better understand the transition from using drugs as a coping mechanism to developing a crippling addiction, it is essential to explore how addiction works in the brain. Dr. Anna Lembke, in her book Dopamine Nation, states that dopamine is one of the most important neurotransmitters, and its function is more closely linked to the motivation to obtain a reward than to the pleasure of enjoying that reward. Dopamine also serves as a scale to measure the addictive potential of any drug because the more dopamine that is released, the more motivation people have towards seeking the drug, ultimately leading to higher rates of addiction.
Neuroscientists have discovered that our brain's pleasure and pain regions overlap, creating an opponent-process mechanism that works like a balance striving to reach equilibrium. This can also be called the "pleasure-pain balance" and was theorised by social scientists Richard Solomon and John Corbit. They explain that when drugs are consumed, they trigger the pleasure side of this balance. However, due to the need to reach homeostasis, this also triggers self-regulation mechanisms that happen reflexively, tipping the scales until an equal and opposite amount is reached on the pain side. Another important aspect of addiction is tolerance. Dr. Lembke writes, "With repeated exposure to the same or similar pleasure stimulus, the initial deviation to the side of pleasure gets weaker and shorter, and the after-response to the side of pain gets stronger and longer." This process is called neuroadaptation. This is the key aspect that causes withdrawal symptoms and leads to relapses in people suffering from addiction. They describe reaching a point where the drug stops working for them, and they are not able to feel high, but at the same time, they cannot stop the use of the drug because they feel miserable without it. People, places, and things can also trigger the pleasure-pain balance, and these triggers are theorized to be due to classical conditioning. Addiction is a serious and complex condition that not only alters the brain's reward system, leading to a cycle of dependency, but also significantly impacts an individual's overall health, relationships, and ability to function in daily life. The compulsive nature of addiction often results in a loss of self-control, making it a chronic disease that requires comprehensive treatment and support to overcome.
Addressing the issue of drug use vs. abuse among the new generations requires a multifaceted approach. It's essential to provide young people with the support and resources they need to manage stress and mental health challenges healthily. By fostering open conversations about the risks of substance abuse and promoting healthy coping mechanisms, we can help break the cycle of addiction and improve the overall well-being of the next generation.
If you are struggling with addiction, know that there is light at the end of this dark tunnel, talk to a trusted friend or family member and get the help that you need. It is never too late to seek help and your addiction does not define you.
Useful resources:
NIDA - Provides comprehensive information on drug abuse, including research, resources, and treatment options.
SAMHSA's National Helpline - A confidential, free, 24/7 information service for individuals and family members facing substance abuse and mental health issues.
Childline India - Provides resources and support for children and teenagers dealing with substance abuse and addiction.
End Addiction - Offers resources, support, and education for families and individuals struggling with addiction.
Citations:
Johnston, L. (2007). Monitoring the future: National survey results on drug use, 1975-2006.
Ministry of Social Justice and Empowerment, Government of India. (2019). Comprehensive national survey on the extent and pattern of substance use in India. National Drug Dependence Treatment Centre, AIIMS, New Delhi. Retrieved from http://www.aiims.edu/en/national-drug-dependence-treatment-centre.html
Deppe, R. K., & Harackiewicz, J. M. (1996). Self-handicapping and intrinsic motivation: Buffering intrinsic interest from the threat of failure. Journal of Personality and Social Psychology, 70(4), 868-876. https://doi.org/10.1037/0022-3514.70.4.868
Lupien, S. P., Seery, M. D., & Almonte, J. L. (2010). Self-handicapping and regulatory focus: Influences on performance and learning. Journal of Experimental Social Psychology, 46(1), 128-138. https://doi.org/10.1016/j.jesp.2009.08.011
El-Guebaly N. Substance Abuse and Mental Disorders: The Dual Diagnoses Concept. The Canadian Journal of Psychiatry. 1990;35(3):261-267. doi:10.1177/070674379003500313
Wilson, J., Freeman, T. P., & Mackie, C. J. (2019). Effects of increasing cannabis potency on adolescent health. The Lancet Child & Adolescent Health, 3(2), 121-128.
Raheemullah, A. (2022). Dopamine Nation: Finding Balance in the Age of Indulgence by Anna Lembke, New York: Dutton, 2021. Cambridge Quarterly of Healthcare Ethics/CQ. Cambridge Quarterly of Healthcare Ethics, 31(4), 573–574. https://doi.org/10.1017/s0963180122000032
Solomon, R. L., & Corbit, J. D. (1974). An opponent-process theory of motivation: I. Temporal dynamics of affect. Psychological review, 81(2), 119.
