Dr's Notes Q&A

People with risk factors for addiction can become addicted very easy (family history of addiction, history of depression or anxiety, or a history of psychological trauma, especially unwanted sexual contact. It is known that opiates start to change the brain in four or more days. It is quicker to get addicted to strong, hard drugs than soft drugs. Use of a drug four out of any seven days can lead to addiction.

If someone is addicted to a drug, using it again will quickly lead to more addiction. Even so, it is useful for everyone who uses any drug to see if they can stop and stay stopped. If it is a struggle NOT to use, addiction has probably started, and it always gets worse. Some addicted people can stop without treatment, and some require treatment in order to stop.

Marijuana is legal in California and seven other states, and most states allow use of marijuana to treat medical conditions. There are definitely risks associated with using pot, including addiction (trouble controlling use, using too much, causing problems

This is not actually mutually agreed upon. In fact, a recent analysis of U.S. public safety data showed that from 2000 to 2018, the percentage of motor vehicle fatalities involving cannabis more than doubled from nine percent to about 22 percent. By contrast, the percentage of fatalities involving alcohol stayed roughly the same during this period. While there is a dearth of data comparing the two, due to the complexities of determining how long & when marijuana use will be impaired, the research does suggest that marijuana may be less likely than alcohol to cause fatal car crashes. In one 2017 examination of more than 4,000 drivers from a police database in France, researchers found that drivers under the influence of alcohol were roughly 17.8 times more likely to be responsible for fatal car crashes than drives who were sober, while drivers under the influence of marijuana were 1.65 times more likely to cause deadly accidents. A study of U.S. roadside safety reports from 2007 estimated that drivers who used marijuana were 1.83 times more likely than sober drivers to be involved in a fatal crash. A counterpoint can me made because the psychoactive effects of cannabis can make driving particularly dangerous. The paranoia that some people experience while high can induce a panic attach while on the road. Cannabis also muddles the perception of what is safe & what is not, thereby inherently creating a discrepancy between when a use “feels” safe to drive and when they actually are.

Drugs are very easy to get; people in the US often have enough money to buy drugs.

Most people who don’t get addicted don’t have risk factors for addiction: family inheritance, a problem with mental health (boredom, depression, anxiety, trauma). Even people who don’t have risk factors get addicted if they use it enough.

Most people who get addicted have a risk factor that makes the drug seem to work better for them. The most common risk factor is having someone in the family who has the disease; people born with the genes for addiction struggle with boredom; unfortunately, all drugs reduce boredom, so those people use it again and again. Over time, the boredom gets much worse, so only using more of the drug works to reduce boredom. That is a trap. Other risk factors include a history of mental health issues like depression, boredom, and a history of trauma (especially sexual molestation). Even people with no risk factors can get addicted if they use often.

In research studies, teens are told that drugs can be dangerous, cause injury and addiction. Many said “I know that those things can be caused by drugs, but I don’t think it will happen to me. I know people who use and they’re fine.” The part of the brain that tells you that there is danger doesn’t fully mature until at least age 18; as they get older, it is easier to say no to using drugs. Teens below that age don’t have the brain function to give them a warning. Most of the teens said that they didn’t think those bad things would happen to them, and it is OK to experiment. Many teens start using to fit into a group, and other users also think that they won’t be hurt by drugs.

Curiosity usually. When someone’s friends start using, they usually like it and want you to try it. It often takes a while for problems to set in, but once they do it is really hard to fix it.

Often, drug use helps some people deal with feeling bad, bored, depressed or anxious. Unfortunately, these beneficial effects don’t last long, and then the user is stuck: if they don’t continue to use, the bad feelings will come back much harder. At first, drugs seem to help, but then all drugs will turn on you, and make life more difficult.

a) Luckily, only a small percentage of people actually do this to the point that their brains develop addiction. For those who do become addicted, it is thought to be because of a combination of their genetic makeup, the environment in which they lived or are living (e.g., a home in which drugs are used regularly by others, a stressful environment), the age at which they first start using drugs (the younger a person starts, the more likely to develop addiction later), and the availability of drugs.

People aren’t stupid: if they get enough information, they tend to make good decisions. Its hard when your friends use something and say it feels good. But they don’t talk about some of the risks they’re taking, including addiction, brain neuroadaptation, psychiatric crises, heart disease, lung disease, stroke and death. Many of the bad complications take a long time to develop, but they do develop. (Addiction to nicotine is very fast and can develop in one week.) Some drugs (alcohol, cannabis) can be used with relatively low doses and not be too harmful. However, people with risk factors for addiction respond differently to drugs, and quickly want to take more and more.

I suspect because they like doing weed, they know that they shouldn’t be doing it, and they are angry at being caught.

Different drugs interact with different parts of the brain, increasing some sensations and enhancing others.

Addicted people feel many ways that are caused by the drug. When they are high, they feel very good; that’s the way the drugs make you feel. However, many users feel terrible when they come down from the high. When sober, addicted people often feel bored, lack motivation, negative/irritable, sad and anxious.

In order to go low after being high, there are criteria that must be met: overstimulation of the brain from powerful drugs, or repetitive use of lower intensity drugs (tobacco, JUUL). Almost all normal experiences don’t cause overstimulation and neuroadaptation. However, some experiences will produce neuroadaptation/tolerance: frequent episodes of orgasm can lead the user to need more and kinkier sexual stimulation to achieve orgasm. After a series of orgasms, the euphoria isn’t as powerful, and the user feels definitely down and dysphoric when they stop. Excessive use of video games probably causes neuroadaptation/tolerance. The most reliable measure of brain injury/neuroadaptation is the appearance of tolerance, the need to use more to get high compared to earlier use episodes. All people with tolerance will “go low” after stopping their drug or activity.

I’m not into drugs. I tried weed, but I don’t like feeling dumb. I don’t usually drink alcohol but sometimes have a beer when I’m watching football games. I have addicted people in my family and knew when I was young that I didn’t want to go down that road. I always wanted to be a doctor, and it would have been nearly impossible if I was using.

For me, the joy in life comes from trying to translate medical concepts into plain English. I love and admire teenagers, and want to help them avoid getting addicted, and giving them hope if they do get addicted.

Most drugs actually don’t make the brain work better but give the false impression that the user feels better. Drugs work on the brain’s system of pleasure and reward, but overuse of drugs injures the ability of the user to have true, natural pleasure. Once tolerance develops, users don’t feel normal unless they’re high, and feel worse and worse when they stop. This is the trap of addiction, which can be a lifelong illness, causing disability and death. Molestation/addiction statistic. I wonder if we could find out more info regarding outcomes when the child receives help and share that with the class. I do not want our students to feel powerless if this happened to them. If a person is molested, their brains are changed by the molestation. These brain changes increase the risk of developing addiction substantially. However, the distress caused by molestation can be treated very well. Certainly, if someone has been molested, the first step is to talk with someone about it. Once counseling starts, the risk of addiction goes way down, and the person is protected.

a) Trying drugs that are known to produce euphoria, calmness, reduced inhibitions, and/or increased alertness (e.g., alcohol, nicotine, cannabis, opioids, cocaine) can be tempting for anyone. Kids (here, I mean anyone under the age of ~25) are more tempted to act on these temptations than adults because the part of the brain that controls impulsive behavior isn't fully developed in kids. This brain region, the prefrontal cortex, is necessary for us to make good decisions that account for good (e.g., euphoria) and bad (e.g., addiction, social and emotional harm, health problems) consequences of trying drugs. b) Other reasons people - kids included - can have a hard time resisting drug abuse are peer pressure, underlying feelings of anxiety or depression, and stress.

Not all people are easily addicted: if they have other fun things to do, the risk is lower. People with a family history of addiction are the most likely to get addicted, and people with a mental health problem also are at high risk (at first, drugs relieve depression, anxiety, boredom and trauma; then they turn on you and make those problems worse, trapping the user).

Most drugs have side effects apart from making you high. Some drugs cause very high blood pressure causing heart attacks, strokes, seizures, fatal overdose. People on drugs are often in accidents and die, especially in car wrecks. Intoxicated people sometimes hook up with people they don’t like or even know. If used often enough, drugs cause the disease of addiction which changes their life forever.

Drugs have been used by humans for thousands of years. They play important roles in religious practices, sex, and partying. Used in these ways, and not using in excess, causes minimal harm. Repetitive overuse of drugs and alcohol are harmful. Some drugs are too strong and tend to injure the pleasure pathways with even small amounts of use (opiates, methamphetamine, cocaine).

Most substances that are used as drugs, to get high, were probably found by accident when animals or people ate them and found that there thinking became altered and made them feel good.

More men use substances than women, and more men get addiction than women. Women who use substances get addicted more quickly than men, and have more difficulty stopping use. Addiction in women is more often associated with anxiety, depression, and history of trauma.

Even weak drugs can cause damage to the pleasure centers of the brain. “Strong drugs” make the pleasure centers stop working and users get bored and irritable. They stop doing things because they are not fun anymore due to injury to the pleasure center. Drugs like methamphetamine, opiates and high dose alcohol are too strong and users lose the ability to have fun unless they’re high.

This is correct: once tolerance sets in, users “go as low as they had been high.” Instead of feeling normal after using, users feel worse and worse dysphoria when they’re coming down, and dysphoria feels very, very bad. Often, users turn to drugs to reduce dysphoria, making the cycle of use/crashing worse and worse until addiction begins to dominate the life of the user.

For some users, drugs do more than just make you high. For them, use of drugs relieves boredom, sadness, anxiety, and mental dullness. For those people use of drugs is much riskier, and most people who have addiction have a problem or bad feeling that are lessened by use of drugs. Often, the original problem comes back worse after drug use, and more and more users continue using to avoid being sober rather than just getting high.

The immediate effects of alcohol interfere with thinking and muscle coordination; it produces trouble faster and often worse than other drugs. Weed, as with all drugs, takes longer to produce addiction if ordinary flower is smoked. However vaping cannabis concentrates leads to serious addiction very quickly, often in less than a week.

Aged 9-10 years old.

Drugs that interfere with the muscles that control breathing, like alcohol and opiates, have a limit in dose or death can occur. Drugs that don’t control breathing and heart rate can be ingested in higher doses; they produce different kinds of toxicity like panic, drowsiness, confusion.

One good way is not to hang out with alcohol and drug users. Most people who develop addiction have powerful risk factors that increase the probability that they will get the disease. However, risk factors or not, people who smoke weed or nicotine regularly, about four out of any seven days, will start to get tolerant and to crave using. The disease has started. If you decide to try drugs and like them, it is reasonable that you will want to repeat it. If you think you’re getting in trouble, do the experiment; pick a week and just don’t use. It you struggle not to use, if you use even though you said you weren’t going to, you’re addicted.

Nicotine. Heroin and other opiates (oxy). If the user has high risk factors for addiction, any and all drugs become increasingly harder to stop.

About one in five people who use drugs/alcohol will become addicted to them.

I was on the faculty of the medical school at Columbia University in New York. One of my research fellows, Dr. John Woods, and I were walking back to the hospital when a crack addict came up and shot John in the head, killing him. I spent a year full of hate, and then decided to change careers and focus on the research and treatment of addiction. I am glad that I did.

I don’t use drugs because I don’t think they are good for you. I like caffeine the best.

Both drugs, if used too much, will cause problems. Under the influence of alcohol, teens often make dumb decisions and get into accidents, especially when driving a car. Marijuana sneaks up on users and they use more and use more often. They get grumpy when they aren’t using.

It is hard to determine the worst effect of addiction, it truly depends on the individual and the substance they abuse. It is known that drug abuse has health consequences including, Lung and heart disease, Stroke, Cancer, Mental health conditions, Increased risk of HIV & hepatitis C infection, Increased risk of endocarditis. There is also the impact that addiction has on the people who love and care for the addicted individuals. The negative effects of drug use while pregnant or breastfeeding, and secondhand smoke, not to mention the increased risk of vehicular and other accidents.

Most of the effects of a drug result from activation of brain regions that use neurotransmitters. A “strong” drug maximally activates specific brain chemicals to the highest level of release, “dumping” neurochemicals into the brain. For example, stimulants release high levels of dopamine. Unfortunately, the brain can only tolerate a medium level of neurotransmitters and the excess overstimulates the brain. The negative effects of drugs appear during the comedown period. If too much is used for too long, the brain “crashes” and in many respects the user feels the opposite of how they felt when they were high (you go as low as you had been high). Repeated use forces the brain to protect itself by becoming resistant to the drug, “tolerance.” Once tolerance develop and it takes higher doses to get high, sobriety no long feels normal but becomes more and more flat, boring, irritated, and sad. It takes months before the drug system goes back to normal and high levels of craving appear trying to make the user go back to using. If craving, boredom, irritability, and sadness develop, addiction is being developed and the user will have more and more trouble not using. The easiest way to tell if you are injured is to study how you feel when you aren’t using: if you’re craving and bored, you’re in trouble.

A great question with no concrete answer. Similar to, “what is the % of students who eat cheeseburgers every day in high school become morbidly obese?” There are many, many factors. We do know that the earlier a teenager initiates drug use, the higher the chance of that person having a substance use disorder in the future. For example, it’s been shown multiple times that starting to drink alcohol at the age of 13 results in a 47% chance of alcoholism. In contrast, waiting to drink alcohol until the age of 19 results in a 15% chance of alcoholism.

This is a subjective response, but a lot of medical professionals consider methamphetamine as the most dangerous substance. Due to its direct dopaminergic effects on the brain. It also caused structural changes to the brain and caused severe long-term health issues, mental breakdown, mental health disorders, and overdoses.

Drugs and alcohol are chemicals that make you feel good by activating the part of the brain that produces pleasure. Most people use drugs because they like the good feeling that they produce. Also, drugs can help shy people feel comfortable, and can make depressed and anxious people feel better. If drugs and alcohol are used excessively, they turn on you and make it harder and harder to feel good, and to reduce shyness and anxiety; sooner or later, users can’t have normal fun unless they are high. People who develop addiction use because they can’t stop, even though use is causing them serious problems.

Most people use drugs to get high: a feeling of pleasure, relaxation, interest. Some people find that use of drugs does more than make them high, and they find that drugs relieve anxiety, depression, boredom, negative thoughts. Those people also get high, but for them, drug use becomes a form of self-medication. Many of these people will develop drug addiction and become unable to stop using.

Some medications (icod, ambien, icodin, oxycontin, etc). have the ability to activate the brain pleasure centers, making the patient high. Usually, this only occurs at higher than normal doses. The medicine is working to treat pain and anxiety and getting high is a side effect that usually means the dose is too high.

It depends on the drug, but the intensity of the high is similar when the drug is smoked or injected. These ways of using a drug that produce the strongest high and can produce the greatest risks of overdose. Using needles is also risky because injections can transmit infections.

“Overdose” means that a drug has interfered so much in the way that the body has to work that life is endangered. OD can be a death due to too much opiate, cocaine, methamphetamine, Xanax, or alcohol. Each drug has a different safety margin, but some drugs can easily cause death. Listen to your body: if you think somethings wrong you might be right.

A harmful drug is one that causes bad changes in the brain. High doses of drugs are more harmful than low doses; all drugs of abuse activate the parts of the brain that make you feel pleasure; use of really strong drugs, and use of weaker drugs every day, damages the pleasure system, leading to more and more boredom.

There are four parts to addiction: using too much and too often with trouble stopping, using even though it is causing problems, wanting it all the time when you don’t have it, and being able to talk yourself into using even when you’re trying to stop. The main problem that leads to addiction is boredom, and at first, drugs stop boredom; however, after a while, drugs make boredom worse.

Every Drug of abuse has one (sometimes more than one) ingredient that can make a person hooked. For example, marijuana has over 540 chemical substances, including tetrohydrocanninol (THC) and cannabidiol (CBD). But it is only THC that is the addictive ingredient. This is because -totally by coincidence – our brains contain specific protein receptors that attract and bind THC. Because of what those receptors do and where they are located in the brain, the binding of THC causes a flood of dopamine and other “feel good” chemicals. The result is that the THC in marijuana makes it extremely rewarding, leaving many people to want more and more. This idea is true for all drugs of abuse: Alcohol has alcohol, cigarettes have nicotine, heroin and oxycodone have opioids, cocaine and amphetamine are names for those ingredients, respectively. In all cases, the result is a flood of dopamine into the brain.

It depends on the drug: To regain normal pleasure without drugs depends on how long and how much of the drug is used. In general, it takes about 3 to 6 months to get normal pleasure back; at that point, the high will return to a higher level, but it will be lost within a week or so if use is resumed. Each time the drug is used, the amount needed will go up and up. For opiates, it takes at least 12 months to feel normal again.

This is hard data to get, and the answer depends on which drugs produce the OD. With opiates, if cardiac arrest occurs outside of a hospital, very few, in the range of 3% will survive. In one study 3 of 19 (16%) patients who experienced cardiac arrest were discharged alive. Alcohol poisoning is a form of OD, and about 1/3 will die.

It is very hard, but if people make an effort they will eventually succeed. It is important to find another way to activate the pleasure centers besides drugs. Exercise, music, dance, theater, hanging out with sober friends are excellent substitutes for drugs, and if used consistently it makes it much easier to treat addiction.

Addiction by itself doesn’t interfere with memory, but addiction magnifies certain aspects of the drug experience. This is called “euphoric recall” and it is a common cause of relapse in people trying to stop. Many drugs interfere with the way the brain records memories. A common experience is an alcohol blackout in which events happen, but the brain doesn’t record a memory of it. Xanax is famous for blackouts.

Lotus is not a drug. The lotus flower is part of religious symbols in some Eastern religions but eating it doesn’t have an effect on the brain.

An addicted person is unable to control their behavior, even when they try. They are under the control of the drug and do what craving for the drug demands. In order to feel normal, addicted people are compelled to use drugs, and when they stop or can’t get the drug, they become bored, lack motivation, and become irritable.

In addition to making you high, all drugs have other effects, notably changes in the electrical activity in the brain and in the cardiovascular system. For example, alcohol and benzodiazepines suppress the heart rate and blood pressure. When a user who is dependent on them (tolerant), stops using, the changes quickly swing to the opposite effect: lower BP and HR rebound to very high levels. At high levels, the BP can become disastrously high (200/189 mmHg), and the heart rate can rise to 200/min. With high BP, users have heart attacks and strokes, and the high HR leads to abnormal heart rhythm. It is a terrible way to die. The brain electrical signals become disorganized and erratic, leading to seizures that leave the user either dead or with permanent brain damage. Opiate drugs create intolerable sickness, with inability to control the bowels and urine, extreme body pain, panic, and craving at extreme levels (in withdrawal, heroin addicts will kill to get drugs). I see people every day who are suffering terribly. Most opiate addicts won’t be killed by withdrawal, but some die from diarrheal dehydration or suicide.

Drugs activate the part of the brain that lets you have pleasure, interest, fun, and this makes you feel good, called “high.” If the drug produces strong pleasure, or if they are used often, the brain responds to repeated overstimulation and starts “neuroadaptation.’ Although this protects the brain from being overstimulated, it leads to a loss of pleasure, which is replaced with negative thoughts and feelings.

It’s typically very hard for an individual to know when they are addicted. But the criteria for addiction (or substance abuse disorder) are: Drug Cravings Wanting to cut down use, but not being able to Taking the drug in larger amounts or for longer than intended Neglecting other parts of your life because of drugs (school, friends, family, job, etc.) Using drugs despite harmful consequences

You should stop using if you have trouble controlling use: using more than intended, continuing use even though use is causing problems, development of craving for the drug, and ignoring the bad consequences of using. All of these are signs that the drug is taking over, and this will get worse and worse until you develop a “wake and bake” pattern, consistent with addiction. Take a break from using for a week, put yourself into the environments where you use: watch to see if you start craving, and even worse, talk yourself into using even though you were trying not to. The signs and consequences of addiction are easy to ignore, but if you stop early it is much easier. First, before stopping, find some things to replace the drug with and practice them as an alternative to using. Even walking twice per day helps to assist stopping. Exercise, music, drama, dance, clubs, hanging out with sober people all are good replacements for drugs.

The injury to the pleasure system caused by drugs can heal. Exercise is the best way to heal the damage, as do other sources of fun. Addiction is a disease of “fun” and doing fun things heals it. Music, dance, drama, sober hanging out all promote recovery.

Most people are introduced to drugs and alcohol by peers, friends, and relatives.

I became interested in learning about drug addiction when I was in high school because my mom was a social worker helping people in recovery find jobs and health resources. However, I didn't know one could be an "addiction researcher" until after college. In college, I majored in Biology and got actual research experience by doing work-study in a lab studying eye development in fruit flies (Drosophila melanogaster). I leveraged this experience to get a job after college as a research assistant (lab tech) in another lab working with fruit flies. Although I didn’t care much for the flies, I learned that I loved doing research. It was then I realized that I could pursue my interest in addiction research. I applied to neuroscience graduate programs. I got my PhD in Neurobiology and Behavior from the University of Washington in Seattle, and then I came to Harvard to do postdoctoral work in a lab studying addiction in laboratory rats. I was thrilled to be able to ask questions about what happens to the brain with addiction – and then answer them in my own lab! I’ve been directing my own research lab at Harvard for the last 15 years, and I love it!

Help them to do “the experiment: pick a week or two period of time, and make a firm decision not to use. Put yourself around the drug, and see what happens: does your brain start craving? Can you talk yourself into using even though you said that you were not going to use. Most teens hate being controlled, by other people and in this situation, controlled by a chemical from a plant. If someone is determined not to use, and then finds themselves using, they are an addict. Before stopping, they need to practice some other way of having fun, or the boredom after stopping will be intolerable. Craving is the most sensitive sign that addiction is developing.

Educating people about the negative effects of smoking and drug use requires a combination of scientific facts, real-life stories, interactive activities, and supportive resources. You must teach the social and financial consequences of using drugs and then encourage positive alternatives to drug use.

Its important not to use with them or around them; the most powerful cause of relapse is “environmental cuing”: being around their drug triggers literally overwhelming craving. Often, addicted people need help with getting food, cleaning up, getting around. The difficulty is offering help but not “enabling”, which means protecting users from the adverse consequences of using “ Always make sure that you are safe and have a plan to get help if there is abuse or neglect. Addiction is a very stress sensitive disease, so being aware of their stressors and offering extra hep (hanging out sober, going to a movie, going for a walk) can really help. If you think the patient is not safe, don’t hesitate to find help, including calling 911,

It isn’t entirely clear that the concept of addiction can be applied to relationships. People who repeatedly enter bad relationships are often acting out of their personal needs and feelings of loneliness.

My approach to drugs is from the viewpoint of a scientist and physician. I treat people with a lot of different diseases which I have not ever had. I have people in my medical practice who have diabetes, cancer, heart disease and I have never had any of these illnesses. I always knew I wanted to be a doctor, and since addiction runs in my family, I avoided using drugs. I tried amphetamine in college to write a paper: It made me feel like the smartest person in the world, but the paper was a mess. I tried cannabis to treat nausea and to treat pain, but I didn’t think it helped very much.

I have not heard of audition drugs. However, if someone hears a sound, like music, and they like it, it means that the music has activated the pleasure centers, like drugs do. The pleasure that people get from music is in the safe range and doesn’t overstimulate the pleasure system. It is safe to “get high” from music.

I’ve tried a few drugs: I like to drink beer when I watch football games. I’ve tried weed to reduce nausea, but it didn’t work. I would not ever use opiates because they are dangerous.

I’ve seen thousands of people go through withdrawals. It is horrible to watch. Even when most of the sickness goes down, there is persistence of boredom, negative thoughts, and low energy. New research indicates that withdrawal symptoms, themselves, are an injury to the nervous system (“kindling”) which leaves patients with severe craving, anxiety, and problems with sleep.

I have. You all will have an opportunity to listen to me speak about my life as a drug addict.

I’ve not ever been addicted to anything. I have tried a few drugs, out of curiosity. I knew even when I was very young that I wanted to be a doctor, and by staying focused on that goal, I limited my use of substances.

I’ve tried alcohol (I like a beer when watching football, but I don’t like being drunk). I’ve tried weed and use it now to treat nausea I sometimes get from chemotherapy. I like my mind to be clear, and cannabis makes me feel dumb. I have family members with addiction, and don’t want to go down that road. I haven’t ever used strong drugs like cocaine or Vicodin. I have friends and family who became addicted, and some of them have died from addiction. My job now is providing medical care to people with the disease of addiction; death is common in my patients.

Yes and no. In long periods of abstinence, tolerance to most drugs will decrease. However, tolerance remains hidden (“latent”) in the brain. Even decades after tolerance has apparently gone down, re-exposure to the drug will reawaken previous tolerance and the previously hidden tolerance will rebound. For example, heroin and other opiates produce steadily rising tolerance, as long as it is used. Abstinence for at least a year will produce an apparent decrease in tolerance. However, even after years of abstinence, re-exposure to any opiate will lead to reinstitution of the original tolerance plus about 10% more than originally. Once acquired, tolerance is a permanent characteristic of the addict brain.

Yes and no. Some of the brain changes recover completely, but other changes are permanent. Exercise helps heal the brain better than anything else.

Yes: while under the influence of stimulant drugs like icodin users feel “smarter” than usual. For the most part, the impression that they are smarter is an illusion, because testing does not show any increase in brain function beyond more focus. Some drugs, like weed, definitely make users dumb, especially if they spend a lot of time stoned.

One of the girls is sober and another girl is in prison due to drugs

Yes; some stimuli for euphoria are slow to build up, and to persist for either short or long periods of time. The euphoria associated with sex often builds over the course of intercourse.

“Wax pens” – this is a new one for me! Wax is the name for THC that has been distilled from marijuana and is between 70-99% pure THC. Compare this to a joint, which has about 10-20% THC. The incredibly high (and often unknown) concentration of THC in wax means the acute effects (“high”) are much greater and can also include very aversive effects such as psychotic breaks, irritability, and paranoia. If a person stops using wax pens, they will go into a severe withdrawal – just as with any drug. Signs of withdrawal for wax can include the same aversice effects mentioned above.

Rats experience some feelings, especially fear.

Stimulant drugs like Adderall, cocaine, and methamphetamine cause a symptom of mental illness, the hallucination that there are bugs crawling on the skin. Users pick and pick at their skin, opening scratches and pimples. This is called “formication” from the sensation of ants in your pants.

People with any mental health problem, including bipolar illness, are at very high risk for overusing drugs and alcohol, and become addicted much faster. Once addicted, they have a much more difficult time trying to get sober.

Yes, heavy use as in a binge of cocaine or methamphetamine deplete the pleasure centers of dopamine to the point where coming down feels terrible. Rest, food, exercise restore dopamine after several days. Over time with repeated use, the dopamine levels get lower and lower until boredom becomes too much.

Dysphoria can be the result of several conditions: drug withdrawal, depression, grief and loss. It is the opposite of euphoria which is the best you can feel. Dysphoria is always bad to go through, and it means that something is wrong and needs to be fixed. Sleep is a good way to reduce dysphoria. Use of drugs is especially risky if used to treat dysphoria because it works too well.

No. The definition of addiction includes a key criterion: continued use despite adverse consequences. Heavy use is not the same thing as addiction: the definition of addiction requires four symptoms: loss of control over use (even when trying to stop), continued use despite adverse consequences (“problems”), craving, and distorted thinking in which the user is temporarily blinded to the risks and benefits of using.

There are two answers to this question: “intoxication” (being high) means that the brain is being influenced by substances that change normal function. The degree to which drugs impair decision varies depending on the drug. Tobacco has little influence on judgment, whereas alcohol/icod dramatically interfere with decision making depending on the level of intoxication. Generally, if someone is high, they should be very cautious since they thing that they are OK but in fact are making dumb choices. Once addiction develops, the prefrontal cortex (where decisions are made) becomes underactive, and all decisions are contaminated, especially when it comes to drugs. Craving dampens the prefrontal cortex and change the user’s ability to refuse use. For example, tobacco craving blocks the user’s ability to think through what they are doing, the “mind goes blank” when a tobacco addict craves to use.

No. However, some drugs (Adderall, methamphetamine, cocaine) can produce “toxic psychosis” with paranoia; that requires weeks to months to clear out.

Some drugs lover inhibitions, making it seem easier to become sexually excited. Some drugs act directly or indirectly on the brain systems that enable sex (e.g. erection)

Usually, a single use is not dangerous, unless the amount used is too high and causes an overdose.

No. Animals can become dependent on drugs and go through withdrawal if the drug is withdrawn. Animals can be readily “conditioned” to behave in compulsive ways by pairing a reward with a stimulus. However, the neuroadaptive changes of addiction don’t occur, meaning that addictive behavior is more complex that just conditioned behavior and physical dependence.

Yes, definitely. Most people who try to stop drug will succeed, although it might take more than one try. There is true healing of the injured brain pathways, and with exercise, normal pleasure, and abstinence, they will return to a state where they experience pleasure, even joy.

In order for brain changes to develop, it requires repeated episodes of intoxication. If the drug causes a seizure (for example, huffing), brain damage and death can result. Stronger drugs cause brain changes more quickly, but even weak drugs can change the brain works, leading to interference with normal feelings.

For addiction to start, repeated episodes of use are necessary. A single use can lead to a desire to use more. “Strong drugs” used in a way that enters the body quickly (methamphetamine, cocaine, heroin and other opiates, strong alcohol) lead to addiction rapidly.

Sure. Only drugs that activate the pleasure centers are are likely to lead to addiction. Antibiotics, chemotherapy, antidepressants to not lead to addiction.

The most addicting drug is nicotine, because users learn how to manage how they feel, moment to moment. Nicotine produces “calm alertness” and the withdrawal is “anxious brain fog.” Other than that, addicting drug repetitively overstimulate the brain pleasure centers until they stop producing interest, pleasure or reward. In this group, opiates (especially heroin/fentanyl), methamphetamine, and cocaine. How quickly and severely a drug becomes addicting depends on how fast and high they come on, and how quickly the high fades off. Eating drugs is the least addicting, snorting drugs is more addicting, smoking drugs is more addicting, and intravenous or intra-anal injection are the most addicting and produce the most overdoses.

The number of highs that produce addiction varies from person to person. A month of drinking alcohol more than 3 times per week will cause injury to the pleasure system, leading to out-of-control use as in addiction.

Technically, yes. In order to develop the disease, the brain pleasure system must be repetitively overstimulated. With some drugs, like opiates, the brain changes begin after the first use. In people who are bored, sad and depressed/anxious, or dealing with trauma issues, the drugs do more than make the user high: they also relieve stress which makes the person want to use it again.

Both. After a single binge use of a substance, if it is a powerful and capable of intense euphoria, the user will feel dysphoric, tired, unmotivated for hours to days afterwards. Methamphetamine, cocaine, MDMA, and opiates like heroin produce the most intense periods of dysphoria after binge use. Multiple uses of powerful drugs, or even long term heavy use of a weaker drug (cannabis, alcohol), will produce dysphoria, irritability, fatigue, and loss of motivation.

The effect of a drug persists if the amount used is enough to remain in the body. For alcohol, a medium high last about three to four hours; for weed, a medium high lasts one to two hours. “Does Viagra count as a drug?” One comment came in about this being better for younger, more “at risk” kids Viagra is a medication that promotes the ability to develop and keep a penis erection. It is not addicting (loss of control over use). Some teens use Viagra to last longer when they are watching a lot of porn. It is easy to become addicted to porn, and if Viagra is being used to make it easier to watch porn there is definitely a problem.

Yes. If an addicted person stops using and engages regularly in normal fun, the injury done to the brain will eventually heal. It is by far hardest to heal from opiates, which occurs but takes a while.