While we have amazing facilities in the US that aid in overcoming drug addiction, why are the chances of relapse are so high in drug addiction? The National Institute on Drug Abuse states that about 40-60% of people relapse. Relapse can be due to strong withdrawal symptoms and environmental triggers. Drug rehabilitation centers focus on cognitive behavior therapy to help change the thoughts associated with drug usage. These programs often last about three months or 90 days. While emersion in these programs often helps, there are still other factors at play.
In the case of drug addiction, we cannot forget biological processes as an opponent. With chronic drug use the cells change things that can be long lasting, and are a constant battle even after treatment.
Changes include increase receptors on the neurons which allow more binding of the drug and stronger effects of the drug. In the brain there is a region affected by drug use that contains spiny neurons which are true to their name, a neuron with spines coming off it. With chronic drug use, more spines develop on the neuron (long term potentiation) so it increases the receptors for drug interactions.
A common pathway associated with drug abuse is the dopamine or reward system. In the case of drug addiction, the brain system for reward is increased and punishment is decreased. Therefore, the good feelings associated with drug use are heightened and the feelings of punishment are lowered.
Some common words associated with drug use are sensitization and tolerance. In a biological sense sensitization means that with the increase of receptors, the brain is more sensitive or susceptible to drug use. With the same exposure a heightened or enhanced reaction happens. Tolerance means that although you may be sensitive to a small amount of drugs, it takes a longer time to satisfy the craving. This causes a user to need to increase the amount of drugs consumed to get the same effect.
Current treatments typically help with symptoms of drug addiction, withdrawal and aid in preventing relapse. However, we do not have drug that can target and stop these adverse pathways from happening. There are a few novel drug targets being researched. Until we are able to identify a viable, effective strategy, the battle continues.
Looking forward is important to continue researching and understanding the pathways involved in reward and drug-seeking behavior. Once we are able to couple therapy with an effective drug treatment can we begin to fight drug addiction on all fronts.