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Exploring the healthy side with Fardad

The science behind drug addiction, and how drugs affect the body

It’s said we are creatures of habit. Sometimes though, those habits can turn into addictions. In this edition of The Healthy Side, we are going to explore drug addiction and its real effects on the body.

Drug addiction is an organic disease of the body. Using addictive substances literally changes the brain’s chemistry, leading to a strong physical dependency on them.

The brain is a very complex organ, made up of billions of cells called neurons. The connections between these neurons is what enables us to think, move, feel, act and essentially process every conscious and unconscious intake of environmental stimuli and respond accordingly.

You may have heard that there is electrical current in the brain.

A neurotransmitter can be excitatory or inhibitory—that is, it may contribute to exciting the next neuron or inhibiting its excitation. For our purposes, we are going to talk about a well-known excitatory neurotransmitter called dopamine. Dopamine, along with a few other neurotransmitters, is responsible for making you feel good.

Once dopamine is released via transporters in the producing cell, called the presynaptic cell, it temporarily latches on to the receptors on the surface of its target, called the postsynaptic cell, and causes further actions to occur in that cell.

The dopamine itself is not taken in by the target cell—its binding is temporary and after a short period it is detached and taken back into the presynaptic cell.

Substances can affect and alter this natural pathway in three broad ways:

  1. Overproduction of dopamine: the opioid family of substances such as heroin and fentanyl stimulate VTA to over-produce dopamine. This rush of abnormally large amounts of dopamine hits the user with a sudden and very strong feeling of euphoria.  An unfortunate side-effect of opioids is slowing down breathing. This can be particularly dangerous if mixed with other substances that also slow down the body such as alcohol, anti-anxiety medications and other opioids. Current statistics indicate every 19 minutes, someone dies from accidental prescription drug overdose (most of them containing opioids).
  2. Blockage of the transporters: drugs such as cocaine quickly enter the brain and bind to the transporters on the presynaptic cell, blocking dopamine from being taken back inside. This accumulates large amounts of dopamine in the space between these cells (called the synaptic cleft) and for longer. Constant presence of larger than normal levels of dopamine in the cleft causes the postsynaptic cell to be hyper-activated, leading to a prolonged feeling of euphoria. This establishes a powerful link between this feeling and the drug – which makes the user want to use it again.
  3. Stimulation and blockage: amphetamine family of drugs behave both like opioids and cocaine. In lower dosage, meth acts like cocaine in blocking the uptake of dopamine back to the presynaptic cell. In higher doses, in addition to the blocking effect, meth stimulates the presynaptic cell to release even more dopamine. Because of this dual effect, the accumulation of dopamine in the synaptic cleft becomes extreme, leading to dangerously high hyper-activation of the postsynaptic cell. This results in an extreme feeling of euphoria making meth incredibly addictive.

Drugs alter how the reward centre communicates with the rest of the brain: affecting emotions, movement, reasoning and decision making. Repeated use of these drugs makes changes to the chemistry of the brain, which eventually prevents the user from experiencing the same euphoria when first using the drug: the user builds tolerance toward the substance.

Fardad is a science student here at Concordia. He wants to share his research and learning about the science field with the Concordia community.

Graphic by Florence Yee

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Opinions

Addiction 101

According to the Centre for Addiction and Mental Health, 1 out of 10 Canadians over the age of 15 will experience a dependence to either drugs or alcohol. Though there are numerous support groups out there to help deal with this disease, the rate will likely only increase unless steps are taken to help doctors learn how to help their patients.

The health care system in this country is not fully equipped to deal with the ever-growing problem of addiction. There are barely any training programs for doctors, nurses, and specialists when it comes to dealing with addiction in its many forms. This desperately needs to change, for it is disheartening to live in a society where people can’t get sufficient treatment for such a common and difficult disease.

Dr. Evan Wood is a Vancouver medical doctor focusing on inner-city medicine. This lack of training for doctors, said Wood, extends beyond the shortcomings of British Columbia’s system.

“The problem is typical of all Canadian provinces,” he said. “Dedicated and caring as they usually are, most Canadian physicians who consider themselves addiction medicine specialists assembled their knowledge about addiction treatment after completing their medical training.”

What Canada really needs are doctors and specialists who know exactly how to approach addiction and have formal training, as well as experience in the field. We need to teach physicians how to help people who are struggling with such deeply personal and psychological issues, using the latest scientific and therapeutic advances.

Wood has familiarized himself with many addiction centres in and around the country and believes that having a trained doctor when it comes to dealing with addiction can make all the difference.

“What was really eye-opening from my visit to [the Boston Medical Center’s Clinical Addiction Research and Education Unit] was the impact that a skilled addiction medicine workforce can have in turning patients’ lives around,” he said.

Canada needs to invest more time and money in the creation of programs where such skills and techniques can be taught and developed. Hope is not lost though, said Wood, referring to a new initiative which could prove game-changing in the fight to improve addiction treatment.

“A potentially ground-shifting opportunity has emerged with the recent establishment of the American Board of Addiction Medicine,” he said. “The board has created guidelines for the development of addiction medicine fellowship programs enabling Canadian medical schools to create programs that are eligible for full accreditation.”

Now it’s Canada’s turn to invest more money and time, in order to create effective addiction training programs, and stop ignoring the larger problem at work.

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