Try it once, to see the effect it does. A second, because the desire to still feel that surge of pleasure is so much. And then a third, because I stop whenever I want. But this is not the case and slowly many, almost without realizing it, slip into the dependence on the most disparate substances but also on behaviors that in one way or another cause pleasure, from sex to food, from gambling to social media. The drugs of abuse are very powerful in binding those who try them and often it only takes once to fall into them: a recent study on Neuropsychopharmacology noted that with most drugs, it doesn’t take a habit of taking them to get addicted. We are, in short, very vulnerable in front of cocaine, alcohol and the like and according to what emerged during the last congress of the Italian Society of Pharmacology (Sif) to be more or less fragile it depends both on genes and on the environment.
Effects on the brain
Studies of twins adopted from different families suggest that about half of the risk of addiction may come from genes that favor it, explains Marco Pistis, member of the Sif board and professor of pharmacology at the University of Cagliari. The rest depends on the environment and life choices, which regulate and remodel the expression of genes by modifying their functionality through molecular mechanisms: for example, marking the DNA and making it “unroll” in specific points so as to be able to produce greater quantities of proteins which are associated with addiction to substances. The periods in which the influence of the environment on the risk of addiction is highest are fetal life and adolescence, moments of tumultuous brain development: exposure to substances of abuse by the mother during pregnancy or their consumption as a child determine alterations in genetic function and therefore in brain development which increase the subsequent danger of substance abuse and mental illness. Most people with a substance addiction, from cigarettes to drugs, started in adolescence, he confirms Leonardo Bontempi, researcher of the Laboratory of Neuromodulation and cortical and subcortical circuits of the Italian Institute of Technology in Genoa. The development of the frontal areas responsible for controlling behavior is completed around 25 yearsIf a child comes into contact with an addictive substance, it is easy to play because the impulsivity is greater and more reactive is the dopamine system, the key neurotransmitter for gratification and learning.
The motivating molecule
The mechanisms by which the inability to do without something is established change a little depending on the substance, but they have in common precisely the increase in the release of dopamine in the brain; known as the pleasure molecule but not only for this reason that leads to addiction, on the contrary. As Bontempi points out Dopamine strengthens the memory of the pleasant sensation and thus prompts us to behave in such a way as to get it again, in short, a “motivating” molecule which is released from all substances of abuse not so much at the time of consumption, but in the sole presence of them, therefore in view of the reward. It is no coincidence that dopamine increases with sex and food: the system evolved to create a positive association with essential elements for survival, so that we actively seek them out. Unfortunately drugs are capable of increasing dopamine a lot in the brain, motivating us to want more to the point of putting out of use the frontal brain areas that evaluate risks and inhibit behavior.
Different power
Some substances are more powerful than others, both in increasing the release of dopamine (such as cocaine) and in causing intense pleasure, which instead depends on the ability to press other keys in the brain, such as opiate receptors. The result is often addiction, which it can be diagnosed relatively easily taking into account the presence of ten criteria, depending on the substance involved, there are therapies to get out of it, often with replacement molecules. In practice, the same pathways activated by the drug of abuse are stimulated but with something that is less harmful: methadone in the case of heroin, varenicline if you have to quit the nicotine of cigarettes and so on. On the other hand, one cannot act on the dopamine system, as Bontempi points out, because blocking it would mean leading to a lack of pleasure and motivation, to depression; activating it would be like giving other drugs of abuse.
Recognize the problem
However, the first step is to recognize the problem, then the intervention in addition to drugs must foresee psychological and psychotherapeutic support, he points out Guido Mannaioni, councilor of the Italian Society of Toxicology and director of the Medical Toxicology Unit and Poison Control Center of the Careggi University Hospital in Florence. Detoxification is possible and in some ways easy, most of those who have a minimum willingness to get out and start an outpatient or hospital path succeeds. The real problem is not to fall back on it or not to switch from one substance to another, as unfortunately often happens. This is also why non-pharmacological techniques such as Transcranial Magnetic Stimulation (Tms), which was initially successfully tested on the cocaine addiction and now we are trying on others, such as alcohol or tobacco: it reduces the craving, or the irrepressible desire for the substance, and therefore it can help. But not a panacea and does not turn off the urge as if we flick a switch. Unfortunately, addictions have a huge impact on the brain and body, even if now the underlying mechanisms are clearer, it is not easy to get out of them, Bontempi admits.
Not a vice
There are so many addictive substances, not just drugs of abuse such as heroin, cocaine, amphetamines: alcohol and cigarettes are highly addictive, my pure fmedicines such as benzodiazepines, used for their anxiolytic effect or for sleeping. The gravest mistake, however, is to believe that addiction is a vice, a bad habit, a problem of weak personalities: a real disease, to be treated once it is established, explains Pistis. Patients experience stigma and prejudice, many do not turn to the local drug addiction services out of shame, because they believe they are to blame, but not so. The risk of slip into a disorder substance abuse often depends on the context of life, adds Bontempi. There are those who are depressed and no longer taking pleasure in anything, he finds in substances a shortcut to feel something, who suffers strong social pressures for work performance and tries to “cheer up” with cocaine, the shy teenager who uses alcohol to be bolder: It is essential to warn the population about the risks involved in trying certain substancesbut when a person has fallen into the trap of addiction and can no longer control himself, he can no longer choose. a sick person, and as such must be helped to recover from a very complicated pathology.
The risks of cannabis
the most used drug of abuse in the world: according to 2020 data from the United Nations Office on Drugs, about 192 million people took recreational cannabis last year. very widespread among young people: in Europe one boy between 15 and 24 years of age has used it at least once in the previous year, one in ten in the last month. A serious problem, because it does not cause death by overdose and so is wrongly perceived as a soft drug: many think that it is not addictive, for example, but as they have explained Tiziana Rubino,of the University of Insubria, and Miriam Melis , of the University of Cagliari, during the last congress of the Italian Society of Pharmacology Those who use it once or twice have a 9 percent risk of addiction, if the consumption is frequent and begins in adolescence the probability rises to 17 percent. Therefore, less than other substances, but the danger is high because there is now the certainty that use in adolescence, even if it does not lead to real addiction, is associated with a high risk of developing cognitive deficits, depression, psychosis.
In pregnancy and on boys
In fact, children’s brains have a specific vulnerability to the effects of cannabis because the endocannabinoid system, on which this drug acts, plays an essential role in the maturation of brain circuits and remodeling typical of adolescence: using cannabis alters this system, modifying the development of the brain and its delicate balances in a sometimes irreversible way. Self in some, brain plasticity can compensate for the damage, in people more fragile for genetic or environmental reasons the brain’s self-repair capacity may not be enough to guarantee a correct cognitive development: in this way one can have inadequate responses to stimuli and the danger of mental and cognitive disorders increases. Woe to believe that all this applies only to heavy abuse: the most recent studies have been conducted with low dosages of the active ingredient (tetrahydrocannabinol or Thc) and, as Melis explains, they show that the most important variable for adverse effects is the age of intake: the lower, the more deleterious the consequences on the maturation processes of the brain. true for adolescence, even more so if the exposure is even earlier: Cannabinoids cross the placenta and pass into breast milk: Exposure during pregnancy and in the first months is very harmful because it alters the baby’s brain circuits and behavior, with a long-term negative impact on cognitive development, specifies Melis. Anyone who has been exposed to cannabis in utero has reduced attention and learning skills, increased aggression and impulsiveness, a higher risk of hyperactivity and sleep disturbances as well as the propensity to risk behaviors, including early drug use, and psychotic experiences already as children.
June 9, 2021 (change June 9, 2021 | 18:26)
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