On Addiction Mechanisms

Some suffer for years, not seeking help, donning a mask and putting on a brave face in the face of adversity. Often, the entire family suffers, especially children. Addictions have many faces, and anyone can become addicted to… practically anything. However, addictions to psychoactive substances are perceived as the most challenging and dramatically severe.

According to statistics, 1.6 million Poles, 3.2 million Britons, and 6 million Germans have had active contact with drugs at least once in their lives. One in 12 adult residents of the European Union consumes alcohol daily. Despite campaigns promoting healthy lifestyles, the trend of being “fit,” and increasingly comprehensive preventative programs, the issue of addiction remains relevant, and combating its consequences drains state budgets. The most tragic aspect, however, is that addictions claim lives every day.

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Drug Addict = Junkie?

Drug addiction is a serious health and social issue. The stereotype of the street “junkie” has shaped the general perception, often picturing the drug addict as someone straight out of the book and movie about Christiane Felscherinow (Wir Kinder vom Bahnhof Zoo, translated into English simply as Christiane F.).

However, the use of psychoactive substances in the 21st century has taken a completely different form. The clientele of dealers often includes well-off individuals, successful people, executives, and children from affluent homes. Dealers themselves resemble elegant salespeople rather than hooded villains lurking in dark alleys. Acquiring a “fix” in a large city is as easy as ordering a pizza. Despite ongoing efforts to combat the distribution system, drugs remain highly accessible. And addiction is rarely kept under control.

The primary problem for someone addicted to drugs is that the body invariably develops a tolerance to the substance. This is why overdoses, often fatal, are common. However, before severe addiction sets in, there is a phase of experimentation. This is a critically dangerous period because, although there have been theories to the contrary, not every psychoactive substance is addictive from the first use. The first encounter with drugs is often unremarkable or accidental. Initiation occurs under various circumstances, often among friends. It is not uncommon for the first psychoactive substances encountered by young people to be medications found, for example, in the home medicine cabinet.

The Most Formidable Adversary: Euphoria and the Absence of Pain

The first encounter with opioids often occurs through the misuse of medications prescribed for severe pain management, such as Oxycodone. Individuals experience a state of euphoria, analgesia, disappearance of pain sensation, muscle relaxation, and a feeling of bliss. Physical dependence develops after regular, prolonged use, but even short-term use over a few days can lead to mild withdrawal symptoms. Long-term misuse of these substances requires controlled detoxification in a hospital setting.

Similar to many other substances, the body quickly develops tolerance, unfortunately, only to the euphoric effects of opioids. Therefore, diminishing experiences necessitate increasingly stronger doses, which can ultimately lead to fatal respiratory depression (although it is difficult to determine the exact amount of substance that can cause this).

Anxiety Eventually Disappears…

Among those addicted to medications, substances from the benzodiazepine group (alprazolam, lorazepam) are also popular. Their biological mechanism of action differs, but their misuse is equally destructive. While fatal poisoning is difficult if the individual limits themselves to the drug alone, deaths often occur in combination with alcohol, which intensifies the depressive effect of benzodiazepines on the central nervous system, leading to fatal coma.

The misuse of drugs in this category is often linked to addiction to the calming and anti-anxiety effect brought about by their action on the GABA-ergic receptor complex. This results in a strong psychological dependence, especially among individuals suffering from anxiety disorders of various origins.

Immortality Mode

A completely different category of psychoactive substances consists of stimulants, which have effects opposite to opioids and benzodiazepines. The most popular among them, amphetamine, is used to treat Attention Deficit Hyperactivity Disorder (ADHD), narcolepsy, and obesity. It acts on the central nervous system by increasing the effects of neurotransmitters: dopamine and norepinephrine. When abused in non-therapeutic doses, it induces a feeling of intense stimulation, increased strength, and endurance, while psychologically enhancing sociability, openness, and a propensity to take risks. Taking increased doses of amphetamine is associated with numerous side effects, including anxiety and psychomotor agitation.

Another popular stimulant is cocaine, derived from the leaves of the coca plant (Erythroxylum coca). It inhibits the reuptake of the same neurotransmitters mentioned above – norepinephrine and dopamine, causing their increased bioavailability to receptors. Depending on the dose and method of consumption, the psychotropic effects include euphoria, reduced anxiety, openness to social interactions, and increased self-confidence. Intravenous administration allows the substance to reach the brain more quickly. Its effects can lead to the emergence of vivid, narcotic visions that remain etched in memory for a long time.

Cocaine is highly addictive and causes permanent and irreversible changes in the brain. After the pleasant sensations subside, a phase of rapid deterioration in mood follows, prompting the consumption of another dose. Rapidly developing tolerance requires increasingly larger amounts of the substance to achieve the desired effect. The consequences of drug use include personality disorders, depression with suicidal attempts, and cocaine-induced psychosis. Death most often occurs from an intravenous lethal dose of 20 milligrams, leading to asphyxiation caused by paralysis of the respiratory center.

Escaping to Another World

Addiction also develops through the use of substances that alter perception. The most popular among these, psychedelics, contrary to popular belief, do not induce hallucinations. Instead, they bring about a completely different, alien state of mind in the user. The experiences associated with taking these substances are often described as mystical. The euphoria and exaltation experienced encourage subsequent substance use.

Occasionally, as reported by those who are addicted, a reaction known as a bad trip may occur. These are terrifying and unbearable experiences of anxiety attacks or delusions. A popular psychedelic, LSD, is considered to be a substance from which physical addiction is unlikely. However, like any substance, it can lead to psychological dependence.

Staying in the Healthy World

What does a person desire? A reality without pain. A sense of continuous happiness and attachment, unconditional acceptance, spiritual upliftment, connection with one’s emotions and the world. It sounds like a description of paradise, but it is the genuine longing of the human soul. Some of these states can be achieved by building healthy relationships based on love.

However, those who have not experienced love often seek happiness elsewhere. Sometimes they find powder, a pill, or a syringe along their path that helps them momentarily. But the state achieved in this manner is not real. A harsh landing awaits them shortly. How, then, can we keep a person sober? Love them – from the first to the last day of their life.

Translation: Klaudia Tarasiewicz