The Science of Addiction

The National Institute on Drug Abuse defines addiction as a chronic, relapsing brain disease characterized by compulsive drug seeking and use, despite harmful consequences. Drugs can change the structure of the brain and how it works, which is why addiction is considered a brain disease.

According to the National Center on Addiction and Substance Abuse (CASA) at Columbia University, adolescent substance abuse ranks as this country’s greatest health problem [1]. Today, nearly half of all U.S. high school students currently smoke, drink, or use other dangerous drugs; a third of users meet the DSM-IV criteria for addiction according to the report. The 400-page CASA report is being considered the most comprehensive look at teen substance use to date. The study is based on nationally representative online surveys of 1,000 high school students, 1,000 parents of high school students, and 500 school personnel, including teachers, principals, counselors, and coaches. The findings of the report include the following:

  • Three-fourths of high school students have smoked cigarettes, drank alcohol, or used another drug.
  • Alcohol is the most preferred addictive substance among high school students, followed by cigarettes, marijuana, and controlled prescription drugs, such as narcotic analgesics (hydrocodone and oxycodone).
  • Two-thirds of high school students have used more than one addictive substance. ·A quarter of teens that responded to the CASA survey said they consider marijuana to be harmless, and about one in six view it as medicine.

A major concern with these findings is the younger a person is when experimenting with an addictive substance the greater the likelihood the person will become addicted as an adult.  People who use addictive substances before age 18 are six times more likely to later develop a substance use disorder than those who did not start using until they were 21 or older.

Calibrating prevention programs to deal with the forces that drive junior high and high school drug use could generate exponential benefits in adulthood.  Another startling statistic is 90 percent of Americans who meet the medical criteria for addiction started smoking, drinking, or using other drugs before age 18. Previous articles from this Journal have touched upon adolescent drug use and the effects they have on teens; this new study makes a clear connection between adolescent “start-up” use and lifelong addiction in adulthood. The adolescent brain has an immature development of the prefrontal cortex that can cause poor impulse control and the favoring of low-effort, yet thrilling, drug experiences. They also feel heightened sensitivity to the social benefits of intoxication which may contribute to an initial decision to use drugs and make the experience rewarding enough to repeat. In a statement in the report, former Representative Jim Ramstad, R-Minn., chair of the CASA national advisory commission on substance use among high school-age Americans, explains, “It is time for America to deal with our Nation’s number one public health problem: substance abuse and addiction. While we must provide treatment for those in need, the best cure is prevention.” The report emphasizes that “teen substance use is a preventable public health problem and addiction is a treatable disease.” There are approximately two million U.S. high school students meeting the criteria for an alcohol or drug use disorder, yet only about 100,000 have received treatment in the past year. [1] National Center on Addiction and Substance Abuse at Columbia University.

Adolescent Substance Use: America’s #1 Public Health Problem. June 2011