Introduction
Drug addiction is defined as a lack of control over the taking of drugs to the point where it becomes harmful to the individual. Drug addiction in the UK is renowned for being an expenditure on the NHS's time and resources as well as the cause of more than 4,000 deaths a year. Being such a prevalent issue, drug addiction sparks large debates in the media and politics on whether addiction should be classed as a disease or a personal choice. Evaluating the extent to which an addict chooses to use drugs helps to eliminate the blame culture seen in the media today. The villainization of addicts only furthers their isolation and prevents them from being able to reach out for help. There are serious implications for addicts when people view their predicament as entirely their own choice, the process of recovery from addiction is painful and takes tremendous willpower. It can be made easier when the addict receives support from friends or family. When the media pedals ideas of addicts being the villain they feel as if they cannot share their struggles with those closest to them, increasing the likelihood of continued usage or relapse while on the path to recovery.
Our perceptions of addiction largely influence the way we delegate funding for treatment and rehabilitation strategies, alongside the approach to prevention schemes for drug addiction. The consideration of the nature of addiction may reduce the stigma that surrounds drug addiction in society, however, it is important to remember that drug addiction is a debilitating condition that can not only ruin the sufferer's lives but the lives of the people around them. Which only magnifies the importance of a well-informed understanding of the condition. By investigating all the factors that influence the likelihood of one developing an addiction work can be done to protect children from drug addiction in later life. Evaluating the extent of a person's choice in using drugs also impacts criminal sentencing and responsibility, in some countries addicts are sent to prison for years on end for a condition that they arguably have no control over.
There are many different aspects to explaining and understanding addiction that influence the incidence and persistence of drug use. This is evident from the countless number of explanations of addiction (and its causes) available. This essay will consider the most prevalent ways of interpreting addiction in order to make a sound conclusion on whether it is indeed a choice. It will take primarily, a psychological approach to explaining addiction, this is due to drug addiction's impacts on the brain. As the brain is the site where drugs act, a psychological explanation is most relevant. The psychological explanation looks at a cognitive model of addiction while applying principles of neuroplasticity and brain structure to best depict the impact of drugs on the brain. Alongside looking at the explanation for addiction the analysis will include an overview of contributing factors that can increase the likelihood of developing an addiction. For example, there are various environmental, social, and situational factors that one may not initially realize can dramatically increase an individual's chances of addictive behavior. Childhood events can also increase the probability of a child becoming addicted as they grow older, specifically trauma experienced in the early years of childhood. There will also be an analysis of the representations of drug addiction in the media, this is an important factor in determining choice as media becomes more prevalent in everyday life. Approximately 1 in 11 people in the UK between the ages of 16 to 59 used drugs at least once in 2018, this statistic addresses the importance of understanding addiction. There is a common saying that every addict is chasing their first experience with their drug of choice, hence why it is important to evaluate the degree of choice involved in an individual's first usage, as well as the subsequent addiction. With such a high number of people using drugs it is vital that the general public gains an understanding of the lack of control that addicts have over their condition; similarly, knowledge of the risk factors associated with addiction can aid people in making informed decisions about drug usage. A risk factor is an element of an addict's life that increases their chance of becoming addicted to drugs, identifying these factors in oneself or a peer can prevent people from becoming addicts due to their own lack of knowledge. The consequences of drug addiction are so momentous that measures need to be taken to provide education to the whole population.
Analysis
The Psychological Explanation of Addiction: The use of psychology to explain drug addiction is fundamental as drugs act directly on the brain, the psychological explanation of addiction outlines the effect of drug use on brain function and how addiction surfaces consequently. The brain's reaction to drugs is sequential, and thus not chosen by the user. Which highlights the degree of choice an addict has after first using drugs.
The brain is made up of neuron cells, which is how it receives and translates signals. Neurons communicate with one another across a synapse, which is a gap between the presynaptic and the post-synaptic neuron, electrical signals are passed through the neurons in the brain. Neurons can also communicate using neurotransmitters like dopamine, which is released in response to drug usage. The reason addiction is such a long-lasting condition is largely down to the brain's neuroplasticity, which is essentially the brain's ability to rewire itself, consequentially changing the way in which it functions. The brain's neuroplasticity allows it to manipulate its physical structure in response to experiences, repeated behaviors, emotions, and thoughts. In the case of drug addiction; the effects of drug usage. Using drugs for the first time is a new experience for the brain, new pathways are formed and neurons that have not been used before are now active. Once this pathway is created there is no going back for the addict, reducing the amount of activity the pathway receives can deplete the cravings drug users experience. However, the only way to do this is to stop using drugs completely, for a prolonged period of time, which for addicts is no easy feat. Drugs are also known to influence the limbic system in the brain, which is associated with the feeling of pleasure due to the release of chemical messengers.
The majority of drugs interfere with the brain's reward circuit:
- Stimulus: an external or internal cue associated with the drug
- Urge: the limbic system registers the stimulus which creates the urge to use
- Desire: the cortex registers the urge
- Action: the body is instructed to use the drug by the cortex
- Reward: the limbic system will release neurotransmitters in response
- Satisfaction: these neurotransmitters increase the levels of dopamine, creating the high
The way that the reward system is altered is seen in the brain's reaction to the spikes in dopamine levels, it will begin to produce less dopamine altogether, creating what is known as tolerance to the drug. The satisfaction will never be of the same intensity it was before, resulting in less enjoyment in their lives without drugs. The user is then left with less fulfillment in the other aspects of their life and spends their time attempting to experience the same feeling of their first high, leading to repeated use and thus drug addiction. This demonstrates how dopamine plays a key role in the development of drug addiction. Another way the reward system is changed is in attention to cues, cues that prior to becoming addicted would have been random and unrelated will trigger the reward circuit . Giving the addict the urge to use more frequently, feeding their addiction.
There are multiple brain structures that are involved in or affected by drug addiction. Primarily the nucleus accumbens, which releases dopamine after usage. A brain structure impacted by addiction is the extended amygdala, which produces the symptoms of discomfort associated with withdrawal. Consistent usage over time increases its sensitivity, the addict eventually uses the drug to relieve their discomfort rather than to feel the high. The basal ganglia are impacted by drug addiction the same way. A general area of the brain altered is the prefrontal cortex; with a role in executive functions like rational judgement or impulse control, the prefrontal cortex is weakened . This becomes one of the reasons that recovery from drug addiction is such a difficult process as the addict struggles to see sense and has little will power against the effects of the drugs.
Environmental Risk Factors: The list of environmental factors that increase an individual's chance of developing an addiction to drugs is extensive; the acknowledgment of environmental pressures influencing drug addiction helps to demonstrate the lack of control some addicts have over their situation. The majority of environmental risk factors stem from early childhood, which can help identify which individuals will be most at risk when they grow older.
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Primarily there are family related risk factors (not to be confused with the influence on genetics on drug addiction), the family environment a child grows up in can greatly impact their chances of becoming reliant on substances. Particularly, children who experienced maltreatment or abuse have been found to be seven times more likely to use drugs or alcohol before their 12th birthday . Alongside the impact of abuse, children who grow up in homes that exhibit drug use (specifically in parental figures) are more likely to develop drug addiction in their future . Exposing young children to casual drug use at such a young age normalises it for them; when they grow old enough to access drugs themselves they will not see it as morally wrong or dangerous as their own parents (a child's moral compass) will have used drugs openly themselves.
Comparatively, some drug addicts are forced into recovery when they can no longer fund the consistent usage an addict relies on, meaning that an individual's economic status can impact their chances if becoming addicted to drugs. Those who live more lucrative lifestyles have the means to consistently purchase and use drugs where other people may not be able to fund such behaviors. This factor is most impactful in an individual's decision to buy drugs for themselves for the first time, if they do not have the spare funds to buy initially they may decide against it. Drug addicts with less money often end up homeless and spend the only money they have on drugs, pushing them into poverty and creating a dangerous environment for an addict.
Another environmental factor influencing addiction is an individual's peer environment; peer pressure can make a big impact on whether someone decides to use drugs or not. They may be coerced into usage by friends or the impact may be more indirect. If one is surrounded by friends who regularly exhibit casual drug usage, they are more likely to fall into the same behavioral patterns.
The age that an individual first uses drugs can impact their vulnerability to addiction. Teenagers who begin using any addictive substance before age 18 are six and a half times more likely to develop a substance use disorder than those who are exposed during adulthood, suggesting that age has a major role in the chance of developing a drug addiction. Demonstrating how
There are community risk factors involved with a person's chances of becoming addicted to drugs, with a similar nature to peer risk factors. If members of the community are actively using drugs it not only normalises usage; it also increases an individual's accessibility to drugs. This is in conjunction with the risk factors associated with geographic location, it is more commonplace for urban neighbourhoods (as opposed to rural) to house people who distribute and use drugs due to population density and other factors. The establishment of a community is dependant on location hence the relationship between the two.
If someone is suffering from a mental disorder of some nature it is not unusual for them to turn to drugs as a form of self-medication, they may become reliant on the drug to reduce their discomfort . If they succeed in achieving that relief they will become addicted much faster than someone who does not have a mental disorder. For those who don't they achieve a new euphoria that exceeds the joys in their day-to-day lives, for people with mental disorders they experience the euphoria alongside the temporary reduction of the symptoms of their disorder that makes their lives more difficult. Providing them with the seemingly perfect escape. In reality, they will only suffer more further down the line, and it is most likely the mental issues they previously suffered with will only become more amplified.
The consideration of these environmental risk factors is essential in evaluating whether addiction is a choice, with all of these factors the individual does not choose to be exposed. One cannot choose the home or area they are brought up in; when the environment has such a large influence on their chance of using drugs there appears to be very little choice in the matter. The majority of environmental risk factors are unavoidable and are rooted in childhood; making it even more challenging for people to escape the future that has been laid out for them and eliminating the ability to choose. The more environmental risk factors that a person is victim to, the chance of drug usage that leads to addiction is greater.
The Impact of Drug Illegalisation: Drug policies from nation to nation widely differ, we see the most relaxed policies in the world in the following countries: Portugal, Switzerland, the Czech Republic, The Netherlands, and Uruguay (there are also some states in America which have more relaxed policies). It is difficult to properly deduce the effectiveness of these policies against addiction rates due to the sheer number of extraneous variables that impact the results. However, one can safely assume that more relaxed policies can aid an easier recovery from addiction; government resources can be channeled into rehabilitation prevention programs, providing addicts with the support they need. Punishment for possession under certain policies can be years in prison, resulting in a passive recovery from addiction. This means that upon release the individual may return to using drugs just as they were before. If criminal sentencing is reduced and efforts are made to provide the perpetrator with access to successful rehabilitation programs, there is less chance of re-offending and falling back into the unhealthy lifestyle of a drug addict.
The Netherlands has a famously unrestricted approach to the distribution and usage of marijuana, which is often seen as a gateway drug to more addictive substances. The creation of coffee shops that can sell marijuana resulted in only 14% of marijuana users being able to get other drugs from their source, which is a significantly lower amount than in other countries with stricter policies. The prevalence of this statistic in addiction prevention is monumental, the consequences of frequent marijuana use are minimal when compared to higher-classed drugs like cocaine, heroin, methamphetamine, and more. This dispels the argument and possibility of marijuana being a gateway drug as mentioned previously. The impact of illegalization can be related to the geographical location risk factor; government law surrounding drug use is entirely dependent on an individual's place of living. This is not a choice for many, demonstrating how drug policy may contribute to addiction.
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