Pathogenesis of addiction
Contemporary medicine defines addiction as a chronic progressive mental illness with a tendency to somatization.
Drugs have a destructive and toxic effect on:
- certain brain systems and structures
- internal organs and systems
- the offspring
To understand the changes that arise in addicts and to determine the type of medical assistance, one needs to clearly grasp the underlying biological mechanisms of addiction.
These are complex disorders of brain functions, its various structures, and neurochemical processes
As contemporary scientific facts confirm, neurophysiological mechanisms of the development of addiction to psychoactive substances take place in the mesolimbic structures of the brain, in the reward system.
The reward system participates in the regulation of the emotional state, mood, motivation, behavior, and adaptation to the environment.
The influence of psychoactive substances on these parts of the brain leads to the intense secretion of neuromediators, primarily dopamine, causing the extreme triggering of the reward system with positive emotional reactions.
Psychoactive substances continually affect the motivation system in the brain, which is usually triggered by stimulants such as water, food, danger, and friends. Under the influence of the substance, the brain begins to “falsely” react, as if psychoactive substances and stimulants associated with them are biologically necessary to it.
After the frequent taking of psychoactive substances, the associative relationship grows stronger and leads to an ever-more pronounced neurochemical reaction and behavior change.
Retaking of psychoactive substances leads to spending of reserves of neuromediators, especially dopamine. The person is in a bad mood, feels languor, weakness, boredom, emotional discomfort, symptoms of depression. Re-taking of psychoactive substances causes additional secretion of neuromediators, temporarily normalizing the situation.
Subjectively, the mood improves to psychological excitement, when neuromediators are rapidly destroyed again, leading to a sudden worsening of the psycho-emotional condition and a strong desire for drugs. Positron emission tomography data confirm the above-mentioned changes in the brain work.
When comparing the brain tomography results of addicts and those of healthy people, one can notice changes in the work of the addicts’ brain, a disorder of neurochemical processes, disorders of the brain centers responsible for emotions, decision making, and self-control.
Changes in the activity of the ferments lead to dopamine accumulation. It is this process that causes the emergence of significant clinical signs of withdrawal syndrome, such as anxiety, tension, excitement, sleep disturbance, high arterial pressure, tachycardia, other vegetative disorders, psychotic conditions.
The lack of dopamine in the brain leads to a desire for drugs and relapse. The blood level of dopamine is associated with the clinical picture of withdrawal syndrome: if it is twice as high, it is a sign of severe withdrawal syndrome, and if it is three times higher, it indicates acute psychotic condition.
Frequent and long-term consumption of psychoactive substances leads to disturbances in the operation of neuromediators. The level of dopamine increases independently of which chemical group the substance belongs to.
The identity of the basic mechanisms for the development of addiction and the clinical picture of different types of addictive disorders points to the essential similarity of biological mechanisms of all forms of addiction.
Given the close functional relationship of all neurochemical processes in the brain, the regulation of the dopamine system functions can be achieved by directly influencing various links and regulators of dopamine, and through other neuromediators and neuromodulators.
Contemporary medicine offers a complex approach to treating addictive disorders: psychotropic drugs, xenon gas, neurometabolic therapy, and stem cell therapy are used.