Adaptive Habit: a ‘good’ habit. Helps us survive by enabling us to perform many important behaviors automatically, without thinking about them. Adaptive habits are promoted by the release of dopamine into the “prefrontal cortex”… The release not only creates a feeling of pleasure, it ‘conditions’ us. “Conditioning” creates a “long-term memory” that enables us to recognize a “stimulus” the next time we see it, and to respond accordingly. If the stimulus is positive, conditioning motivates us to pursue it. For example, if you eat a banana and fined it delicious, the next time you see a banana you will feel motivated to eat it. (Kandel4, 202)

Addiction Impact: Addiction to substances takes an enormous toll on our society, with an estimated economic cost of over $740 billion annually in the United States. The human cost of addiction, for individuals and for society, is incalculable. (Kandel4, 198) Drug overdoses are now estimated to be the leading cause of death among Americans under the age of fifty. Studies have found that 40 percent of eighteen- to nineteen-year olds in the United States have been exposed at least once to an illegal drug and 75 percent or more have been exposed to alcohol Some of them— approximately 10 percent— will become addicted. (Kandel4, 211)

Addiction Pathways: The (“reward pathway”) from the "ventral tegmental area" to the "nucleus accumbens" is critical for addiction. Animals with lesions in these brain regions no longer show interest in substances of abuse. (Nestler, 146)

Addiction Processes: addictive drugs… stimulate dopamine-producing neurons in the brain’s reward system. In this case, however, the result is greatly increased dopamine concentrations in the prefrontal cortex. The excess dopamine generates intense pleasure. (Kandel4, 202) In the past, addiction was considered to be a manifestation of weak moral character. Today, we understand the it is a mental disorder, a malfunction of the brain’s “reward system.” All drugs of abuse act on this reward system. Each drug acts on a different target, but in every case the net effect is to increase the amount and persistence of dopamine in the brain. Activation of dopamine ‘signaling’ is responsible for the initial high that people experience from drugs. (Begins) with the addictive process itself, in which a drug takes over the brain’s reward system. As a person continues to take the drug… he or she builds up a “tolerance” to it. The dopamine “receptors” no longer respond as effectively as they did before. The same amount of the drug that initially produced a high now produces a normal feeling. As a result, the person needs more of the drug to provide an equivalent high. (Kandel4, 199-202)

Addiction Structures: Other brain regions - namely, the "amygdala,"  "hippocampus," and "frontal cortex" - are involved in addiction and communicate back and forth with the ventral tegmental area and the nucleus accumbens. (Nestler, 151)

Alcohol: a chemical substance found in beer, wine, and liquor, and some medicines, mouthwashes, household products, and scented liquid taken from plants. Alcohol contains a "carbon" "atom" attached to a "molecule" made of an "oxygen" atom and a "hydrogen" atom. (NCIt) Produced by the “fermentation” of sugar by "yeast." The alcohol in alcoholic drinks is ‘ethyl alcohol.’ When taken into the body ethyl alcohol depresses activity of the "central nervous system." (OxfordMed) Alcohol is generally considered a sedative, but actually may have precisely the reverse effect. It makes sleep more fragmented. (Leschziner, 54) Alcohol affects the "prefrontal cortex." (Lewis, 155) ‘Alcoholic intoxication’ is an acute brain syndrome which results from the excessive ingestion of ethanol or alcoholic beverages. (MeSH)

Amphetamines: a group of drugs that have a marked stimulant action on the central nervous system, alleviating fatigue and producing a feeling of mental alertness and well being. Tolerance to amphetamines develops rapidly, and prolonged use may lead to dependence. (OxfordMed) Enhance “dopamine” (production). (Lambert, 41) Powerful central nervous system stimulants. Amphetamine has multiple mechanisms of action including blocking uptake of (adrenalin) and dopamine. Amphetamine is also a drug of abuse. (NCIt) Editor’s note - street names include 'ice,' 'glass,' 'meth,' 'molly,' 'tina,' and 'MDMA.'

Barbiturates: drugs used to treat “insomnia,” “seizures,” and ‘convulsions,’ and to relieve “anxiety” and tension before surgery. It belongs to the family of drugs called central nervous system depressants. (NCIt) Depressant drugs that cause relaxation and sleepiness. At relatively low doses, barbiturates may cause you to seem like you are drunk, or intoxicated. A barbiturate overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication. This is life threatening. A major addiction problem for many people. Most people who take these medications for seizure disorders or pain syndromes do not abuse them. However, those who become addicts usually start by abusing medication prescribed for them or other family members. (PubMedHealth2) Editor's note - street names include 'benzos,' 'downers,' 'reds,' 'blues,' and 'yellow jackets.'

Cocaine: an "alkaloid" that is derived from the leaves of the ‘coca plant’ or prepared synthetically. Causes feelings of exhilaration and may lead to psychologic dependence. Sometimes used as a local anesthetic. (OxfordMed) Affects "norepinephrine" and dopamine levels. (LeDoux, 58) Why do some substances, such as cocaine, produce addiction rather than an “adaptive habit”? Normally, when dopamine binds to receptors on target cells it is taken up and removed from the “synapse” within a short period of time. However, brain imaging reveals that cocaine, a highly addictive drug, interferes with the removal of dopamine from the synapse. As a result, dopamine lingers there and continues to produce pleasurable feelings that persist beyond those produced by ordinary physiological stimuli. (Kandel4, 202) Binds to… “transport proteins” and “inhibits” the “reuptake” of dopamine, serotonin, and norepinephrine. This leads to an accumulation… and may result in increased “postsynaptic receptor” activation. (NCIt) Interacts with the “reward system” in the brain. Fits lock-and-key into the microscopic machinery of the reward (pathway). By plugging into the dopamine system, cocaine and its cousins commandeer the reward system, telling the brain that this is the best possible thing that could be happening. (Eagleman, 205) Editor's note - street names include 'crack,' 'yay,' 'powder,' 'blow,' and 'yayo.'

Dependence: the psychological or physiological need to take a substance in oder to experience its effects or to avoid the effects of its absence. (NCIt) The physical and/or psychological effects produced by the habitual taking of certain drugs, characterized by a compulsion to continue taking the drug. In psychological dependence, repeated use of a drug induces reliance on it for a state of well being and contentment. In physical dependence, withdrawal of the drug causes specific symptoms such as sweating, vomiting, or tremors. (OxfordMed) The onset of withdrawal symptoms upon stopping use of the drug. (Lewis, 154)

Kava: a beverage or extract that is made from a plant native to the western Pacific islands. The name "kava" comes from the Polynesian word "awa," which means bitter. In the South Pacific. Kava is a popular social drink, similar to alcohol in Western societies. It is consumed as a beverage in ceremonies to promote relaxation. Kava is most commonly used for anxiety. Some people take kava for stress, restlessness, sleeping problems, and many other conditions. But there is no good scientific evidence to support these uses. There have been some safety concerns about kava. Cases of liver damage and even some deaths have been traced to kava use. (PubMed) The intoxicating sap of a pepper. Drinking sakau has been a central part of Micronesian life, as chewing coca leaves has been in the Andes, for thousands of years. It may evoke a delicious sense of floating and ease, as well as a variety of visual illusions, or hallucinations. (Sacks6, 187) Also referred to as ‘sakau,’

Nicotine: a poisonous alkaloid derived from tobacco, responsible for the dependence of regular smokers on cigarettes. In small doses nicotine has a stimulating effect on the "autonomic nervous system," causing in regular smokers such effects as raised "blood pressure" and "pulse" rate and impaired appetite. Nicotine replacement therapy (nicotine products formulated as chewing gum, skin patches, and nasal sprays) is used as an aid to stop smoking. (OxfordMed) The nicotine in tobacco products causes "lung cancer." Nicotine is highly addictive. The nicotine in tobacco causes addiction and susceptibility to lung cancer, and it delivers the "carcinogens" (Lewis, 155) It is the “agonist” at (nicotine) receptors where it dramatically stimulates "neurons" and ultimately blocks "synaptic transmission." (MeSH) Exposing animals to nicotine modifies their dopamine-receiving neurons in such a way that they respond more powerfully to cocaine. In contrast, giving the animal cocaine first has no effect on their subsequent response to nicotine. Thus, nicotine primes the brain for cocaine addiction. Society has taken great pains to discourage people from smoking, and it is quite likely that reducing the number of smokers will reduce other sorts of addictions as well. (Kandel4, 207)

Tobacco: a plant genus of the family ‘solanaceae.’ Members contain nicotine and other biologically active chemicals; its dried leaves are used for smoking. (MeSH) After harvesting, tobacco leaves are cured, aged, and processed in various ways. The resulting products may be smoked (in cigarettes, cigars, and pipes), applied to the gums (as dipping and chewing tobacco), or inhaled (as snuff). Cured tobacco leaves and the products made from them contain many cancer-causing chemicals, and tobacco use and exposure to secondhand tobacco smoke have been strongly linked to many types of cancer and other diseases. (NCI1)

Opiates: opiates are (narcotics) made from opium or have opium in them. Opiates bind to opioid receptors in the central nervous system. Examples of opiates are "codeine," "heroin," and "morphine." An opiate is a type of analgesic agent. (NCIt) Various drugs derived from the opium poppy and used as narcotics, hypnotics, sedatives, and "analgesics." (Oxford) Substance used to treat pain or cause sleep. Opiates are made from opium or have opium in them. Opiates bind to opioid receptors in the central nervous system. (NCI1) Imbalances of neurotransmitter at synapses result in an imbalanced mind. (Fields, 146) Neurons increase their "excitability" when exposed to opiates for prolonged periods. Therefore more morphine or heroin is necessary to suppress their activity again. (Fields, 201)

Codeine: analgesic derived from morphine but less potent as a pain killer and sedative, and less toxic. (OxfordMed) An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. Codeine mimics the actions of endogenous opioids by binding to the opioid receptors at many sites within the central nervous system. (NCIt)

Heroin: a white crystalline powder derived from morphine that is a highly addictive drug of abuse. (OxfordMed) Affects synaptic transmission in the brain. (Fields, 146) An easy drug to 'overdose' on. One's tolerance increases over time, making ever stronger doses necessary to achieve the same effect. The effective dose for a hardened addict may be a fatal dose for someone trying heroin for the first time. (Fields, 200) (According to pain researchers) the source of "chronic pain" is not in pain neurons themselves, but rather in "glia." This insight is cracking the case of drug addiction to heroin and other narcotics. (Fields, 186) Editor's note - street names include 'dragon,' 'black tar,' 'brown sugar,' 'white lady,' and 'tigre.'

Morphine: a potent analgesic used mainly to relieve severe and persistent pain, particularly in terminally ill patients. It also induces feelings of “euphoria.” With regular use tolerance develops and dependence may occur. (OxfordMed) Narcotics like morphine block pain where the pain signals are passed from the "sensory neurons" to the pain (pathways) inside the spinal cord. (These) neurons have receptors for these narcotic drugs, which inhibit the activity of the neurons. (Fields, 191) Morphine binds to and activates specific opiate receptors, each of which are involved in controlling different brain functions. (NCIt)

Opium: the air-dried (product) from the unripe seed capsule of the opium poppy. Opium has been used as an analgesic. (MeSH) A reddish-brown strong-scented addictive drug prepared from the thickened dried juice of the unripe capsules of the opium poppy flower. (Oxford)

Opioids: substances used to treat moderate to severe pain. Opioids are like opiates, such as morphine and codeine, but are not made from opium. Opioids bind to opioid receptors in the central nervous system. (NCI1) Opioid pain relievers are medicines that can help manage pain when other treatments and medicines are not able to provide enough pain relief. Opioids have serious risks, including misuse and abuse, addiction, overdose, and death. The misuse and abuse of illicit and prescription opioids and the risks of addiction, overdose, and death are a public health crisis in the United States. (MedlinePlus) Editor’s note- sometimes used in a broader sense as “narcotics.”

Oxycodone: medication is used to help relieve moderate to severe pain. Oxycodone belongs to a class of drugs known as opioid analgesics. It works in the brain to change how your body feels and responds to pain. (WebMD) Used to relieve pain severe enough to require opioid treatment and when other pain medicines did not work well enough or cannot be tolerated. Oxycodone acts on the central nervous system to relieve pain. ‘OxyCONTIN’ is a US brand name for oxycodone. (Mayo)

Relapse: a deterioration in a patient’s condition after a partial or apparently complete recovery. (Oxford) Return to drug use after an attempt to stop. (National Institute of Drug Abuse) An addicted person has learned to “associate” the drug with a certain place, certain people, certain music, and a certain time of day. These associations, rather than the drug itself, often lead to… relapse. Relapse is possible even after a person has given up drugs for weeks, months, or even years. The memory of the pleasurable drug experience and the cues associated with it essentially persist forever. Exposure to those cues— the sight or smell of the drug, walking down a street where the person used to buy the drug, or bumping into people who used the drug— triggers a tremendous urge to use the drug again. Because of the ease with which addicted people relapse, we now know that addiction is a “chronic” disease, like “diabetes.” People can be helped to avoid relapse, but recovery is a lifelong process requiring great effort and vigilance on the part of the addicted person. (Kandel4, 203)

Tolerance: a condition that occurs when the body gets used to a medicine so that either more medicine is needed or different medicine is needed. Increased doses are required to produce the same magnitude of effect previously produced by a smaller dose. (NCIt) The need to take more of the drug to achieve the same effects as time goes on. (Lewis, 154) The reduction or loss of the normal response to a drug or other substance that usually provokes a reaction in the body. Drug tolerance may develop after taking a particular drug over a long period of time. In such cases increased doses are necessary to produce the desired effected. (OxfordMed)

Withdrawal: cessation of use or provision of a drug; specifically the interruption of doses of an addictive drug, with resulting craving and physical reactions. (Oxford) Alcohol withdrawal symptoms usually occur within 8 hours after the last drink, but can occur days later. (Nicotine withdrawal) occurs following suspension of nicotine use. Clinical features may include nicotine craving, irritability, "anxiety," "depression" and increased appetite. The onset of symptoms may be rapid with severity proportional to length and amount of nicotine use. Unsuccessful management of symptoms may prompt a return to nicotine use. Quitting opiates cold turnkey throws the (pain) system suddenly out of balance. As pain circuits (pathways) are abruptly released from the suppression of opiates they fire wildly and this causes pain and extreme 'hypersensitivity.' Because of this hypersensitivity, normal sensations, light and sound for example, become painful. (Fields, 202)

Delirium Tremens (‘DTs’): severe form of withdrawal that involves sudden and severe mental or nervous system changes. (PubMedHealth2) The dangers of DT’s include: confusion, disorientation, hallucination, delusion, dehydration, fever, rapid heartbeat, exhaustion, seizures, and death. (Sacks6, 186)