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2012, Number S1

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Rev Med UV 2012; 12 (S1)

The addicted brain

Ruiz CAE, Méndez DM, Romano LA, Caynas S, Prospéro GO

Language: Spanish
References: 103
Page: 43-50
PDF size: 441.09 Kb.


ABSTRACT

Addiction to substances of abuse is a universal public health problem. The addict brain is a result of physiological changes. The pursuing of addiction substances depends on their ability to activate the rewarding brain system thereby increasing the probability of persisting in exhibiting this behavior. The drug intake not only activates the rewarding system but also the punishment system, meaning, the system that mediates displeasure or fear. Due to this effect, the drug becomes less a positive reinforcer and more a negative reinforcer. Once the user of drugs try to quit their use, the rewarding system is less active and the punishment system which is more active is expressed, and the user suffers all the condition of the withdrawal syndrome. As a result, the user persists in the use of drugs, among other things, to avoid the suffering caused by the withdrawal syndrome, mediated to a large extend by the punishment system. In addition to these two systems, there is the prefrontal cortex system that inactivates both rewarding and punishment systems. The prefrontal cortex also down-regulates the expression of the behavior. Via basal ganglia, the prefrontal contex prevent the execution of a given behavior. It is able of interrupting an on-going behavior in order to prevent damage. However, with the frequent use of drugs, the prefrontal cortex loses control over these systems; consequently, the subject becomes impulsive and unable of foreseeing the consequences of his/her acts. Other brain regions, i. e. hippocampus and striatum nucleus are also modified by the frequent use of drugs, making the subject to learn environmental cues and facilitating the habit formation. There is some literature supporting the possibility of the existence of a predisposition to be a user of drugs, a sort of pre-addict brain. This preaddict brain depends on genetic traits that somehow make the subject vulnerable to drugs use. Epigenetic changes also count to explain some subject’s vulnerability. Hence, it is of great importance to take into account all these variables: genetic, epigenetic and environmental to have a big picture of the user of drugs in order to mount more efficient pharmacological and not pharmacological interventions.


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