The Brain Chemistry Behind Tolerance and Withdrawal

🌈 Abstract

The article discusses substance use disorders (SUDs) and their relationship to neurotransmitters, the body's natural chemical messengers. It explains how drugs can affect neurotransmitters, leading to intoxication, tolerance, and withdrawal. The article also highlights the complexity of SUDs as chronic, treatable brain diseases.

🙋 Q&A

[01] Substance Use Disorders (SUDs)

1. What is the definition of substance use disorders (SUDs) according to the CDC?

• SUDs are defined as "treatable, chronic diseases characterized by a problematic pattern of use of a substance or substances leading to impairments in health, social function, and control over substance use."

2. How can SUDs be incorrectly perceived, and what is the correct understanding of them?

• SUDs can be incorrectly thought of as "a moral failing" instead of "a chronic treatable brain disease."
• The correct understanding is that SUDs are chronic, treatable brain diseases, where the body sends signals in the absence of the drug, causing the user to "crave" the substance.

[02] Neurotransmitters

1. What are neurotransmitters, and what are some examples?

• Neurotransmitters are the body's natural chemical messengers that control bodily functions such as breathing, heartbeat, blood pressure, muscle movement, sleep, digestion, and thoughts and memories.
• Examples of neurotransmitters include dopamine, glutamate, serotonin, norepinephrine, GABA, epinephrine, and histamine.

2. How is the volume and storage of neurotransmitters regulated in the body?

• The body can sense when there is too little or too much of a neurotransmitter and responds by creating more or destroying the neurotransmitter.
• Any change in this homeostasis can have severe consequences on the body's ability to react to external stimuli, which can be referred to as intoxication.

[03] Drug Effects and Neurotransmitters

1. How do drugs interact with neurotransmitters?

• Drugs can mimic neurotransmitters (agonists), increase or decrease the level of natural neurotransmitters (resulting in increased or decreased signals), or block the body's natural neurotransmitters (antagonists).

2. What are the effects of these drug-neurotransmitter interactions?

• The effects of drugs can be desirable, such as euphoria or relaxation, or undesirable, like paranoia or increased blood pressure.

[04] Tolerance and Withdrawal

1. How does the body compensate for imbalances in neurotransmitters caused by drug use?

• With repeated drug usage, the body will compensate for the imbalance of neurotransmitters to restore homeostasis.
• For example, with chronic amphetamine use, the body recognizes the unnaturally high levels of dopamine and starts producing less dopamine naturally.

2. What are the consequences of this compensation process?

• Tolerance: The user needs to take more of the drug to experience the same "high" due to the body producing less of the neurotransmitter naturally.
• Withdrawal: When the user suddenly stops using the drug, they can experience side effects of low neurotransmitter levels, such as lack of motivation, lethargy, moodiness, or difficulty sleeping.

[05] Complexity of SUDs

1. How are SUDs more than just a psychological need to use a substance?

• SUDs are complex diseases that affect the natural chemistry of the user's body, not just a psychological need.

2. What is the recommended approach for individuals suffering from SUDs?

• Due to the complexity of SUDs, individuals are recommended to seek treatment from professionals.