desire for the drug and establishes the foundation for the addiction. Again, who becomes addicted to a particular drug and who doesn’t is often complicated and hard to predict.
As we can see, there is a whole lot going on in the brain during the process of becoming addicted. All of the changes the brain goes through in adapting to an addictive compound change the structure and chemistry of the brain. The brain of an addicted person is not a normal brain. Even if the person ends the addiction, it will take years for the brain to normalize, if it ever does. But it’s not just about nerves and chemicals and the body, it is just as much about behavior.
The process of addition leads to drug-seeking behaviors and patterns that drive the addiction. What are the situations where the person is using the drug? What are the emotional triggers that make a person use? Who are the people the person interacts with to acquire and use drugs? What measures does the person use to conceal their drug use? How do they get the money to support it? These behavioral aspects of the addiction may contribute to the changes in the brain networks and reinforce the addiction.
We can use medicines to treat drug addiction (there are medicines that suppress craving for the drug of abuse and halt withdrawal). We can use behavioral models to treat drug addiction (e.g.12 step programs, cognitive behavioral therapy). While either approach, medicinal or behavioral can be effective, It is my belief that both areas should be targeted to get a more effective, durable response to treatment. In the next article, I will present some treatment options for persons addicted to opioids, whether they are prescription or street drugs. I will focus on approved medicines.
Dr. Crawford has over 25 years of experience in the treatment of HIV. While at Howard University School of Medicine, he worked in two HIV-specialty clinics at Howard University Hospital. He then did clinical research as a visiting scientist with the AIDS Clinical Trials Group (ACTG) at Johns Hopkins University School of Medicine. He served as the Assistant Chief of Public Health Research with the Military HIV Research Program where he managed research studies under the President’s Emergency Plan for AID Relief (PEPFAR) in four African countries.
He is currently working in the Division of AIDS in the National Institutes of Health. He has published research in the leading infectious diseases journals and serves on the Editorial Board of the journal AIDS. Any views and perspectives in his articles on blackdoctor.org are not representative of any agency or organization but a reflection of his personal views.