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Ethics and Treatment of Drug AIDiction

The use of drugs in the world has been increasing from the past years.The National Institute of Drug Abuse [NIDA] (2014) estimated that about 24 million Americans of 12 and above years of age had used an illicit drug in the past one month. This percentage has changed from 2002 when it was 8.3 to 9.2 in 2012. These findings are alarming for the youths because it’s more likely that drugs abuse will continue increasing if appropriate actions won’t be taken in time.

Thesis Statement:aIDiction to drugs is a disease that should be treated therapeutically and it would be unethical to force people into aIDiction treatment programs against their wishes

Part I: Drug AIDiction:

Is the primary and chronic disease affecting the brain’s reward, memory, motivation and the related circuitry (American Society of AIDiction Medicine [ASAM], 2011). The dysfunctions produced by aIDiction in these circuits results in characteristic psychosocial, spiritual and biological manifestations. The affected individual pathologically pursues reward and relief by indulging in substance abuse and other behaviors. AIDiction is known to affect the neurotransmission as well as interactions within the brain structures of reward that includes the anterior cingulate cortex, nucleus accumbens, amygdala and the basal forebrain (ASAM, 2011). Such a phenomenon alters the hierarchies of motivation and aIDictive behavior that may include drug use such as alcohol, supplant behaviors related to healthy self-care. On the same line, aIDiction affects interactions and neurotransmission between the hippocampal and cortical circuits as well as the brain reward structures in that the memory of previous reward exposure results in behavioral and biological responses to the external cues, which in turn triggers craving in aIDition to engagement in in aIDictive behaviors (ASAM, 2011).

Part II: What Controls Wanting and Liking

Dopamine release is an essential thing in drug aIDiction as well as the aIDictive personality of a given person. Drugs are known to affect the dopaminergic, mesolimbic and the reward system of the brain (NIDA, 2014). The pathway starts from the ventral tegmental area (VTA) in the midbrain and then connects to the mesolimbic system all the way through the amygdala, nucleus accumbens and hippocampus. The nucleus accumbens and VTA are essential in the pathway since they release natural drug dopamine. Upon the use of drugs as in drug aIDiction, the release of dopamine stops due to the influx of dopamine from the drug. Upon aIDiction, the dopamine from the drug increases, suppressing the naturally produced one from the brain. due to this, the person goes into great need to have the drug every time so as to get dopamine into the system. Such creates the craving for the drug during the withdrawal times as a result of having low dopamine amounts in the system(Robinson &Berridge, 2008).

If the individual becomes aIDicted to the drug, partly because of the dopamine high he/she receives from taking the drug, then the brain slows down its natural production of dopamine. When this happens, the individual needs the drugs to get the dopamine into their system, hence why they person goes through withdrawals when they don’t have the drug because they have a low amount of dopamine in their system (NIDA, 2014).More recent research has shown that the rewards system of the brain is modified in aIDicted individuals, which makes them crave for rewards of their next fix (ASAM, 2011).

Part III: Treatment of Drug AIDiction

Drug aIDiction can be treated since it’s a chronic disease. It is realistic to treat and manage it since drug treatment helps the aIDicts stop their compulsive urge of seeking and using the aIDictive drugs (McClelland, Elkington, Teplin, & Abram, 2004). According to ASAM (2011), treatment occurs in different forms, settings and can last for varying lengths of time. Since the condition is chronic and associated with occasional relapses, treatment can take a long time because a short-term and one-time treatment can’t be sufficient. There are very many options that can be used in treating, managing, and monitoring drug aIDiction as a condition such as the use of medications and behavioral therapy. The specific type of treatment option or a combination of the available options varies from one individual to the other depending on needs and drug types that have led to aIDiction.

Part IV: Effects of Drug AIDiction on Brain Circuitry

Drugs of aIDiction target the brain’s reward system by flooding the circuitry with a lot of dopamine, which is a neurotransmitter that regulates the feelings of pleasure(Volkow, Fowler, Wang, & Swanson, 2004).

Part V: Relationship of wanting to use drugs and the cravings among individuals

The overstimulation of the system by the drugs causes more pleasure by producing euphoria, something that reinforces the behavior of repeating the use of the drug by the user. The National Institute of Drug Abuse (2014) asserts that the brain notes that there’s something important that should be remembered and repeated once the reward circuit is activated. In this case, the aIDictive drugs are the ones that activate the circuit leading to pleasurable feelings. The pleasure cannot be realized once the drugs aren’t used and the brains function is disrupted due to the extrinsic dopamine, hence the individual starts to crave for the drugs any time to achieve the pleasurable euphoria and upgrade the moods.

Part VI: Impact of Drug AIDiction on Decision-making

NIDA (2014) explains that chronic exposure of individuals to aIDictive drugs of abuse interrupts the interaction of the critical structures of the brain in controlling and inhibiting drug use related behaviors. The use of these drugs can result in tolerance as well as the need for higher dosages so as to produce a desirable euphoric effect. Such a thing makes the individual to compulsively seek and use drugs without giving the behavior some prior thinking. In this regard, drug aIDiction suppresses an individual’s self-control and the ability of making sound decisions by producing impulses that are intense to take drugs.

Part VII: Ethics in forcing people into aIDiction treatment programs against their wishes

An individual’s initial decision to use an aIDictive drug may be voluntary or sometimes involuntary such as the case when the person takes it due to being tricked against his or her wish. However, the National Institute of Drug Abuse (2014) says that the continued use of the drug that results in aIDiction is involuntary due to the drug’s effect of impairing the ability to have self-control. Brain studies have shown that there are many changes in the brain of aIDicts, especially in the parts involved with memory, behavior control, decision-making, and judgment. Therefore, it’s ethically wrong to blame the individuals for their behavior since it’s not their voluntary decision. In regard to (Robinson &Berridge, 2008). individuals shouldn’t be forced to get treatment for drug aIDiction as this cannot work. A person has the autonomy in making decisions by himself as long as his acts aren’t infringing on the rights of other people. In aIDition, some of the treatment regimens for such individuals includes behavior therapy, which requires cooperation of the individual so as to adhere to the treatment. If such people are forced into the treatment programs, it will be against their wish, and they may likely resist.

Conclusion: Thesis restatement

AIDiction to drugs is a disease that should be treated therapeutically and it would be unethical to force people into aIDiction treatment programs against their wishes.

References

American Society of AIDiction Medicine (2011).Public Policy Statement: Definition of AIDiction [online]. Accessed on 13th March, 2015. From: http://www.asam.org/for-the-public/definition-of-aIDiction

McClelland, G. M., Elkington, K. S., Teplin, L. A., & Abram, K. M. (2004). Multiple substance use disorders in juvenile detainees. Journal of the American Academy of Child & Adolescent Psychiatry, 43(10), 1215-1224.

National Institute of Drug AIDiction (2014). Drugs, Brains, and Behavior: The Science of AIDiction, [online]. Accessed on 13th March, 2015. From:http://www.drugabuse.gov/publications/drugs-brains-behavior-science-aIDiction/drug-abuse-aIDiction

Robinson, T. E., &Berridge, K. C. (2008). The incentive sensitization theory of aIDiction: some current issues. Philosophical Transactions of the Royal Society B: Biological Sciences, 363(1507), 3137–3146. doi:10.1098/rstb.2008.0093

Volkow, N. D., Fowler, J. S., Wang, G. J., & Swanson, J. M. (2004). Dopamine in drug abuse and aIDiction: results from imaging studies and treatment implications. Molecular psychiatry, 9(6), 557-569.

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