Some of the pharmacological effects of very different drugs are quite similar. Marijuana and alcohol affect at least three of the same brain biochemical systems. Alcohol can become a form of opiate in the brain following some specific chemical transformations. These similarities raise an old and continuing question in the substance use field: Is there a fundamental addictive mechanism common to everyone that differs only in the level and nature of expression? Older theories of drug-abuse behavior approached this question by postulating the "addictive personality," a type of person who would become indiscriminately addicted as a result of his or her personal and social history. With advances in neuroscience have come theories concerning the possibility of an "addictive brain," which refers to a neurological status that requires continued adjustment provided by drugs.
An example of the workings of the addictive brain might be a low-opiate brain that does not produce normal levels of analgesia or normal levels of organismic and behavioral euphoria (joy). The chemical adjustment sought by the brain might be satisfied by use or abuse of any drug that results in stimulation of the opiate function of the brain. As discussed above, several seemingly unrelated drugs can produce a similar chemical effect. Thus, the choice of a particular substance might depend both on brain status and on personal or social experience with the effects and availability of the drug used.
The example of the opiate-seeking brain raises at least two possibilities for prevention and treatment, both of which have been discussed in substance-use literature: reregulation of the brain and substitution. So far, socially acceptable substitutes or substitute addictions offer some promise, but reregulation of the dysregulated brain is still primarily a hope of the future. An example of a socially acceptable substitute might be opiate production by excessive running, an activity that can produce some increase in opiate function. The success of such a substitution procedure, however, depends upon many variables that may be quite difficult to predict or control. The substitution might not produce the required amount of reregulation, the adjustment might not be permanent, and tolerance to the adjustment might develop. There are a host of other possible problems.
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