By Richard Riemer, DO, Senior Associate Dean of the College of Osteopathic Medicine at Touro University California
You may think that the current epidemic of drug addiction in the United States is limited to adults. After all, whether it’s addiction to cigarettes, alcohol, gambling or drugs, cultural norms hold these to be the moral failings of our older population. But scientific research has confirmed that addiction is a brain disorder and that immature and developing brains are especially vulnerable to the unhealthy effects of these drugs. Complex interactions between the two “B’s”, your biology and biography, contribute to your personal risk of addiction, including your genetic makeup, where you were raised, exposure to physical or psychological trauma, even your family structure. Since our brains do not fully mature until age 25, it would make sense that a young person’s brain is most vulnerable to the ravages of these drugs.
Brain maturation does not occur to all parts of the brain at a uniform pace and at the same time. The last portion of the brain to mature is called the prefrontal cortex, located just behind your forehead, and it is a one of the key actors that plays a role in substance abuse and addiction. Science first dismissed the prefrontal cortex as silent or insignificant. But on September 13, 1848 at 4:30 pm in Cavendish, Vermont, a 25-year-old railroad foreman named Phineas Gage was severely injured in a construction site explosion which launched a 3.5-foot iron rod through his head. This tamping iron damaged his frontal lobes, and miraculously, Phineas still walked away from the work site. Soon after the accident he seemed completely healthy. But friends who knew him noticed a big change in his personality. While there were no overt signs of brain damage, friends who knew him best recognized a big change in his personality. No longer patient and agreeable, he was impulsive, moody, restless, obstinate and childish. He disregarded advice which conflicted with his own personal desires. In fact, Phineas manifested behaviors which we often observe in an addicted personality, such as the inability to make decisions in their best interest and carry through on plans, as well as the inability to control cravings.
Illicit drugs in vulnerable populations are the equivalent of a chemical tamponing rod. They cause brain destruction and rewiring of formerly healthy brain circuits. Just like Phineas, the addict has difficulty sustaining attention, concentrating, reasoning, and solving problems. He also loses the daily struggle to resist urges to pursue and use drugs despite knowing their unhealthy consequences.
Our observations prove the point that immature brains are at risk. Consider that substance use often starts during adolescents. Approximately 7.9% of adolescents or 2.0 million adolescents aged 12 to 17 in 2016 were current users of illicit drugs according to the National Survey on Drug Use and Health (2017). It would then make sense that strategies that foster brain health and healthy brain maturation will reduce risk for substance abuse and addictive disorders.
So how do we personally curb the stem of illicit drug use, particularly in our most vulnerable populations? Interventions introduced as early as the prenatal period and throughout the brain’s developmental years may prevent many of these risks according to the National Institute on Drug Abuse’s Principles of Substance Abuse Prevention in Early Childhood. Early intervention can increase protective factors and reduce risk, have positive long-term effects, increase physical health, and even reinforce positive behaviors in the social environments where children interact like home and school. Themes of healthy nutrition during infancy and toddlerhood, a nurturing parent, a supportive and sensitive home, school and community environments, school readiness, and maternal avoidance of smoking, excessive alcohol use, illicit drug-use and prescription drug abuse, all reduce the risk to our children. Mental illnesses that affect our youth such as anxiety disorders or impulse-control disorders also increase the risk for drug abuse. Deploying these strategies and practices in our homes, communities and schools will stem the tide on the opioid epidemic and in particular, reduce the risk to the most vulnerable in our society, our children.
Learn more by visiting www.drugabuse.gov.
