The Complicated Case of Adolescent Drug Abuse: Implications of Brain Plasticity

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Comments   |   Blog, Substance Abuse

Erich Engelhardt M.A.

Joseph Shrand, MD

However, thiBrain synapses images process of change leaves the adolescent brain particularly vulnerable to the toxic influence of drugs and alcohol.  Already in a major state of flux, the addition of drugs and alcohol that artificially induce dramatic and brutal changes in it’s neurochemistry, (especially the increase of dopamine, the molecule of pleasure that drugs and alcohol force out of the neurons),  places this brain at risk of life-long addictions.   This is partly due to the process of myelination that occurs in the adolescent brain as it forms.

But, at the same time that myelination is occurring, many of the neurons and networks themselves are being “pruned.” This pruning results in the elimination of redundant connections between brain cells, (one brain cell may have hundreds of connections to other brain cells), the reduction of brain cells themselves, and the organization of neural networks into more efficient processes. This process is believed by scientists to lead to more capable thinking and competent cognitive capacity (Gogtay, et al., 2004).

This series of processes occurring in the development of the teenage brain also can create unique challenges for the “recovering” adolescent. Clinicians who work with adolescents recognize these needs: simply being an adolescent may interfere with their interests in sobriety and their attention to the clinical work needed for achieving sustainable recovery. According to the National Institute on Drug Abuse (NIDA), adolescent drug abusers have distinctive needs stemming from their immature neurocognitive and psychosocial stage of development.  In other words, some kids may not have the reflective ability to even consider that they have a problem.  And if this is not addressed, it can continue into adulthood.  Any of you readers know someone who has no idea that they have a drug or alcohol problem?  This may not just be denial, but a true inability to make the cognitive connections needed for insight!  (Fear not.  In a later blog I will address some ways to help shift a person from this pre-contemplative, pre-motivational stage to at least acknowledging there may be a challenge.)

A series of separate reports at the Society for Neuroscience conference adds new support to the idea that the dramatic remodeling of the brain during adolescence holds opportunities for development and learning but also appears to enhance a teen’s vulnerability to the long-term effects of environmental influences such as stress and drug experimentation (SFN, 2007).The development of our mental facilities in adolescence is not produced solely by the addition of new synapses (a synapse is the small gap between neurons.  Chemicals either float or are actively transported across this synaptic cleft, inducing a change in the “down-stream” neuron), or connections between neurons. Development is also facilitated by the elimination of neural networks that are weak and underused. The brain is a “use it or lose it” kind of organ (Ratey, & Hagerman, 2008).

This is why adolescent addiction is so dangerous: it occurs during pruning.  The formations of pathways most frequently used are less likely to be discarded.  Thus the neural connections most often being used, such as the teen getting and finding the ways and means to deliver more drugs to the system will be solidly reinforced. In addition, the dopamine reinforcing pleasure response of the brain using drugs results in the teen unconsciously attributing greater importance to those immediately gratifying actions at the expense of rewarding activities with longer term returns such as school and family responsibilities.