The teenage years in an individual’s life are tumultuous, both physiologically and emotionally. Societal and academic expectations skyrocket, combined with bodily and cognitive developments outside of their scope of comprehension These pressures may lead to the development of a Substance Use Disorder (SUD). An SUD can be categorized as a coping mechanism for the teenage mind, seeking refuge from the arbitrary constraints of their modern contemporaries. As per the statistics provided by the National Institute on Drug Abuse, 7.5% of adolescents aged 12 to 17 reported using drugs in the past month, with marijuana being the most commonly used substance. Given this unprecedented heightened level of drug availability and by extension intake, this article aims to delve into the intricacies of the adolescent mind, and the way in which said intricacies react, adapt, and disseminate under the influence of narcotics. Two facets of the human brain on which most of the focus will be diverted are the Prefrontal Cortex, the executive command and relay center of the brain, and the Basal Ganglia, the brain’s reward circuit. Drugs deleteriously affect the basal ganglia by convulsing reward circuitry and enabling compulsive behavior, while simultaneously impairing the prefrontal cortex, which leads to the deterioration of executive functions and impulse control.
The Adolescent Brain: A Brief Overview
The brain conventionally reaches 90% of its optimum size at the age of 9, leaving little room for significant physical development in regards to size. However, the creases within the brain continue to diverge and increase in number and complexity. One particular region takes a substantially long time to develop fully: The prefrontal cortex. This region of the brain governs impulse control, logical forethought, long-term planning, etc. This growth occurs primarily during the end of the teenage years, spanning up until the age of 25, which is to say that the human brain is largely left underdeveloped in reference to its cognitive function in the teenage years. Due to the constant developments, the neuroplasticity of the brain is amplified; heightened neuroplasticity provides to be beneficial for cognitive development, facilitating learning and adaptation. According to Harvard Medical School, the ease in adaptability can have both beneficial and detrimental effects on the teenage mind. As a result of the prefrontal cortex being under development, the adolescent mind inclines toward letting the emotional, impulsive regions of the brain govern its functions. The most prominent regions are the Basal Ganglia and the Amygdala. Consequently, adolescents tend to react emotionally, rather than logically. Reliance on the emotional command centers rather than the logical ones leads to such outcomes. The Basal Ganglia is the region of the brain which serves as a channel, or more commonly alluded to as the brain’s “reward circuit”, it activates the body’s dopamine releasing mechanism consequent to healthy, pleasurable experiences : eating, socializing, and sex. It leads the body to unconsciously seek these activities out, developing what we commonly refer to as habits.
SUD: The Disorder’s Widespreadness and What That Entails
Heightened levels of drug usage globally, as mentioned before, can be attributed to the simultaneous heightened levels of expectations and responsibility. The refuge these drugs provide may be temporary, but the consequences of their intake are anything but; drugs such as marijuana and heroin can activate neurons by mimicking neurotransmitters due to their chemical compositions. Additionally, cocaine and amphetamines alter brain function by significantly increasing the release of natural neurotransmitters from neurons or by preventing their normal recycling through interference with transporters. This disrupts the usual communication between neurons, amplifying or disturbing neurotransmitter activity in the brain. In any case, conventional brain activity is inhibited or amplified. According to the Adolescent Brain Cognitive Development (ABCD) study conducted by the National Institutes of Health (NIH), drugs change the primary structure of the adolescent brain. This is confirmed via advanced neuroimaging technologies. Furthermore, cognitive functions such as memory, attention, and decision-making are influenced by the intake of drugs.
Now let us discuss what SUDs entail, particularly regarding the prefrontal cortex and the basal ganglia. The prefrontal cortex is in a relatively vulnerable state, and the influence and change elicited by drugs can permanently impair its functions, before it even gets fully developed. This goes on to have dire effects on that teenager’s adult life, leaving them to struggle with making logical judgment in all facets of life. The brain of such adolescents never truly matures, leaving them as a fragment of what they could have been, had the drugs not been in their system. In regard to the Basal Ganglia, it too falls victim to the drug’s overpowering influence. The Ganglia’s reward circuit is hijacked by the drugs, providing pleasure to the point that the body becomes numb to all other sensations which previously supplied its needs. Eventually, the body builds up a tolerance to the drug itself, entering a state of displeasement, tiredness, and restlessness, with only from consuming higher doses of the concerned drug can bring solace to the restlessness it caused. As mentioned before, the usage of drugs also deteriorates the structure and functionality of not just these specific regions, but the body as a whole. A study published in The Journal of Neuroscience states that adolescents who partook in drug use had a devastating 6-8% reduction in prefrontal cortex as compared to peers who stayed clear from such substances. This reduction is said to be critical because–as mentioned before–the prefrontal cortex plays a vital role in cognitive functions, including decision-making, impulse regulation, and strategic planning. A 6-8% depletion in the volume of this region can substantially jeopardize these cognitive capabilities, resulting in long-lasting deficits in operational function. Said deficits can negatively impact academic achievement, vocational prospects, and overall daily functioning, while also adversely affecting social interactions and personal relationships. This brings attention to the substantial impact that substance use during adolescence can have on neurodevelopment, particularly in areas fundamental to adaptive behavior and cognitive resilience. Furthermore, a study in The Lancet Psychiatry also found that the brains of adolescents who regularly consume drugs grow at a 15% slower rate.
Addressing the impact of SUDs on the adolescent brain demands a multifaceted approach, necessitating focus on both immediate and long-term solutions. Neuroimaging studies allude that targeted cognitive-behavioral therapies (CBT) can substantially reverse the structural and functional impairments observed in the prefrontal cortex and basal ganglia. For example, interventions that encourage and facilitate executive function and impulse control may help mitigate some of the cognitive deficits elicited by substance use. Furthermore , pharmacological treatments that emulate neurotransmitter systems disrupted by drugs—such as those targeting dopamine or glutamate pathways—show immense potential in ameliorating the neurochemical imbalances associated with SUDs. Longitudinal studies highlight the quintessence of early intervention, as adolescence stands as a critical period for neurodevelopmental plasticity. Effective prevention strategies, including school-based programs that integrate psychoeducation and resilience training, are essential in curbing the onset of substance abuse. Future research should focus on optimizing these therapeutic approaches and exploring novel neuroprotective strategies to safeguard adolescent brain development from the deleterious effects of substance abuse.
Conclusion: Reformation and Rehabilitation
It can be concluded that drugs bear no beneficiary value, except for the temporary high. However, that high comes with an exponentially high, catastrophically deteriorative price: the permanent (in severe cases) impairment of arguably the two most quintessential regions of the brain–the prefrontal cortex and the basal ganglia– when it comes to cognitive development. The most important factor being the sheer vulnerability of the adolescent mind, and its tendency to fall prey to the parasitic, hijacking nature of narcotics, an act of defeat that leads to substantial reduction of cognitive growth. Nevertheless, it is
pivotal to state that as a community, we must re-evaluate the circumstances that drive our youth to the point where they would succumb to the enticing nature of drugs, and ensure our collective efforts in order to safeguard a safer, healthier, and brighter future for all.
Written by: Maizah Hassan
CITATIONS
1. Harvard Medical School. (2014, October 17). Under the hood of the adolescent brain. Harvard Medical School. Retrieved from https ://hms.harvard.edu/news/under-hood-adolescent-brain
2. Harvard Medical School, Department of Psychiatry. (2016, September 14). Marijuana and the teen brain. Harvard Medical School. Retrieved from https://psych.hms.harvard.edu/news/marijuana-and-teen-brain
3. National Institutes of Health. (n.d.). Adolescent Brain Cognitive Development (ABCD) study. Retrieved July 1, 2024, from https://abcdstudy.org/
4. Mayo Clinic Staff. (n.d.). Teen drug abuse. Mayo Clinic. Retrieved July 1, 2024, from https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-drug-abuse/art 20045921
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6. The Lancet Psychiatry. (2014). Adolescent brain cognitive development study: Imaging genetics and: The transition to adolescence. The Lancet Psychiatry, 1(7), Retrieved from https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)00081-9/fulltex
7.National Institute on Drug Abuse. (2023). Reported drug use among adolescents continued to hold below pre-pandemic levels in 2023. Retrieved from NIDA
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