Drugs of abuse produce chemical reactions within the brain that largely account for the development of drug addiction. However, the disease may also depend, to a certain extent, on the environmental risks of associating drug use with a particular location or setting.
In a 2013 Addiction Biology study, researchers from the University of Chicago conducted one of the first experiments to directly test the effects of setting on drug abuse and addiction risks in healthy human beings. These researchers found that the process of getting used to a particular drug-using location can indeed boost the effects of a drug, and can therefore increase the chances for abuse and addiction.
Drugs, Brain Changes and Addiction
Drugs of abuse produce such a powerful effect because they enter the bloodstream and travel directly to the brain. Inside the brain, they trigger chemical changes that stimulate the pleasure centers far above normal levels. In some individuals, the reaction to this highly increased pleasure (also known as euphoria) is a desire to use drugs repeatedly in order to feel stimulated over and over again at will. Unfortunately, the brain doesn’t react to repeated drug use in the same way that it reacts to initial drug use.
Eventually, it adapts to the presence of the drug in question and starts to produce less pleasure for any given amount of drug intake. This process, called the development of drug tolerance, indicates the establishment of certain long-term changes in the brain’s everyday operation. It is also one of the key indicators of the development of drug addiction (dysfunctional reliance on a drug/medication).
Understanding Drug Settings
Setting is a general term used to describe the various environments we inhabit during our daily activities and over the course of our established routines. Examples of settings that are familiar to the vast majority of adults include home, supermarkets and other stores, school and the workplace.
Drug use also takes place within some sort of setting. In some cases, an individual may take drugs in settings also commonly employed for other purposes. However, in other cases, an individual may habitually take drugs in specific locations that become heavily associated in his or her mind with the act of drug use. Drug settings produce their effects, in part, through interaction with an unconsciously or consciously understood code of drug-using conduct known as a user’s drug mindset or drug set.
The Impact of Setting on Drug Effects
In the study published in Addiction Biology, the University of Chicago researchers tested the impact of drug use settings on a group of volunteers’ sensitivity to the effects of a substance called dextroamphetamine or d-amphetamine. Along with the closely related drug amphetamine, d-amphetamine is used to produce Adderall, a very common treatment for attention-deficit/hyperactivity disorder (ADHD). People who regularly misuse this medication have known risks for developing an addiction and meeting the criteria for a diagnosable mental health condition calledstimulant use disorder.
All told, 34 healthy adults participated in the study. Prior to receiving any d-amphetamine, all of these adults were asked to inspect two rooms, and then identify one of the rooms as “preferred” and the other as “non-preferred.” After making their choices, the participants then underwent a series of four conditioning sessions. During these sessions, one group of 19 participants only received d-amphetamine in their non-preferred room, while another group of 15 participants received the drug in both their preferred and non-preferred rooms. Essentially, this meant that the first group of individuals developed an association between drug use and one particular setting, while the second group of individuals did not.
After completing their experiment, the researchers made several findings. First, they concluded that the individuals who only received d-amphetamine in one room developed a stronger preference for that room over time. This fact held true even though the people in the group initially did not express a liking for this room. The researchers also concluded that, compared to the participants who received d-amphetamine in both rooms, the participants who only received the drug in one room experienced a higher level of drug enjoyment, felt that d-amphetamine had a stronger effect and experienced higher levels of d-amphetamine craving between drug sessions.
How Drug Setting Increases Addiction Risks
The authors of the study published in Addiction Biology believe they are among the very first scientists to experimentally confirm the effects of habitual drug settings in human beings. They also believe that, because of the heightened impact of d-amphetamine use in an established drug setting, people who regularly misuse the drug in such a setting may have increased risks for the brain changes that support the onset of problems with drug addiction. The authors’ findings may very well also apply to the impact of drug setting on the addiction risks associated with other commonly abused substances.