Drug abuse means any use of drugs that is not prescribed or mentioned on the drug package. There are several drugs being misused in Pakistan, ranging from mood stabilizers and sleep inducers to eye ointments and pain-relieving creams.

By Jamshed Arslan

Many of these drugs compel the person to use them repeatedly, a phenomenon we call addiction. Illegal drugs are accessible to none but a few; what we may come across more commonly is the addiction of prescription drugs and non-prescription medicine. The first step in addressing this problem is to understand why we are built for addiction. Along these lines, this essay will outline the brain circuit involved in addiction in the simplest possible way.

Addiction is in the brain

Brain is composed of many regions. It is the communication between various brain structures that makes it possible for you to read this essay, anticipate what is coming and plan ahead. When it comes to addiction, there are five key structures (see Table) whose interaction plays a major role in our compulsive urges.

Table. Five key brain areas and their role in addiction pathway

Brain structure

Role in…

Ventral tegmental area (VTA)

Reward-related and motivated behavior


Emotional responses


Memory formation

Nucleus accumbens

Control of movement

Prefrontal cortex

Executive decision making


The feelings that one gets from using certain drugs stimulate the emotion-responding area called amygdala. The neurons in the amygdala “talk to” the memory-forming area called hippocampus to store the memory of the wonderful experience of using that addictive drug. This amygdala-hippocampus communication ensures that you remember the “happy”, “high” and other pleasurable drug-associated sensations. Involvement of VTA in this process stimulates prefrontal cortex and nucleus accumbens. Prefrontal cortex chalks out the plan to go to a pharmacy to get the drug, while nucleus accumbens plays a key role in the physical act of walking towards the pharmacy.

In other words, the interconnected circuit of the above mentioned 5 brain regions get stimulated repeatedly to compel the person to take the medicine multiple times. As the habit grows, so does the circuit and the person becomes an addict. Drugs change the brain a way that makes the quitting hard.

Why quitting is hard?

Of all the brain regions involved in addiction, prefrontal cortex can be considered to be in your direct control. If your prefrontal cortex makes a decision to STOP taking a drug, it can send inhibitory signals back, and all the cycle of addiction can break. To stimulate prefrontal cortex, education or friendly “lectures” may be helpful. If it were an illegal drug, cutting the supplies would be of much help, but since the addictive drug is non-illegal, the accessibility compounds the issue. Moreover, willpower is not enough since the remaining 4 brain regions are not as directly controllable. The fact that addictive drug changes the brain chemistry has led the official guidelines ( to declare addiction a chronic brain disease, albeit a treatable one. In other words, we humans are pretty much helpless in the face of addiction. One strategy to prevent ourselves could be to replace drug addiction with some other form of addiction like gym activities. It can keep the addiction circuit busy and facilitate the quitting process.

In summary, we are prone to addiction because of our brain circuitry. After understanding the neural communication, we can sympathize with the drug addicts and get them the help that they need. Remember, addiction is preventable and treatable!

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By Jamshed Arslan

Pharm D (gold medalist); PhD (Neuropharmacology) Skilled in basic and clinical research and scientific writing, with over a decade of teaching and research experience.