– Why is the brain so effective in adapting to substances like MDMA and Cocaine?
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The brain does not ‘adapt’ to Cocaine. The effect of Cocaine is to make the brain release chemicals it normally has at relatively steady levels in a higher amount, in a rush as it were and temporarily blocks the re-absorption of those chemicals. The person gets less and less of a response because Cocaine doesn’t affect ‘manufacturing’ of that chemical only it’s release and re-uptake.
MDMA works the same way, it facilitates the release of the normal (keep me awake and alert / happy) chemicals and blocks their re-absorption so that levels stay higher than normal for a period of time. The chemicals are Serotonin, Dopamine and Norepinephrine S D N), these chemicals sit at the synaptic gaps between brain cells to facilitate nerve impulse transmission. When S D N levels are high you make more detailed longer lasting memories than when S D N levels are low. When S D N levels are very very low this affects the way the brain works and you can suffer severe psychological effects like hallucinations. When a drug or behaviour affects medium and long term memory formation this is called psychological addiction.
It’s like flushing a toilet – if you flush too often and the water tank isn’t allowed to refill then you get less and less water per flush – because nothing is making ‘more water’ it’s rate of manufacture hasn’t changed. Eventually the person needs the Cocaine just to get a normal level of the substances that maintains mental health balance, but the effect lasts for shorter and shorter periods.
Cocaine is not chemically addictive, you don’t develop a tolerance for it the way you do with alcohol for example (but it does alter overall brain chemistry) but it is very psychologically addictive, all that happens to a Cocaine addict who reduces/stops taking Cocaine is that they will feel awful for about a week to ten days until the levels of the brain chemicals return to normal. The most common ‘withdrawal’ symptom of Cocaine is low mood – which can develop into severe depression with hallucinations with continued use, loss of appetite and muscle cramps (due to the lower than normal levels of Dopamine).
This is why Cocaine addicts are generally poly-drug users (alcohol is also a mood changing drug), they use one drug to manage the side effects of their ‘drug of choice’. The effects of Cocaine last usually around 15 -30 minutes after which the user gradually gets more ‘down’, they’ll often assume their supplier is deliberately selling them less potent Cocaine, where-up the dealer will start mixing Cocaine with other drugs to keep the customer happy. Of course no drug addict ever believes their counsellor when they tell them this happens.
Your 10th reaction to Cocaine use will never be as strong as the first unless you space those doses out giving the brain time to re-manufacture the chemicals. The most common drug taken to control the ‘down’ from amphetamines is alcohol, then Benzodiazepines (Valium, Qaludes, ‘sleepers’) because their effect is very similar to alcohol, then eventually with heavier Cocaine use it’s Heroin.
The vast majority of non-opiod stimulant drug users only use them recreationally and they manage their own use without requiring professional intervention. The reason people return to those stimulant drugs is because of the way the brain makes memories, it prioritises saving ‘good memories’ over saving ‘bad memories’ So the user forgets the ‘down time’ and associates that drug with only the period of hyper-stimulation.
High levels of drug users have underlying mental health conditions which they are ‘self-treating’ with illicit drugs. Most of them are not aware they have an underlying mental health condition. Of course if they stop taking the illicit drugs those mental health issues re-emerge, only worse now because they are dealing with the aftermath of the drug use as well.
I am a registered nurse who specialised in drug and alcohol treatment for the last 10 years of my 30 year career.
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