HLTH 252 Week 2 Discussion Board Forum 2 Example

Discussion Board Forum 2: The Nervous System and the Actions of Drugs

HLTH 252 Drugs in Society, Discussion Board Forum 2

Thread by [Student Name]

The classmates are composites; the textbook, Scripture and the peer-reviewed sources cited are real.

Whether addiction is a disease of the brain is not only an academic question. If it is a disease, it calls for medical treatment and insurance coverage; if it is a choice, it may call for punishment or willpower. This week's chapters give us the tools to think about the question more carefully.

Hart and Ksir (2018) explain that drugs act by altering the activity of neurotransmitters, chemicals that carry signals between neurons by binding to receptors. Some drugs mimic a neurotransmitter, others block its receptor and others change how much of it is released or reabsorbed. With repeated use, the body adapts, producing tolerance, in which more of the drug is needed for the same effect, and in many cases physical dependence, in which stopping causes withdrawal.

Volkow et al. (2016) build on those mechanisms to describe addiction as a three-stage cycle. In the first stage, intoxication, drugs produce large surges of dopamine in reward circuits. In the second, withdrawal, stress systems become overactive and the person feels worse without the drug. In the third, preoccupation, the prefrontal regions that support self-control are weakened, so craving is harder to resist. Critics argue that this model is too deterministic, because many people quit without treatment. Heilig et al. (2021) accept that some criticisms have merit but respond that the brain is the organ where both addiction and recovery happen, and that denying a biological basis reduces access to treatment. Calling addiction a brain disease does not mean the person has no part to play; it means the struggle is harder than it looks from the outside.

Paul wrote, "For I do not do what I want, but I do the very thing I hate" (English Standard Version Bible, 2001/2016, Romans 7:15). His words describe the experience of many people with addiction, who know what they want yet feel pulled the other way. Scripture does not excuse sin, but it treats this struggle with honesty and points toward help beyond ourselves.

Reply to Priya

Priya, you raised an important concern that calling addiction a disease could excuse people from responsibility for their choices. I think the research supports a middle position. Heilig et al. (2021) argue that the brain changes in addiction make stopping much harder but do not make change impossible; in fact, they point out that the same brain that changes with drug use is also capable of recovery, which is why treatment and personal effort both matter. Other chronic conditions work the same way. A person with type 2 diabetes did not choose the disease, but they still choose whether to take medication and change their diet. In Galatians 6, Paul asks believers to help shoulder each other's heavy loads (v. 2) and also says every person must carry their own pack (v. 5). I read those verses together as saying that the person with addiction is responsible for taking steps toward recovery, and the rest of us are responsible for helping them carry a weight that is heavier than it appears.

Reply to Marcus

Marcus, you asked why tolerance develops and why it makes overdose more dangerous after a period of not using. Hart and Ksir (2018) explain that with repeated exposure, the body adapts in several ways, for example by breaking the drug down faster or by reducing the number or sensitivity of receptors, so the same dose produces a smaller effect. That is why a person who uses opioids regularly may need much larger doses over time. The danger comes when someone stops for a while, such as during a jail stay or a stay in treatment. Their tolerance falls, but they may return to the dose they used before, which their body can no longer handle, and breathing can stop. This is one reason overdose risk is very high right after release from prison. First Corinthians 10:13 promises that God provides a way of escape with every temptation, and I think public health programs that offer naloxone and treatment at release are part of providing that way out.

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Hart, C. L., & Ksir, C. (2018). Drugs, society, and human behavior (17th ed.). McGraw-Hill Education.

Heilig, M., MacKillop, J., Martinez, D., Rehm, J., Leggio, L., & Vanderschuren, L. J. M. J. (2021). Addiction as a brain disease revised: Why it still matters, and the need for consilience. Neuropsychopharmacology, 46(10), 1715-1723. https://doi.org/10.1038/s41386-020-00950-y

Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363-371. https://doi.org/10.1056/NEJMra1511480