Why do people take drugs when they know they’re bad?

Every day we make choices that affect our health. People take drugs for a lot of different reasons, like to deal with life’s challenges, to escape from reality, to relieve pain, or to try to fit in—just to name a few.

Some people can be aware of the negative effects of drugs on their health and in their life and still struggle to stop using them. This is because repeated drug use can lead to changes in the brain that make it hard to stop using them, even when people want to stop. When this happens, the person is experiencing a medical problem known as substance use disorder. Addiction is a severe form of substance use disorder.

All addictive drugs cause the brain to release the chemical dopamine. Dopamine is usually released after pleasurable and satisfying activities. Dopamine causes the brain to remember rewards, like food and sex, and reinforces the desire to seek them out again. Repeatedly using a drug floods the brain with more dopamine, which can change the way the brain responds to that drug.

With repeated use, a greater quantity of drug is needed to produce the same pleasurable effect. When the drug is not available, people may experience the negative symptoms of withdrawal, which may include stress, anxiety, depression, and sometimes physical symptoms such as sweating, vomiting and pain. Repeated cycles of drug use and withdrawal can disrupt brain function to the extent that people may have difficultly experiencing pleasure in their daily lives. At this point, many people continue drug use to avoid the lows caused by withdrawal rather than seek the highs they once experienced.

Fortunately, treatment can help people with a substance use disorder counteract these disruptive effects and lead healthier lives. The sooner a person receives treatment, the better the chance that they will recover.