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As we discussed previously the psychoactive substances (drugs) causes high level of dopamine in the brain. The chronic presences of the dopamine in the brain lead to structural changes in the reward pathway and other brain areas.
The reward pathway is highly connected to the various areas of the brain and prefrontal cortex which is executive functioning center associated with cognition, problem solving, memory, judgment and decision making. The long term drug abuse causes structural changes in brain some neurons die some regenerate. In short whole brain circuit is rewired.
These brain changes are more apparent in adolescence, as brain keeps on developing till mid-twenties so earlier the substance taken more risk for personality changes and permanent negative brain changes.
With these changes in brain the thinking pattern of the person is completely altered. His judgment of self and decision making is compromised. The person neglects self-care, continue to miss important tasks like job study etc. Daily life activities are disrupted and social life is completely lacking.
He develops typical drug seeking behavior where his whole life revolves around the obtaining, using and recovering from abuse of drugs. He can and will do anything to achieve the pleasure associated with drugs.
These brain changes are also visible on imaging. The functional MRI of brain in addicts shows decreased brain metabolism and altered brain functionality.