worried woman struggling with clouded judgment and substance abuse

Substance Abuse Impacts Three Crucial Aspects: Decision Making, Judgment, and Risky Behavior

Research has demonstrated that substance use distorts the brain’s workings and interferes with sound decision-making. Additionally, substance use disorder (SUD), which includes alcohol abuse and alcoholism, leads a person to make choices that he/she/they would never make under normal circumstances. The drive or compulsion to obtain drugs leads one down a dark path despite the negative consequences usually associated with taking drugs and alcohol.

Judgment is the ability to “characterize thought, opinion, or evaluation of a stimulus…

Decision making is the behavior of choosing among options [for action].”

“Poor decisions are related to impulsivity and risk-taking. Much literature has shown that drug and alcohol addictions are associated with impulsivity…One measure of impulsivity… indicates that individuals with substance use disorders devalue long-term rewards in favor of short-term rewards…”

There are many reasons for impulsivity, which can lead to risky behavior while under the influence of substances. This situation is interrelated to genetics, environment, stress, mental health, trauma, adverse childhood experiences, and several other factors. Sometimes, a mental health condition exists before substance use, while other times, substance abuse can bring on mental health conditions. Sometimes, people use substances to reduce symptoms of mental health conditions, commonly called self-medicating. Other times, people who suffer from SUDs can develop mental illnesses associated with changes in brain structure, function, and activity.

What is Risky Behavior?

With regards to SUD, risky behavior takes many forms. The most frequently referred to high-risk behavior tends to be sexual behavior. It can range from unprotected sex, sexual activity at an early age, intercourse with multiple partners, sex for drugs, and prostitution. But, it also includes erratic behavior such as aggression, driving while drunk, and taking unwarranted risks that during “normal daily functioning” would not be taken. There is a tendency among people with SUD to place self-interest above personal safety, obligations to others, or irresponsible financial behavior. 

How Drugs Impact Brain Function

There are billions of brain cells called neurons, and each neuron controls the flow of information. Many circuits of neurons work together to send and receive data, ensuring that other parts of the brain, the spinal cord, the autonomic nervous system, and the peripheral nervous system receive communications. The messages sent to and from the neurons go to the neurotransmitters and attach to the receiving neuron. Transporters recycle and bring them back to the neurons once the message has been received, thus shutting off the signal. These actions are all stimulated by chemical responses. “Drugs interfere with how neurons send, receive, and process signals via neurotransmitters…[some drugs] can activate neurons because their chemical structure mimics a natural neurotransmitter…They lead to abnormal messages being sent through the network…”

Other drugs cause neurons to release significant quantities of neurotransmitters and prevent the recycling of the neurotransmitters (interfering with the brain’s ability to stop the signal). Different drugs influence different parts of the brain and its associated functions, such as the prefrontal cortex, which enables one to think, plan, solve problems, make decisions, and manage self-control. Other parts of the brain are needed to create language, carry information about senses, motor control and coordination, etc. The use of drugs and alcohol can severely alter all these functions. One significant chemical necessary for healthy brain function is dopamine. Dopamine signals the experience of pleasure and motivation. The flood of dopamine in the brain caused by drugs and alcohol accounts for the intense drug and alcohol seeking experienced by users. In the brain’s everyday occurrences, dopamine is released, and the signal is turned off. Once the signal is turned off, under healthy brain function, the dopamine is reabsorbed. Drugs and alcohol interfere with that mechanism. Problems arise when dopamine continually floods the brain. Regular or long-term use of substances such as psychoactive drugs “can lead to…changes in the brain (i.e., the development of new reward pathways), leading to multiple symptoms and features of addictions, including craving, withdrawal, and tolerance.”

It should be noted at this point that there are many compulsive, addictive behaviors that can produce the same problems and changes in brain function as drugs and alcohol. These include compulsive eating, gambling, compulsive shopping, compulsive internet usage, and workaholism, just a few examples.

Mental Health Illnesses and SUD

As stated earlier, sometimes a mental health condition such as bipolar disorder or ADD can motivate a person to self-medicate. Other times, consuming drugs can alter brain function and lead to mental health disorders.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), substance abuse occurs more frequently with the following conditions (but is not limited to this list)

  • Depression
  • Anxiety and Mood Disorder
  • Schizophrenia
  • Personality Disorder
  • Bipolar Disorder
  • Conduct Disorders
  • ADHD

According to SAMHSA, 9.2 million adults in the US suffer from a co-occurring disorder (a substance abuse disorder plus a mental health disorder). The severity of SUD becomes complicated when, for example, a person becomes addicted to opioids. Research has demonstrated that those who suffer from opioid use disorders (OUD) are more likely to engage in high-risk behaviors, increasing the chances of adverse health outcomes. Those with mental health disorder(s) and OUD are more likely to use polysubstance (combining drugs). They are also at greater risk of accidental overdoses. A recent study found that those suffering from OUD also used alcohol, marijuana, cocaine, nicotine, heroin, hallucinogens, methamphetamines, benzodiazepines, and crack cocaine.

Treatment Can Break the Cycle of SUD and Mental Health Disorders

The amount of drugs, the type of drugs, and the physical and mental health of a person can determine how dangerous going “cold turkey” may be (the abrupt cessation of using alcohol and drugs). Further, mental health disorders can worsen if not monitored by professional addiction doctors and clinicians.

Several forms of therapy help educate the addict and help him/her/them address the addiction and mental health disorder. A comprehensive treatment plan that is regularly updated is necessary.

Call us now and speak to one of our professional staff members if you are experiencing trouble with decision-making, judgment, and risky behavior associated with SUD. Our staff are trained to answer all your questions while treating you or your loved one compassionately. Don’t let drugs and alcohol take the rest of your life or that of your loved ones. We are here to help you!