October 24, 2022

Every court case has unique challenges, but criminal cases involving drug abuse require special consideration. In our current opioid crisis, more often than not, judgments and sentencing should consider the complexities of drug use to ensure the best possible outcome for the defendants.

Drug addiction and brain function are closely tied, and the consequences of substance use almost always bleed into the outcome of cases. To better understand the needs drug addicts face on the road to recovery, judges should know how drug use, directly and indirectly, affects the actions, decisions, and mental health of substance users.

Drug Addiction and Brain Function

The human body operates through a series of electrical signals triggered by brain activity. The brain operates much like a complex network of circuits, and these circuits are activated by neurotransmitters. When a neurotransmitter is present, certain circuits are activated or deactivated, causing a reaction to a stimulus. Drug use supercharges these reactions by either adding external neurotransmitters to the circuits or activating a high level of natural neurotransmitters. This overstimulation of neural pathways results in serious and long-lasting brain function changes. But the effect of this overstimulation depends on the region of the brain in which it occurs and the neurotransmitters that trigger it.

The Role of Neurotransmitters in Drug Addiction

Drug use most significantly affects two key neurotransmitters in the brain: endorphins and dopamine. Endorphins are the pleasure chemicals in the brain. When we have positive experiences, such as eating, social interactions, or sexual encounters, the brain releases endorphins, which deliver varying feelings of pleasure.

Dopamine, while somewhat related, isn’t caused by pleasurable experiences. Instead, it trains neurons to create pathways that make certain movements or patterns faster and more consistent. We build habits through dopamine release when we repeat an activity that brings pleasure. Even the cues surrounding that activity can activate a dopamine release (things like environment, sounds, feelings, or movements). This is why many recovering addicts experience strong triggers from things like sounds or physical locations that they associate with their past drug use.

Regions of the Brain Affected by Substance Use

The human response system is controlled by different areas of the brain and forms based on neurotransmitters released over time. When drug use occurs, these areas of the brain experience unnaturally strong stimulation. The effects are significant, often creating profound impairment to daily functions.

Basal Ganglia

The basal ganglia play an essential role in the response system for motivation and forming habits. They provide a large portion of the reward circuit, reacting to endorphins to give a slight mood boost when you experience positive stimuli. When overstimulated by drug use, the basal ganglia create the euphoric feeling known as a “high.” With prolonged exposure to these extreme stimuli, euphoric feelings may diminish or disappear while experiencing normal and natural positive experiences. Eventually, the only way a user can experience pleasure is through the use of drugs.

Extended Amygdala

The extended amygdala manages stress responses, including anxiety, irritability, and unease. When we experience negative stimuli, this part of the brain creates a reaction that helps us avoid similar situations in the future.

Drug addiction and brain function cause the extended amygdala to become increasingly sensitive. When addicts do not receive continuous stimulation, the extended amygdala creates a painful response that only worsens with continued drug use. This brain response is what is commonly known as "withdrawal symptoms."

Prefrontal Cortex

The prefrontal cortex manages decision-making processes and facilitates problem-solving, planning, self-control, and basic thinking. Before the prefrontal cortex is developed fully at age 25, decisions are often made impulsively and with less logic and reason.

With "highs" created by the basal ganglia and "withdrawals" from the extended amygdala, the prefrontal cortex is especially vulnerable to override in teens and adolescents who use drugs frequently. Short-circuited brain function related to drug addiction creates a cycle of dependence to avoid painful responses and chase synthetic euphoria.

Psychological Effects of Drug Addiction

The cyclical nature of drug addiction and brain function stems from and creates psychological issues. So, it’s important to keep both in mind when considering sentencing for drug-related cases. Prior to drug use and abuse, individuals frequently experience excessive stress, depression, and anxiety. They see the drug and its related high as an escape from these feelings. The euphoric highs mask the initial psychological issues for a short time. When the high subsides, and brain chemistry returns to normal, individuals may seek the same high to escape again. However, overstimulating the reward circuit reduces the drug’s effectiveness in recreating the high, leading to increased use, either in dosage or frequency.

Once an individual is using drugs, other effects begin surfacing. Many drug users experience violent mood swings, more intense feelings of depression and anxiety, heightened paranoia, and physically violent responses to stressful situations. Drug addiction creates, or at the least exacerbates, an individual’s reactions. And some of these psychological effects are the foundation of drug-related legal cases.

How Drug Addiction and Brain Function Affect Trial Outcomes

Clearly, the close relationship between drug addiction and brain function can lead to decisions that cause considerable harm, both to the addict and the people around them. But the past conventions of punitive responses in these cases are ineffective in guiding substance users into recovery or reintegration. Instead, many convicted criminals with substance abuse issues relapse after serving time.

So how does the judicial system move forward in a more positive direction? How do we work to support substance users to provide a path toward abstinence and personal responsibility?

Knowing that drug addiction and brain function can cause (and be caused by) deeper psychological and physical issues, judges can look to more expansive therapies. This approach can narrow the gap between addiction and recovery and keep individuals in recovery longer—perhaps indefinitely.

Overstimulation of pleasure pathways in the brain causes self-destructive behavior patterns. Likewise, overstimulation in pain centers can result in criminal acts to avoid withdrawal symptoms. In criminal cases, consider the motives of addiction-related crimes when sentencing.
The psychological effects of drug addiction increase the risk of death by suicide and overdose. Individuals need addiction recovery treatment mandates and psychological support to overcome these risks.
The propensity of mental health disorders leading to drug addiction is staggering. As such, sentencing in drug-related convictions should provide counseling and therapy along with addiction recovery methods like twelve-step facilitation and cognitive-behavioral therapy.
Relapse-related dangers, in these cases, increase the likelihood of death by overdose due to reduced chemical tolerance. Abstinence is of the utmost importance, and monitoring for substance use should be a tool for guiding the recovery process.

Utilizing Substance Detection for Addiction Recovery

Drug addiction and brain function present unique challenges in criminal cases. Judges should strive to meet users' physical and psychological needs using intentional strategies that guide recovery. It is in these instances that substance detection methods come into play.

Most drug screening is invasive in one way or another. Whether there is a need for several weekly appointments to provide a screening sample or the sampling method requires an unsanitary approach. But one way offers a solution to both problems.

The PharmChek® Drugs of Abuse Sweat Patch is a clean, convenient alternative to conventional drug testing. Its simple and continuous collection method supports recovery in many ways. And with a well-documented history of judicial precedence, judges can be confident that PharmChek® is a proven and effective choice for nearly any drug-related sentencing procedure.

With a sampling period of as many as 10 days, this method offers continuous detection of substance use.
Since the sampling period only requires an initial application and a final removal, the individual required to provide proof of abstinence reduces required appointments and related scheduling around work, childcare, and other requirements.
The standard panel detects many major drugs of abuse, including methamphetamine, heroin, cocaine, and marijuana. And the new extended opioid panel can also detect both synthetic and natural opioids in addition to the standard panel.
While many sample methods only detect the metabolites of the drugs, the Sweat Patch detects all metabolites and the parent drug, leaving no doubt in an individual’s abstinence.
The Sweat Patch is best utilized in conjunction with cognitive-behavioral therapies, contingency management, and motivational enhancement therapies. In these contexts, the screening results can be used to find patterns and triggers that lead to relapses, as well as an incentive to remain abstinent, either through rewards or through observation and evaluation of the individual’s treatment plan.

In cases that involve drug addiction and brain function considerations, judges must consider the importance of facilitating an environment where recovery is possible. Strong support systems must be in place, and knowing how brain function is altered by substance use and abuse can help judges make well-informed decisions that make this possible.

Since every case is unique, there is no clear-cut answer to sentencing. But it is possible to encourage recovery and reduce the risk of relapse when individuals receive the support they need through research-supported therapies, individualized treatment plans, and systems of accountability.