It’s Off to Rehab for Billie Joe Armstrong

You kinda had the feeling something was off…

Last weekend at the iHeartRadio music festival in Las Vegas, Green Day front-man Billie Joe Armstrong interrupted the band’s performance of their 1994 hit Basket Case and launched into an expletive soaked rant. He was apparently set off by the  digital ticker that said the band had one minute left onstage. At the end of the rant, Armstrong demolished his guitar, hitting it again and again against the floor.

This morning, the band announced on their Facebook page that:

Billie Joe is seeking treatment for substance abuse. We would like everyone to know that our set was not cut short by Clear Channel and to apologize to those we offended at the iHeartRadio Festival in Las Vegas.  We regretfully must postpone some of our upcoming promotional appearances.

The statement did not specify what kind of substance abuse Armstrong is dealing with. In the past he had admitted to drug use, and was he was arrested in 2003 for a DUI.

Green Day was just about to embark on a tour to promote the first of a trilogy of albums. The first, ¡Uno! is set to be released tomorrow, with second and third albums scheduled for release in November and January. Armstrong was also scheduled to be a mentor on NBC’s  The Voice.

According to the National Institute on Drug Abuse, abuse and addiction to alcohol, nicotine, and illegal substances cost Americans upwards of half a trillion dollars a year, considering their combined medical, economic, criminal, and social impact. Every year, abuse of illicit drugs and alcohol contributes to the death of more than 100,000 Americans, while tobacco is linked to an estimated 440,000 deaths per year.

 What is the difference between drug abuse and drug addiction?

Drug abuse is an intense desire to use increasing amounts of a particular substance or substances, often to the exclusion of other activities.

Drug addiction is the body’s physical need, or dependence on a specific agent. Over the long term, this dependence results in physical harm, behavior problems, and association with people who also abuse drugs. Stopping the use of the drug can result in a specific withdrawal syndrome.

Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain – they change its structure and how it works. These brain changes can be long lasting, and can lead to the harmful behaviors seen in people who abuse drugs.

How do drugs work in the brain?

Drugs are chemicals. They work in the brain by tapping into the brain’s communication system and interfering with the way nerve cells normally send, receive, and process information.

Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter. This similarity in structure “fools” receptors and allows the drugs to lock onto and activate the nerve cells. Although these drugs mimic brain chemicals, they don’t activate nerve cells in the same way as a natural neurotransmitter, and they lead to abnormal messages being transmitted through the network.

Other drugs, such as amphetamine or cocaine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals. This disruption produces a greatly amplified message, ultimately disrupting communication channels. The difference in effect can be described as the difference between someone whispering into your ear and someone shouting into a microphone.

How do drugs work in the brain to produce pleasure?

Most drugs of abuse directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and feelings of pleasure. The over-stimulation of this system, which rewards our natural behaviors, produces the euphoric effects sought by people who abuse drugs and teaches them to repeat the behavior.

Our brains are wired to ensure that we will repeat life-sustaining activities by associating those activities with pleasure or reward. Whenever this reward circuit is activated, the brain notes that something important is happening that needs to be remembered, and teaches us to do it again and again, without thinking about it. Because drugs of abuse stimulate the same circuit, we learn to abuse drugs in the same way.

When some drugs of abuse are taken, they can release 2 to 10 times the amount of dopamine that natural rewards do.

Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine (and other neurotransmitters) by producing less dopamine or by reducing the number of receptors that can receive signals.

As a result, dopamine’s impact on the reward circuit of a drug abuser’s brain can become abnormally low, and the ability to experience any pleasure is reduced. This is why the abuser eventually feels flat, lifeless, and depressed, and is unable to enjoy things that previously brought them pleasure. Now, they need to take drugs just to try and bring their dopamine function back up to normal. And, they must take larger amounts of the drug than they first did to create the dopamine high – an effect known as tolerance.

Source: National Institute of Drug Abuse

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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