Neurobiology of substance use in adolescents and potential therapeutic effects of exercise for prevention and treatment of substance use disorders
Open accessAbstract
Substance use (e.g., alcohol, marijuana, opioids, cocaine., etc,) use often initiates during adolescence, a critical period of physiological and social development marked by an increase in risk‐taking due, in part, to heightened motivation to obtain arousal from rewards. Substance use during adolescence has been associated with a greater risk of substance use disorders (SUD) in adulthood. Although use rates for most substances have remained relatively stable, the frequency of marijuana use and the perception that regular marijuana use is not harmful has increased in adolescents. Furthermore, the nonmedical use of opioids has increased, particularly in the South, Midwest, and rural low‐income communities. Substance use in adolescence has been associated with adverse structural and functional brain changes and, may exacerbate the natural “imbalance” between frontal/regulatory and cortical‐subcortical circuits, leading to further heightened impulsive and reward‐driven behaviors. Exercise increases growth and brain‐derived neurotrophic factors that stimulate endogenous dopaminergic systems that, in turn, enhance general plasticity, learning, and memory. Exercise may help to reinforce the “naïve” or underdeveloped connections between neurological reward and regulatory processes in adolescence from the “bottom up” and “offset” reward seeking from substances, while concomitantly improving cardiovascular health, as well as academic and social achievement. In this review, we provide an overview of the current state of substance use in adolescents and rationale for the utilization of exercise, particularly “assisted” exercise, which we have shown increases neural activity in cortical‐subcortical regions and may modulate brain dopamine levels during adolescence, a unique window of heightened reward sensitivity and neural plasticity, for the prevention and adjunctive treatment of SUD.
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Adolescents exposed to nicotine are at heightened risk of developing addictive behaviours.
“Importantly, during this critical period of development, the neuromodulatory and neurotoxic effects of nicotine may more profoundly impact the structure, function and con nectivity of the adolescent brain, and place adolescents at heightened risk of developing cognitive problems (Counotte et al., 2009) and addictive behaviours (Conrod and Nikolaou, 2016; Nock et al., 2017).”
From Age-dependent Effects of Tobacco Smoke and Nicotine on Cognition and the Brain: A Systematic Review of the Human and Animal Literature Comparing Adolescents and Adults. (2023) · cites this paper as Nock et al., 2017
In “Adolescence is a Critical Period of Development” (page unavailable), the review describes adolescents as vulnerable to reward-seeking and potential substance misuse. “Substance Use Rates in Adolescents” (page unavailable) associates adolescent use of alcohol, cigarettes, and marijuana with later substance use disorder, but does not establish that nicotine exposure itself heightens the risk of addictive behaviours through effects on the adolescent brain. (LLM, conf=0.84)
Experimental — accuracy not yet measuredNicotine's neuromodulatory and neurotoxic effects may more profoundly impact the structure, function and connectivity of the adolescent brain than the adult brain.
“Importantly, during this critical period of development, the neuromodulatory and neurotoxic effects of nicotine may more profoundly impact the structure, function and con nectivity of the adolescent brain, and place adolescents at heightened risk of developing cognitive problems (Counotte et al., 2009) and addictive behaviours (Conrod and Nikolaou, 2016; Nock et al., 2017).”
From Age-dependent Effects of Tobacco Smoke and Nicotine on Cognition and the Brain: A Systematic Review of the Human and Animal Literature Comparing Adolescents and Adults. (2023) · cites this paper as Nock et al., 2017
The “Adolescence is a Critical Period of Development” section describes heightened adolescent reward sensitivity and vulnerability to substance misuse, which supports the cited point about risk of addictive behaviours. It does not say that nicotine has more profound neuromodulatory or neurotoxic effects on adolescent brain structure, function, or connectivity than on the adult brain; a search for nicotine found discussion of nicotine replacement therapy, not that comparison. Page numbers were unavailable in our copy. (LLM, conf=0.78)
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References 240 · Cited by 61
Research works printed but not linked: 3
- Lipari RN Park-Lee E van Horn S 2016 America's Need for and Receipt of Substance Use Treatment in 2015. National Survey on Drug Use and Health Research Triangle Park, NC Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services 28080008
- National Academy of Sciences, E. a. M 2017 Pain Management and Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use Washington, DC National Academies Press 29023083
- National Institute on Drug Abuse National Institutes of Health U.S. Departmenr of Health and Human Services 2017 Principles of Drug Addiction: A Research-Based Guide (Rep. No. Third Edition)
- Authors
- Nock, N. L., Minnes, S., & Alberts, J. L.
- Affiliations
- Case Western Reserve University (US)
- Cleveland Clinic (US)
- Corresponding author
- Nock, Nora L.
- Venue
- Birth Defects Research
- Publisher
- Wiley
- Published
- 2017-12
- Volume
- 109
- Issue
- 20
- Pages
- 1711-1729
- ISSN
- 2472-1727 (ISSN-L)
- PMC
- PMC5751741
- OpenAlex
- W2777832155
- Semantic Scholar
- 6de1d119eb9d27197be3dd58d71c520adca13d91
- Cited by
- 61
- References
- 240
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 3 · 2023: 9 · 2022: 14 · 2021: 8 · 2020: 6 · 2019: 6 · 2017: 1
- FWCI
- 0.47
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Birth Defects Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01‐CA175100)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- adolescent substance use, substance use disorders, physical activity, brain-derived neurotrophic factor, dopamine, reward sensitivity, neuroplasticity, cannabis use, opioid use, substance use prevention, addiction treatment
- MeSH terms
- Adolescent, Exercise Therapy, Humans, Neurobiology, Substance-Related Disorders
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