What is Addiction?

Addiction Recovery

For many years, experts believed that only alcohol and powerful drugs could cause addiction. But thanks to recent research and improved technology, the science and medical community has also shown that certain “pleasurable” and normally harmless activities – such as gambling, shopping, and sex – can also hijack the brain in the same way. Now we know that the use of both illegal drugs, prescription medicine and nicotine, as well as some activities (e.g., sex, eating, gambling, exercising, shopping etc.) can result in addiction.

An addiction is a complex and relapsing condition that not only exerts a powerful influence over basic brain functions, but physically changes our brain chemistry. Addiction is a lot like other diseases, such as for example heart disease. Both conditions disrupt the normal, healthy functions of the body, have serious harmful consequences, and are preventable and treatable – but if left untreated, can last for a lifetime or result in an untimely demise. Simply explained, a person who suffer from an addiction have very little control over what they are doing, taking or using – even if their addiction reaches a point where it becomes life-threatening.

The difference between use, abuse, and addiction

The road to addiction is often divided into three steps or stages, namely: use, abuse, and dependence or addiction. Trying a substance or a drug ones or a few times is often called experimental drug use while using multiple times but without negative consequences is often referred to recreational drug or substance use. If an individual increase its drug or alcohol use due to certain types of difficulties or situations, we may say that the person is affected by symptoms characterized or situation characterized use. If such activity causes harm or disrupts a person’s life/relationships negatively is often called abuse or misuse. And lastly, if we see signs that a user attempts to quit but is unable to resist, it makes sense to characterize this as addictive use or dependency.

The factors and circumstances that affect the frequency of use and the motivations for use changes over time. Experimental use, for example, is dominated by curiosity and coincidences, and is often a combination of environment, milieu, and chance. Regular use is dominated by the wish to use. Amongst the many factors that influence drug or substance use, it’s especially common to point out of funds and the degree of social acceptance. The factors that affects a person’s control over drug or alcohol use may also vary. The loss of control is never absolute, and the difference between unscrupulous frequent use and addiction can be difficult to draw.

The anatomy of the addicted brain

Central for understanding how a drug, substance, or behavior creates an addiction is, its ability to interfere with an individual’s cognitive behavioral systems, the nerve pathways that connects the brains cortex and the basal ganglia (which functions include control over cognition and emotion). These cognitive behavioral systems are programmed to absorb contextual wisdom so that we can continuously change our behavior in relation to the sensory signals we receive from our surroundings and interaction. This process of “contextual knowledge absorption” is constant throughout a person’s whole lifespan in order to best assure that that person have a behavioral pattern that corresponds with an individual’s well-being. For example, a person’s cognitive behavioral system will evaluate the importance and necessity of the sensory signals it receives and alter our behavior accordingly. It’s the reason why we, in most cases, learn to resist doing activities with high risk – low reward (low importance). Brain cells that use dopamine as signal molecules are therefore key in this process. However, a number of substances and behavioral interactions seems to have the common property that they can influence the activity of these dopaminergic brain cells with the consequence that the substance or behavior are perceived as important and rewarding when in fact they are not. Additionally, repeated drug use (as well as compulsive repetition of certain activities such as gambling) may further change the function of these brain cells (neuroplastic) so that any and all signals associated with substance abuse or certain activities become stronger and are perceived as more significant and important in comparison to other functions or relations (e.g., the importance of keeping a job, having rewarding relationships, being law-abiding, etc.).

These drug or activity-induced neuroplastic changes does, by no means, render a person incapable of making sensible, appropriate behavioral choices, however, it does mean that the choices become more difficult. This is because the person who suffer from addiction will find it much more difficult to appreciate and value the more sensible alternative and will struggle with controlling different impulses.

Contrary to what many believe, it takes more than willpower and good intentions to overcome addiction. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self-control and hinder his or her ability to resist intense impulses to take drugs.

What causes addiction?

As with other mental disorders, abuse or addiction to substances and/or pleasurable activities may have several causes, and both genetic vulnerability, risky connections and life stress can help the problems develop.

While the mechanisms behind the development of addiction are still not clear. Modern theories have largely emphasized the ability of drugs to induce long-lasting changes in the function of certain brain areas (mesolimbic structures, amygdala, hippocampus and frontal lobe, often known as the disease model. In principle, this model proposes that anyone who uses drugs for long periods of time can develop addiction. While this certainty seems the case, a number of other theories do exist.

For example, some suggest that addiction is more dependent upon dysfunctional thoughts and habituated behaviors; that addiction is a moral or spiritual problem; or that addiction results from a lack of social connection.

Today, most psychologists accept that addiction results from the complex interaction of many factors, including but not limited to biological, social, and psychological. Often referred to as the Bio-Psycho-Social-Spiritual (BPSS) Model.

Signs and Symptoms of Addiction

The condition does not have very clear diagnostic criteria, but it is possible to place it in diagnostic systems such as DSM-IV (Diagnostic and Statistical Manual of Mental Disorders). The intensity of the feeling of addiction varies considerably between people and the same person over time.

Characteristics of substance dependence includes recurrent, compulsive desire to take intoxicants, poor control of the termination and the amount injected/used in individual situations, use of a lot of time and effort on the procurement, storage and ingestion of drugs, loss of other life interests and difficulties in getting out of an unfortunate pattern of use despite the damage and the desire to quit.

The condition is often characterized by addiction to several different drugs at the same time. Health and social maturity, as well as any crime, can follow the addiction, but not in all cases. It is also not the case that drug dependence will necessarily result in tolerance development and physical withdrawal disorders when the supply of drugs is interrupted. Such ailments can come after consuming alcohol, opiates, opioids, barbiturates and benzodiazepines, but need not.

Withdrawal complaints can occur without the condition being characterized as substance dependence. The so-called physical dependence, characterized by withdrawal complaints, is therefore no longer set as a central criterion in the diagnosis, but withdrawal will naturally make it more difficult to get out of substance dependence.

The cost of addiction

Addiction is most known for the impact it has on an individual’s health and relationships. However, while these losses feature a more prominent role in addiction, they only tell part of the story.

Financial and personal problems are common in those with an addiction.

Typically, addicts and their families also pay a heavy financial cost, both in terms of the money spent on the substance or activity in question and in terms of lost wages and job opportunities.

One can even consider the cost that society also pays due to factors such as lost productivity, health care expenses for indigent addicts, drug treatment programs, drug-related law enforcement efforts, and the housing of drug offenders in jails and prisons.

Facts and Statistics of Drug Abuse

Drug abuse statistics can be alarming, but the numbers also show a potential for help and healing. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Substance Abuse and Health states that while 21 million Americans aged 12 and over needed drug or alcohol treatment in 2016, only 3.8 million received the help they needed at a specialized treatment facility. Other research sources on drug addiction show that:

  • Drug abuse takes a financial toll on all Americans. The use of illicit drugs such as heroin, cocaine, meth and ecstasy costs the U.S. $11 billion in health care. According to the U.S. Department of Justice, total yearly costs in terms of hospitalization, emergency medical care, lost work productivity, premature death and criminal behavior surpassed $193 billion in 2007.
  • Pharmaceutical drug abuse facts from the Centers for Disease Control and Prevention (CDC) indicate that almost 3 percent of Americans age 11 and older had used psychotherapeutic medications (e.g., sedatives, tranquilizers, or stimulants) without a doctor’s prescription in 2012.
  • Some drug abuse facts and statistics show a significant and steady increase in American opioid use, contributing to the nation’s growing opioid crisis. The CDC reports a 29.7 percent increase in opioid-overdose emergency room visits from July 2016 to September 2017. Wisconsin and Delaware saw the largest rise in overdose emergency room visits, with an increase of 109 and 105 percent respectively.
  • Stimulants like cocaine and meth can cause long-lasting damage to the brain, altering the way you think, feel and experience reality. Drug addiction facts from the Journal of Neurology, Neurosurgery & Psychiatry highlight that chronic cocaine use can cause the brain to shrink, a condition called cerebral atrophy. Long-term cocaine use can cause cognitive impairment even after the drug is no longer used, while those who have used methamphetamine may continue to experience hallucinations and psychotic episodes after quitting.
  • SAMHSA’s drug addiction statistics indicate that roughly 20.1 million people over the age of 11 struggled with a substance use disorder in 2016. Alcohol was the most prevalent addiction, with 15.1 million people dealing with an alcohol use disorder, followed by 7.4 million struggling with illicit drugs.

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