Addiction
Many misconceptions surround what addiction really is and therefore it is a highly misunderstood condition. Some view addiction as a sign of moral weakness and believe stopping the addictive behavior is simply a matter of willpower. Clinical studies have proven this is not the case but instead, have identified certain structural changes in the brain which contribute to addiction and make recovering from addiction much more challenging.
Another common misconception is that all people who use drugs or alcohol on a regular basis are addicted, and that being “addicted” describes being physically dependent on a substance. In reality, addiction is not that simple. Some people who use drugs and alcohol regularly are not addicted, and others who are addicted may not be physically dependent on the substance.
Addiction is a non-medical term that refers to a wide range of mental disorders called Substance Use Disorders. There are a variety of different types of Substance Use Disorders, including Alcohol Use Disorder, Stimulant Use Disorder, and Cannabis Use Disorder, just to name a few. Regardless of the type of Substance Use Disorder, health and mental health professionals use to look for the same signs and symptoms in order to diagnose these disorders.
Symptoms of Substance Use Disorders
Symptoms of Substance Use Disorders include frequent use, prolonged use, cravings to use, and an inability to stop or cut back. A hallmark symptom of a Substance Use Disorder is continued use even after a person has experienced negative consequences as a result of their use. Negative consequences might include conflict in relationships, an inability to meet expectations at work or home, receiving a DUI, incarceration, DSS involvement, or experiencing financial difficulties as a result of continued substance use. Continuing to use even after having experienced negative consequences indicates the likelihood one has developed some type of dependence (or addiction), to the substance being used.
Some individuals may use drugs or alcohol frequently or heavily but might not meet the criteria to be diagnosed with a Substance Use Disorder. If one has not experienced any negative impacts, consequences, or impairment as a result of substance use, they would not be diagnosed with a Substance Use Disorder, although they are at higher risk of developing one.
Individuals struggling with addiction may go to great lengths in hiding their drug or alcohol use from others and thus may make it difficult to detect. If you suspect a loved one is struggling with addiction you may notice concerning changes in their behavior. You may notice that the person is acting in ways out of character for them, like becoming less reliable or not following through on things they agreed to do. Other warning signs may include unexplained financial difficulties, unemployment, or the loss of relationships.
An individual struggling with addiction might deliberately fall out of contact with their loved ones, not calling for a prolonged period. Those struggling with addiction may also develop changes in their mood or thinking. You may notice them becoming more irritable, less engaged, appearing drowsy, or saying things that seem far-fetched or that do not make sense.
How Does Addiction Develop?
Addiction develops over time, as a person continues to use a substance and grows more dependent on it. Certain drugs, like nicotine and heroin, have more addictive qualities and individuals who use these drugs may be at higher risk of dependence earlier on than those abusing drugs with lower addictive qualities, like alcohol or marijuana. In these ways, a person’s decision to use and to continue using certainly increases the risk for addiction, but there are other involuntary factors involved in the process as well.
Addiction affects a person’s inhibitory control over their behavior as well as the brain circuits involved in motivation, reward, memory and learning. Specifically, drug and alcohol use trigger the release of Dopamine, a neurotransmitter which causes pleasurable feelings. According to clinical research, the brain begins to form associations between the pleasurable feeling and the use of the substance, creating a “reward pathway” in the brain that acts as a strong incentive to continue using the substance. This is experienced by the individual as a strong urge or craving for the substance, increasing the risk of continued use. Interestingly, these same areas of the brain are known to be involved in specific behaviors that, for some people, become compulsive and problematic. Examples of behaviors known to interact with the reward pathways in the brain include eating, gambling, risky behaviors, and sexual behaviors.
Although the initial decision to drink or take drugs was probably voluntary, the changes in brain chemistry caused by repeated drug or alcohol substance abuse is an involuntary response that affects certain users. Research indicates that some people might be more at risk for developing these reward pathways based on a number of factors including having an underlying mental illness, genetics, or having experienced a stressful or traumatic life event.
Researchers have also discovered that the frontal lobe in the brain is essential to being able to delay gratification and avoid impulsive actions. In some people, an underdeveloped prefrontal cortex may place them at higher risk of developing an addiction. Since this part of the brain develops even beyond adolescence and into early adulthood, teens and young adults are at higher risk for developing addictions.
So, while addiction does result in specific changes to the structure of the brain, including the development of reward pathways, it is still possible for people to reverse this damage. In fact, scientists now understand that the brain can change in response to our behavior, even into adulthood. Individuals who have developed addictions can rewire their brain circuitry in ways that reduce their risk of addiction by not using drugs or alcohol for a prolonged period. Recovering from addiction is difficult and often is a non-linear process that includes several trials and errors, but receiving treatment can significantly improve the likelihood of a successful recovery.
The Progression of Addiction
Over time, an untreated Substance Use Disorder often progresses and gets worse. An individual may begin to use more frequently and may stop other important activities in order to do so. One may also develop a tolerance to the substance, increasing the need to use more of it in order to get the same effects, which heightens the risk for further negative consequences. Depending on the substance being used, an individual may begin to develop a physical dependence on the substance, resulting in uncomfortable or even dangerous withdrawal symptoms when they attempt to stop using.
Others might not become physically addicted, but may notice they have become more dependent on the substance in other ways; such as using drugs or alcohol to cope with stress, numb painful emotions, or to be able to face daily tasks and activities. The growing dependence on the substance could be described as addiction, regardless of whether the dependence is physical in nature or not.
Treatment For Addiction
Individuals in the early stages of addiction, or with just a few signs of dependence, might be suffering from a Mild Substance Use Disorder. While individuals with numerous signs and symptoms are most likely suffering from a Moderate or Severe Substance Use Disorder. With proper treatment, a person with a Substance Use Disorder can effectively get rid of their symptoms and put their disorder into remission, regardless of the severity of their disorder. The severity of the disorder may influence what treatment is recommended.
Treatment is provided in a variety of ways, including treatment provided in outpatient settings, inpatient settings, and treatments that may incorporate individual, family, and/or group therapy. Speaking with a professional who is knowledgeable about the services available in your community is a recommended first step. Often, this first point of contact would be a health or mental health professional like a primary care physician, psychiatrist, social worker, or therapist. In other cases, a person might contact their insurance company to get additional information about what treatments are covered under their insurance plans.
Once an individual begins participating in a treatment, they will begin learning new skills and strategies to regain control of their lives and begin repairing some of the damage done while they were using. Often, this process includes taking inventory of the consequences of the drug or alcohol use, identifying risks and triggers for continued use, learning skills to overcome cravings, and developing routines and habits which support a healthier lifestyle.
When treatment is completed and remission is achieved the individual will need to continue to use their new support system and learned skills and strategies to protect against a future relapse. Due to the risk of relapse, Substance Use Disorders are considered chronic in nature, meaning that people in remission are still at higher risk for addiction than those who have not had these disorders. Often, those in long periods of remission may not need active treatment but still will benefit from participation in recovery communities and support groups.
Another common misconception is that all people who use drugs or alcohol on a regular basis are addicted, and that being “addicted” describes being physically dependent on a substance. In reality, addiction is not that simple. Some people who use drugs and alcohol regularly are not addicted, and others who are addicted may not be physically dependent on the substance.
Addiction is a non-medical term that refers to a wide range of mental disorders called Substance Use Disorders. There are a variety of different types of Substance Use Disorders, including Alcohol Use Disorder, Stimulant Use Disorder, and Cannabis Use Disorder, just to name a few. Regardless of the type of Substance Use Disorder, health and mental health professionals use to look for the same signs and symptoms in order to diagnose these disorders.
Symptoms of Substance Use Disorders
Symptoms of Substance Use Disorders include frequent use, prolonged use, cravings to use, and an inability to stop or cut back. A hallmark symptom of a Substance Use Disorder is continued use even after a person has experienced negative consequences as a result of their use. Negative consequences might include conflict in relationships, an inability to meet expectations at work or home, receiving a DUI, incarceration, DSS involvement, or experiencing financial difficulties as a result of continued substance use. Continuing to use even after having experienced negative consequences indicates the likelihood one has developed some type of dependence (or addiction), to the substance being used.
Some individuals may use drugs or alcohol frequently or heavily but might not meet the criteria to be diagnosed with a Substance Use Disorder. If one has not experienced any negative impacts, consequences, or impairment as a result of substance use, they would not be diagnosed with a Substance Use Disorder, although they are at higher risk of developing one.
Individuals struggling with addiction may go to great lengths in hiding their drug or alcohol use from others and thus may make it difficult to detect. If you suspect a loved one is struggling with addiction you may notice concerning changes in their behavior. You may notice that the person is acting in ways out of character for them, like becoming less reliable or not following through on things they agreed to do. Other warning signs may include unexplained financial difficulties, unemployment, or the loss of relationships.
An individual struggling with addiction might deliberately fall out of contact with their loved ones, not calling for a prolonged period. Those struggling with addiction may also develop changes in their mood or thinking. You may notice them becoming more irritable, less engaged, appearing drowsy, or saying things that seem far-fetched or that do not make sense.
How Does Addiction Develop?
Addiction develops over time, as a person continues to use a substance and grows more dependent on it. Certain drugs, like nicotine and heroin, have more addictive qualities and individuals who use these drugs may be at higher risk of dependence earlier on than those abusing drugs with lower addictive qualities, like alcohol or marijuana. In these ways, a person’s decision to use and to continue using certainly increases the risk for addiction, but there are other involuntary factors involved in the process as well.
Addiction affects a person’s inhibitory control over their behavior as well as the brain circuits involved in motivation, reward, memory and learning. Specifically, drug and alcohol use trigger the release of Dopamine, a neurotransmitter which causes pleasurable feelings. According to clinical research, the brain begins to form associations between the pleasurable feeling and the use of the substance, creating a “reward pathway” in the brain that acts as a strong incentive to continue using the substance. This is experienced by the individual as a strong urge or craving for the substance, increasing the risk of continued use. Interestingly, these same areas of the brain are known to be involved in specific behaviors that, for some people, become compulsive and problematic. Examples of behaviors known to interact with the reward pathways in the brain include eating, gambling, risky behaviors, and sexual behaviors.
Although the initial decision to drink or take drugs was probably voluntary, the changes in brain chemistry caused by repeated drug or alcohol substance abuse is an involuntary response that affects certain users. Research indicates that some people might be more at risk for developing these reward pathways based on a number of factors including having an underlying mental illness, genetics, or having experienced a stressful or traumatic life event.
Researchers have also discovered that the frontal lobe in the brain is essential to being able to delay gratification and avoid impulsive actions. In some people, an underdeveloped prefrontal cortex may place them at higher risk of developing an addiction. Since this part of the brain develops even beyond adolescence and into early adulthood, teens and young adults are at higher risk for developing addictions.
So, while addiction does result in specific changes to the structure of the brain, including the development of reward pathways, it is still possible for people to reverse this damage. In fact, scientists now understand that the brain can change in response to our behavior, even into adulthood. Individuals who have developed addictions can rewire their brain circuitry in ways that reduce their risk of addiction by not using drugs or alcohol for a prolonged period. Recovering from addiction is difficult and often is a non-linear process that includes several trials and errors, but receiving treatment can significantly improve the likelihood of a successful recovery.
The Progression of Addiction
Over time, an untreated Substance Use Disorder often progresses and gets worse. An individual may begin to use more frequently and may stop other important activities in order to do so. One may also develop a tolerance to the substance, increasing the need to use more of it in order to get the same effects, which heightens the risk for further negative consequences. Depending on the substance being used, an individual may begin to develop a physical dependence on the substance, resulting in uncomfortable or even dangerous withdrawal symptoms when they attempt to stop using.
Others might not become physically addicted, but may notice they have become more dependent on the substance in other ways; such as using drugs or alcohol to cope with stress, numb painful emotions, or to be able to face daily tasks and activities. The growing dependence on the substance could be described as addiction, regardless of whether the dependence is physical in nature or not.
Treatment For Addiction
Individuals in the early stages of addiction, or with just a few signs of dependence, might be suffering from a Mild Substance Use Disorder. While individuals with numerous signs and symptoms are most likely suffering from a Moderate or Severe Substance Use Disorder. With proper treatment, a person with a Substance Use Disorder can effectively get rid of their symptoms and put their disorder into remission, regardless of the severity of their disorder. The severity of the disorder may influence what treatment is recommended.
Treatment is provided in a variety of ways, including treatment provided in outpatient settings, inpatient settings, and treatments that may incorporate individual, family, and/or group therapy. Speaking with a professional who is knowledgeable about the services available in your community is a recommended first step. Often, this first point of contact would be a health or mental health professional like a primary care physician, psychiatrist, social worker, or therapist. In other cases, a person might contact their insurance company to get additional information about what treatments are covered under their insurance plans.
Once an individual begins participating in a treatment, they will begin learning new skills and strategies to regain control of their lives and begin repairing some of the damage done while they were using. Often, this process includes taking inventory of the consequences of the drug or alcohol use, identifying risks and triggers for continued use, learning skills to overcome cravings, and developing routines and habits which support a healthier lifestyle.
When treatment is completed and remission is achieved the individual will need to continue to use their new support system and learned skills and strategies to protect against a future relapse. Due to the risk of relapse, Substance Use Disorders are considered chronic in nature, meaning that people in remission are still at higher risk for addiction than those who have not had these disorders. Often, those in long periods of remission may not need active treatment but still will benefit from participation in recovery communities and support groups.