Understanding Addiction

May 28

What Is Addiction?

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use, engagement in activities or relationships despite harmful consequence. People with addiction have an intense focus on using a certain substance(s) or activities, such as alcohol or drugs or gambling, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. These behaviors were developed as a desperate effort to survive unbearable misery or physical pain. All of your other coping skills have been overwhelmed, yet, somewhere, deep inside, you want to survive. You just have to make the pain stop.

People can develop an addiction to:

Alcohol
Marijuana
PCP, LSD and other hallucinogens
Inhalants, such as, paint thinners and glue
Opioid pain killers, such as codeine and oxycodone, heroin
Sedatives, hypnotics and anxiolytics (medicines for anxiety such as tranquilizers)
Cocaine, methamphetamine and other stimulants
Tobacco
Gambling
Internet/gaming
Pornography and sex
Work

People with an addiction disorder have distorted thinking, behavior and body functions. Changes in the brain’s wiring are what cause people to have intense cravings for the drug or compulsive activities and make it hard to stop using. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory and behavior control.

Substance abuse can cause harmful changes in how the brain functions. These changes can last long after the immediate effects of the drug — the intoxication. Intoxication is the intense pleasure, calm, increased senses or a high caused by the drug. Intoxication symptoms are different for each substance.

Addictions (even behavioral ones) also mess with your brain chemistry. Whatever it is that you are doing to get the rush/relief/escape causes your brain to rapidly burn through happy chemicals. While it feels great at the moment, you are using up your reserves. At a certain point, your happy chemicals run out and the only way to get the rush is through the addiction. At a certain point that does not even work anymore, so you start doing riskier things or using harder drugs, or both—sometimes just to feel normal. While this is a very oversimplified explanation of what is happening during the addiction process, you can see that a large part of recovery is allowing your brain to rest, recover and rebalance. This process takes anywhere from a few weeks to a couple of years depending on the amount of damage. The great news is that your brain (and body) can recover.

Over time people with addiction build up a tolerance, meaning they need larger amounts to feel the effects.

According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:

to feel good — feeling of pleasure, “high”
to feel better — e.g., relieve stress
to do better — improve performance
curiosity and peer pressure

People with addictive disorders may be aware of their problems, but be unable to stop it even if they want to. The addiction may cause health problems as well as problems at work and with family members and friends. The misuse of drugs and alcohol is the leading cause of preventable illnesses and premature death.

Symptoms of substance use disorder are grouped into four categories:

Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use
Risky use: substance is used in risky settings; continued use despite known problems
Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance)

Addiction is a solution to a problem, a bad solution, but a solution nonetheless. For this reason, you probably have “back up” addictions. When you cannot access your addiction of choice, you probably use something else to help you escape, or lash out at anyone or anything that stands between you and your addiction. You can be addicted to just about anything that produces pleasure or distracts you. While it is easy to see the connection between using drugs or alcohol and feeling better, other addictive behaviors like obsessing over a person, exercise, shopping or gambling can also not only distract your mind, but also usually has a pleasurable result.

Many people experience both mental illness and addiction. The mental illness may be present before the addiction. Or the addiction may trigger or make a mental disorder worse. All of the same brain chemicals that are adversely affected in addiction are the same ones that can cause disorders like depression, anxiety and schizophrenia. When you feel bad, you want relief, so you may have self-medicated with your addiction. This is why it is important to not only address the addiction and coping behaviors, but also make sure you are addressing any mental health issues such as anxiety, depression, grief, anger or schizophrenia.

Finally the good news, a number of treatment methods are proven effective and people can recover from addiction and lead normal, productive lives.

If taking drugs makes people feel good or better, what's the problem?

When they first use a drug, people may perceive what seem to be positive effects. They also may believe they can control their use. But drugs can quickly take over a person's life. Over time, if drug use continues, other pleasurable activities become less pleasurable, and the person has to take the drug just to feel “normal.” They have a hard time controlling their need to take drugs even though it causes many problems for themselves and their loved ones. Some people may start to feel the need to take more of a drug or take it more often, even in the early stages of their drug use. These are the signs of an addiction.

Even relatively moderate drug use poses dangers. Consider how a social drinker can become intoxicated, get behind the wheel of a car, and quickly turn a pleasurable activity into a tragedy that affects many lives. Occasional drug use, such as misusing an opioid to get high, can have similarly disastrous effects, including impaired driving and overdose.

Do people choose to keep using drugs?

The initial decision to take drugs is typically voluntary. But with continued use, a person's ability to exert self-control can become seriously impaired. This impairment in self-control is the hallmark of addiction.

Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control. These changes help explain the compulsive nature of addiction.

What are the factors that increase risk of addiction?

Biological factors that can affect a person's risk of addiction include their genes, stage of development, and even gender or ethnicity. Scientists estimate that genes, including the effects environmental factors have on a person's gene expression, called epigenetics, account for between 40 and 60 percent of a person's risk of addiction. Also, teens and people with mental disorders are at greater risk of drug use and addiction than others.

Environmental factors are those related to the family, school, and neighborhood. Factors that can increase a person's risk include the following:

§ Home and Family. The home environment, especially during childhood, is a very important factor. Parents or older family members who use drugs or misuse alcohol, or who break the law, can increase children's risk of future drug problems.

§ Peer and School. Friends and other peers can have an increasingly strong influence during the teen years. Teens who use drugs can sway even those without risk factors to try drugs for the first time. Struggling in school or having poor social skills can put a child at further risk for using or becoming addicted to drugs.

§ Early use. Although taking drugs at any age can lead to addiction, research shows that the earlier people begin to use drugs, the more likely they are to develop serious problems.31 This may be due to the harmful effect that drugs can have on the developing brain.32 It also may result from a mix of early social and biological risk factors, including lack of a stable home or family, exposure to physical or sexual abuse, genes, or mental illness. Still, the fact remains that early use is a strong indicator of problems ahead, including addiction.

§ How the drug is taken. Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes. Scientists believe this powerful contrast drives some people to repeatedly use drugs to recapture the fleeting pleasurable state.

Do I have an addiction?

In an addiction, you may have spent so much time trying to figure out how to get the substance, getting the substance and recovering from the substance that you formed a relationship with the substance. Remember your first love? How you felt the butterflies in your stomach and excitement when she or he would walk in the room? How he or she was all you could think about all day? How your day was planned around trying to spend as much time with the person as possible? In a normal relationship when this preoccupation started interfering with other areas of your life, you would be able to refocus your attention and take care of business. In an addiction, you cannot get refocused in one or more areas of your life because of your preoccupation (obsession) with the addiction. When you began to have major problems in your life as a result of the addiction, but continued to use anyway, you had become an addict.

If you answer yes to any of the following questions, you may have an addiction.

Have you tried to cut down and failed?
Do you need more of the same substance or activity or need to combine substances or activities to get the same high?
Do you spend more time than intended thinking about, preparing for and/or recovering from using the substance or engaging in the behavior?
Have you spent more money than intended on the substance or behavior?
Have you neglected other areas of your life (hobbies, family, work, finances) for the substance or behavior?
Do you continue to engage in the behavior even though it has directly or indirectly caused you multiple problems (health, relationship, financial, legal, work etc.)

“More than 173 million people living in China are suffering from a mental disorder with fewer than 10% having ever been seen by a mental health professional.”

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