According to the National Institute of Mental Health (NIMH), addiction to intoxicating substances is believed to be a mental illness, and state that a “substance use disorder changes normal desires and priorities [and] changes normal behaviors and interferes with the ability to work, go to school, and to have good relationships with friends and family.”
Moreover, the current scientific consensus is that no one “chooses” to be addicted. They may make the decision to experiment with substances, but they continue to do so due to brain changes that drugs and alcohol cause that is no fault of their own.
Mental Illness or Moral Failure?
Today, it’s universally accepted by leading scientific and health organizations that addiction is a mental illness. Both the American Psychiatric Association (APA) and the National Institute on Drug Abuse (NIDA) describe addiction as a chronic brain disease. Furthermore, the DSM-V has put forth criteria for classifying addiction as a mental health issue, also referred to as a “substance use disorder.”
However, this is a relatively recent development. In the United States, there’s a lengthy history of reviling persons who abuse intoxicating substances. Just decades ago, addiction was not viewed as a mental health condition outside of one’s power, but instead, as an ethical failure deeply rooted in the individual’s moral inclinations and personality.
In the 1930s, the prevailing belief was that addicts simply did not put forth the willpower to abstain. And because addiction wasn’t considered an illness, it was not generally treatable using rehab and 12-step programs. Heavy drug users and alcohol users were viewed as criminals or morally corrupt, and they were treated as such. In fact, severe addicts were often imprisoned to isolate them from a society that saw them as menacing.
The scientific opinion began to evolve as studies and technology showed that repeated use of drugs causes functional and structural brain changes. These maladaptations inhibit self-control and cause intense cravings for substances. This discovery countered the idea that continued drug use is a choice and disproved the allegation that addicts could quit using at any time they wanted.
How Addiction Alters the Brain
The main argument for why addiction is not a mental health disorder is based on the concept of choice. For example, some individuals might state that a person can’t choose to stop having diabetes or cancer. However, they believe that the person can decide to quit using drugs or alcohol if they have the willpower available to do so. They do not consider that this disorder alters the brain’s structure and function, contributing to the mental illness.
Drugs work in the brain by stimulating the reward and pleasure centers. In doing this, dopamine, a chemical that induces feelings of pleasure, is released into the brain. As a result, a solid psycho-emotional association is formed between substance abuse and pleasurable sensations, fostering the motivation to repeatedly engage in substance use.
When an individual uses intoxicating substances, the brain can release up to ten times the amount of dopamine than it would without physical interference. This influx of feel-good chemicals produces intense euphoria that prompts the person to crave the substance’s presence. As they continue using the drug, their brains start to adjust to this abnormal flooding of dopamine by reducing sensitivity to it.
This effect is called tolerance, also defined as the need to take higher and higher doses to achieve the same result. These functional brain changes also inhibit the addict’s ability to receive pleasure from everyday activities that produce only moderate amounts of dopamine, such as eating, engaging in hobbies, and spending time with loved ones.
Next, the user becomes chemically dependent on the substance and faces uncomfortable or painful withdrawal symptoms, such as headache, fatigue, and insomnia, when they try to discontinue use. As a result, they will continue to use the substance to delay the onset of withdrawal. Their bodies and brains have become addicted to it, and they now need it to function normally and experience any pleasure.
An Individual’s Addiction Risk
Despite evidence that chronic drug use results in structural and functional brain changes, some individuals continue to claim that addiction is markedly different from other mental health disorders because the decision to experiment with drugs or alcohol is an individual’s choice. Moreover, if someone exercises the willpower not to use substances in the first place, they will never need to be concerned about developing an addiction.
However, this argument overlooks the fact that many risk factors outside of a person’s control increase the likelihood they will experiment with drugs. These include environmental factors such as an upbringing by parents or caregivers who use drugs or have a co-existing mental health disorder such as depression or anxiety.
After an individual has started using drugs, factors such as biology can increase the rate at which they become dependent. Studies have suggested that genetic factors may account for about half (40-60 percent) of an individual’s susceptibility to addiction.
Getting Professional Help for Addiction
Just Believe Detox and Just Believe Recovery centers offer comprehensive treatment programs to help those who need it most recover from addiction and foster long-lasting sobriety. Our state-of-the-art programs include various services and therapies beneficial for the recovery process, such as behavioral therapy, group support, counseling, aftercare planning, and more.