According to the American Society of Addiction Medicine (ASAM), addiction is defined as:
“…a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”
Furthermore, ASAM contends that addiction “…is characterized by [an] inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.”
Most medical experts agree that three overlapping factors characterize addiction:
- A loss of control
- Continued abuse of a substance or engagement in a particular behavior despite adverse consequences
- A high potential for relapse
In general, most people with addictions will encounter all of these at some point during the development process.
The Three Primary Components of Addiction
Loss of Control
When an individual has an addiction, using a substance or behavior in certain ways is so ingrained that he or she will probably lose control of their actions. It doesn’t matter how determined the person is to reduce substance abuse or behavioral addictions if a person is an addict, he or she will be vulnerable to falling back into former destructive habits despite how earnest he or she is about getting control of these behaviors.
Addiction-driven behaviors occur because when an individual is addicted, changes to certain brain regions make it extremely challenging for a person to exercise the same self-control he or she once had. The obsessive seeking of the substance or activity in question is the most obvious sign of addiction, but there are many others. Unfortunately, many people don’t understand just how difficult it is for an addict or alcoholic to exert control.
In fact, NIDA states that brain imaging research has shown that in people with addictions, specific areas of the brain that govern emotions, behavioral control, judgment, and decision-making are structurally different from non-addicts. Medical experts contend these changes help explain the compulsive and unhealthy behaviors in which an addicted individual will willingly engage.
Most people recognize that some behaviors are associated with severe adverse consequences and avoid participating in that behavior again. For example, the shame of getting caught deceiving friends or family members can help keep people honest.
Regarding addiction, there is a host of unwanted outcomes that is usually enough to convince most people that they should not engage in addictive behaviors. Serious health issues such as organ damage, cardiac problems, and breathing abnormalities are commonly associated with substance abuse. Financial and legal implications can also result from many addictions.
Also, when a person is an addict, his or her social and family life is likely to suffer, as well. But for the addict, all of these adverse effects of a substance or behavioral addiction are not enough for them to modify their actions. Moreover, continuing to engage in these activities despite one’s life falling apart is a clear indicator of a severe problem.
The final trait of addiction is its chronic nature, and many addicts and alcoholics end up relapsing at some point in their lives. Studies have shown that people with substance use disorders (SUDs) have as much as a 50% chance of returning to the use of drugs or alcohol sometime in the future, perhaps long after they have achieved sobriety.
This statistic may seem alarming, but the fact is that these numbers aren’t much different than those associated with other longstanding diseases. According to NIDA, for instance, type 1 diabetes has a relapse rate of about 30-50%, and hypertension has a relapse rate of around 50-70%, which is similar to those who have asthma.
Like other chronic diseases, there is no single cure for addiction. Instead, an emphasis is placed on intensive, long-term treatment and management. Beyond that, relapse doesn’t necessarily mean that the person or their treatment has failed, but that the approach used needs to be adjusted.
Brain Changes Caused by Addiction
As noted, studies have shown that the brain of an addict is structurally (and functionally) different than those of non-addicts. Many intoxicating substances affect the brain’s reward and pleasure centers by flooding it with dopamine, a neurochemical responsible for feelings of well-being and happiness. Everyday activities such as eating food, engaging in a hobby or sports, exercising, and spending time with loved ones may impact this reward circuit.
But these activities provide people with a controlled release of dopamine, whereas using drugs or alcohol results in an inundation of neurochemicals. In fact, NIDA asserts that some substances can increase the amount of dopamine up to ten times that which is triggered naturally. This overstimulation of the pleasure/reward system induces the intensely pleasurable “high” that drives many people to use the substance repeatedly.
As an individual continues drug or alcohol use, the brain eventually grows accustomed to the excess dopamine. Over time, it starts producing less and less of it and reduces the body’s ability to respond to it (an effect known as tolerance). The human body knows when it has been exposed to too much of something, and it immediately begins trying to reestablish balance.
Sometimes the brain increases the potency of specific chemicals to neutralize the influence of a drug, as is the case with alcohol and benzodiazepines. Other times it deactivates key receptors that enable the euphoric high, such as is the case with opioids. And finally, the brain causes adrenaline to be less effective, as with some behavioral or process addictions.
How Brain Changes Affect Those with SUDs
Regardless of the changes that occur, it’s all about the brain’s attempt to ensure that the substances or behaviors to which an individual is addicted begin to have a less intense effect, or tolerance, as mentioned above.
Another effect of these changes is a noticeable reduction in the pleasure once experienced from activities the person used to enjoy. Addicts often become less interested in food, self-care, social events, and hobbies. These activities no longer excite the brain’s reward system because the excess dopamine produced by substances has made the individual less sensitive to enjoyment garnered from regular activities and the corresponding healthy amounts of dopamine typically associated with them.
Moreover, this is one reason why people with SUDs commonly experience a loss of interest in a variety of things once considered enjoyable. This effect is a hallmark sign of an addiction.
Finally, as the addiction continues to progress and become more severe, the brain’s structural and functional changes become increasingly pronounced. And when and if an individual does attempt to quit or cut back, these extensive changes can induce some highly uncomfortable physical and psychological symptoms known as withdrawal. The onset of withdrawal symptoms is a telltale sign of the development of physical dependence.
Treatment for Addiction
Just Believe Recovery offers comprehensive, research-based programs that address both the causes and effects of substance abuse. Our caring and highly-trained staff provide those we treat with the tools, education, and support they need to achieve a full recovery. We provide services beneficial for the recovery process, such as psychotherapy, counseling, group support, and long-term aftercare planning.
If you or someone you love is suffering from an addiction to drugs or alcohol, we urge you to contact us today and find out how we can help!