Addictions

According to the National Institute on Drug Abuse (NIDA) addiction is a brain disease that is characterized by:

• Compulsive behaviors to get and use drugs or alcohol
• Continuing to use drugs or alcohol despite obvious harms from that use
• Changes in the brain’s structure and neural processes

Although people initially choose to use and even abuse drugs or alcohol, once a person becomes addicted, changes in the brain remove a lot of ‘personal choice’ from the equation. Most people who become addicted to drugs or alcohol require professional substance abuse treatment to achieve remission and recovery.¹

What’s the Difference between Substance Abuse and Addiction?

People with both substance abuse and addiction consume drugs or alcohol (or have problem behaviors, such as gambling) in ways that cause them harm, and people with substance abuse problems are at risk of developing an addiction.

But an addiction is more…

An addiction is a brain disease that is characterized by compulsive actions and a loss of control over use. People addicted to drugs or alcohol will continue to use (or drink) despite the harms obviously done by that use and will generally crave their substance of choice.

Addiction and Changes to the Brain? The chronic use of drugs and alcohol can lead to lasting, or even permanent changes in brain structure and function. These brain changes tend to reinforce drug seeking behaviors and make it harder for people to resist temptation.

• In some cases, changes in the brain result in a diminished ability to experience pleasure without intoxication (diminished dopamine response). People who cannot experience normal pleasure without using drugs have an understandably hard time quitting their use. Drugs that can cause this response include heroin and other opiates, methamphetamine, cocaine and alcohol

• Changes in brain chemistry can result in temporarily or permanently diminished memory and cognitive function. Changes to activity in the prefrontal cortex alters our ability to make good decisions and to stick to long term plans, and this contributes to the perpetuation of addiction¹

Do I Have an Addiction?

According to the American Psychological Association (APA), you meet the diagnostic criteria for addiction if you meet 3 or more of the following.

1. You have a tolerance
2. You have experienced withdrawal symptoms when not using – or you take another substance to stave off feelings of withdrawal
3. You sometimes take your drug of choice in larger quantities or more frequently than you had intended on
4. You have tried and failed to cut down or quit, or you very much want to quit, but don’t
5. You spend a lot of time, energy and resources getting, using and recovering from the use of the drug
6. You have given up activities you used to enjoy because of your drug use
7. You keep using your drug of choice even though you know it does you physical, social or occupational harm²

Although with regular use of certain drugs or alcohol anyone risks addiction, some people may have a genetic or environmental predisposition towards the disease. People who may be at greater risk of developing an addiction include:

• People who start using drugs or alcohol at a younger age - People who start drinking before the age of 15 are 5 times more likely to develop an addiction to alcohol than people who wait until the age of 21 to start drinking. ¹

• People with a close genetic relative who’ve had a drug or alcohol addiction (doctors think that genetics play a 40% to 60% role in the development of addiction) ²

• People with mental illness (people with mood disorders are about twice as likely to have a drug abuse disorder) ³

• People immersed in environments that promote or model drug use or heavy alcohol use as normal behaviors – or in areas with easy drug or alcohol availability

• People who have been a victim of abuse, whether emotional, physical or sexual

• People who feel socially excluded or discriminated against because of gender, race or sexual orientation

• People who use highly addictive drugs, such as heroin, OxyContin, cocaine or methamphetamine are at a greater risk of developing an addiction than people who use less addictive drugs like marijuana

Some of the warning signs of addiction can include:

• A preoccupation with using (thinking about getting or using drugs or alcohol a lot) – making sure that you’ll have as much as you’ll need to get you through.
• Using or drinking every day
• Trying to cut down your use, but being unable to do so
• Feeling like you need your drug of choice, or feeling withdrawal symptoms when you can’t get it or don’t take it
• Spending more than you can afford on drugs or alcohol
• Getting in trouble at work, at school, with friends or with family for your drug or alcohol use
• Feeling angry or irritated when people question you about how much you use or drink
• Hiding your use, or lying about how much you use
• Feeling like you need a drink or a hit early in the day

Can Addiction Be Cured?

If you participate in a professional addiction treatment program, you have a very good chance of achieving remission from drug or alcohol use - and the longer you can stay in recovery, the better your chances of avoiding a relapse back to use.

That being said, relapse is a very common stage in the disease’s progression. Addiction seems to create some changes in the brain that endure for a lifetime, and many people will need more than one period of treatment during that time.

Doctors cannot currently ‘cure’ addiction, but treatments do work and they can help you to stop using to achieve remission. Some people can stay in remission indefinitely, while other people may need intermittent periods of treatment after relapses, to maintain the gains of treatment.