Most public health institutions now recognize addiction as a disease, including the American Society of Addiction Medicine an American Medical Association. The National Institute on Drug Abuse (NIDA) defines addiction as “a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain.”
A person can be addicted to an activity, such as gambling, or to a substance, such as alcohol. Addiction symptoms can range from mild to severe, and, in some cases, can last a lifetime. Just like cancer or diabetes, addiction is caused by many biological, behavioral, and environmental factors.
Indeed, experts believe that genetic predisposition may account for about half of the likelihood that a person will develop an addiction. Addiction, however, is also a product of the numerous physiological changes that occur when a person engages in substance abuse.
An individual’s genetic vulnerability to addiction combines with drug or alcohol abuse and other factors to establish an environment where addiction is able to take hold and thrive. Untreated addiction can result in severe physical health complications and mental disorders and usually escalates over time, becoming increasingly difficult to treat—and it can even become life-threatening.
How Substance Abuse Hijacks the Brain
People feel pleasure when basic survival needs, like hunger, are satiated. These enjoyable feelings are produced as a result of the release of certain brain chemicals, also known as neurotransmitters, such as dopamine and serotonin. However, addictive substances also cause the brain to release unnaturally large amounts of these chemicals, which induces a euphoric high—a feeling that goes way beyond everyday pleasure and reward.
Over time, the continuous release of these neurotransmitters structurally alters regions in the brain associated with reward, motivation, and memory. As these changes emerge, the person requires the presence of the substance in their brain just to feel normal—a condition known as dependence. At this point, the person will likely also experience strong urges or cravings for the drug and will continue to use it in spite of the incurrence of adverse consequences.
Due to the brain’s tendency to diminish the response to drugs and alcohol as a result of repeated exposure, long-term use also typically results in tolerance, a state in which the person requires an increasing amount of a substance in order to achieve the desired effect. A person suffering from addiction may also neglect other responsibilities and activities in favor of drug or alcohol abuse. In the most severe cases, addiction can cause a person to stop caring about their own well-being or that of others.
These neurological changes can endure for an extended period, long after the person stops using substances. It is believed that such changes may leave those with addiction especially vulnerable to physical and environmental triggers associated with substance use, which significantly increases the risk of relapse.
Is Drug Addiction a Disease or a Choice?
A chronic disease is defined as a long-term, persistent condition that can usually be managed or controlled but not completely cured. Around 25-50% of people with a substance use disorder appear to have a severe, long-standing condition. For these individuals, addiction is an accelerating, relapsing disease that requires intensive treatment and long-term aftercare, close supervision, and the support of loved ones to maintain progress.
Even the most severe and chronic form of addiction can be managed, though, and many symptoms are reversible. This management is often achieved through participation in comprehensive addiction treatment and continued monitoring and support.
The Myth of Willpower and Moral Weakness
It is true that the initial decision to use a substance is a product of a person’s free and conscious choice—indeed, many addictions start when an individual uses a prescription drug. However, once the brain has been altered by repeated drug use, a person’s willpower becomes critically impaired, and they will have lost nearly all conscious control and restraint over their substance use.
Moreover, people who suffer from addiction should not be wholly blamed for their condition, and while all people make decisions about whether or not to use substances, they do not choose how their body reacts to those substances. This disparity between individuals is why some can seemingly control their substance use while others simply cannot. Nonetheless, many still believe that addiction reflects a person’s moral or societal failings.
This perception, however, is generally unhelpful, and instead groundlessly assumes that the person with the addiction could just stop if they were to embrace a morality that shuns drug or alcohol abuse. And yes, some people do this, and it can be a very beneficial tool in the context of a much broader approach to addiction. However, the overwhelming majority of people with addiction find it nigh-impossible to achieve and sustain sobriety through morality or spirituality alone.
Regarding personal accountability, though, one thing is true: people with addictions are responsible for seeking treatment and maintaining recovery. This decision can be exceedingly difficult to make alone, though. As such, the help of family and friends is vital for increasing the chances that the person suffering will enter into and remain in treatment, and take advantage of the care and support for as long as possible.
The Other Side
Some people contend that addiction cannot be a disease because it is provoked by the individual’s choice to use drugs or alcohol. But, as noted, while the first use may indeed be initiated by choice, once the brain has been altered by addiction, experts assert that the person then loses control of their urges and behavior.
It is important to note that the ability to execute a choice does not determine if a condition is a disease or not. For example, heart disease, diabetes, and even some types of cancer can all be impacted by personal decisions such as diet, exercise, smoking, etc. Ultimately, the development of many diseases is only partially impacted by certain lifestyle choices, not a direct choice in and of itself.
Others contend that addiction is not a disease because some people with addiction get better without treatment. But, this can also be said for other diseases, such as high blood pressure, which can oftentimes be resolved through lifestyle changes rather than by the long-term use of medication. Unfortunately, however, people looking to escape the most severe forms of addiction usually require a dramatic intervention followed by intensive treatment and long-term management.
Treatment for Addiction
Despite extensive research, we do not fully understand why some people can quit using drugs or alcohol on their own or through self-help meetings. Therefore, most people who are suffering from addiction are advised to take advantage of the most comprehensive treatment they can find.
The most effective approaches currently available involve the integrated use of psychotherapy, counseling, education, group support, health and wellness programs, and aftercare planning. These services are offered in a variety of formats, including partial-hospitalization and intensive outpatient.
Harmony Treatment and Wellness employs highly-skilled addiction professionals who facilitate treatments with care and expertise. Our center provides clients with the tools, resources, and support they need to experience a full recovery, prevent relapse, and enjoy long-lasting sobriety and well-being.
Although there is no single, perfect cure for addiction, it is very treatable. Contact us as soon as possible to find out how we help people free themselves from the grip of addiction and begin to experience the healthy and fulfilling lives they deserve!