What is Addiction?

Addiction is a complex condition wherein a person uses a substance or repeatedly engages in a behavior despite harmful consequences. The brain of an addict feels compelled to relive the rewarding effects of substance use.

Addiction can comprise alcohol, inhalants, opioids, PCP, cocaine, nicotine, steroids, or gambling behaviors. Any severe substance use can reach the point that it takes over the life of an addicted person. 

Evidence shows that this behavior results from a neurobiological interaction: the involvement of the neurotransmitter dopamine. It intensely involves brain pathways of reward and reinforcement, leading to synaptic pruning of the prefrontal cortex (the core area of the brain’s highest function) to the targeted substance or activity. Such brain changes are reversible with effective treatments and after the substance use or behavior is discontinued.

A neuroimaging study can reveal how substance addiction affects various brain areas related to judgment, decision-making, learning, memory, and behavior control. These addictions also increase the likelihood of other mental conditions like anxiety and depression. People who continue with substance use experience social impairment and disruption of everyday activities, including responsibilities at work or school. They continue to harm their personal and professional relationships with constant cravings.

Another distinctive feature of addiction is they persist in using it, even when they know it is causing them physical and psychological harm. As addiction affects the brain’s executive functions, centered in the prefrontal cortex, they fail to understand that their behavior causes problems for themselves and others around them. The pursuit of the pleasurable effects of the substance corrupts their brains. On the other hand, the tolerance to a substance increases as the body conforms to its presence.

Recoveries can happen in many ways, but they provoke hopelessness, feelings of failure, shame, and guilt in all addictions. On the road to recovery, an individual can achieve renewed physical, psychological, and social functioning. Support of community and peer-based networks also play a vital role in the recovery of an addict. However, the road to recovery is hardly straight – relapses or recurrence of substance use can happen. 

Causes of Addiction

Research indicates that there is no way to predict who will become an addict. Studies only highlight the risk factors for developing substance abuse disorders to some degree than direct causes.

Biological factors:

Genes: 

Behavioral scientists and geneticists estimate that genetic factors contribute to about half the risk of developing a substance addiction. According to them, two factors link vulnerability to addiction. 

1. The disparity in a gene that defines the makeup of brain receptors for the neurotransmitter dopamine
2. The hormone response of the body to stress

Physiological factors:

The liver enzyme disparities are another factor affecting how a body metabolizes the substances. It directly influences the health risks of an individual, especially in the case of alcohol use disorder.

Gender:

According to Harvard Medical School, males are susceptible to more substance addiction than females, and females are more likely to experience intense cravings and relapses than males. Researchers believe it is due to biological differences like testosterone and estrogen production and their average body size and composition. 

Sociological differences like childcare responsibilities, addiction stigma, relationship dynamics, etc., can also be factors for females creating different levels of susceptibility to substance addictions.

Psychological Factors:

Personality traits: 

Impulsive and sensation or thrill-seeking behaviors mostly show the inclination to substance addictions or gambling. Instead of fearing the risks, they indulge in it with the intent to conquer it. They seek high reveling in risk-taking activities like mountaineering, cliff diving, etc. They are more susceptible to begin recreationally experimenting with drugs or gambling. 

Trauma and abuse:

Early exposure to traumatic events and abuses can adversely affect an individual psychologically. It sensitizes the brain pathways of alarm or distress and adds to the burden of stress, making them fall prey to addictions as a part of their coping mechanism.

Mental health factors:

Mental conditions wherein individuals have difficulty managing their intense emotions often get inclined towards addictions. Moreover, mental illnesses like depression, anxiety, attention deficit disorder, and post-traumatic stress disorder (PTSD) enhance addiction risk.

Environmental Factors

Family environment:

Researchers have found that in family conditions wherein parent-child relations are troubled or where a family has disruptions such as divorce, and sexual, physical, or emotional abuse, the addiction risk increases. Moreover, in cases wherein a parent or a sibling in a family already has an addiction, the risk multiplies further. 

On the contrary, they found marriage and child responsibility to mitigate the risk of addictions. They also found that well-bonded family relationships could protect individuals more against substance use disorders and addictions. 

Accessibility factors:

Another alarming environmental factor to addiction is the easy availability of addictive substances like drugs and alcohol. If a person can readily access them at home, school, workplace, or in the community, the risk of repeated use also increases further. 

Peer pressure:

The psychological need to be a part of a group, particularly during adolescence, can strongly influence individuals. The need to be liked or get included in the group often bends them towards addictions like smoking, alcohol, or drugs. On the other hand, positive peer relations can protect them against it.

Employment status:

Unemployment or financial instability can trigger the need for substance addictions in individuals. Similarly, having a job, developing skills for employment, and having financial stability mitigate addiction risks.

Symptoms of Addiction

Its grouped into four categories:

1) Impaired Control: 

• There is a craving or intense urge to use the substance
• There is a desire to cut down but an inability to do so
• When the pursuit of addiction or recovery from it takes an indispensable amount of time
• When an individual uses a substance in a larger quantity or for longer than the intended period.

2) Social Problems:

• Wherein the addiction disrupts or causes failure to complete significant tasks at work, school, or home
• Wherein addictions overpower individuals to cut back on participating in social, work, or leisure activities 

3) Risky Use: 

• Physically high-risk situations raise the use of substances
• When a person continues to use it, despite the social or interpersonal problems it causes
• When a person knowingly continues to use it, even after exacerbating physical or psychological issues

4) Drug Effects:

• When tolerance occurs to lower doses of substance and needs large amounts to get a similar effect
• The presence of withdrawal symptoms is mostly physiological (different for each substance) 

Physicians gauge the severity of the addiction by tracing the number of symptoms present. Two to three symptoms indicate mild conditions, whereas four to five symptoms show moderate addiction disorder. However, symptoms six or above are severe conditions that require immediate medical intervention. 

Treatment of Addiction

The first step to recovery and treatment is accepting and recognizing the problem. It becomes complicated when addicts get stuck in denial mode and lack an understanding of substance misuse or addiction. 

As addiction affects many aspects of the life of an individual, the treatment can often be multifaceted. Complete remission from substance addiction is entirely possible, but the road to recovery is long. Relapses are now considered part of the process and are managed with effective treatment regimes addressing reuse prevention and management.

The progress of a treatment is measured based on the signs of improvement and the ability to tolerate frustration in establishing and maintaining a productive role in society. A well-rounded treatment focuses on multiple dimensions of life, including family roles, work skills, and overall mental health.

Medications help in restraining drug cravings and reduce severe symptoms of withdrawal. Along with this, therapy can help addicted individuals further. 

• Understanding their behaviors and motivations
• Developing their self-esteem
• Help them in coping with stress
• Addressing other mental health problems

 An Addiction Treatment Program can also include:

• Hospitalization
• Therapeutic communities (highly controlled, drug-free environments)/ Sober houses
• Outpatient programs

A treatment procedure for addiction can include any number of components. The doctor decides the combinations based on the prognosis. It can change during the phase of recovery:

• Detoxification: It’s the first stage of treatment and should always be conducted under medical supervision.
• Medications: They reduce or counter the use of illicit substances. It’s also used to target co-occurring disorders such as anxiety and depression.
• Motivational Interviewing: A short-term counseling process to help people resolve their doubts about treatment and find motivation for change.
• Cognitive Behavior Therapy (CBT):  It can help a person identify and cope with circumstances that trigger the desire to use substances.
• Group therapy and other peer-support programs: A process wherein many individuals share their recovery journey to support an individual to recovery. It helps in preventing the recurrence of substance use.
• Family therapy: It helps individuals repair their family relationships from the damages caused by them and establish a more supportive environment for recovery.
• Life-skill training programs: In some cases, these skill training programs help individuals develop employability skills to supplement their treatment plan.

Treatment can happen in various settings, from a doctor’s office to an outpatient clinic to a long-term residential facility. However, a good treatment program regularly monitors individual progress.