When people hear the word 'addiction', most people’s first thoughts go straight to drugs or alcohol, but addiction is so much more than drugs. Some people have that one thing they cannot go without. It might be a cell phone, a cigarette, caffeine, drugs, or shopping. No matter what, most people have a vice. Addiction surrounds us whether we choose to believe it or not, and it does not discriminate. Addiction impacts our relationships due to the hardships of maintaining trust and respect for the individual whether personally, romantically, or professionally. Watching someone neglect their relationships and responsibilities because of addiction is difficult. Some are fortunate to not let addiction take over their lives, but not everyone is so lucky. Substance abuse is a complex lifelong, mental disease. It is one of the toughest addictions to beat. This is because it is brought on by a biological process causing chemical changes in the brain, interfering with the brain's normal functioning. To better understand why substance addiction is largely a disease, we need to recognize addiction as a whole: psychological, physiological, social, and environmental factors.
To understand addiction, one needs to understand the criteria for substance abuse. Addiction is medically classified as a DSM-5 mental disorder according to the Diagnostic and Statistical Manual of Mental Disorders (Form, 2020). To understand if someone is suffering from substance abuse, they must meet two of the following criteria: impaired control, social problems related to use, risky use, and physical dependence. If the person is suffering from cravings, wanting to discontinue use but cannot, or using larger amounts than needed, then these fall under impaired control. If this person finds themselves failing to keep up with responsibilities at work, home, or school, these are considered social issues related to using. If the person is using in precarious situations or causing harm to their physical and mental health, this falls under risky use. Lastly, physical dependence means going through withdrawal when not using, or needing more of a substance to achieve the same effect.
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Thinking of addiction being a self-inflicted choice is an outdated way of thinking. Substance abuse works very similarly to other common medical diseases, with periods of recovery and relapse. Over time substance abuse gets worse. It does this because it changes the way the brain works by altering the areas responsible for decision-making, memory, learning, self-control, and reward. Many people who oppose the fact that addiction is a disease say that it is a choice. People argue saying “addiction is self-acquired and is not transmissible, contagious, autoimmune, hereditary, degenerative, or traumatic. Treatment consists of little more than stopping a given behavior. True diseases worsen if left untreated” (Holden, 2012). While this is true, everyone has a choice to start using a substance, they cannot choose how the substance will chemically alter and change the way the brain reacts. “Once substance use changes the brain, willpower changes too” (IU Health, 2020). Substance abuse is treatable and will need to be managed for years to come or the rest of the addict’s life. There is no cure, but the disease can be managed through drug therapy and behavioral therapy.
Substance addiction is no different than other lifelong diseases. Like diabetes or heart disease, substance abuse interrupts the normal functioning of the body. In this case, addiction would affect the brain just as heart disease affects the heart. Both diseases can significantly affect one’s quality of life and can lead to early death. As with heart disease or diabetes, substance abuse can be prevented by living a healthy life and making good life choices. The good news is, all these diseases that are talked about can be treated through various therapies, inhibiting any further destruction. It will require persistent effort to manage these diseases. Symptoms can return if treatment is not consistent but can diminish when following the proper treatment measures. People argue that addiction is as simple as choosing to stop using the drug. If it was that simple, addiction would not be an issue in the United States today. No one chooses to have their lives ruined by a substance.
To grasp how addiction can consume a person’s life, it is important to know how drugs alter the chemicals in the brain. Everyone has experienced euphoria countless times in their life. This could be experienced by exercising, a favorite meal, or even sex. “When a rewarding event occurs, the brain releases dopamine to signal the experience and encourage repetition. In terms of natural rewards, this is healthy and keeps life going; consider the pleasure derived from sex: it encourages repetition, thus perpetuating the reproduction of the species” (Lautieri, 2021). When a person experiences euphoria from a substance, it is the most gratifying feeling they have ever experienced. Nothing can compare to that euphoric moment. Dopamine that is released from the drug use sends signals to the brain that the substance should be used again. The brain then remembers these bursts of dopamine, making it easier for the user to use the drug again. The surges in dopamine begin to train the brain to think drugs are better than any other natural euphoria. Now, the brain no longer finds pleasure in naturally rewarding situations and just wants more drugs to feel good. “Because of dopamine bursts in the brain due to substance abuse, natural rewards become less appealing as the brain rewires itself” (Lautiere, 2021). With continued drug use and the rewiring of the brain, it is now second nature to crave drugs.
Some people are fortunate to be born into supporting, loving, successful families, while others are not so fortunate. These are key environmental factors that can help protect a person from suffering from substance abuse and addiction. After learning how easy it is for the brain to be chemically altered from drug use, several environmental factors also put a person at a much higher risk of suffering from substance abuse. Having a family history of addiction puts a person at significant risk of developing dependency, along with mental illness. “Addiction is a family disease often with deep roots in genetics, trauma, mental and behavioral issues, relationships, and family history. Studies have found that one of the most significant influences on an individual’s addiction is the environment” (Sison, 2019). Traumatic childhood experiences such as sexual or domestic abuse can cause a person to seek refuge through drugs due to a poor home environment. Family, friends, or coworkers might use drugs regularly, normalizing it and making it seem harmless. This can create a false sense of normalcy for an at-risk individual. Some individuals may be experiencing life-changing transitions such as divorce or job loss, which can lead them to turn to substances to cope. Even having positive environmental factors does not protect a person from addiction, it can happen to anyone. Having more exposure to negative risk factors, ultimately, puts a person at higher risk of developing substance dependence.
Addiction is more of a disease than a choice. It is a lifelong condition that can be managed through a variety of treatment options. As with other diseases, treatment needs to be consistent, if not, it can lead back to a state of illness. The best way to cope with substance abuse is to change behaviors. Learning how the brain is changed with addiction can be difficult. Understanding the science behind addiction is critical for recovery and treatment. After stopping the drug, treating the withdrawal symptoms aids in preventing relapse. Creating a treatment plan with a licensed professional is the safest and most effective route to address the individual’s needs through recovery. Suffering from addiction does not mean a person is weak. It only means they are struggling with an illness that is hard to overcome, but with the proper treatment, recovery can be achieved.
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