Why is it so powerful?
When most people hear the word addiction, their first thought is that a person has problems with drugs. This is especially true now more than ever thanks to the opioid epidemic. However, addiction doesn’t just apply to drugs, but can be a number of substances or behaviors. So, what exactly is addiction? What makes it so hard to stop doing something? Is there a cure?
Addiction is a very powerful reaction from your brain in response to use of a substance or engagement in behavior that results in a positive feeling in the “reward center” part of your brain. In either case, it’s something that usually happens overtime. Currently, there are 10 substance use disorders that all share the defining features of addiction. These are alcohol use disorder, caffeine intoxication, cannabis use disorder, phencyclidine/other hallucinogen use disorder, inhalant use disorder, opioid use disorder, sedative/hypnotic/anxiolytic use disorder, stimulant use disorder, tobacco use disorder and other substance use disorder (a wide variety of substances—the key is that they affect the central nervous system and lead to compulsive, addictive behavior). Behavior, or compulsion, addiction is when an individual receives the same positive feelings from repetitive behavior that a person addicted to a substance gets when they use the substance. Most people associate this with gambling or pornography. However, as of June 2018, the World Health Organization (WHO) included gaming disorder in this list. There are ongoing studies looking into smartphone use, eating and shopping to see if they fall under the category of addiction for some individuals.
Every time you are exposed to the substance or behavior, your brain releases dopamine (a chemical messenger), which causes the positive feelings. This positive rush of feelings reinforces to your brain that you need to repeat the behavior in order to experience it again. This reward mechanism is good when we are trying to reinforce healthy behaviors, but can be extremely detrimental when it comes to unhealthy behaviors. Your brain is very powerful, so overtime it is able to adapt. It cues your body’s reward center to not be as responsive to the stimuli, which in turn, decreases the amount of positive feelings. Often this is referred to as developing a tolerance to the substance or behavior. In order to get the same feeling as you did with the initial time, you would need to take in higher quantities of the substance or engage in the behavior more frequently to get the same affect. Ultimately, your brain further adapts and you aren’t unable to enjoy other things that you once did because it doesn’t provide your body with the same level of the positive feeling that the substance or behavior does.
It is key to understand no single thing can predict whether or not someone will become addicted to something. It is thought to be the result of genetic or other biological factors mixed with social, psychological and environmental factors that lead to addiction. There are several symptoms of addiction and a diagnosis is based on having at least two of them. Symptoms include substance/activity is being used in larger amounts or for longer periods of time, having cravings to use the substance/do activity, the quest to find the substance/participate in the activity consumes a significant amount of time, use of the substance/participation in the activity disrupts obligations at work, school or home, you continue to use the substance/do activity despite it causing problems, you stop participating in other activities, substance use/activity occur in situations where you are in physical danger, you build up a tolerance level and need to increase amount of substance/frequency of activity or you experience withdrawal if you don’t use the substance/do the activity. The number of symptoms you have indicates the severity of your addiction. Mild is when you have two to three, moderate is when you have four to five and severe is if you have six or more.
Addiction is a treatable condition with remission being a very real possibility. It’s key to understand that it is a long-term process because it affects so many different areas of your mental and physical being. Due to this, relapse is considered part of the process and sometimes an individual may have to make multiple efforts to finally succeed. This is why any improvements are felt to be significant signs of progress. Treatment involves a number of elements that are often used together. It’s vital that the treatment process focuses on multiple areas in your and prepares you for management of a relapse. A motivational interview is often used to help you realize that you have a problem, need help and figure out your reasons to change. Detoxification, or detox, is done under medical supervision and is when you go through the withdrawal process. Often, several types of therapy are used. Cognitive Behavior Therapy (CBT) is designed to help you realize and deal with the events that prompted the substance use or compulsive behavior to begin with. Group therapy is a good way to have peer support from those going through a similar situation, which helps you to not feel like you’re going through the process alone. Family therapy is essential in fixing any relationships that where impaired by your addiction and helps you to form more supportive relationships. Since addiction affects all aspects of your life, it is key that treatment includes life skills training to help you with employment opportunities and other essential abilities.
There are several different ways to get treatment, such as inpatient versus outpatient and doctor’s office versus long-term residential facility. Everyone is different, so what works for one person may not work for another. The main thing is that you are committed to making the change. Some tips to help you identify a valuable program include patients have thorough medical and psychiatric screenings, treatment is tailored to each person and addresses other conditions while being monitored and changed the course of treatment as necessary to better suit the current situation, families are encouraged to participate in the treatment process, the environment is respectful, treatments are based on evidenced-based data and follow best practices, staff members are licensed/certified in their respective areas, program is accredited by a nationally recognized monitoring agency, facility provides outcome data on performance and continuity of care is maintained vis access to resources.
Preventing addiction can be challenging because most people don’t realize that they have a problem until after they already are addicted. The key is to be aware of what risk factors you possess. Don’t engage in behavior that could result in an addiction, especially if you are at increased risk. Be sure to assess your activities and if you are concerned that any of them are getting out of hand or you feel that you are unable to control your behavior, then seek help from a doctor.
Addiction is a life altering condition that many people suffer with for their entire lives. It is treatable, but you have to be prepared for the process. If you have any questions or concerns, please speak with your doctor. If you would like more information, please visit the Center on Addiction at https://www.centeronaddiction.org/ or the Substance Abuse and Mental Health Services Administrations’ (SAMHSA) Helpline page at https://www.samhsa.gov/find-help/national-helpline or call them at 1-800-662-HELP (4357).