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 powerful reaction from your brain in response to the 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 over time. Currently, there are ten 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 (this encompasses a wide variety of substances—the key is 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 item. Most people associate this with gambling or pornography. However, as of June 2018, the World Health Organization (WHO) included gaming disorder in this list. Ongoing studies are looking into smartphone use, eating, and shopping to see if they fall under the category of addiction for some individuals.
Every time you’re exposed to a substance or behavior, your brain releases dopamine (a chemical messenger), which causes positive feelings. This positive rush of feelings reinforces to your brain that you need to repeat the behavior to experience it again. This reward mechanism is good when trying to support healthy behaviors but can be extremely detrimental when it comes to unhealthy behaviors. Your brain is very powerful, so it can adapt over time. It cues your body’s reward center not to be as responsive to the stimuli, decreasing the number of positive feelings. Often this is referred to as developing a tolerance to the substance or behavior. To get the same sensation 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 effect. 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 positive feeling that the substance or behavior does.
It’s vital to understand no single thing can predict whether or not someone will become addicted to something. It’s thought to result from 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 being used in larger amounts or for longer periods, cravings to use the substance/do the activity, and the quest to find the substance/participate in the activity consumes a significant amount of time. Also, the 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, and you stop participating in other activities. Further, the substance use/activity occurs in situations where you are in physical danger, you build up a tolerance level and need to increase the amount of the substance/frequency of the 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 critical to understand that it is a long-term process because it affects 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 several elements that are often used together. It’s vital that the treatment process focuses on multiple areas and prepares you for managing a relapse.
A motivational interview (or intervention) 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. Group therapy is an excellent way to have peer support from those going through a similar situation, which helps you not to feel like you’re going through the process alone. Family therapy is essential in fixing any relationships that were impaired by your addiction and allows you to form more supportive relationships. Since addiction affects all aspects of your life, treatment must include life skills training to help you with employment opportunities and other necessary abilities.
There are several different ways to get treatment, such as inpatient versus outpatient and doctor’s office versus a 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 good program are patients have thorough medical and psychiatric screenings, treatment is tailored to each person and addresses other conditions, and the course of treatment is changed as necessary to suit the current situation better. Also, families are encouraged to participate in the treatment process, and the environment is respectful. Treatments are based on evidenced-based data and follow best practices, staff members are licensed/certified in their respective areas, the program is accredited by a nationally recognized monitoring agency, the 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’re already 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, seek help from a doctor.
Addiction is a life-altering condition that many people suffer with for their entire lives. It’s 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).