What Is Addiction? Causes, Symptoms & Evidence-Based Treatment
Addiction is a chronic condition that affects the brain and body. Several substances can trigger addiction, which is complicated by family history and genetics, mental and behavioral health, environment, and more.
Signs of addiction include escalating use, being unable to stop use, and continuing use despite harm to work, school, family, or friends.
Fortunately, there is help through evidence-based treatment. While there are many substances that are addictive, treatment programs offer personalized care using scientific approaches to manage addiction and help you get healthy again.
What Is Addiction?
Substance use disorder (SUD) is defined as uncontrolled use of an intoxicating, harmful substance despite the consequences. People who struggle with addiction often abuse substances that cause a feeling of euphoria, or a high, although they experience mental, physical, and social issues as a result.
Taking the substance may begin as a social experience, like at a party or music festival, but it often turns into escalating use and physical dependence. Many people abuse substances in an excessive way, but the most severe SUDs are called addictions.
Drugs like tobacco, alcohol, marijuana, cocaine, heroin, and even some prescription drugs can change the brain’s structure and chemistry. This means it is more difficult to quit taking the substance because the presence of the drug begins to manage the release of certain brain chemicals like serotonin or dopamine, so the individual feels like they need to take the substance again in order to feel normal. This can lead to changes in behavior, cognition, and memory.
Many drugs also harm other parts of the body, like the lungs, heart, liver, kidneys, and digestive system.
Addiction is a chronic illness, which means, like diabetes, heart disease, asthma, and other chronic illnesses, medical oversight is important to managing symptoms. Getting help from medical professionals in an evidence-based recovery program is the best approach to overcoming addiction. Part of the recovery process is understanding addiction.
What Causes Addiction?
There are many potential underlying causes of addiction. It is important to remember that not everyone who has these underlying risk factors will develop addiction since these work in complex ways; however, they can put you at a higher risk.
- Genetics and family history
- Trying substances like alcohol or marijuana at a younger age
- Mental health issues
- Environmental factors
- Developmental experiences
People begin taking intoxicating substances in ways that can lead to addiction because:
- They are curious.
- Their friends pressured them.
- They think the drug will enhance their performance.
- They want to feel relaxed or better due to stress.
- They feel good (a high or intoxication).
Intoxicating substances trigger a part of the brain called the reward center, which initially makes the person feel good and happy by flooding the brain with dopamine, serotonin, and related neurochemicals. When this surge occurs without drugs, it is often because the person has made a positive choice. They have accomplished a task, exercised, or eaten a meal.
Drugs short-circuit this system, causing a high sensation of reward that is then associated with taking the substance. This can lead to compulsive behaviors and cravings, meaning the person takes it again and again.
People who struggle with mental and behavioral health conditions are at higher risk of developing addiction due to imbalances of neurochemicals. Depression, anxiety, bipolar disorders, post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), and similar conditions all affect how dopamine, serotonin, norepinephrine, and other important neurotransmitters are released. The reward system in the brain does not function in the same way.
Taking drugs can make a person with these conditions feel immediately better, although continuing to take them can make the person feel worse.
Are There Different Types of Addiction?
Different types of addiction are grouped based on the main substance of abuse. Sometimes, people abuse multiple intoxicating substances, like smoking and drinking alcohol, but often, one of these drugs is the main craving or compulsion.
Categories of substance abuse include the following:
- Alcohol use disorder: Also called alcoholism or alcohol addiction, alcohol is one of the most common problematic drugs in the world. Although drinking alcohol is socially acceptable, this intoxicant can cause a release of neurotransmitters that cause relaxation, sleepiness, and euphoria. Excessive or problem drinking is common in many countries. Becoming dependent on alcohol to feel better may lead to addiction.
- Cannabis use disorder: As marijuana becomes more socially acceptable in the United States, more people are abusing this drug as they would abuse alcohol. Similarly, this substance can lead to relaxation and euphoria, although marijuana also has some hallucinogenic properties. Like alcohol, it is possible to become dependent on cannabis without becoming addicted, but dependence can lead to escalating use, which can be a sign of addiction.
- Hallucinogen use disorder: Hallucinogenic drugs alter one’s perception of the world by flooding the brain with neurotransmitters. There are many types of hallucinogens, including LSD, ketamine, shrooms, DMT, PCP or “angel dust,” and increasingly, research chemicals. Some hallucinogens occur in nature, while others are made in a laboratory. While hallucinogens are not considered addictive, it is possible to abuse them to the point that the brain becomes tolerant of them and might crave them compulsively to feel normal. In recent years, microdosing hallucinogens to get a mild high has become trendy. This can actually cause addiction issues, as the person quickly needs more than a small dose.
- Inhalant use disorder: Sniffing glue, huffing paint, and whippits are comedic tropes in pop culture, but these activities are extremely dangerous. While some volatile chemicals can cause a mild euphoric effect, this does not last long. The substance is much more likely to cause other problems, including heart irregularities, stroke, brain damage, and psychosis.
- Opioid use disorder: Opioid addiction can lead to overdose, which is one of the most common causes of drug-related death in the US. The most common underlying cause of opioid addiction in this modern epidemic is prescription painkillers. At a certain point, a person may no longer receive a prescription for painkillers. If the individual cannot taper their use, they may begin to steal other prescription opioids from friends and family or find counterfeit versions on the black market. This often leads to heroin addiction as well as fentanyl abuse and overdose.
- Stimulant use disorder: There are several types of stimulants, from prescription to illicit. Drugs like Adderall, Ritalin, cocaine, crystal meth, and others are all very addictive. While prescription stimulants have legitimate uses with oversight from a medical professional, people who do not need these drugs and try them for fun are at risk of becoming addicted. Stimulants create a high-energy euphoria. When this wears off, the person may feel tired, grumpy, sad, or anxious.
- Sedative addiction: Although some sedatives, like alcohol and marijuana, are obvious intoxicants, there are many prescription sedatives that can become addictive too. Sleep aids like Ambien and anti-anxiety medications like Xanax are currently the most common. These drugs have a similar effect on the brain as alcohol, leading to a sense of relaxation and well-being. The body can also quickly become tolerant to them with regular use, meaning the person may feel the need to take more than prescribed to get the original effects. The person may also take the drugs recreationally rather than for medical reasons. This can lead to addiction.
- Other substances of abuse: Research chemicals like bath salts or synthetic marijuana, new prescription medications based on opioids or stimulants, steroids, and combinations of drugs can cause intense highs that lead to addiction.
What Are the Symptoms of Addiction or Substance Abuse?
People who struggle with an addiction might exhibit various behaviors, including:
- Taking more of the drug in one evening or event than intended.
- Taking the drug for longer than intended.
- Trying to quit but being unable to.
- Intense cravings for the drug until it is all the person can think about.
- Giving up other activities in order to become intoxicated.
- Continuing to consume the substance despite health and social consequences.
- Experiencing physical or psychological problems because of intoxication, like worsened depression or anxiety.
- Having problems at work, with school, or in one’s personal life because of being intoxicated or being sick after being intoxicated, perhaps leading to loss of opportunities or friends.
- Getting into dangerous situations, like driving while intoxicated.
- Lying to friends and family about substance use, stealing substances from them, or stealing in order to get more of the drug.
- Developing a tolerance, or feeling the need to take more of the drug to get the original high.
- Developing a dependence on the drug, or feeling the need to take the drug to feel normal.
- Suffering from withdrawal symptoms when not taking the drug.
If you recognize these symptoms in yourself or in a loved one, it is important to remember that there is help available from evidence-based recovery programs.
What Are the Best, Evidence-Based Approaches to Treating Addiction?
It is important to remember that addiction is a treatable condition. Medical research has found a basic path that helps people overcome the physical and emotional dependence on drugs or alcohol, and helps them rebuild their lives. Several components can be part of the process, depending on individual needs.
These are the three basic steps of addiction treatment:
- Detox: This is the first step in the treatment process, when the body must overcome its dependence on the substance. For people with mild or moderate addictions, it is possible to go through detox with medical oversight and supportive therapies like nutritional supplements and exercise. This typically takes one to two weeks, depending on the substance. Many medical professionals advocate for various types of medication-assisted treatment (MAT), or using a prescribed medication to help the person taper the body off the need for drugs. For example, buprenorphine is often used to help people with opioid use disorder slowly end their dependence on opioids.
- Rehabilitation: The next step in the recovery process is rehabilitation, which centers around therapy. For most recovery programs, group therapy is the focus, but many are beginning to offer individual therapy too. Other therapies include animal therapy, art therapy, yoga, nutrition therapy, occupational and physical therapy, speech therapy, and family support therapy. Since different programs offer different approaches, the experience should be tailored to individual needs.
- Aftercare: At the end of rehabilitation, the person may develop a plan to support themselves if they become stressed or experience triggers for relapse. This includes avoiding certain neighborhoods and keeping a list of safe people to call. It should also include positive events like a daily schedule; motivational and inspirational details like art, podcasts, books, or movies; an exercise routine; and new hobbies that do not involve substance abuse.
Alongside rehabilitation and aftercare, many recovery programs are now also offering additional support like job training, book clubs, help finding housing and resources, and even help finding post-rehabilitation programs like sober housing or mutual support groups.
When looking for a good program, here are some things to consider in addition to individual needs:
- Accreditation: Local, state, and federal health agencies offer different certifications. Make sure the recovery program has medically trained staff and is certified at the state level.
- Evidence-based treatment: Using the guide above, ask the program how they approach detox and rehabilitation. Programs that claim very high success rates or “cures” for addiction are not based on medical science. There is no cure for addiction, though it can be managed on a long-term basis.
- Family support: Family members and close friends are vital to ongoing recovery. Staying balanced means maintaining healthy connections with these individuals. This may mean attending family therapy as well as ensuring the program offers regular communication through letters or visits or that families are included in other ways in the treatment process.
- Continuing care: Most programs recognize that chronic illness means a lifetime of support, so they offer ongoing support through aftercare planning and other resources. Continued family involvement, access to outpatient support groups, a stepped plan for care, and other approaches all recognize that treatment can take time, without restricting the person’s life.
Evidence-Based Treatment Programs Offer Support
Although relapse is one of the symptoms of all chronic illnesses, struggling to overcome cravings, compulsions, stress, or other triggers does not mean treatment has not worked. Like other chronic illnesses, experiencing symptoms of addiction again after treatment simply means a return to care for a new treatment plan.
People who go through the full recovery process achieve balanced, fulfilling lives. Get help from an evidence-based treatment program to understand more about an individual treatment plan that will work best for you.
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Struggling With Addiction? Tips on Finding Quality Treatment. (January 2019). SAMHSA Blog.