What Is Addiction?
Addiction is a chronic, relapsing brain disease defined by a physical and psychological dependence on drugs, alcohol, or a behavior. A person with an addiction will often pursue their toxic habits despite putting themselves or others in harm’s way.
An addiction heavily impacts the way a person thinks, feels, and acts. Many individuals with addiction disorders are aware they have a problem but have difficulty stopping on their own.
While it can be tempting to try a drug or addictive activity for the first time, it’s all too easy for things to go south — especially in the case of drug and alcohol abuse. People develop tolerances when they repeatedly abuse substances over time. That means larger amounts of drugs or alcohol are required to achieve the desired effects, escalating the nature of the addiction.
Prolonged substance abuse can result in a dangerous cycle of addiction: one where people need to continue using drugs or alcohol in order to avoid the uncomfortable symptoms of withdrawal. By the time people realize they have a problem drugs or alcohol may have already seized control, causing users to prioritize substance abuse over everything else that was once important in their lives.
No one ever plans to become addicted. There are countless reasons why someone would try a substance or behavior. Some are driven by curiosity and peer pressure, while others are looking for a way to relieve stress. Children who grow up in environments where drugs and alcohol are present have a greater risk of developing a substance use disorder (SUD) down the road. Other factors that might steer a person toward harmful substance use behavior include:
Research estimates that genetics account for 40 to 60% of a person’s likelihood of developing an SUD.
Mental Health Disorders
People with mental health disorders are more likely to develop an SUD than the general population.
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Addiction And The Brain
Excessive substance abuse affects many parts of the body, but the organ most impacted is the brain. When a person consumes a substance such as drugs or alcohol, the brain produces large amounts of dopamine; this triggers the brain’s reward system. After repeated drug use, the brain is unable to produce normal amounts of dopamine on its own. This means addicted people may struggle to find enjoyment in pleasurable activities, like spending time with friends or family, when they are not under the influence of drugs or alcohol.
If you or a loved one is struggling with a drug dependency, it’s vital to seek treatment as soon as possible. All too often people try to get better on their own, but this can be difficult and, in some cases, dangerous.
Recognizing And Understanding Addiction
Identifying an SUD can be a complicated process. While some signs of addiction are obvious, others are more difficult to recognize. Many people who realize they have a problem will try to hide it from family and friends, making it harder to tell whether someone is struggling.
Television, media, and film often depict people with SUDs as criminals or individuals with moral shortcomings. The truth is, there’s no single face of addiction. Anyone can develop patterns of abuse or risky behaviors, no matter their age, culture, or financial status.
The Difference Between Addiction And Dependence
The terms “addiction” and “dependence” are often confused or used interchangeably. While there is some overlap, it’s important to understand the major differences between the two.
A dependence is present when users develop a physical tolerance to a substance. They may experience withdrawal symptoms if they stop using the drug altogether. Usually a dependency is resolved by slowly tapering off the use of a particular substance.
On the other hand, an addiction occurs when extensive drug or alcohol use has caused a person’s brain chemistry to change. Addictions manifest themselves as uncontrollable cravings to use drugs, despite the harm done to oneself or others. The only way to overcome an addiction is through treatment.
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Diagnosing An Addiction
Identifying addiction is like diagnosing any other illness. The patient is examined by a medical professional for symptoms meeting specific, scientific criteria defining the illness in question. One of the best tools for spotting addiction is the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association.
The criteria outlined in the DSM are generally accepted and used by professionals to help determine the presence and severity of an SUD. They include:
Lack of control
The substance is used in larger amounts or over a longer time than the person originally intended. Those with problematic substance use patterns may feel as though someone else is choosing their actions for them, and may find themselves taking steps to acquire and use drugs without an abundance of conscious awareness of how they got there.
Desire to limit use
Users may want to cut back on use but are unable to do so. They may repeatedly say to others and to themselves that they plan on quitting, and quitting very soon at that. There can be a clear knowing that misuse of substances isn’t the proverbial “right thing to do.”
A considerable amount of time is spent trying to acquire a substance. Those who struggle with addiction may plan out how they are going to acquire their desired substance, spend a long time executing their plan (especially if things go wrong), and then spend time under the effects of the substance — possibly incapacitated by its effects and aftereffects.
The user experiences an intense desire or urge to use the drug. Recurring thoughts of using, or of the feelings that one anticipates after using, may occur at various points throughout the day or night. These can be incredibly unpleasant and distracting.
Lack of responsibility
Substance use takes priority over work, school, or home obligations. Sick days may be used more often, plans may be made and then canceled at the last minute, and there may be a variety of excuses and rationalizations that are ostensibly concerned with external circumstances but are actually driven by addiction.
Problems with relationships
Interpersonal relationships are consistently strained from drug use. Friends may become alienated, trying to help but feeling unsure of how to do so. Family members may feel the same way; home life can suffer, divorce may occur, and psychosocial support can dwindle.
Loss of interest
The user stops engaging in important social or recreational activities in favor of drug use. Much like with depression, there no longer seems to be any reward in participating in hobbies or interests that once held charm.
Use continues despite dangerous circumstances. Users may find themselves living in dwellings with other users, potentially sharing drug paraphernalia in a way that may contribute to disease. Intoxicated driving can occur, which can end in death.
Use continues despite worsened physical or psychological problems. A downward spiral may take shape; users may see the conditions of their lives deteriorating around them and decide that, given the situation, they may as well continue taking drugs. This only makes matters even more dire.
Larger amounts of the substance are needed to achieve the desired effects. One or 2 drinks can become 3 or 4, climbing upwards from there. A joint can become a bong, which can turn into a dab. Doses increase as the brain adjusts itself to the repeated stimuli it is being given in an attempt to maintain homeostasis.
This can be physical and emotional. Side effects may include anxiety, irritability, nausea, and vomiting. In the case of severe alcoholism, withdrawal can even be fatal; delirium tremens, a condition that can cause hallucinations and seizures, is one hazard an alcohol user that drinks heavily should be careful to guard against.
Warning Signs Of Addiction
Addictions begin with experimentation with a substance. There are many reasons someone might initially try a drug: curiosity, peer pressure, stress, and problems at work or home being some of them.
If you are concerned someone you care about is struggling with addiction, there are several red flags you can look for. However, it’s important to remember everyone is different; it may be harder to detect an addiction in some people than in others. That being said, here are some general warning signs to be aware of:
- Ignoring commitments or responsibilities
- Problems at work, school, or home
- Unexplained absences
- Appearing to have a new set of friends
- Considerable monetary fluctuations
- Changes in sleep pattern
- Lapses in concentration or memory
- Being oddly secretive about parts of personal life
- Withdrawal from normal social contacts
- Sudden mood swings and changes in behavior
- Unusual lack of motivation
- Weight loss or changes in physical appearance
No one expects to develop an addiction when they begin experimenting. But continued experimentation can lead to addiction, often unknowingly to the individual using the substance.
What Is Addiction?
Dr. Ashish Bhatt explains what it means when someone has an addiction and how to identify the key characteristics.View All Videos
Millions of Americans struggle with some form of addiction. If you are one of them, know you are not alone — and that many treatment options exist to help you overcome your addiction. Find addiction statistics here.
Over 20 million Americans age 12 or older have an addiction (excluding Nicotine).
people per day
100 people die every day from an overdose. This rate has tripled in the past 20 years.
Over 5 million emergency room visits in 2011 were related to drugs or alcohol.
The Controlled Substances Act
The Controlled Substances Act (CSA) is a law that regulates legal and illegal drugs in the United States. Under the CSA, drugs are categorized into different “schedules” according to a drug’s perceived danger and potential for dependence. For example, Heroin is classified as a Schedule I drug because of its illegal status and extremely addictive qualities. Legal medications on the other hand, such as over-the-counter Painkillers and cough Suppressants, are categorized as Schedule V because of their low chances for abuse.
The CSA’s drug scheduling system exists for several reasons. In common cases, the system is used by judges to help them determine sentences for drug-related crimes. It is also helpful for medical professionals when writing prescriptions.
Common Questions About Rehab
A majority of people who seek treatment for an SUD are struggling with a dependence on more than one type of substance. Polydrug use involves the consumption of one type of substance alongside another. This is often done to intensify a drug’s pleasurable effects or to reduce its unpleasant side effects.
A person may take a Stimulant such as Adderall, for example, to counteract the Sedative effects of an Opioid, such as Oxycodone. Mixing multiple types of drugs together is extremely dangerous and can potentially lead to overdose and death.
The Most Common Addictions
Millions of people around the world struggle with SUDs. Some of the most common drugs that impede people’s lives include:
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Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience