Is Addiction a Disease?

Addiction is a complex condition of the brain that is created by compulsive substance use, regardless of the consequences. People who suffer from addictions have a clear focus on using a certain drug or substance to the point that it takes over their lives. 

Understanding that addiction affects the brain in many ways can reduce the stigma surrounding addiction. Stigmas and shame surrounding addiction give the perception that addicts are weak, irresponsible, and careless. Knowing about the brain and how it reacts to an addiction can help identify effective treatments and even prevention. During adolescent years, the brain is at its most vulnerable state. This is when intervention and caution regarding drug use is most valuable. 

So yes, addiction is a disease that affects the brain both chemically and psychologically.

The Science of Addiction

When a person is addicted, they have the inability to stop using drugs or alcohol. This has to do with deficits in the function of the prefrontal cortex. The prefrontal cortex is responsible for executive function and has many very important roles: self regulation, delaying reward, and integrating what intellect tells you is important with what the libido is telling you. 

When the brain is deprived of a substance that is used to receiving (drugs or alcohol), it reacts to stress differently. It can be exaggerated emotions and increase the craving for the substance. Neurotransmitters in the brain that become intoxicated during drug use make the brain insensitive to “regular” sources of happiness – like a peaceful sunrise or lunch with a good friend. 

The Brain and Addiction

There are a number of areas in the brain that are crucial to the development and persistence of addiction. 

Pathways with Dopamine

In pathways which contain dopamine, drugs exert their full effect. Dopamine is a chemical in the brain which carries signals from one brain cell to another. Pathways where dopamine is present are typically involved in reward-motivated behavior. In a non-affected brain, dopamine is released in response to natural, healthy rewards, such as exercise or a healthy meal. Drugs take over dopamine pathways and teach the brain that drugs are good. Some substances have similar chemical structures as other chemicals in the brain, which allow them to attach to brain cells and release dopamine. For example, if a drug creates a positive, euphoric feeling, your brain will attach that feeling to using drugs. This only reinforces drug use behavior. 

Drugs release approximately 8 times more dopamine than natural reward. Of course, it is dependent on the drug (amphetamines release more dopamine than cocaine). As a result, an increased influx of dopamine means an increased feeling of pleasure or motivation. However, when substances are abused and use is continued, the number of brain structures that receive dopamine, eventually reducing a person’s ability to feel and recognize pleasure. 

Long Term Effects on the Brain

Negative effects on the brain from chronic drug use can last years after a person quits or goes through a recovery process. This is why it is so common that relapse occurs after long periods of abstinence. Despite devastating consequences, the brain may overpower a person’s ability to “just say no.” 

This is why treatment types need to be specialized for each person. A well-rounded treatment plan that incorporates mental, physical, emotional, and psychological therapies can give people the tools they need to avoid triggering situations, cope with unhealthy thoughts, and learn how to distract themselves when cravings appear. 

Treatments are not generally a short-term process, and can be a lifelong commitment. 

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