Addiction: A Choice Or A Disease?

Let's discuss the science and break the stigma surrounding addiction.

By Rosewood Recovery Team
July 10, 2024

Understanding Addiction as a Disease

Addiction is now widely recognized as a complex brain disease that goes beyond being a mere choice. It involves chronic and sometimes permanent changes in the brain, particularly in the pleasure circuits, as addictive substances trigger an outsized response in the brain, causing dopamine to flood the reward pathway. This flood of dopamine is often 10 times more than what is produced in response to a natural reward, leading to the development of addiction.

Brain Changes in Addiction

Chronic substance use leads to adaptations in the brain over time. The brain becomes less sensitive to dopamine, the neurotransmitter responsible for feelings of pleasure and reward. As a result, more of the substance is needed to achieve the desired pleasurable sensation. This phenomenon is known as tolerance. With increased substance consumption, the brain's reward pathway becomes less responsive, driving the individual to seek higher doses or more frequent use to generate the desired high. These adaptations and changes in the brain are part of what makes addiction a chronic and relapsing condition.

Impact on Decision-Making

Addiction can have profound effects on various cognitive functions, including decision-making. The brain areas responsible for focus, memory, learning, and judgment can be significantly impacted by addiction. The drive to seek drugs becomes habit-driven rather than based on conscious, rational decisions. This challenges the notion that addiction is simply a result of bad choices. The compulsive nature of addiction overrides the individual's ability to make rational decisions, highlighting the underlying brain changes that occur [1].

By understanding addiction as a disease, we can approach it with greater empathy and focus on evidence-based treatments and interventions. Recognizing the impact that addiction has on the brain helps to combat stigma and promotes a more compassionate approach to supporting individuals dealing with addiction. It also underscores the importance of comprehensive treatment approaches that address both the physical and psychological aspects of addiction.

Genetic Factors in Addiction

The development of addiction is influenced by a combination of genetic and environmental factors. In recent research, scientists have made significant strides in understanding the genetic basis of addiction. By analyzing genomic data of over 1 million individuals, they have identified shared genetic markers underlying substance use disorders, regardless of the specific substance being used.

Shared Genetic Markers

Through their study, researchers discovered 19 independent single nucleotide polymorphisms (SNPs) significantly associated with general addiction risk and 47 SNPs for specific substance disorders among individuals of European ancestry. These findings suggest that certain genetic variations increase the susceptibility to addiction across various substances.

The genomic patterns associated with general addiction risk also predicted a higher risk of mental and physical illnesses, including psychiatric disorders, suicidal behavior, respiratory disease, heart disease, and chronic pain conditions. This highlights the intricate relationship between genetic factors and the broader health implications of addiction.

Influence of Inherited Genes

The study revealed that the genetic variations associated with addiction risk are concentrated in areas of the genome that regulate dopamine signaling. Dopamine is a neurotransmitter involved in the brain's reward system and plays a critical role in addictive behaviors. The findings suggest that genetic variation in the regulation of dopamine signaling is central to addiction risk.

It is important to note that while genetic factors contribute to addiction risk, they do not determine an individual's fate. Substance use disorders are influenced by complex interactions between multiple genes and environmental factors. Understanding the genetic underpinnings of addiction can help inform preventative measures, personalized treatment approaches, and the development of targeted interventions.

The study's findings provide valuable insights into the genetic basis of addiction. However, it is essential to continue research in this field to gain a comprehensive understanding of the complex interplay between genetics, environmental influences, and addiction risk.

Behavioral Addictions vs. Substance Use

When discussing addiction, it's important to recognize that it extends beyond substance use. Behavioral addictions are a distinct category of addiction that involves compulsive behaviors or feelings induced by certain actions. Some examples of behavioral addictions include overeating, compulsive television watching, internet addiction, and gaming addiction.

Behavioral Addiction Overview

Behavioral addictions, such as internet addiction, share similarities with substance use addiction. The key distinction lies in the fact that behavioral addictions do not involve an addiction to a substance but rather to the behavior itself or the feeling brought about by the relevant action. Unlike substance use addiction, physical signs associated with drug or alcohol addiction are absent in behavioral addictions.

Individuals struggling with behavioral addictions often exhibit certain symptoms and face similar consequences as those with substance-related addiction or other obsessive behaviors. These symptoms may include craving, excessive behavior, psychological and physical withdrawal symptoms, loss of control, development of tolerance (increased behavior range), and the perception of expected psychotropic effects. The high comorbidity between behavioral addictions and substance-related addictions suggests comparable mechanisms underlying their development.

Co-Occurrence and Symptoms

Behavioral addictions can co-occur with substance use disorders, highlighting the complex nature of addiction. It is not uncommon for individuals to experience multiple addictive behaviors simultaneously or sequentially. For example, someone struggling with alcohol addiction may also develop gambling addiction.

Symptoms of behavioral addiction can encompass a range of psychological, emotional, and behavioral changes. These may include an intense preoccupation with the behavior, unsuccessful attempts to cut back or stop, withdrawal symptoms when the behavior is discontinued, and a loss of control over the behavior. Additionally, individuals with behavioral addictions may experience negative consequences in various aspects of their lives, such as relationships, work, and overall well-being.

By understanding the distinction between behavioral addictions and substance use disorders, healthcare professionals and individuals themselves can better identify and address the specific challenges associated with each type of addiction. Treatment approaches for behavioral addictions often involve therapies aimed at modifying behaviors, addressing underlying psychological factors, and providing support for recovery.

Remember, whether it's substance use or behavioral addiction, seeking professional help and support is crucial for overcoming addiction and regaining control over one's life.

Treatment Approaches for Addiction

When it comes to addressing addiction, there are various treatment approaches available. These approaches aim to help individuals overcome their addiction and lead healthier, more fulfilling lives. Two common treatment approaches for addiction are medication-based treatments and behavioral therapy programs.

Medication-Based Treatments

Medication-based treatments have been shown to be highly effective in treating addiction, particularly when combined with counseling and behavioral interventions. Research indicates that medication-based treatments are the most effective approach for addiction. Similar to medical conditions like depression, diabetes, or hypertension, conditions such as opioid use disorder are often treated most effectively with a combination of medication and counseling.

Medications used in addiction treatment can help reduce cravings, manage withdrawal symptoms, and restore balance in brain chemistry. They can be prescribed by healthcare providers who specialize in addiction medicine or psychiatry. Some commonly used medications for specific addictions include:

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Medication Addiction Treated
Methadone, Buprenorphine, Naltrexone Opioid addiction
Disulfiram, Acamprosate, Naltrexone Alcohol addiction
Nicotine replacement therapy (patches, gum, lozenges) Nicotine addiction

These medications, when used as part of a comprehensive treatment plan, can significantly improve the chances of successful recovery.

Behavioral Therapy Programs

Behavioral therapy programs focus on addressing the underlying psychological and behavioral factors that contribute to addiction. These programs help individuals develop coping mechanisms, learn healthier ways to manage stress, and acquire new skills to prevent relapse.

There are several types of behavioral therapy programs available, each tailored to meet the unique needs of individuals. Some commonly used behavioral therapy approaches for addiction include:

These behavioral therapy programs can be delivered in various settings, such as outpatient clinics, residential treatment centers, or through individual or group therapy sessions.

By combining medication-based treatments with behavioral therapy programs, individuals can receive comprehensive care that addresses both the physiological and psychological aspects of addiction. It's important to consult with healthcare professionals experienced in addiction treatment to determine the most appropriate treatment approach for each individual's unique needs.

Factors Influencing Addiction

Addiction is a complex issue influenced by various factors. Understanding these factors can provide insights into the nature of addiction and help guide effective treatment approaches. Two key factors that play a significant role in addiction are environmental influences and mental health.

Environmental Influences

Environmental factors can significantly impact an individual's susceptibility to addiction. Lack of parental supervision, peer pressure, childhood trauma, and easy access to drugs or alcohol at home are all factors that can increase the risk of experimentation with substances, leading to addiction. These environmental factors can influence young people to engage in substance abuse as a coping mechanism [5].

It's important to note that environmental influences are not limited to external factors alone. Social norms and cultural acceptance of substance use can also contribute to the development of addiction. Creating a supportive environment that promotes healthy coping mechanisms and discourages substance abuse is crucial in preventing and addressing addiction.

Mental Health and Addiction

The relationship between mental health and addiction is complex. Underlying mental health disorders can increase the likelihood of addiction, as individuals may turn to prescription medication or illicit drugs to self-medicate or cope with their condition. Common co-occurring disorders include anxiety, depression, PTSD, and ADHD. Treating addiction in individuals with co-occurring disorders requires specialized care in an inpatient or residential program [5].

Addiction itself can also lead to or exacerbate mental health issues. Prolonged substance use can alter brain chemistry and contribute to the development of mental health disorders. The interplay between addiction and mental health requires a comprehensive and integrated treatment approach that addresses both conditions simultaneously.

Understanding the environmental influences and the relationship between mental health and addiction is essential in addressing addiction effectively. By considering these factors, treatment professionals can develop personalized treatment plans that address the unique needs of individuals struggling with addiction. Combining therapy, support networks, and addressing underlying environmental and mental health factors can significantly increase the chances of successful recovery.

Addressing the Stigma of Addiction

It is crucial to address the stigma associated with addiction to ensure that individuals struggling with addiction can access the necessary treatment and support. Stigmatizing language and beliefs that people with addictions are making bad choices can create barriers to treatment, perpetuating misconceptions and hindering recovery. Understanding and addressing the stigma surrounding addiction is vital for promoting empathy and effective interventions [1].

Barriers to Treatment

Stigma surrounding addiction creates significant barriers for individuals seeking treatment. The negative perceptions and judgments associated with addiction can discourage people from seeking help and support. Fear of judgment from family, friends, colleagues, and society as a whole can prevent individuals from openly discussing their addiction and seeking appropriate treatment.

Moreover, the stigma surrounding treatment methods can further compound the challenges faced by individuals with addiction. Misconceptions about addiction treatment, such as the belief that it is ineffective or a sign of weakness, can deter individuals from accessing the help they need.

Importance of Education

Education plays a crucial role in addressing the stigma associated with addiction. By increasing awareness and understanding of addiction as a complex disease rather than a moral failing, we can reduce stigma and promote empathy and support for individuals struggling with addiction.

Education is also key to preventing the development of behavioral addiction. Recognizing the signs of addiction and understanding the risk factors can help individuals make informed choices and take proactive steps to prevent or recover from addiction. Risk factors for addiction include stress, anxiety, depression, and other psychological issues.

In addition, educating healthcare providers and the general public about addiction can help reduce the inappropriate use of potentially addictive drugs. Health care providers should prescribe these medications at safe doses, monitor their use, and provide education on the risks and alternatives. Steps can also be taken to prevent drug misuse in children and teenagers, such as promoting healthy coping mechanisms and providing education on the dangers of drug use.

By fostering a society that is knowledgeable about addiction and supportive of individuals seeking treatment, we can break down the barriers to recovery and create an environment where individuals with addiction can access the help they need. It is through education and empathy that we can combat the stigma surrounding addiction and promote a more compassionate approach to supporting individuals on their journey to recovery.

References

[1]: https://www.yalemedicine.org/news/how-an-addicted-brain-works

[2]: https://nida.nih.gov/news-events/news-releases/2023/03/new-nih-study-reveals-shared-genetic-markers-underlying-substance-use-disorders

[3]: https://fortbehavioral.com/addiction-recovery-blog/drug-addiction-vs-behavioral-addiction/

[4]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/

[5]: https://www.sanantoniorecoverycenter.com/rehab-blog/the-3-biggest-factors-of-addiction/

[6]: https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112

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