What Is Addiction?
Addiction is diagnosed as a substance use disorder (SUD), which is a condition marked by an overwhelming, irrational desire to get and consume drugs.1-3 The compulsion to use substances is so powerful during addiction that a person will continue abusing drugs or alcohol even when negative or harmful outcomes are likely to occur.2,3 Often, once addiction has developed, the substance becomes the individual’s primary focus and all other people, activities, and responsibilities become less important by comparison.1
Repeated and consistent drug use begins to modify the brain’s normal functioning and reward pathways.2 When addiction is present, the brain feels far more rewarded by substance use than other activities, and so the individual’s ability to prioritize anything above substance use is diminished.2 Addiction is a complicated problem that directly and indirectly affects millions of people every day and requires treatment to manage.
Is Physical Dependence the Same as Addiction?
Both physical dependence and addiction are serious consequences of substance abuse, and even though there are many overlapping features, they are not the same.3 Physical dependence presents when the brain adapts to the presence of a substance in the system. Where addiction is frequently seen through a shift of behaviors and interests of the individual, dependence is a physical adaptation in which the body needs the drug to feel normal. A dependent person is likely to experience some form of withdrawal when they decrease their doses or try to stop altogether.2,3 Withdrawal can range from mild distress to dangerous medical complications and even death.
Because they are not equivalent, someone can be addicted to a substance without being physically dependent, and someone can be physically dependent on a substance without being addicted.
Is Addiction a Choice?
Given the many negative outcomes associated with addiction, it is challenging to imagine a person would wish to become addicted to alcohol or other drugs. Most people actively choose to use a substance initially, but they think that they can stop at any time.3 In many cases, people do stop using a drug before an addiction develops, but many others find themselves addicted and unable to stop before they even realize how immense the problem has become.
Many others find themselves addicted and unable to stop before they even realize how immense the problem has become.
Drugs change the way the brain functions in numerous ways, altering circuits involved in motivation and pleasure, memory, learning, and impulse control.3 These changes can last for an extended period, even after substance use ends.3 Due to these brain changes, people are at greater risk for continued use and future relapse. The brain is increasingly sensitive to cravings triggered by people, environments, and other stimuli that remind the user of their drug use.3
It is the nature of the biological changes that occur in the brain that lead many in the field of addiction medicine—those dedicated to the prevention and treatment of substance abuse—to espouse the belief that addiction is a disease rather than a choice.1,2,3
How Quickly Can Addiction Occur?
Even though this is a common question, there is no set, definitive answer.2 Addiction grows and develops over time and the process is unique to the individual. One person might use a substance and become addicted very quickly while another person using the same substance might never become addicted.
The time from first use to a full substance use disorder, or addiction, is influenced by the interaction of various factors that include:1,2
- The person’s age. People that use drugs earlier in life are at greater risk.
- Family stability.
- Current environment, stressors, and supports.
- Past trauma like childhood abuse or the death of a loved one.
- Mental health issues.
- The type of drug used, as well as its dose, frequency, and method(s) of use. Smoking or injecting drugs can hasten the onset of addiction, for example.
Another factor affecting addiction is family history of substance abuse and addiction.3 If a person has an extensive family history of addiction, they have a greater risk of becoming addicted more quickly.3
What Are the Effects of Drugs?
While, of course, specific drugs will produce specific effects, common reasons people use drugs include rewarding sensations like:4
- Relaxation and sedation.
- Changes in sensory perception, e.g., hallucinations.
- Pain relief.
- Increased alertness and energy.
Certain negative effects of drugs may begin mildly before becoming more problematic with time.
Unfortunately, the pleasurable effects are often accompanied by several unwanted influences of the drugs, like poor judgment, anxiety, and impaired thinking.4 Certain negative effects of drugs may begin mildly before becoming more problematic with time.
Drugs have a long list of harmful effects on the body. Some are unique to a particular substance, while many others will overlap between similar drugs.4 For example, cocaine, methamphetamine, and prescription stimulant medications all have the potential to elicit:4
- Cardiovascular changes like:
- Higher blood pressure.
- Quicker heart rate.
- Higher body temperature.
- Suppressed appetite/weight loss.
- Sleep disturbances.
- Anxiety and panic.
- Anger and paranoia.
On the other hand, depressants such as alcohol and prescription sedatives like barbiturates (e.g., phenobarbital) and benzodiazepines (e.g., Xanax) all have the potential to cause sedation, loss of coordination, slurred speech, and respiratory depression (which can be fatal).
How Do I Know if I or Someone I Love Needs Help?
Identifying addiction in a loved one can be a very challenging task. It can be even harder to acknowledge a problem within yourself. If a problem exists, the chances are good that at least a few of the following specific signs of a substance use disorder are present:5
- Taking large amounts of a substance for long periods of time
- Spending a lot of time and energy acquiring, using, and recovering from the substance
- Having strong drug cravings.
- Finding yourself unable to stop using even when the drug is wreaking havoc on your life
- Having relationship, professional/academic, and or legal problems resulting from substance use
- Giving up important activities because drug use has taken priority
- Needing to take higher and higher doses to get the effects you want (tolerance)
- Feeling uncomfortable or ill when not using the substance (withdrawal)
If any of these signs apply to you or your loved one, it could indicate the need for help.5
Is Addiction Treatable?
Yes. While there is no “cure” for addiction, professional treatment that comprehensively targets the entire person (not just their addiction) can help a person achieve long-term recovery.2,3 There is no one approach that is right for everyone, so addiction treatment will be unique to the person.3 When treatment begins, the person will receive a full evaluation to assess their status, needs, supports, and stressors to determine the best fit.3
There are many treatment approaches utilized to help people overcome addiction. Treatments include:2,3There is no one approach that is right for everyone, so addiction treatment will be unique to the person.
- Detoxification—Often this is the first step in treatment, as it focuses on establishing safety and comfort during withdrawal so you can move forward from a stable and healthy starting point.3
- Behavioral therapy—This may include individual, group, or family sessions that work to motivate change, reward abstinence, improve problem-solving skills, and foster effective interpersonal communication to maintain a drug-free lifestyle.
- Medications—Certain medications may be used in conjunction with behavioral therapy to reduce cravings and manage withdrawal symptoms. Medications are most useful for treating opioid and alcohol addictions.
It is important to note that there is no way to ensure life-long abstinence from substance abuse, though longer periods of treatment are associated with longer periods of recovery.3 Like other chronic conditions, relapse is always possible even with appropriate treatment.3
How Can I Find Treatment?
You can find treatment programs by:
- Seeking consultation from a trusted physician or addiction specialist.
- Speaking with friends or loved ones that have personally undergone addiction treatment.
- Searching online for programs in your desired location.
- Contacting your insurance provider to learn what programs are covered and recommended for your symptoms.
If you or your loved one needs help, don’t wait another day. There are numerous resources available to help you find the right kind of care.
- National Institute on Drug Abuse for Teens. (2017). Brain and Addiction.
- National Institute on Drug Abuse. (2017). Frequently Asked Questions.
- National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
- National Institute on Drug Abuse. (2017). Commonly Abused Drug Charts.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.