What Is Addiction?
Comprehensive Insights From Top Addiction Experts
Everyone has a basic idea of what addiction is, yet it’s a complex and involved topic that goes far beyond common knowledge.
Nonetheless, it’s worth delving deeper to learn more about addiction if you or someone you know is affected by it – or if you’re trying to determine whether the person does in fact have an addiction.
Arguably, you could be addicted to different kinds of activities, but this guide refers directly to an addiction to substances, whether to drugs or alcohol.
What is Addiction?
If you start researching what addiction is, you will notice disparate definitions and theories on the cause of addiction across various professionals and fields. Different people and groups see it as one of the following:
A medical disease
A psychological state
A behavioral problem
A social or experiential issue
Nonetheless, a common thread between viewpoints seems to be that a person is considered addicted when he is either unable or unwilling to stop using the substance. He continues to use the substance even when it is causing consequences in his life – he may or may not be aware of this cause and effect relationship.
Signs and Symptoms of Addiction
Certain signs and symptoms are associated with addiction to a substance:
- 1. Less ControlOne of the main signs you might notice is that you or your loved one has less control over the use of drugs or alcohol. So you might be addicted if you are using a substance more or for a longer period of time than you meant to. Maybe you even decided that you were going to cut back or stop, but that didn’t happen.
- 2. Physical SymptomsVarious physical symptoms can show themselves. For example:
- Substances can alter your appearance.
- An addiction can make you focus less on your personal hygiene and looks.
- Your body can become tolerant to a substance so you no longer get the same effects unless you have more of the drug or alcohol.
- If you do decide to stop using your substance of choice, you go through withdrawal effects that could include irritability, trouble sleeping, sweating and other symptoms.
- 3. Behavioral ChangesIt’s also likely for you to change your behaviors if you are addicted. You might not spend as much time as you previously had on certain activities, including:
- Family time
Instead, getting and using your chosen substance takes precedence over these activities. You might spend time hiding your drug use or related aspects such as how much you used or where you went. And you might also end up engaging in risky behaviors to get your drug or because you’re on a substance.
- 4. Additional SignsThere are various other signs and symptoms associated with both drug abuse and drug addiction, which include:
- Mood changes
- Changes in your eating habits
- Isolating yourself
- Talking quickly or erratically
What causes Addiction
As previously mentioned, various theories exist on how and why addiction starts. What are some of the prevalent viewpoints on addiction?
Addiction as a Disease
One idea that’s generally accepted in the medical field is that addiction is a disease that involves your brain. If you have an addiction, this viewpoint follows the idea that you are not capable of simply quitting, but instead need medical help to manage the disease.
The definition for addiction on the National Institute on Drug Abuse website follows this model, saying that addiction alters the brain’s functioning. In addition, the institute explains that these changes to the brain can lead to various mental concerns, including mood swings and difficulty with decision-making.
The American Society of Addiction Medicine, or ASAM, website goes deeper into this viewpoint, explaining that this chronic disease involves dysfunction in various parts of the brain, including the centers of reward, memory and motivation. You could notice these problems showing themselves in a myriad of ways through mind, body, spiritual and social applications.
The ASAM definition notes that because of an addiction, you are likely to:
- Have cravings for the substance
- Be unable to continually refrain from using the substance
- Have difficulty controlling your behaviors, responding with healthy emotions and realizing when you have a problem
Also, the ASAM website explains that addiction is included with other chronic diseases in part because it is characterized by relapse and remission periods, and because it worsens in the absence of treatment.
A Psychological Addiction
The Psychology Today website discusses psychological addiction, in addition to
acknowledging two types of physical addiction:
- 1. the body developing a tolerance to drugs or alcohol
- 2. the brain reacting too strongly to substances or certain cues related to the substance
Psychological addiction, according to the website, is where you would compulsively use a substance or perform a certain activity because you are emotionally stressed – this can coincide with a physical addiction or not.
Psychology Today mentions that with this type of addiction, you could switch from one kind of drug to another or even to a behavior separate from drugs, such as gambling or shopping.
A Viewpoint on Morals and Willpower
Some people believe that those who are addicted to drugs do not have the strength or the morals to stop taking drugs. This viewpoint follows the idea that people could just stop using drugs if they simply had the desire to do so.
Those who hold this viewpoint tend to demonize and attack people who have a problem with substances. Meanwhile, health professionals and scientists generally do not agree with this viewpoint, but instead feel that other factors are at play with addiction.
The DSM Viewpoint and Its Critique
The latest version of the Diagnostic and Statistical Manual of Mental Disorders, used by professionals in mental health, changed its discussion of addiction from the previous version.
How do they differ?
- The last version: referred to this problem as dependence.
- The current version (the DSM-5): calls it addiction. This better encompasses the extent of addiction, which goes beyond just a physical dependence on the drug.
This new classification goes on to say that addictive substances affect people in a unique biochemical way that is different from activities that were previously thought of as addictive. In the same vein, it removes most behaviors from being considered addictive.
Separate from addictive substances, this new version only acknowledges gambling as being addictive, referring to it as a behavioral addiction. However, it does not consider sex, eating and other behaviors as addictive if a person’s compulsion to them greatly interferes with his life.
Is there a problem with the current version?
In a Psychology Today article, addiction professional Stanton Peele takes fault with the current DSM-5’s classification of addiction. Peele feels that the true characteristics of addiction have to do with how much drug use negatively affects your life and how much you don’t want to or can’t stop using the substance.
Peele notes that imaging technology does show effects of drugs on the brain, but that people go to treatment because of how harmful the substance is to their lives and how they can’t seem to stop in spite of that harm.
He also believes eating, sex and other behaviors can be addictive in the same way as gambling and substances.
In addition, Peele finds it problematic that the DSM-5 connects its classification of addiction so closely with the chemical effects of substances and the claim that someone could be addicted to just one substance. He notes that these claims are especially problematic because people tend to show a pattern of becoming addicted to different substances and activities, opening the idea that there is more to addiction than how this DSM-5 version classifies it.
A Social Theory
Another viewpoint on the cause of addiction that has been gaining traction recently is that the chemical addiction theory might not have as much credence as previously thought. In an article for Huffington Post, Johann Hari, author of Chasing the Scream: The First and Last Days of the War on Drugs, brings up a social theory on addiction.
The overall idea of this theory: isolation leads to addiction and
human connections can stop it.
Hari provides numerous examples to back up this theory and points out problems with the idea of chemical addiction in the process. In the article, he discusses that one of the main studies backing up the chemical addiction theory was a rat experiment where the rats would repeatedly go back to a water bottle with cocaine or heroin in the water rather than drink from a separate water bottle filled with just water.
Inevitably, the rat subjects continued returning to the water bottle with drugs until they died.
But a different rat study, conducted by psychology professor Bruce Alexander, pursued the idea that there could be more to the story than just the effect of the drugs on the brain. Alexander noticed that the previous studies featured a single rat in a cage; he wondered if a change in the rat’s life might also change the rat’s desire to go for the drugged water.
His study provided Rat Park to the rats, which included top-notch food and plenty of areas and features to keep the rats active and amused, in addition to putting numerous rats together instead of leaving them isolated.
The result: rats who had more to their lives in Rat Park went for the plain water for the most part, drinking under one-fourth of the amount of drug-laced water the isolated rats took in. The rats in Rat Park all lived through the study.
In a later test, the same professor conducted the isolated rat experiment for 57 days in an effort to get them addicted. Then, he transferred the rats from a cage by themselves to Rat Park, where they experienced some signs of withdrawal yet stopped heavily using the drugs as they had been in the cage. This part of the experiment addressed the question of whether you could get over the addiction once it starts.
Hari notes a similar example of the Vietnam War, which coincided with the Rat Park experiment. This case is even more relevant because it involves people instead of rats. Hari explains that about 20 percent of American soldiers developed a heroin addiction in Vietnam, and then about 95 percent of them stopped using the drug, most without rehab, when their environment changed.
Another human example is medical patients who are given medical heroin for pain for extended periods of time; when their treatment is over, instead of being addicted and pursuing the drug, these people are able to halt their drug use instantly. Hari related this case to the others in that a heroin user on the street tends to not have the same social support or positive environment as the medical patient going back home.
This social theory addresses additional problematic aspects of the chemical addiction approach, highlighting that gambling is another example of an addiction that doesn’t involve chemicals in the brain.
The chemical theory seems to have difficulty addressing how other types of addiction work, and goes back and forth on whether abuse of certain behaviors falls under the classification of addiction at all.
A Lack of Professional Consensus
As you can see, there is not a consensus on what addiction is or how it starts. Not all professionals agree that it is a disease or that chemical effects in the brain are the main component of it.
In addition, treatment programs often approach addiction and recovery from a certain viewpoint. But even though there are different views on the subject, treatment is still possible and effective.
If you need treatment, you might want to find a program that lines up with your beliefs. Also, consider that many treatment programs provide a multi-faceted approach that addresses numerous causes or components of addiction, so one of these programs could potentially help address the cause even if it’s unknown.
There are also other possibilities, such as that a number of factors are at play at once, or that substances create addiction in varying people for different reasons. For instance, perhaps a drug affects one person’s brain but another person is addicted because of social isolation.
Is Addiction the Same as Abuse or Tolerance?
The terms addiction, abuse, dependence and tolerance are often used interchangeably, yet they have different meanings.
- Tolerance is where your body gets used to the substance you’re using, so you need to use more of it to get the same effects you previously got from a smaller amount. Tolerance is a component of addiction, yet there is more that addiction encompasses, such as the consequences to your life from not giving up drugs or alcohol.
- Physical DependenceIn the same way, physical dependence on a substance is generally a part of addiction, but addiction encompasses more features. Plus, dependence can also happen with medical drugs when the person is not considered addicted.
- AbuseDrug or alcohol abuse is a little different than addiction. This is where you use too much of a substance, but it doesn’t control your life quite so much as with an addiction. With abuse, you are able to cut back or stop using the substance, and it may not have the same level of consequences to your life or create the same level of dependence. Nonetheless, abuse often progresses into addiction.
Can Anyone Become Addicted?
The pattern of drug use and addiction shows that some people are more likely to become addicted than others. If you and your friend use the same drug on an ongoing basis, it’s possible for you to become addicted while your friend does not, or vice versa. There are many theories on what makes someone more likely to become addicted, including:
How old you were when you began using drugs
How often you use drugs
How long you’ve been using a certain substance
How connected you are to other people and society
What addiction is and what causes it is not a cut and dried issue. It’s easy to gain a different answer depending on who you talk to. In addition, the definitions sometimes change, as you can see by the revised versions of the DSM in psychology.
Nonetheless, professionals do seem to agree on the essence of addiction: you don’t or can’t stop using drugs or alcohol despite how much it negatively affects your life.
Another agreed-upon viewpoint is that treatment exists that can help you gain control of an addiction, no matter the cause.