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.