Addiction is a serious problem that many Americans deal with every day. According to the 2018 edition of the National Survey on Drug Use and Health (PDF), approximately 20.3 million people over the age of 12 had a substance use disorder related to the use of alcohol or illicit drugs. Individuals who heavily use alcohol or drugs are often stigmatized and face many challenges in their personal and professional lives. To many people, addiction is viewed as a lack of self-control. However, there is growing evidence to support the view of addiction as a neurological disease.
When considering whether addiction is a disease, it is important to start with the basic definitions. A disease is any condition of the body or one of its parts that impairs normal functioning and is characterized by specific signs and symptoms. Addiction is defined as a compulsive, chronic, physiological, or psychological need for a substance, behavior, or activity having harmful effects and causing well-defined symptoms upon withdrawal. Addiction certainly impairs the normal functioning of the individual and is characterized by specific symptoms. Taken together, the link between addiction and disease becomes apparent.
Definitions from the dictionary, however, are not sufficient to establish a link between addiction and disease. Recent research shows that the use of drugs and alcohol, as well as engaging in certain behaviors can alter the way the brain functions.
Link between dopamine and addiction
When a person ingests a potentially addictive substance, the activity of dopamine in the brain is directly influenced. Dopamine is a neurotransmitter that is involved in many healthy functions of the brain. Dopamine is released in response to a person doing things that are biologically constructive like eating, exercising, or having sex. Dopamine is essentially a reward for doing something good.
Dopamine is also released when a person uses drugs, however, at a much higher rate. As a person continues to use drugs, the amount of dopamine released decreases, sometimes leading them to do drugs more frequently and in greater quantities in order to achieve the same feeling that arose from previous drug use.
In 2016, the United States Surgeon General released a report that covered the scourge of drug use and abuse among American citizens. The report identified three stages that comprise the addiction cycle.
- The first stage, binge/intoxication, is when the individual first consumes an intoxicating substance and experiences the reward brought about by the release of dopamine.
- The next stage, withdrawal/negative affect, occurs when the individual has gone without the substance for a period of time and experiences unpleasant physical and emotional symptoms.
- The last stage, preoccupation/anticipation, takes place when the individual seeks out the intoxicating substance again. Without treatment, the cycle of addiction (PDF) can continue and become more severe, resulting in an inability to control one’s behavior.
Enlightened views lead to improved treatments
Increased acceptance of the view of addiction as a disease has led to improved treatment protocols. For example, studies have shown that treating individuals with opioid use disorder with methadone or buprenorphine is associated with reduced risk of overdose and other opioid induced complications. In addition to medications, other treatment methods include counseling, behavior modification, changes of environment, and addressing underlying physical and mental health issues.
Addiction can affect anybody at any time. It crosses all racial, gender, and socioeconomic boundaries. Although addiction often begins with a decision made by an individual, evidence suggests that addiction is a disease of the brain that leads to a loss of self-control and a cycle of behavior that perpetuates the abuse of substances. As more is learned about addiction, the medical community will hopefully continue to improve and develop new treatments to mitigate the effects of addiction on individuals and their loved ones.
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