If you’re visiting our website, you probably have some experience with addiction, whether it’s personal, through a friend or a loved one, or because you work in the treatment sector. As a matter of fact, almost everyone has been touched by the physical and emotional fallout from this dis-ease. According to the charity Action on Addiction, 1 in 3 people is addicted to something, whether it’s alcohol, caffeine, gambling, the internet, or an illicit drug. But even people who have lived with addiction for years can misunderstand the fundamental nature of the dis-ease. Let’s take a look at the latest literature and scientific findings, and try to define this elusive and crippling ailment.
The Old Definition
According to the traditional understanding of addiction, it is basically defined as using, taking or doing something until one loses the ability to stop and the activity or substance becomes harmful. It is commonly used to describe an individual’s relationship with alcohol, drugs, nicotine, or gambling, but as our understanding of the dis-ease has expanded, experts have included work, social media, sex, shopping, food, pornography and even video games in the category of addictions.
A New Understanding
As psychologists and neuroscientists have continued to study addiction, they have noticed that it has profound effects on the central nervous system. As Psychology Today’s definition of the disorder notes, there “is scientific evidence that the addictive substances and behaviors share a key neurobiological feature—they intensely activate brain pathways of reward and reinforcement, many of which involve the neurotransmitter dopamine.”
The authors of the Psychology Today piece note that many of the changes to neurological function that addicts experience are similar to other compulsive disorders, and they respond to the same forms of treatment.
Because addiction reshapes the brain’s executive functions, addicts typically are slower to recognize (or perhaps incapable of recognizing) the problems that addiction creates for themselves and those around them. This often leads them to pursue the pleasure they gain from their addiction at the expense of all other areas of their lives, such as family, health, work, and friends.
So, rather than a failure of self-control, or a choice to prioritize opiates or blackjack ahead of a healthy life and happy family, the medical establishment has come to characterize addiction as a neurological problem. As the American National Institute on Drug Abuse defines it, drug abuse is “a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control, and those changes may last a long time after a person has stopped taking drugs.” They note that, as with heart dis-ease, addiction disrupts the normal functioning of an organ, has profound harmful effects and is often treatable and preventable. However, if left untreated both dis-eases can be fatal.
What this ‘disease model” understanding of addiction fails to take into account, however, are the psycho-spiritual conditions which make some people’s bodies and mind such fertile ground for addiction to take root in the first place. To understand this aspect of addiction fully, it is necessary to dig a little deeper, to the root of the problem.
The Roots of Substance Misuse
Why do people use drugs and alcohol, or partake in other harmful forms of behaviour? There are generally a few reasons, but most would agree that usually, the user wants one of three things: The first is to feel good, to gain the intense pleasure caused by an activity or substance. The second is to feel better, to gain relief from pain, stress, anxiety or depression. The third is to do better, to increase performance in a sport, activity or academic pursuit.
While drugs are generally pleasurable at first, habits are formed quickly. In what most people would see as a fairly harmless example of the birth of an addiction, a student hasn’t slept enough during an exam period and starts drinking coffee to stimulate their mental faculties. They keep drinking coffee in order to study more and soon realize that they need more and more of it to achieve the same effects. When they try to stop, they suffer from headaches, have difficulty concentrating, and are in a funk for a few days. This cycle plays out the same way with far more dangerous substances and problematic behaviours than drinking coffee in other forms of substance misuse.
As substance misuse begins moving further toward addiction, physical changes occur in areas of the brain crucial to judgment, decision-making, learning, memory and behaviour control. While a student who drinks coffee for two weeks may find it fairly easy to break free, most addicts find their self-control seriously impaired by these neurological changes.
What Is the Difference Between Substance Abuse and Addiction?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), drug abuse is defined as an individual experiencing either legal problems caused by use, an inability to manage responsibilities, or causing physical harm to others while under the influence and then continuing to use the problematic substance. The criteria for a diagnosis of addiction includes these problems, as well as the onset of withdrawal symptoms, neglect of work, hobbies, family and friends, and patterns of behavior that revolve around getting and staying high.
The key differentiator between abuse and addiction is an inability to stop using. A person who abuses drugs can generally stop for extended periods of time when faced with the catastrophic effects of their habit. An addict recognizes the detrimental effects of their dis-ease, but cannot cut down or stop their use, despite their best efforts and intentions. This is why the American Government defines drug addiction as a “chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.”
A New Conception of Addiction
After years of study, Canadian doctor and philosopher Gabor Maté has concluded that addiction is, in its simplest terms, a response to pain – a coping mechanism for traumatic events and circumstances. He notes that the same parts of the brain respond in the same ways to physical and mental pain and that addicts are generally seeking relief from physical or mental trauma. Maté feels that, in order to treat addiction, we must ultimately face our pain and learn to live with it.
Swiss-British journalist Johann Hari conducted a years long study of addiction. He concluded that people who are isolated and alienated from loved ones and society at large are at higher risk for addiction than those with loving bonds and healthy relationships with those around them. He posits that addictions are rooted in a desire to create bonds with others and an inability to create those bonds with the people in one’s life. Therefore, the addict turns to a drug, or alcohol, or a behaviour to cope with the psycho-spiritual gap left by one’s lack of connection to others, often to their own detriment.
The Good News
While addiction is a horrible affliction, and even those who make progress frequently relapse, evidence shows that the majority of addicts recover from addiction at some point in their lives. And there are a wider variety of effective treatments now than ever before. Powerful new substances, such as Ibogaine, have been shown to ease the effects of withdrawal while resetting key neural networks to a pre-addiction state. Meanwhile, holistic and alternative treatments have shown great promise in addressing the roots of addiction, whether trauma, anxiety, or depression. As Psychology Today notes, for addicts who achieve remission of the disorder for 5 years, the risk of relapse is no greater than that experienced by an individual who never suffered from an addiction in the first place!
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