For Patients & Families Struggling with Addiction

Substance abuse (substance use disorder) is one of the top health problems in the United States. In 2018, approximately 20.3 million people aged 12 or older had a substance use disorder (SUD) related to their use of alcohol or illicit drugs in the past year. But what exactly is addiction and why is it affecting so many lives?

What is Addiction?

Many can find it hard to understand why or how certain people get addicted to drugs or alcohol. Some may argue that those who use drugs lack moral principles or willpower, or that they can just stop using simply by choosing to.

Unfortunately, addiction isn’t as simple as it can seem. It is actually a very complex disease that, in short, changes how the user’s brain is wired. This means that it usually takes more than good intentions or a strong will for an individual to quit using a substance.


The Brain on Addiction

Most addictive substances cause the brain to release high levels of a chemical called dopamine. This is the same chemical that the brain associates with pleasure or reward – such as hunger, thirst, or sex for example. Over time, continued release of dopamine causes the brain to attempt to balance things out by producing less dopamine overall. When this change to the brain occurs, the brain starts to rely on substances to trigger any release of dopamine. This can lead a person to an obsession with obtaining more of the substance just to feel “normal.”

For this reason, the person may also continue to use a particular substance despite the harmful or dangerous consequences. Eventually their dependency starts to interrupt their ability to function on a day to day basis. And once this process begins, it soon becomes self-perpetuating and the dependent person becomes unable to stop even though the chemicals could possibly be destroying their life socially, economically, and physically. In the most extreme cases of the disease, addiction can cause a person to stop caring altogether about their own or others’ well-being or survival.


Is it really a disease?

Though addiction has been classified as a disease for more than 40 years, there are still some who argue that addiction cannot be a disease because it is caused by the individual’s choice to use drugs or alcohol.

While the first or early stage use may be an initial choice by the user, once their brain has been changed by addiction, they can lose control of their behavior. Perhaps the most defining symptom of addiction is a loss of control over substance use.

“At the end of the day, choice does not determine whether something is a disease. Heart disease, diabetes and some forms of cancer involve personal choices like diet, exercise, sun exposure, etc. A disease is what happens in the body as a result of those choices.” –

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