While the term addiction might conjure up stereotypical images of certain demographics or substances, addiction and substance use doesn’t discriminate against age, gender, or social class and could involve substances such as illicit drugs, prescription pills, alcohol, and/or nicotine.
Not all addictions look the same. For some people, addiction and substance use can be a quiet struggle experienced in isolation; while for others, it might be a battle that includes intervention, detox, or adhering to a strict treatment plan.
In order to better understand how people are affected by addiction & substance use, and how to treat addiction, we want to dispel some misconceptions surrounding the topic.
The terms ‘substance abuse’ and ‘addiction’ are often used interchangeably, but there are some key differences. Substance abuse is primarily defined by how someone voluntarily uses drugs, while addiction is categorized by a person’s inability to control their impulse to use a substance, experience of withdraw from a substance, and compromised brain functions.
Scientists believe the compulsive and destructive behaviors that come about in addiction are due to physical changes in areas of the brain that are critical for decision making, memory, learning, and behavior control.
According to the National Institute on Drug Abuse (NIDA), “Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful, often self-destructive, behaviors.”
Some argue that the difference between substance abuse and addiction is that substance abuse alters the brain only briefly, while a substance addiction alters the brain to a point where it becomes a mental disorder.
“Choices do not happen without a brain – it is the mechanism of choice. The quality of a person’s choices depends on the health of that mechanism. Even if taking a drug for the first time is a free choice, the progression of brain changes that occurs after that involves the weakening of circuits in the prefrontal cortex and elsewhere that are necessary for exerting self-control and resisting the temptations of drug use. Once addiction takes hold, there is greatly diminished capacity, on one’s own, to stop using.”- Dr. Nora Volkow, writing for the National Institute on Drug Abuse
Dr. Gabor Maté, addiction expert, speaker and best-selling author, argues that it’s not drugs themselves that change the brain’s chemistry and create addiction; it’s trauma or the experience of loss, however minute over the course of our lives, that causes the brain neuropathways to alter and predisposes someone to develop addictive habits. He points to how addictive tendencies govern the most basic and life-sustaining needs and function, such as incentive and motivation, physical and emotional pain relief, the regulation of stress and the capacity to feel and receive love. Furthermore, Mate believes that addiction should be treated with compassion. Click here to view Dr. Gabor Mate’s video, What is addiction?, where he elaborates on this.
Pain relievers, tranquilizers, stimulants, and sedatives can be useful when taken as directed or prescribed appropriately, but are commonly misused to produce pleasure or alleviate stress, changing the brain’s inhibition and reward center and leading to a lack of control over one’s behavioral impulses.
While prescription drugs are largely perceived as ‘safe’ because they are dispensed by a doctor, their effects can be just as harmful, if not more dangerous, than illicit drugs. If you look at heroin and oxycodone, for example, they have the same addictive properties and effects, but one is accessible over the counter. In fact, the current opioid epidemic in America highlights prescription drug addiction as the fastest growing form of addiction in the world, due in part to it’s widespread availability and public misconceptions about prescription pills.
Depending on the substance and length of time someone has been reliant on a substance, the physical and psychological withdraw symptoms can become life threatening, meaning an abrupt stop could shock the brain and body to the point of causing severe medical distress, and sometimes even death!
It’s no surprise, then, that most people who struggle with a substance use issue continue to use as a way to avoid the withdraw symptoms.
Rather than quitting cold turkey, NIDA suggests that addiction treatment medications should be paired with behavioral therapy to suppress and eliminate the withdraw symptoms. While some people believe that willpower is the only way to combat addiction, the chemical make-up of the brain can be altered to a point where one’s construction of reward, motivation, memory and decision making process becomes dysfunctional.
Often time drug usage is a way to cope with and/or avoid stress, triggers from trauma and/or discomfort. Therapy can provide healthier tools + resources to manage this stress, thereby helping the addict have much better and more sustainable ways to deal with the inevitable stressors of life.
Many factors play into the development of an addiction, including psychological conditions beyond an individual’s control or choice, such as anxiety or depression; family history of addiction; life stress; peer pressure from friends; and/or a dependence brought on by drugs prescribed for an injury/condition. However, Dr. Maté argues that addiction is often the result of a lack of nurturing during childhood, trauma, and/or the experience of loss.
Despite the difference of opinion, addiction is nonetheless categorized as a mental disorder/disease that affects memory, decision making and judgment, meaning a person suffering from addiction may no longer have the psychological mechanisms necessary to carry out acts of willpower.
NIDA- The Science of Drug Use and Addiction:The BasicsThe Science of Drug Use and Addiction:The Basics
Four Differences: Substance Abuse vs. Addiction
Treating addiction requires both science and compassion, says Dr. Gabor Maté
Jerica Rossi is a Marketing & Marketing Associate of PIMSY EHR. For more information about electronic solutions for your practice, check out Behavioral Health EHR.