What is addiction?

A Substance Use Disorder is a troubling pattern of alcohol or drug misuse, leading to negative consequences.  It starts with experimentation and "recreational" use.  From there, it grows into a substance abuse problem. Left untreated, it can escalate into addiction. The sooner that we are able to address someone's issues, the better the chances are returning to a place of healthy choices and sustained recovery.  To learn more, click below:

Understanding Substance Use Disorders

The symptoms associated with a substance use disorder fall into four major groupings: impaired control, social impairment, risky use, and pharmacological criteria (i.e., tolerance and withdrawal). 

We are looking for some combination of these symptoms occurring within a 12-month period.  The more symptoms that are present, the more severe the disorder:

  1. The substance is often taken in larger amounts or over a longer period than was intended.
  2. There is a persistent desire or unsuccessful effort to cut down or control use of the substance.
  3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
  4. Craving, or a strong desire or urge to use the substance.
  5. Recurrent use of the substance resulting in a failure to fulfill major role obligations at work, school, or home.
  6. Continued use of the substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
  7. Important social, occupational, or recreational activities are given up or reduced because of use of the substance.
  8. Recurrent use of the substance in situations in which it is physically hazardous.
  9. Use of the substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
  10. Tolerance, as defined by either of the following:
    1. A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
    2. A markedly diminished effect with continued use of the same amount of the substance.
  11. Withdrawal, as manifested by either of the following:
    1. The characteristic withdrawal syndrome for that substance (as specified in the DSM-5 for each substance).
    2. The substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.
How do drugs work in the brain to produce pleasure?

Nearly all addictive drugs directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and feelings of pleasure. The overstimulation of this system, which rewards our natural behaviors, produces the euphoric effects sought by people who use drugs and teaches them to repeat the behavior. 

Is drug abuse a voluntary behavior?

The initial decision to take drugs is mostly voluntary. However, when addiction takes over, a person’s ability to exert self-control can become seriously impaired. Brain-imaging studies from people addicted to drugs show physical changes in areas of the brain that are critical for judgment, decision-making, learning, memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of an addicted person. 

 

Material from National Institute of Drug Abuse; The Science of Drug Abuse and Addiction: The Basics