- The United States accounts for only 5% of the world’s population; however, two-thirds of illegal drugs are consumed in America
- More than half of American adults have a close family member who has, or has had, alcoholism
- 1 in 4 deaths in the U.S. can be contributed to alcohol, tobacco, or illicit drug use
- According to The National Center on Addiction & Substance Abuse at Columbia University, over 80% of those incarcerated in adult and juvenile penal institutions were there directly or indirectly as a result of addiction.
The “basic” definition of addiction in the Dictionary is: “the state of being enslaved to a habit or practice or to something that is psychologically or physically habit-forming, to such an extent that its cessation causes severe trauma.” The more technical definition comes from the American Society of Addiction Medicine (ASAM): “a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”
I think it is a fair assumption to make that, although addiction has become an epidemic, no one sets out or plans to become an addict. As Dan Mager, MSW, states in his blog: “Using substances and activities to change the way we fell often begins as a vacation and turns into a kidnapping, with a compelling case of Stockholm Syndrome.”
Addiction as a disease. Although the decision to use substances, drink, or act out in other addictive behaviors (i.e. gambling, eating, sex) is initially a choice, an individual progressively loses the ability to control the addiction. The ability to make conscious decisions decreases as the unconscious influence of the “reward system” in the primal survival-based midbrain overrides the more evolved prefrontal cortex. At a certain point in the addiction cycle, the substance or addictive behavior become equated with survival – like water or food.
Addiction is a brain disease that literally changes the brain’s structure and functioning. Brain imaging studies have shown that addicts experience physical changes in areas of the brain that involve judgement, decision-making, learning, memory, and behavior control. These changes help explain the obsessive thinking, compulsive actions, and inability to delay gratification that addicts struggle with.
With treatment and recovery, the addict’s brain has the ability to heal and rebuild connections that were altered during the addictive cycle. However, the unconscious learned responses of addiction are strong enough to remain operative even years after abstinence. Therefore, memory tracks tend to pull people back into experiences and behaviors they are comfortable with, making recovery an ongoing, life-long process that is more of a winding road than a straight one with no slip-ups or relapses.
Genetic Factors. According to ASAM, genetics account for about half of the likelihood that someone will develop addiction. Environmental factors will interact with an individual’s biology and affect which genetic factors are exerted. Resiliencies that individuals acquire (through parenting or other life experiences) can affect the extent to which genetic predispositions lead to addiction. Culture also plays a role.
Other Factors that contribute to addiction include:
- Cognitive and affective distortions, which impair one’s perceptions and affect one’s ability to cope with feelings
- Lack of healthy social support and problems in interpersonal relationships
- Exposure to trauma or stressors that overwhelm one’s ability to cope
- Distortion in meaning, purpose, and values that guide one’s attitude, thinking and behavior
- Distortions in a person’s connection with self, others, and a Higher Power
- Presence of a co-occurring psychiatric disorder
Characteristics of Addiction. The ABC(DE)’s of addiction
- Inability to consistently Abstain
- Impairment in Behavioral control
- Diminished recognition of the significant problems their behaviors are causing
- A dysfunctional Emotional response
More than a behavioral disorder. According to ASAM, features of addiction include one’s behaviors, thoughts, emotions, and interactions with others. This includes one’s ability to relate to family, community, their own psychological state, and a Higher Power.
Addiction as a family disease. Addiction does not just impact the individual struggling with it. Addiction impacts the whole family and other support systems. The family’s ability to function in healthy ways is changed as the family adapts to the addict’s behavior. As the addict’s condition worsens, so does that of the family. The addict is not the only one who benefits from treatment; family members should seek out their own therapeutic services and support as well.
Treatment. Due to the complex nature of addiction, and often the co-occurring psychiatric issues, finding a quality treatment program is so important. The “right type” of program for one person may not be the “right” program for another. Individualized treatment is so important when it comes to addiction because there is no “one size fits all” path to addiction or treatment. Also, getting to the root of the addiction, rather than just treating the behavior of using an addictive substance or behavior, is extremely important as well. Using an addictive substance or behavior is just a symptom of an underlying problem(s).