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What is Addiction?

Addiction, or a substance use disorder, is a long term chronic illness of the brain that is much like having asthma or diabetes. It is characterized by a compulsive use of a substance accompanied by negative consequences, and it can affect anyone: rich or poor, male or female, employed or unemployed, young or old, and any race or ethnicity.

In fact, according to the U.S. Surgeon General's recently released report, over 20 million people have substance use disorders, and 12.5 million Americans reported misusing prescription pain relievers in the past year. Seventy-eight people die every day in the United States from an opioid overdose, and these numbers have nearly quadrupled since 1999.

Many mistakenly believe addiction is a choice or moral failing, but today, this type of thought process has begun to be reversed. The Surgeon General's report called for "a cultural shift in how we think about addiction." He acknowledged that stigma has created an added burden of shame and has made people with substance use disorders less likely to come forward and seek help. He said: "addiction should be approached with the same skill and compassion with which we approach heart disease, diabetes, and cancer."

Nobody knows the exact cause of a substance use disorder, but it's a combination of genetics, a person’s environment, psychological traits, and stress level.

Researchers have found that using drugs for a long time changes the brain in significant and lasting ways. People who start using drugs or alcohol early in life run a greater risk of developing substance use disorders. These changes in the brain remain long after a person stops using drugs or drinking alcohol.

Drugs affect the brain's communication system by:

  • 'Fooling' the brain's receptors through imitating naturally occurring chemical messengers and activating nerve cells to send abnormal messages; or
  • Overstimulating the reward system and producing euphoric effects in response to psychoactive drugs. This reaction sets in motion a reinforcing pattern that "teaches" people to repeat the rewarding behavior of abusing drugs.

As a person continues to abuse their substance of choice, the brain adapts and it reduces the person's ability to enjoy not only the drugs/alcohol but also other events in life that previously brought pleasure. This decrease causes the addicted person to keep abusing drugs in an attempt to get back to normal, but now larger amounts of the drug are required to achieve the same high—an effect known as tolerance.

Long-term abuse can impair cognitive functioning. Brain imaging studies of individuals with substance use disorders show changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. These changes can drive a person to seek out and take drugs or drink compulsively despite adverse, even devastating consequences.

Signs of a substance use disorder include:

  1. Denial – Continued use despite receiving negative consequences. Denial is a distortion of reality that has the person believing "everything is ok"
  2. Tolerance – A person will need increasingly larger amounts of alcohol or drugs to reach the desired effect
  3. Craving – Strong need, desire, or urge to use alcohol or drugs. A person will use despite negative consequences, and will feel anxious and irritable if he or she can’t use them
  4. Loss of control – A person will often drink more or use more drugs than they meant to, or may use at a time or place they had not intended to. A person may also attempt to reduce or stop drinking or using drugs many times, but may be unsuccessful
  5. Withdrawal – Symptoms differ depending on the drug, but they may include nausea, sweating, shakiness, and extreme anxiety. The person may try to relieve these symptoms by taking more of the same substance or a similar substance

Although your family member has an illness, it does not excuse the negative behaviors that often accompany it. Your loved one is not at fault for having a disease, but he or she is responsible for getting treatment for their illness. For information on what to do when your loved one refuses treatment, visit our blog here.

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