Substance abuse costs Americans more than $700 billion a year in increased health care costs, crime, and lost productivity. Furthermore, it contributes to the deaths of almost 100,000 citizens, tens of thousands of those from accidental overdoses. Drug addiction is so prevalent in our society, it behooves all of us to understand this enemy of prosperity.
According to the National Institute on Drug Abuse, the drug addiction definition is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the structure of the brain and how it works. These changes can be long-lasting and can lead to harmful, often self-destructive, behavior.
Drug Addiction Anatomy
All drugs, alcohol included, disrupt the brain’s reward system. Most addictive drugs flood the circuit with dopamine, 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.
Long-term usage can cause changes that influence the brain’s ability to function, affecting areas that tie to decision-making, memory, learning, and control of behavior.
Drug Abuse vs. Drug Addiction
Substance abuse is the act of either (a) using illegal drugs, or (b) inappropriate use of legal drugs. The latter includes taking prescription medications for recreational purposes such as pleasure, relaxation or altering of reality, using someone else’s prescription, and alternate forms of ingestion, such as crushing and snorting tablets meant for the user to take orally.
Drug addiction occurs when a person cannot control the impulse to use drugs despite adverse consequences—the defining characteristic of addiction. This behavioral change is accompanied by changes in brain functioning, especially in the natural inhibition and reward centers. At this point, drug addiction is a disease.
Dependence vs. Addiction
Physical dependence may occur with regular use or abuse (usually daily) of any substance, whether legal or illegal. It occurs as a result of the body’s adaptation to daily exposure to a substance, resulting in withdrawal symptoms when it is taken away because the body has to re-adapt. It can lead to a craving for the substance to relieve those symptoms.
Addiction will include this physical dependence factor, but there are additional factors, usually psychological.
The Diagnostic and Statistical Manual (DSM) lists impairment or distress factors indicating a substance use disorder when occurring within a 12-month period:
- Taking the substance in larger amounts or for a longer period than intended
- Unsuccessful efforts/persistent desire to reduce use of the substance
- Significant time spent in obtaining the substance or recovering from its effects
- Powerful desire or urge to use the substance (cravings)
- Failure to fulfill obligations as a result of use of the substance
- Continuing to use the substance despite its creating or contributing to social or interpersonal problems
- Abandonment of activities previously held as important
- Recurrent use of the drug in situations in which it is physically hazardous
- Continuing use despite knowing it is harming one physically or psychologically
- Withdrawal symptoms
Addiction is a chronic disease, similar to diabetes and asthma, which also have both physiological and behavioral components. Treatment is possible, and there are many options.
The treatment center must tailor an individual program for each client. Per Wickstrom, himself a recovered addict, founded several treatment centers to help others find their way to rehabilitation.
Note that a relapse does not mean treatment has failed. As with any chronic disease, treatment involves changing deeply imbedded behaviors. Lapses indicate that the client may need an alternative treatment program or need to adjust their current treatment.