Understanding & Defining Addiction
Addiction begins where casual use ends.
While a casual drug user can control their abuse and doesn’t depend on using to feel normal, an addict is the exact opposite. Using has become so ingrained in their patterns of behavior and changed their brain chemistry so fundamentally that they essentially become powerless to kick their habit. And it's this lack of control and physical brain changes that make addiction an actual disease.
Despite what many people believe, addiction isn’t just about physical dependency. Sure, being physically dependent on a drug (as defined by tolerance and withdrawals) can make it more likely that you’ll become addicted but there’s more to it than that. Instead, it’s also about what’s going on in the mind as well as the body.
One of the best definitions of addiction that takes a closer look at how the mind is affected is from NIDA:
Addiction is defined as 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 brain—they change its structure and how it works. These brain changes can be long-lasting and can lead to the harmful behaviors seen in people who abuse drugs.
There are three main points about addiction to take away from this definition: it's chronic and relapsing, it’s characterized by compulsive behaviors, and it leads to harmful consequences.
Let's take a closer look at what each of these points really means and how they differ from casual drug use.
Chronic & Relapsing – One aspect that separates addiction from casual drug use is the fact that addiction is often chronic and relapsing. For most addicts, relapse is a fact of life. Experts estimate that most recovering addicts only have a 40 to 60% chance of staying clean after quitting.
Casual drug users, on the other hand, aren’t nearly as compelled to turn back to drugs as addicts. They may, for example, be able to use coke or marijuana just a few times and not even think about it again for years.
Compulsive Behaviors – This is one of the hallmarks of this disease. When someone becomes clinically addicted to a substance, their brain changes on a physical level. And those changes make it near impossible to maintain self-control when it comes to drug use. They’re powerless in the face of cravings and, in a sense, they don’t really even have a choice in whether or not to use again.
For a casual drug user, they decide to get high or use a drug recreationally. And while they may prefer one outcome over another, they may still decide not to use again. And being able to make that choice is often the deciding factor in whether or not someone’s addicted.
Harmful Consequences – Last but not least, addiction leads to harmful consequences and negative impacts on an addict’s life. Maybe they start having serious run-ins with the law because of their drug use. Or maybe they’re alienating friends and family. Or perhaps they put their safety or the safety of others in jeopardy. But despite all of these obvious pitfalls, they still keep using.
Casual drug users, however, are able to stop their drug abuse when it becomes a serious problem in their life. And they’re also less likely to get high at inappropriate or dangerous times like when they’re at work or before driving a car.
When you abuse a psychoactive substance, it causes a surge in the "feel good" chemicals of the brain like dopamine. Normally, this chemical is released naturally by actions like eating a good meal, exercising, or having sex. But when it comes to substance abuse, drugs hijack your brain’s natural systems and cause an enormous amount of dopamine to be released almost instantly.
In fact, some drugs have even been shown to release as much as 10 times the amount of dopamine as any natural behavior.
And as your drug use becomes more and more frequent, the body and the brain begin to adapt. Certain cell receptors grow and die off, special chemicals become stronger or weaker, and in the end, these changes make the euphoria from the drug less powerful than before. And that makes you need to take more to feel that same kind of high.
So, you end up using more of the drug more often to chase that same high.
After enough drug use, the mind stops producing dopamine at the same levels it used to. And that makes everything else a lot duller. Old hobbies that brought you joy before just don’t seem as enjoyable. Social outings aren’t as interesting. Even food and sex may become less pleasurable as a result.
Beyond that, dopamine is also one of the brain’s main chemicals used for learning. And as it becomes harder and harder to create dopamine on your own, the brain starts craving the best source of it – using drugs.
The brain of an addict has become so dependent on drugs that it is wholly unable to function normally without them. And eventually, someone suffering from addiction will lose all control and will start using compulsively – whether they like it or not.
Unfortunately, one of the most common characteristics among addicts is a tendency to deny that they have a problem at all. In fact, the National Survey on Drug Use and Health found that among the 6 million Americans that needed treatment but didn’t receive it, a whopping 93.3% of them (about 5.6 million people) didn’t think they had a problem in the first place.
And part of that has to do with the fact that there is an enormous stigma attached to addiction.
In the eyes of many people, addicts are simply unable to hold back from giving into their basest desires. They’re devoid of willpower, only care about themselves, and will do anything (including hurting the people they love) just to get high.
Obviously, this view of addiction is far from the truth of the matter. As we’ve seen, addicts have little control over their own actions because of the physical changes that have occurred in their brain. And even when they do want to give up their substance abuse (and many do), they’re often simply incapable of doing so on their own.
And yet, an unnerving number of people still believe that addiction is a choice. As a result, they think that a substance abuse problem is something to be ashamed of. And that can make it harder for any addict to come to terms with their disorder and finally get the help they need to recover.
That’s why it’s so important to know how to recognize the signs of addiction before it’s too late.