The American Society of Addiction Medicine defines addiction as follows:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.
It affects neurotransmission and interactions within reward structures of the brain. Addiction also affects neurotransmission and interactions between cortical and hippocampal circuits in reference to brain reward structures. The memory of previous exposures to rewards such as food, sex, drugs, leads to a biological and behavioral response to external cues.
According to the National Institute of Drug Abuse, all mind altering, illicit or prescription drugs directly or indirectly increase the dopamine levels in the brain. This can alter the normal communication between the neurons and results in the brain sending false information regarding the need for dopamine. Thus, the addiction is created and the triggers of cravings and self destructive behavior patterns begin.
Brain scans of individuals reveal how addiction affects and changes the parts of the brain that are responsible for decision making, learning and memory and behavioral control. (1) As one may guess, the clinical research is much more in depth and somewhat confusing regarding the actual structures, reactions and chemical processes that occur when substances are introduced. For the individual suffering from addiction, the critical point is this is a brain disease or disorder and must be treated like any other chronic illness.
Historically, addiction was thought to be an issue of lack of will power or moral fortitude. This has led to many decades of addicted persons being vilified and shamed over their inability to control their disease by determination alone. The lack of understanding of the etiology of the disease led to loss of support systems, which we now know is critical to successful treatment and relapse prevention. This has also contributed to the criminalization of addiction and lack of funding in regards to a public health issue.
Even in our current society where attitudes regarding various social issues are certainly changing, many persons are reluctant to admit to having an addiction for fear of reprisals on the workplace, changed relationships with peers, and loss of family. Addicts often experience guilt and remorse over their actions and feel their lives have become hopeless.
Experts and researchers are unsure of the ultimate causes of addiction and scientists estimate that approximately forty to sixty percent of addicted individuals may have a genetic component that predisposed them to develop the disease. This is an area that is undergoing extensive study by both public and private entities. The studies are focusing on physiological reactions in the brain and tend to support both genetic and developmental causes.(2)
Other factors may include, but are not limited to the following:
- Environmental factors such as family values and experiences
- Exposure to experimental drug use at an early age
- Severe Trauma or Abuse
- Long term use of medications for chronic pain
- Developmental Disorders and Mental Health Disorders
(National Institute on Drug Abuse, 2010)
It is an obvious conclusion that no one uses a drug or substance with the anticipated end result of becoming addicted. Many people experiment in a social setting; others use substances to enhance experiences such as sex, athletics and everyday life. It is also a well known fact that many persons suffering from mental health issues often self medicate with drugs. Once this occurs, it is often difficult to implement a cohesive treatment plan as many mental health medications can be addictive and serve as a trigger for the chemical dependency
In a 2009 survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) over 23.5 million persons over the age of 12 received treatment services for addiction.
That there are many more addicted individuals who did not seek treatment is not in question.
Many persons suffering from addiction are already at a disadvantage due to unemployment, homelessness and lack of a support system.
Subsequent to the economic recession in 2008, it is well known that many states and localities have experienced severe cuts in funding for health and behavioral services. This has led to a void in which only those with sufficient resources or private insurance can easily access addiction treatment. Local Community Services Boards, which offer services based on income, generally have extensive waiting lists which is counterproductive to the concept of addiction treatment.
As of 2010 roughly 2.3 million persons were incarcerated in the prison system. Of these 2.3 million, approximately 50%, or a staggering 1.65 million persons were convicted of previous or have a current addiction to drugs. As can be expected, there is generally minimal treatment available in the prison system other than a few drug education classes.(3)
What becomes painfully clear is addiction is a chronic, debilitating and dangerous brain disease. It has a causal relationship with the transmission of blood borne diseases such as HIV and Hepatitis C and severe injury or death from motor vehicle accidents. It also can lead to criminal activity and incarceration.
The most important thing to take from this article is to seek treatment from addiction as soon as possible. I once heard it said from a long term addict in recovery ” shame kills more addicts than the drugs themselves.”
Citations:
- 1 Nora D. Volkow, M.D. Director of National Institute of Drug Abuse, 2010
- 2 Fowler JS, Volkow ND, Kassed CA, Chang L :Imaging the Addicted Brain; Sci. Pract. Perspect 4/16/07
- 3 Mary Carmichael, The Case for Treating Drug Addicts in Prison; Newsweek, 6/29/10
