Is Addiction a Disease?

A Brief History

Although it is now widely accepted by the American Medical Association and the American Society of Medicine that addiction is in fact a disease, this understanding has not always been the case. At one time (and still today to some extent) a stigma around addiction exists, and there are those who believe that addiction signifies nothing but poor choices and a lack of character.

However advances in technology have rapidly shaped our present view of addiction, and point towards an educated understanding of addiction as a disease of the brain, just as there are diseases of the heart and kidney. This framework of viewing addictive behaviors considers both genetic and environmental factors in the role that they play in their contribution and perpetuation of addictive cycles in families and in society as a whole.

Defining Addiction

Due to its vast reaches and complexities, it can be difficult to settle upon a common definition for addiction that spans all levels of impairment and contexts. However in 2016, Volkow, Koob, and McLellan suggested three primary characteristics of addiction:

  1. Desensitization of the reward circuits of the brain that allow us to feel pleasure and motivation which eventually leads to needing the drug/ behavior to feel “well”
  2. Increased conditioned responses to turn to the vice when experiencing stress in our environment or a range of other emotions, which leads to increased experiences of cravings
  3. Declining functions of brain regions that facilitate decision making, impulse control, and self regulation that leads to repeated relapse

When taken into consideration, it is not difficult to see the cards stacking up against an addict who does truly want to get better, and the ways that their brain is actively working against them.

Changes in the Brain

Scientists have long studied the effects of Dopamine, the neurotransmitter responsible for flooding the system with a pleasurable response when someone is in the midst of their “high” from engaging with their desired drug. However, this is the same neurotransmitter to blame for the consequence defined in the first characteristic listed above. Slowly, an erosion of the individual’s ability to feel pleasure while completing any other task occurs, as the body comes to rely on the drug to provide the dopamine“fix”.

Specific dopamine receptors have additionally been linked with the task of creating motivation to deny instant gratification from a stimulus, and to work towards a rigorous, but more rewarding end. These too, are subject to the laws of supply and demand, and once the outside supply stops, the body has already adapted to no longer produce its own dopamine, and these crucial functions remain lacking.

But Isn’t it their Choice?

It may seem easy to point the finger all the way back to someone’s first experience with their addictive habit and argue that their initial choice to solve their problems in that particular way was the first in a string of dominoes that led them to today. However, many biological, genetic, and environmental factors are at play in determining one’s unique susceptibility towards addictive patterns.

Factors making someone more at-risk for falling prey to addiction initially, continuing in their use, and their resulting brain chemistry consists of things largely out of their control, including family history, early exposure to drug use, exposure to high-risk environments, and co-occurring mental disorders.

Under this logic, where you grew up (high socially stressful environments, or where there is easy access to drugs) and how you grew up (unsupportive parenting practices, permissive attitudes towards substance use) have much greater influence on one’s vulnerability. Culminating in the decision to turn to addictive substances or behaviors is much less a one-time judgement, and more like a series of generational choices leading to the moment of decision.

Overcoming Addiction

At Riviera Recovery, we understand that addiction is a disease like any other, and requires specialized and informed approaches to treating it. We have the knowledge and expertise to help if you or a loved one is struggling with an addiction. Call us at today 1-866-478-8799 to get connected to the support you need.

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