What is Addiction?
The American Society of Addiction Medicine defines addiction as “…a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”
We have two primary parts of the brain that are involved in the disease of addiction. They are the midbrain, and the prefrontal cortex. In short, the midbrain controls our survival responses, memory, and motivation. We cannot consciously control our midbrains. If a person was crossing the street and a car is speeding toward them, they would move out of the way to stay safe from the danger. They do this in a split second, without needing to think through it, because the midbrain quickly senses the danger in the environment and sends the message to move out of the way for survival. The prefrontal cortex is where we make all our decisions. We can consciously control this part of the brain. So, after the person is safe from the danger of the vehicle coming toward them the prefrontal cortex sends the message that it was a good idea to move out of the way from the vehicle and they should remember that walking in the street can be dangerous.
The main function of the brain is to be a contrast detector for our environment. The brain maintains a constant threshold, called homeostasis, from which it compares all things in our environment. A good example of this is our body temperature. When a person gets too hot, the brain tells the body to sweat. When the body is too cold, the brain tells it to shiver. Drugs and alcohol take over this contrast detector for pleasure, and it does so via the release of dopamine.
Dopamine is a chemical in the brain that sends the message that something in our environment is important for survival. For example: drinking a glass of ice-cold water on a hot day when you are parched is a pleasurable experience. Dopamine is released in the midbrain to point this out and our pre-frontal cortex tells us to do it again the next time we get thirsty.
When drugs and alcohol are used to manage stress, they release dopamine at levels far greater than that glass of cold water on a hot day. This excess dopamine release in the midbrain and the relief from the stress sends the message that the drugs are especially important for surviving stressful situations, though in reality they are not. The prefrontal cortex then remembers this for the next time a stressful situation occurs. With repeated use overtime the threshold for what is perceived as important for survival of stressful situations rises, and the brain places use of the drug as the most important activity for survival. Now other important survival behaviors such as eating regular meals, getting enough sleep, or paying the bills don’t seem as important as they used to when compared to using the drug.
It is not all doom and gloom. The American Society of Addiction Medicine also states that “prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.” In substance use disorder treatment the general aim is to help people addicted to drugs and alcohol do two things: increase their ability to manage and decrease craving by giving them tangible skills, and to cultivate the development of things more meaningful than the substance and replace the substance with these.
If you or a loved one is struggling with substance use and want to seek treatment, please visit the treatment tab on this site for a list of community substance use treatment providers.
Sources:
The American Society of Addiction Medicine. What is the Definition of Addiction?. September 15, 2019. https://www.asam.org/quality-care/definition-of-addiction.
McCauley, K. (Director). 2009. Pleasure Unwoven: An Explanation of the Brain Disease of Addiction [Film]. Institute for Addiction Study.
Grisel, J. (2019). Brain Food. In Never Enough: The Neuroscience and Experience of Addiction (pp. 19–33). Doubleday.
What is Addiction?
Presentation from Regional Recovery Day, October 2024, by Dr. Andreas Bienert
Potential Signs of Opioid Addiction/Opioid Use Disorder
- Apathy
- Borrowing money with no explanation of why and not returning it
- Burnt spoons
- Change in friendships
- Change in sleep habits
- Change in exercise habits and/or energy level
- Changes in work habits: excessive absences and missed deadlines
- Complaints of nausea
- Covering arms with long sleeves
- Dark, sticky residue
- Decreased libido
- Depressions
- Drowsiness
- Euphoria
- Flushed skin
- Frequent flu-like symptoms: including vomiting, diarrhea, nausea
- Impaired coordination and concentration
- Lack of good hygiene
- Loss of interest in activities that were previously enjoyable
- Loss of relationships/friendships
- Mood swings
- Overspending
- Rubber tubing
- Runny nose
- Scratching
- Sleepy eyes
- Slow breathing
- Slowed reflexes
- Slurred speech
- Small glass pipes
- Syringes
- Tan or whitish powdery residue
- Tendency to nod off
- Theft and other behaviors to get money for drugs
- Tiny baggies
- Tiny pupils
- Weight loss