Let’s start with the basics. The definition of addiction according to National Institute of Drug Abuse is a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. If this sounds like a bit much to you, that’s because it is. It is a serious brain disease that no one ever chooses to have. What is a disease? A condition that impairs normal functioning and is typically manifested by distinguishing signs and symptoms. Does this sound like addiction to you? It sure does to me.
Lessening the stigma around addiction is important to me. We can start that by simply changing the language and call it what it truly is—substance use disorder. Substances can be alcohol, medication, legal or illegal drugs, and nicotine. The main components highlighted in diagnosis of a SUD is the inability to stop use, especially when there are harmful consequences and a negative impact on daily functioning and relationships. Can I drive after using? Can I have a meaningful connection/conversation with a loved one while high? Can I take care of my job and/or children while under the influence? Can I stop using it without withdrawal symptoms? Are there certain negative behaviors that come from using? Asking these questions are important.
Over 27 million people in the United States have at least one SUD. About 20% of those with anxiety or depression also have a co-occurring SUD. These numbers are only the ones reported and diagnosed. It is my clinical impression that the actual numbers of individuals with SUD are much higher and continues to increase since the Covid pandemic in 2020.
So, what causes this disease? I am glad you asked because I have no clue. BUT I have read tons of research and have immersed myself in the recovery community to understand it well enough to write about it. There are many factors that play a role in someone suffering with a SUD like genetics, family history, and environment. Known risk factors are adverse childhood experiences, trauma, experimenting at an early age, poverty, exposure to alcohol/drugs as a child, and peer pressure. Genes play a large role in developing a SUD, especially when a first degree relative (parent or sibling) has it. There are over 400 different gene clusters that contribute to an individual developing a SUD and there continues to be tons of research being developed. Adverse childhood experiences like emotional or physical neglect, verbal, sexual or emotional abuse, witnessing violence, parental divorce, a close family member with SUD all increase the chances of developing the disease.
Let’s get brainy for a minute! SUD develop when pleasure circuits in the brain get dysregulated. The reward system part of our brain gives us pleasure after eating, exercising, engaging in pleasurable activities by triggering a dopamine release. The brain will remember this and want to engage in those activities again and again (this is a good thing). Alcohol, nicotine, drugs flood our brain with 10 times as much dopamine (Yale Medicine). Soon, the brain’s circuit will adapt to these high levels of the chemicals and need it more and more. Eventually the repetitive use creates a habit and chemical dependency, so using is NOT made by conscious and logical decision. This is so very important in understanding SUD, especially if someone you love has been diagnosed with it. At a certain point, the new overinfluenced and adapted brain just magically MAKES a person want to use and do anything to use, without the person even making a choice. Crazy huh?! I think so.
If you struggle with SUD or know someone who does, I want to tell you that there is hope. You are not alone… 20 million adults in the USA are in recovery. Substance use disorders have been so stigmatized and looked at as a lifestyle choice rather than a disease. Unfortunately, anyone can become addicted to drugs or alcohol. You did not cause it. You cannot control it. But you can choose to change it with patience, persistence, and perseverance. Talk to someone about it or call a therapist. Here are common ways to get in recovery:
Evidence/Science Based Treatment Centers
Alcoholics Anonymous (AA)
Self-Management and Recovery Training (SMART)
Secular Organizations for Sobriety (SOS)
LifeRing
Women for Sobriety (WFS)
SAMHSA National Helpline (confidential and free) 1-800-662-4357
Thank you for taking your time to read this blog. I hope you learned something new, if you did, please share with someone. Check out our next blog which will be about process addictions.
Pam