Why addiction is a disease & how to make recovery last

By

Ella Marcantonio

|

February 8, 2021

people hugging during recovery group showing that addiction is a disease
Addiction is serious, but lasting recovery is possible with the right support and treatment.

Some people see addiction as a weakness or personal failure, which can lead to stigmatization and shame. But here’s something many people may not know: addiction is not a character flaw or moral issue. From a scientific perspective, addiction is considered a disease. In this article, we’ll show you why that’s true and how to find lasting recovery.

For people with anxiety and depression, purposefully engaging in pleasurable activities can improve mental health.
Addiction is serious, but lasting recovery is possible with the right support and treatment.

Some people see addiction as a weakness or personal failure, which can lead to stigmatization and shame. But here’s something many people may not know: addiction is not a character flaw or moral issue. From a scientific perspective, addiction is considered a disease. In this article, we’ll show you why that’s true and how to find lasting recovery.

What is addiction?

The clinical name for addiction is substance use disorder, and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes 10 distinct substance disorders as medical conditions.

The National Institute on Drug Abuse also reports that medical professionals consider addiction to be a chronic disease.

Substance use disorders are complex biological and psychological conditions where the person with addiction loses control of substance use despite the wreckage or consequences it causes.

Why? Modern research demonstrates the brain’s involvement in addiction, and that substance use disorders, like other diseases, happen with identifiable signs and symptoms. Over time, addiction can alter your brain’s neural pathways, changing how you think and behave.

If you’re worried about your substance use, we want you to know that addiction is not your fault and that lasting recovery is a real possibility.

What makes addiction a disease?

Let’s start by looking at the definition of “disease.” Encyclopedia Britannica’s scientific definition of disease is “any harmful deviation from the normal structural or functional state of an organism, generally associated with certain signs and symptoms,” and not including physical injury. As we’ll see, addiction fits this definition well.

Addiction warps the brain of an addicted person in a harmful way that departs from the human brain’s normal structure and function. In fact, researchers have identified several parts of the brain that are physically changed by addiction, causing a recognizable set of signs and symptoms.

Because it changes the function and structure of your brain, chronic substance abuse can alter how you make decisions, exercise judgment, and practice impulse control. Many experience this as an intense craving or need to use, but it can also manifest as changes in your personality, interests, and priorities.

In other words, addiction is a disease according to the scientific definition of that word.

The changes addiction causes to the brain are long-lasting. While many people can understand poor judgment and loss of inhibition while using drugs or alcohol, not everyone is aware that these adverse effects persist even after the substances wear off.

What’s more, addiction is a chronic disease with a high relapse rate. The National Institute on Drug Abuse organization estimates that the relapse rate for addiction is anywhere from 40% – 60%.

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The cycle of addiction

If you have an addiction, you may recall the first time you drank alcohol or took a drug. Many people remember their first experience fondly. At that time, perhaps there were few consequences, and no desire to stop, even if it felt like you could.

Maybe when you first started, substances helped put you at ease and made you more comfortable or confident in otherwise uncomfortable situations. You might also have begun to use substances to cope with mental health issues like anxiety and depression—leading to an even greater risk of mental health conditions down the line.

Once you reach the point of using alcohol or drugs this way, you may no longer personally have the power to choose whether to use or not. You might finally be ready to quit but find you cannot. It’s a tragic reality for many addicted people.

This might sound deterministic, but it isn’t. Losing control is a common experience for many whose substance use has progressed over time. That being said, it’s possible to arrest the development of addiction and find lasting wellness and recovery.

If you’re having a hard time, we want you to know that you’re not alone. According to the National Survey on Drug Use and Health, more than 20 million adults in the United States are battling an addiction involving drugs or alcohol. Help is available, and we’ll show you how and where to get it below.

Dopamine and reward circuitry

So what are the changes in the addicted person’s brain that lead to this loss of control and inability to stop? More than any other neurological system, drugs impact your dopamine pathways. Dopamine is a chemical that transmits signals between different channels in the brain.

Dopamine pathways have various functions, including activating a behavior that’s inspired by a reward. A healthy brain releases dopamine when you eat something you like or get a good workout.

By releasing dopamine, the brain is signaling to you that you’ve done something right and inspiring you to take that neurologically rewarding action again.

Drugs activate the same pathways. When you take a drug, it produces a feeling of euphoria, teaching your brain that you just took an action that’s worth repeating. In the future, your brain’s circuitry changes to encourage that same behavior in hopes of getting more of what was rewarding.

And drugs are especially powerful in this way because they trigger the release of more dopamine than any natural reward, like exercise. In fact, drugs can do this at a rate many times higher than that of natural rewards. Plus, in the initial stages of addiction, using a substance can create an almost continuous release of dopamine.

Drugs are structured in a similar way to the brain’s other chemical messengers. This feature lets them bind to the brain’s cells, where they can trigger the release of dopamine at much higher levels than natural rewards.

Because of this, substances lead to the pathological hijacking of neural networks meant to reward you for taking actions intended to promote your survival and well-being.

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Signs and symptoms

Over time, the changes in your dopamine pathways create impairments in impulse control and decision making, causing the compulsion to use. This loss of control is one of the surest signs or symptoms of addiction.

Other common signs of addiction are:

  • Using when you don’t want or intend to
  • Not being able to stop once you start
  • Antisocial behavior
  • Abandoning relationships, jobs, and other things that used to be priorities
  • Taking harmful risks despite the potential consequences

Your brain adjusts to the substance as time goes on. Even though your neurocircuitry has been programmed to expect a reward when you use it, your brain will start to change its dopamine response to substances.

Diminishing rewards

As time goes on, your brain releases less dopamine, or fewer brain cells receive the chemical. When this happens, dopamine loses much of its ability to affect the brain’s reward center, reducing the pleasure you experience when you use the substance.

In other words, there’s a diminishing return on the reward you get from substances, but your brain continues to expect one.

Even though you’re not getting what you need from a substance anymore, your brain has been trained to believe it will.

For many addicts, this manifests as broken promises to “use responsibly this time” or “just have one.”

It can also look like trying to recreate the euphoria of the first experience with a drug by using more and more of it. This only worsens the difficulty and creates a greater tolerance to the drug, leading to harmful consequences, including overdose.

Recovery and treatment options

If you or someone you love is experiencing addiction, there’s help and hope available. Substance abuse treatment varies, and there’s no right option for everyone. Still, to be effective, substance abuse treatment must address how and why addiction occurs.

It’s vital to match the treatment, services needed, and behavioral interventions to the person with addiction. With the proper treatment, there’s a good chance of successful recovery.

Readiness and willingness are often important precursors for success. When a person with an addiction is willing to join a treatment program, the window of time may be small.

If you find yourself in this situation with a loved one, it’s helpful to take immediate action. The same is true if you have a window of willingness to begin your own recovery. Like other diseases, early substance abuse treatment gives you a better chance of a positive outcome.

Substance treatment takes place at facilities like inpatient and outpatient treatment centers, as well as within recovery groups that support people experiencing addiction to alcohol and drugs.

Inpatient programs

There are long- and short-term residential treatment centers often called inpatient treatment. These are programs that last several weeks to a year or more and focus on anything from detox to re-socialization.

When it comes to inpatient drug treatment programs, consider whether the program is designed to attend to a variety of needs or just addiction. Long-term inpatient facilities usually address drug use as well as other medical, psychological, social, legal, and vocational issues. If you need support in these areas, a long-term, comprehensive program might be the best bet.

According to research, most people require a minimum of 3 months to decrease considerably or completely stop drug abuse. The best treatment outcomes generally happen when you’re in treatment for longer.

It’s crucial to dedicate an adequate amount of time to your treatment. Your recovery timeline depends on the severity of your addiction and what you need to overcome it.

People in inpatient drug treatment centers often leave the program before its completion. That’s why it’s essential to find a program that keeps you fully engaged in your recovery. When you’re personally involved in your program, it’s less likely that you’ll want to leave before it’s over.

Relapse prevention is also essential since relapse following treatment is common, but it isn’t the rule. Recovery experts can help you understand the signs of relapse, so you can adjust your support as needed. If you do relapse, it’s crucial to restart treatment as soon as possible. You may also find you need to change your recovery plan to get more support.

Once you’ve completed your inpatient program, you’re encouraged to attend ongoing aftercare and relapse prevention groups, as well as recovery groups like Narcotics Anonymous (NA)Alcoholics Anonymous (AA)Life Ring, and others.

Outpatient treatment programs

Outpatient programs offer non-residential treatment that usually consists of group meetings, drug and alcohol education, individual meetings with counselors and therapists, and sometimes medication and assistance with other health concerns.

Intensive outpatient programs can offer treatment and effectiveness that’s comparable to inpatient treatment. But some low-intensity outpatient programs report high relapse rates.

Recovery groups

Often, inpatient and outpatient programs require you to attend meetings outside of the facility. These are recovery programs like NAAALife RingWomen for Sobriety, and Moderation Management (MM) that are not affiliated with treatment centers. These groups are often donation-based, providing an affordable, accessible approach to treatment.

These programs work by encouraging members to form sober networks while making an effort to stabilize and maintain their own sobriety.

Members support one another when they’re facing possible stressful situations, decreasing the possibility of relapse.

There’s often guidance for people in the beginning stages of the program that’s provided by someone who has many years in recovery. Longtime members offer hope, support, and insight for people who are just getting started.

Alcoholics Anonymous

Founded in 1935, Alcoholics Anonymous is the original 12-step recovery program. All 12-step programs rely on the process of taking steps to cultivate a relationship with a personal higher power in order to overcome addiction.

It’s not required to adhere to a specific religion, and the program emphasizes that the higher power can be of one that you choose. AA is an abstinence-based program.

Members of AA are supported in this effort by attending meetings, working one-on-one with other sober alcoholics, and doing service to both the group and the wider world.

Alcoholics Anonymous does not employ counselors, therapists, or other mental health professionals, although mental health professionals may themselves be members of the groups. The recovering members of the program form its fellowship. AA is “non-professional,” though the organization may employ special workers at its service centers.

Narcotics Anonymous

Around since the early 1950s, Narcotics Anonymous is a 12-step program similar to Alcoholics Anonymous—but instead of alcohol, this program focuses on narcotics. It’s a nonprofit organization that supports people who are addicted to all types of drugs, including alcohol.

To this end, the organization focuses on what an addict needs to do to overcome addiction, namely completing the 12 steps and forming a relationship with a higher power of their understanding.

When joining the program, members are encouraged to practice complete abstinence from drugs. Narcotics Anonymous does not hire professional counselors, nor does it provide medical services.

Life Ring

Life Ring is a secular recovery program focused on an individual’s personal power. The organization believes that people can manage their own addiction. According to this organization, every human has an “Addict Self” in addition to a “Sober Self.”

When an addict enters the Life Ring treatment program, counselors work to weaken the “Addict Self” and strengthen the “Sober Self.” Instead of turning to a higher power, counselors focus on ways for people to find their own strength and control.

Women for Sobriety

This is an example of a program geared toward a specific demographic. It’s a self-help program designed to support women with alcohol addiction. It focuses on minimizing negative thought patterns and destructive behaviors to help women gain greater health and happiness.

Moderation Management

Modern management is a different kind of treatment program because it offers a pathway to address substance abuse without requiring members to commit to complete abstinence. If members try the moderation approach, and it doesn’t work for them, MM can also support abstinence. Per the website, approximately 30% of MM members choose the abstinence path.

The program is set up to target alcoholism in its early stages. If you notice that alcohol is becoming an issue, the program can help you establish a more balanced lifestyle that may include alcohol.

Outlook

Although addiction to alcohol and drugs is a serious condition, recovery is possible. There are many different treatment options, and those who follow through on recovery can go on to lead sober, fulfilling lives.

If you or someone you love is experiencing an addiction, there is hope and help available. Visit SAMHSA or call (800) 662-HELP (4357) to learn more.

Takeaway

  • Addiction causes changes to the brain’s function and structure and is associated with a common group of signs and symptoms.
  • From a scientific perspective, this fits within the definition of a “disease.”
  • While substance use disorders are serious, many people recover with the right treatment, including inpatient, outpatient, and recovery groups.
  • Recovery organizations like Alcoholics Anonymous, Narcotics Anonymous, Life Ring, Women for Sobriety, and Moderation Management offer support to people with addiction.
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By

Ella Marcantonio

|

February 8, 2021

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