Is Addiction Really a Disease?
In This Article
What is Drug Addiction?
Drug addiction is a term used to describe a physical and/or emotional dependence on drugs.
According to the American Psychiatric Association (APA), the medical community no longer uses this term. They use “substance use disorder (SUD)” instead. Addiction or SUD both describe compulsive and habitual use of a substance.
Addiction encompasses all types of substances, including prescription and illicit drugs, alcohol, nicotine, and marijuana. People addicted to these substances continue using the substance regardless of the harm it causes to their health and in their lives.
Addiction can begin in a variety of different ways. Some people experiment with substances, using them recreationally in social situations. Others receive a prescription for a legitimate medical purpose, only to develop a long-term addiction to the drug.
People with substance use disorder need more and more of their drug of choice to achieve the same effect. Many need the drug just to function in their normal lives. Many attempts to stop using the drug but cannot without professional addiction treatment.
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Is Alcohol Considered a Drug?
The official definition of a drug is “a medicine or other substance which has a physiological effect when ingested or otherwise introduced into the body.”
The medical community and others recognize alcohol as a drug. It’s legal and its use is widely accepted, but it is highly addictive and changes a person’s physiology and consciousness.
Alcohol is physically addictive and causes severe and potentially deadly withdrawal symptoms for addicted people. People withdrawing from heavy alcohol use often experience chills, nausea, vomiting, delusions, seizures, and hallucinations.
Is Drug Addiction a Brain Disease?
Drug addiction is a brain disorder. It alters the areas of the brain involved in stress, reward, and self-control. These changes can last a lifetime, even after someone stops using the drug.
Addiction is a disease and it is very similar to other diseases. All disease disrupts the normal and healthy functioning of the body. They damage organs, cause severe side effects, and are preventable and treatable. Left untreated, drug addiction and other diseases are potentially fatal.
How Addiction Changes the Brain
Addiction affects the brain in different ways. For example, these brain changes include:
Substance use develops into an addiction thanks to activity occurring in the prefrontal cortex and the nucleus accumbens under the cerebral cortex.
Drug use causes the release of up to 10 times the normal amount of the neurotransmitter dopamine in the nucleus accumbens. The prefrontal cortex motivates someone to repeat pleasure activities.
Ongoing drug use causes the body to adjust to elevated levels of dopamine, while also causing the brain to rely on the drug for the release of dopamine.
Over time, a user develops drug tolerance. Their body and brain cannot function normally after adjusting to the dopamine change the drug causes in their brain.
Drug addiction also shrinks and weakens the ACC portion of the brain. This is the section that links thoughts and behaviors to pain and conflict.
A healthy person’s brain evaluates the risks of certain actions and links them to the pain that action causes. Substance use makes it difficult for people to understand the link between their behavior and how they feel.
Changes in the ACC region also affect how deeply a person feels pain, so they are more likely to turn to the drug to numb their feelings.
Why Do Some People Claim Addiction is Not a Disease?
Despite the consensus in the addiction treatment and medical community, some people do not consider addiction a disease. Their claim is based on several factors about addiction, including:
- It is not contagious or transmissible
- It is not hereditary, though many argue that addiction is linked to genetics and therefore is hereditary
- It is not degenerative
- It is not caused by autoimmune issues
- It is self-acquired
The general belief among those who do not view addiction as a disease is that, unlike other conditions that are accepted as diseases, people have a choice whether or not to use a drug.
The majority of people in the medical community do not believe a person with substance use disorder chooses to use their drug of choice.
What are the Signs of Addiction?
There are many signs of addiction. A person need not have them all to have substance use disorder.
Signs of addiction include:
- Ensuring a supply of the drug of choice, regardless of the consequences
- Neglecting careers, school, family, and social obligations and responsibilities
- Using the drug despite the problems it causes in one’s life or with one’s health
- Investing a great deal of time and money in getting the drug
- Failing to stop using the drug despite wanting to and experiencing harmful consequences from use
- Experiencing withdrawal symptoms when not using the drug
- Needing more and more of the drug to achieve the same result
- Using more of the drug than intended
People addicted to drugs experiences physical symptoms, including
- Weight gain or loss
- Itching skin
- Dental health issues
- General poor health
People with a drug addiction have intense urges or cravings to use their drug of choice. Their focus is entirely on obtaining the drug and their thoughts are consumed by their addiction.
People addicted to drugs engage in risky behavior or doing things they would not do when not under the influence of the drug. They also tend to be secretive and shut family members and loved ones out of their lives.
Someone addicted to drugs might abandon old friends and begin spending time with new friends. They often miss school or work and lack interest in activities they once enjoyed.
What Causes Drug Addiction?
The exact cause of drug addiction varies from person to person. There are both environmental and genetic factors.
The most common risk factors include:
- Family history of addiction
- Mental health disorder
- Peer pressure
- Lack of family involvement
- Early use
- Willingness to experiment with highly addictive drugs
The Most Commonly Abused Substances
A person can abuse or be addicted to just about any substance, but some things carry a greater risk of addiction than others.
Some of the most commonly abused drugs include:
- Opioids: heroin, morphine, codeine, methadone, oxycodone
- Inhalants: glue, correction fluid (White Out), felt tip markers, paint thinner, household cleaners, aerosol products
- Hallucinogens: phencyclidine (PCP), lysergic acid diethylamide (LSD)
- Club drugs: Flunitrazepam (Rohypnol or “roofies”), ecstasy, MDMA (molly), gamma-hydroxybutyric acid (GHB), ketamine
- Stimulants: methamphetamine (meth), amphetamine, cocaine, Adderall, Ritalin
- Sedatives: barbiturates, benzodiazepines, and hypnotics
Is an Addicted Person Responsible for Their Actions?
Beliefs about this vary. The vast majority of the addiction treatment and health care community views addiction as a disease.
However, even among those who view addiction as a chronic disease, most would agree that a person with a substance use disorder has some responsibility for his or her actions. They might not have full control over their addiction, but when sober, they can make certain choices to reduce their risk of relapse.
Some of the theories in the addiction community about personal responsibility include:
This model says that people are responsible for creating and solving their problems. A person with a substance use disorder should accept responsibility for their actions and fix their addiction. This describes an internal locus of control.
This model says that a person with a substance use disorder has no responsibility for their addiction. Addiction is a medical issue – a disease – and requires guidance from experts to control. Nobody should feel guilty about their addiction. This describes an external locus of control.
This model says that a person with a substance use disorder is responsible for creating their problems, but not responsible for solving them. A person must rely on an outside source to manage their addiction. This describes an external locus of control.
This model says that a person with a substance use disorder is not responsible for their addiction, but they are responsible for fixing it. The focus is on self-reliance, recognizing personal limitations, and seeking help when needed. This describes an inner locus of control.
Can Someone Overcome Addiction Alone?
Rarely. In some cases, someone could overcome addiction without medical intervention or the support of others. However, it’s highly unlikely and one shouldn’t expect to do this or feel as if they are a failure if they cannot manage their addiction alone.
In almost every case, a person with a substance use disorder needs professional treatment. As strong and determined as someone might feel, willpower is rarely enough to overcome an addiction.
This isn’t to say willpower plays no role in addiction recovery. It might be the factor that leads you to seek treatment. But even if someone lacks willpower or loses willpower over time, certain therapies like cognitive-behavioral therapy (CBT) will help them cope with and manage their addiction.
Willpower also helps people make lifestyle changes that reduce their risk of relapse. It’s like any illness: making healthy lifestyle choices won’t eliminate your risk of developing cancer, but in many cases, it does reduce that risk.
The same is true for addiction. Willpower alone is not enough, but it doesn’t hurt.
How to Help: Treatment for Drug & Alcohol Addiction
Anyone who tries to limit alcohol consumption or stop it entirely without success should consider treatment.
If drug or alcohol use has interfered with your everyday life, you’ve prioritized substance use over other things in your life, or you’ve tried to stop using a substance and could not, treatment can help.
Addiction treatment services are available in a variety of forms, including:
- Inpatient/residential treatment programs
- Outpatient treatment centers
- 12-step groups
- Individual and family counseling
- Medication-assisted treatment
Call to find out how much your insurance will cover
- Mayo Clinic. “Drug Addiction (Substance Use Disorder) - Symptoms and Causes.” Mayo Clinic, 26 Oct. 2017, https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112.
- National Institute on Drug Abuse. “If Your Teen or Young Adult Has a Problem with Drugs.” National Institute on Drug Abuse, 18 Oct. 2019, https://nida.nih.gov/publications/step-by-step-guides-to-finding-treatment-drug-use-disorders/if-your-teen-or-young-adult-has-problem-drugs.
- National Institute on Drug Abuse. “Drug Misuse and Addiction.” Drugabuse.gov, 2018, https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction.
- “Treatment of Stimulant Use Disorders.” Www.samhsa.gov, https://www.samhsa.gov/resource/ebp/treatment-stimulant-use-disorders.
- National Institute on Drug Abuse. “Summary of Misuse of Prescription Drugs.” National Institute on Drug Abuse, June 2020, https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/overview.
- “Addiction, Self-Responsibility, and the Importance of Choice.” Psychology Today, https://www.psychologytoday.com/us/blog/enlightened-living/201006/addiction-self-responsibility-and-the-importance-choice.