Addiction

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life.

Overview

The term addiction does not only refer to dependence on substances such as heroin or cocaine. A person who cannot stop taking a particular drug or chemical has a substance dependence.<ref>,

 Neurobiologic Advances from the Brain Disease Model of Addiction, 
 New England Journal of Medicine, 
 2016,
 Vol. 374(Issue: 4),
 pp. 363–371,
 DOI: 10.1056/NEJMra1511480,
 PMID: 26816013,</ref>

Types of Addiction

Substance Addiction

• Alcoholism
• Tobacco addiction
• Opioid addiction
• Cannabis addiction
• Cocaine addiction
• Amphetamine addiction

Behavioral Addiction

• Gambling addiction
• Sex addiction
• Internet addiction
• Video game addiction
• Food addiction
• Exercise addiction

Pathophysiology

Addiction affects the brain's reward system, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.<ref>,

 Neurobiology of addiction: a neurocircuitry analysis, 
 Lancet Psychiatry, 
 2016,
 Vol. 3(Issue: 8),
 pp. 760–773,
 DOI: 10.1016/S2215-0366(16)00104-8,
 PMID: 27475769,</ref>

Diagnosis

The diagnosis of addiction often involves criteria such as the issues caused by the addiction, the inability to stop the addictive behavior, and the development of tolerance and withdrawal symptoms.<ref>,

 Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), 
  
 Washington, D.C.:American Psychiatric Pub, 
 2013, 
  
  
 ISBN 9780890425572,</ref>

Treatment

Treatment for addiction varies and is tailored to the individual's needs. This could involve counseling, medication, or both. Many people with addiction overcome their condition with professional help.<ref>,

 The Affordable Care Act and treatment for "substance use disorders:" Implications of ending segregated behavioral healthcare, 
 Journal of Substance Abuse Treatment, 
 2014,
 Vol. 46(Issue: 5),
 pp. 541–545,
 DOI: 10.1016/j.jsat.2014.01.008,
 PMID: 24572761,</ref>

Risk Factors

Several factors can increase the risk of developing addiction, including:

• Genetic susceptibility: Genetics account for about half of a person's likelihood to experience addiction. Those with parents or siblings who have struggled with addiction are statistically more likely to develop an addiction.<ref>,

 Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review, 
 JAMA Psychiatry, 
 2016,
 Vol. 73(Issue: 3),
 pp. 292–297,
 DOI: 10.1001/jamapsychiatry.2015.3278,
 PMID: 26842658,</ref>

• Environmental factors: Cultural attitudes, drug availability, peer influences, and life stressors are significant factors.<ref>,

 Chronic stress, drug use, and vulnerability to addiction, 
 Annals of the New York Academy of Sciences, 
 2008,
 Vol. 1141(Issue: 1),
 pp. 105–130,
 DOI: 10.1196/annals.1441.030,
 PMID: 18991954,</ref>

• Psychological factors: Mental health disorders, such as depression and anxiety, and personality traits like impulsivity or sensation-seeking can increase the risk.<ref>,

 Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions, 
 Journal of Clinical Psychiatry, 
 2006,
 Vol. 67(Issue: 2),
 pp. 247–257,
 
 PMID: 16566619,</ref>

Prevention

Prevention strategies aim to reduce risk factors and increase protective factors, including:

• School-based prevention programs: These have been proven to reduce the risk of alcohol, tobacco, and other drug use.<ref>,

 The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial, 
 Drug and Alcohol Dependence, 
 2010,
 Vol. 108(Issue: 1–2),
 pp. 56–64,
 DOI: 10.1016/j.drugalcdep.2009.11.018,
 PMID: 20047888,</ref>

• Community-based programs: Targeting communities, including families, can also prevent substance use disorders.<ref>,

 Youth problem behaviors 8 years after implementing the communities that care prevention system: a community-randomized trial, 
 JAMA Pediatrics, 
 2014,
 Vol. 168(Issue: 2),
 pp. 122–129,
 DOI: 10.1001/jamapediatrics.2013.4009,
 PMID: 24285388,</ref>

Prognosis

The prognosis of addiction varies and depends on the individual's commitment to recovery and adherence to treatment. Some individuals overcome addiction and lead normal lives, while others may experience relapses.<ref>,

 Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation, 
 JAMA, 
 2000,
 Vol. 284(Issue: 13),
 pp. 1689–1695,
 DOI: 10.1001/jama.284.13.1689,
 PMID: 11015800,</ref>

Society and Culture

Addiction has significant societal and cultural implications, including links to crime, unemployment, and domestic violence. The stigma associated with addiction often prevents individuals from seeking help.<ref>,

 Stigma, discrimination and the health of illicit drug users, 
 Drug and Alcohol Dependence, 
 2007,
 Vol. 88(Issue: 2–3),
 pp. 188–196,
 DOI: 10.1016/j.drugalcdep.2006.10.014,
 PMID: 17118578,</ref>

See Also

• Relapse prevention
• Self-help groups for mental health
• Substance abuse prevention
• Substance dependence

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