Addiction: Difference between revisions

Revision as of 08:08, 21 March 2025

File:Brain metabolism and drug addiction.jpg

Brain metabolism and drug addiction

ΔFosB accumulation in addiction

File:An alcoholic man with delirium Wellcome L0060780 (level correction).jpg

An alcoholic man experiencing delirium

Addiction is a complex, chronic brain disorder characterized by compulsive substance use or behavior despite harmful consequences. Individuals with addiction, also referred to as severe substance use disorder, exhibit an intense focus on using certain substances—such as alcohol or drugs—to the extent that it dominates their daily life and functioning.

Overview

Addiction is not limited to dependency on illegal substances like heroin or cocaine. It can also involve legal substances such as alcohol and prescription medications, or even behaviors like gambling. A person suffering from addiction is typically unable to control their urges, often continuing the behavior despite negative social, occupational, or health consequences.<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

Substance-related addictions involve dependence on chemical substances that alter brain chemistry:

Alcoholism – dependence on alcohol
Tobacco addiction – nicotine dependence
Opioid addiction – includes heroin and prescription painkillers
Cannabis addiction – marijuana use disorder
Cocaine addiction
Amphetamine addiction

Behavioral Addiction

These are compulsive behaviors that activate reward systems in the brain similarly to substance use:

Pathophysiology

Addiction primarily affects the brain’s reward system, particularly pathways involving dopamine. The repeated exposure to addictive substances or behaviors alters the brain's normal functioning, resulting in:

Changes in motivation and reward
Impaired decision-making and impulse control
Long-term neuroplasticity in brain circuits associated with habit and compulsion

These biological changes contribute to the persistence of addictive behaviors, even after cessation attempts.<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 is typically made using established criteria, such as those in the DSM-5, which consider:

Persistent desire or unsuccessful efforts to cut down
Tolerance and withdrawal symptoms
Continued use despite knowledge of harm
Cravings and loss of control

These indicators reflect both psychological and physiological aspects of addiction.<ref>,

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

Treatment

Effective addiction treatment is individualized and often involves a combination of:

Behavioral therapies: e.g., cognitive-behavioral therapy (CBT), motivational interviewing
Pharmacological treatment: e.g., methadone, buprenorphine, naltrexone
Support systems: peer support groups, family therapy

Long-term follow-up and relapse prevention are essential for successful recovery.<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

Addiction arises from a combination of biological, psychological, and environmental influences:

Genetic susceptibility: Genetics account for approximately 40–60% of a person's vulnerability.<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: Stress, peer pressure, socioeconomic status, and early exposure to drugs play a critical role.<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: Conditions such as depression, anxiety, PTSD, and traits like impulsivity can predispose individuals.<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 efforts are most effective when they address multiple risk factors at early developmental stages:

School-based programs: Educating adolescents can reduce the onset of substance 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 and family interventions: Programs that involve parents and the broader community enhance protective factors.<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

Recovery outcomes vary greatly depending on the severity of addiction, the presence of co-occurring disorders, and the individual's support system. Many individuals achieve long-term recovery, though relapse is common and should be viewed as a part of the chronic disease process.<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 is not only a medical issue but also a major societal challenge. It is associated with:

Increased healthcare costs
Criminal justice involvement
Homelessness and unemployment
Stigmatization and discrimination

These factors often prevent people from seeking treatment and contribute to the chronic nature of addiction.<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>

@@ Line 1: / Line 1: @@
-'''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.
+[[File:Brain metabolism and drug addiction.jpg|thumb|Brain metabolism and drug addiction]]
+[[File:ΔFosB accumulation.svg|thumb|ΔFosB accumulation in addiction]]
+[[File:An alcoholic man with delirium Wellcome L0060780 (level correction).jpg|thumb|An alcoholic man experiencing delirium]]
+'''Addiction''' is a complex, chronic brain disorder characterized by compulsive substance use or behavior despite harmful consequences. Individuals with addiction, also referred to as severe substance use disorder, exhibit an intense focus on using certain substances—such as [[alcohol]] or [[drugs]]—to the extent that it dominates their daily life and functioning.
 == 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>{{Cite journal|last1=Volkow|first1=ND|last2=Koob|first2=GF|last3=McLellan|first3=AT|title=Neurobiologic Advances from the Brain Disease Model of Addiction|journal=New England Journal of Medicine|volume=374|issue=4|pages=363–371|year=2016|doi=10.1056/NEJMra1511480|pmid=26816013}}</ref>
+Addiction is not limited to dependency on illegal substances like [[heroin]] or [[cocaine]]. It can also involve legal substances such as [[alcohol]] and [[prescription medications]], or even behaviors like [[gambling]]. A person suffering from addiction is typically unable to control their urges, often continuing the behavior despite negative social, occupational, or health consequences.<ref>{{Cite journal |last1=Volkow |first1=ND |last2=Koob |first2=GF |last3=McLellan |first3=AT |title=Neurobiologic Advances from the Brain Disease Model of Addiction |journal=New England Journal of Medicine |volume=374 |issue=4 |pages=363–371 |year=2016 |doi=10.1056/NEJMra1511480 |pmid=26816013}}</ref>
 == Types of Addiction ==
 === Substance Addiction ===
-* [[Alcoholism]]
+Substance-related addictions involve dependence on chemical substances that alter brain chemistry:
-* [[Tobacco addiction]]
+* '''[[Alcoholism]]''' – dependence on alcohol
-* [[Opioid addiction]]
+* '''[[Tobacco addiction]]''' – nicotine dependence
-* [[Cannabis (drug)|Cannabis addiction]]
+* '''[[Opioid addiction]]''' – includes heroin and prescription painkillers
-* [[Cocaine addiction]]
+* '''[[Cannabis (drug)|Cannabis addiction]]''' – marijuana use disorder
-* [[Amphetamine addiction]]
+* '''[[Cocaine addiction]]'''
+* '''[[Amphetamine addiction]]'''
 === Behavioral Addiction ===
-* [[Gambling addiction]]
+These are compulsive behaviors that activate reward systems in the brain similarly to substance use:
-* [[Sex addiction]]
+* '''[[Gambling addiction]]'''
-* [[Internet addiction]]
+* '''[[Sex addiction]]'''
-* [[Video game addiction]]
+* '''[[Internet addiction]]'''
-* [[Food addiction]]
+* '''[[Video game addiction]]'''
-* [[Exercise 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>{{Cite journal|last1=Koob|first1=GF|last2=Volkow|first2=ND|title=Neurobiology of addiction: a neurocircuitry analysis|journal=Lancet Psychiatry|volume=3|issue=8|pages=760–773|year=2016|doi=10.1016/S2215-0366(16)00104-8|pmid=27475769}}</ref>
+Addiction primarily affects the brain’s [[reward system]], particularly pathways involving [[dopamine]]. The repeated exposure to addictive substances or behaviors alters the brain's normal functioning, resulting in:
+* Changes in motivation and reward
+* Impaired decision-making and impulse control
+* Long-term neuroplasticity in brain circuits associated with habit and compulsion
+These biological changes contribute to the persistence of addictive behaviors, even after cessation attempts.<ref>{{Cite journal |last1=Koob |first1=GF |last2=Volkow |first2=ND |title=Neurobiology of addiction: a neurocircuitry analysis |journal=Lancet Psychiatry |volume=3 |issue=8 |pages=760–773 |year=2016 |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>{{Cite book|last1=American Psychiatric Association|title=Diagnostic and Statistical Manual of Mental Disorders (DSM-5®)|publisher=American Psychiatric Pub|year=2013|isbn=9780890425572|location=Washington, D.C.}}</ref>
+The diagnosis of addiction is typically made using established criteria, such as those in the DSM-5, which consider:
+* Persistent desire or unsuccessful efforts to cut down
+* Tolerance and withdrawal symptoms
+* Continued use despite knowledge of harm
+* Cravings and loss of control
+These indicators reflect both psychological and physiological aspects of addiction.<ref>{{Cite book |last1=American Psychiatric Association |title=Diagnostic and Statistical Manual of Mental Disorders (DSM-5®) |publisher=American Psychiatric Pub |year=2013 |isbn=9780890425572 |location=Washington, D.C.}}</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>{{Cite journal|last1=McLellan|first1=AT|last2=Woodworth|first2=AM|title=The Affordable Care Act and treatment for "substance use disorders:" Implications of ending segregated behavioral healthcare|journal=Journal of Substance Abuse Treatment|volume=46|issue=5|pages=541–545|year=2014|doi=10.1016/j.jsat.2014.01.008|pmid=24572761}}</ref>
+Effective addiction treatment is individualized and often involves a combination of:
+* '''Behavioral therapies:''' e.g., cognitive-behavioral therapy (CBT), motivational interviewing
+* '''Pharmacological treatment:''' e.g., methadone, buprenorphine, naltrexone
+* '''Support systems:''' peer support groups, family therapy
+Long-term follow-up and relapse prevention are essential for successful recovery.<ref>{{Cite journal |last1=McLellan |first1=AT |last2=Woodworth |first2=AM |title=The Affordable Care Act and treatment for "substance use disorders:" Implications of ending segregated behavioral healthcare |journal=Journal of Substance Abuse Treatment |volume=46 |issue=5 |pages=541–545 |year=2014 |doi=10.1016/j.jsat.2014.01.008 |pmid=24572761}}</ref>
 == Risk Factors ==
-Several factors can increase the risk of developing addiction, including:
+Addiction arises from a combination of biological, psychological, and environmental influences:
-* '''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>{{Cite journal|last1=Volkow|first1=ND|last2=Swanson|first2=JM|last3=Evins|first3=AE|title=Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review|journal=JAMA Psychiatry|volume=73|issue=3|pages=292–297|year=2016|doi=10.1001/jamapsychiatry.2015.3278|pmid=26842658}}</ref>
-* '''Environmental factors:''' Cultural attitudes, drug availability, peer influences, and life stressors are significant factors.<ref>{{Cite journal|last1=Sinha|first1=R|title=Chronic stress, drug use, and vulnerability to addiction|journal=Annals of the New York Academy of Sciences|volume=1141|issue=1|pages=105–130|year=2008|doi=10.1196/annals.1441.030|pmid=18991954}}</ref>
+* '''Genetic susceptibility:''' Genetics account for approximately 40–60% of a person's vulnerability.<ref>{{Cite journal |last1=Volkow |first1=ND |last2=Swanson |first2=JM |last3=Evins |first3=AE |title=Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review |journal=JAMA Psychiatry |volume=73 |issue=3 |pages=292–297 |year=2016 |doi=10.1001/jamapsychiatry.2015.3278 |pmid=26842658}}</ref>
-* '''Psychological factors:''' Mental health disorders, such as [[depression]] and [[anxiety]], and personality traits like impulsivity or sensation-seeking can increase the risk.<ref>{{Cite journal|last1=Conway|first1=KP|last2=Compton|first2=W|last3=Stinson|first3=FS|title=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=Journal of Clinical Psychiatry|volume=67|issue=2|pages=247–257|year=2006|pmid=16566619}}</ref>
+* '''Environmental factors:''' Stress, peer pressure, socioeconomic status, and early exposure to drugs play a critical role.<ref>{{Cite journal |last1=Sinha |first1=R |title=Chronic stress, drug use, and vulnerability to addiction |journal=Annals of the New York Academy of Sciences |volume=1141 |issue=1 |pages=105–130 |year=2008 |doi=10.1196/annals.1441.030 |pmid=18991954}}</ref>
+* '''Psychological factors:''' Conditions such as [[depression]], [[anxiety]], [[PTSD]], and traits like impulsivity can predispose individuals.<ref>{{Cite journal |last1=Conway |first1=KP |last2=Compton |first2=W |last3=Stinson |first3=FS |title=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=Journal of Clinical Psychiatry |volume=67 |issue=2 |pages=247–257 |year=2006 |pmid=16566619}}</ref>
 == Prevention ==
-Prevention strategies aim to reduce risk factors and increase protective factors, including:
+Prevention efforts are most effective when they address multiple risk factors at early developmental stages:
-* '''School-based prevention programs:''' These have been proven to reduce the risk of alcohol, tobacco, and other drug use.<ref>{{Cite journal|last1=Faggiano|first1=F|last2=Vigna-Taglianti|first2=FD|last3=Burkhart|first3=G|title=The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial|journal=Drug and Alcohol Dependence|volume=108|issue=1–2|pages=56–64|year=2010|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>{{Cite journal|last1=Hawkins|first1=JD|last2=Oesterle|first2=S|last3=Brown|first3=EC|title=Youth problem behaviors 8 years after implementing the communities that care prevention system: a community-randomized trial|journal=JAMA Pediatrics|volume=168|issue=2|pages=122–129|year=2014|doi=10.1001/jamapediatrics.2013.4009|pmid=24285388}}</ref>
+* '''School-based programs:''' Educating adolescents can reduce the onset of substance use.<ref>{{Cite journal |last1=Faggiano |first1=F |last2=Vigna-Taglianti |first2=FD |last3=Burkhart |first3=G |title=The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial |journal=Drug and Alcohol Dependence |volume=108 |issue=1–2 |pages=56–64 |year=2010 |doi=10.1016/j.drugalcdep.2009.11.018 |pmid=20047888}}</ref>
+* '''Community and family interventions:''' Programs that involve parents and the broader community enhance protective factors.<ref>{{Cite journal |last1=Hawkins |first1=JD |last2=Oesterle |first2=S |last3=Brown |first3=EC |title=Youth problem behaviors 8 years after implementing the communities that care prevention system: a community-randomized trial |journal=JAMA Pediatrics |volume=168 |issue=2 |pages=122–129 |year=2014 |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>{{Cite journal|last1=McLellan|first1=AT|last2=Lewis|first2=DC|last3=O'Brien|first3=CP|title=Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation|journal=JAMA|volume=284|issue=13|pages=1689–1695|year=2000|doi=10.1001/jama.284.13.1689|pmid=11015800}}</ref>
+Recovery outcomes vary greatly depending on the severity of addiction, the presence of co-occurring disorders, and the individual's support system. Many individuals achieve long-term recovery, though relapse is common and should be viewed as a part of the chronic disease process.<ref>{{Cite journal |last1=McLellan |first1=AT |last2=Lewis |first2=DC |last3=O'Brien |first3=CP |title=Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation |journal=JAMA |volume=284 |issue=13 |pages=1689–1695 |year=2000 |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>{{Cite journal|last1=Ahern|first1=J|last2=Stuber|first2=J|last3=Galea|first3=S|title=Stigma, discrimination and the health of illicit drug users|journal=Drug and Alcohol Dependence|volume=88|issue=2–3|pages=188–196|year=2007|doi=10.1016/j.drugalcdep.2006.10.014|pmid=17118578}}</ref>
+Addiction is not only a medical issue but also a major societal challenge. It is associated with:
+* Increased healthcare costs
+* Criminal justice involvement
+* Homelessness and unemployment
+* Stigmatization and discrimination
+These factors often prevent people from seeking treatment and contribute to the chronic nature of addiction.<ref>{{Cite journal |last1=Ahern |first1=J |last2=Stuber |first2=J |last3=Galea |first3=S |title=Stigma, discrimination and the health of illicit drug users |journal=Drug and Alcohol Dependence |volume=88 |issue=2–3 |pages=188–196 |year=2007 |doi=10.1016/j.drugalcdep.2006.10.014 |pmid=17118578}}</ref>
 == See Also ==
-* [[Relapse prevention]]
+* '''[[Relapse prevention]]'''
-* [[Self-help groups for mental health]]
+* '''[[Self-help groups for mental health]]'''
-* [[Substance abuse prevention]]
+* '''[[Substance abuse prevention]]'''
-* [[Substance dependence]]
+* '''[[Substance dependence]]'''
 {{Addiction|state=collapsed}}
 {{Drug use|state=collapsed}}
 {{Portal bar|Psychology|Medicine|Biology}}
 {{stub}}
 [[Category:Addiction| ]]
 [[Category:Behavioral addiction|*]]
 [[Category:Brain disorders]]
 [[Category:Substance-related disorders]]
-== Addiction ==
-<gallery>
-File:Brain metabolism and drug addiction.jpg|Brain metabolism and drug addiction
-File:ΔFosB accumulation.svg|ΔFosB accumulation
-File:An alcoholic man with delirium Wellcome L0060780 (level correction).jpg|An alcoholic man with delirium
-</gallery>
-<gallery>
-File:Brain metabolism and drug addiction.jpg|Addiction
-File:ΔFosB accumulation.svg|Addiction
-</gallery>