What is an Addiction?

How to use tools based on neuroscience and human psychology to break your addiction?

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This is the complete guide to addiction. Learn in this in-depth post about the different types of addiction and how to overcome them.

According to the World Health Organization (WHO), it is a physical and psychoemotional disease that creates a dependence or need for a substance, activity, or relationship.

It is characterized by a set of signs and symptoms, involving biological, genetic, psychological, and social factors. It is a progressive and fatal disease, characterized by continuous episodes of uncontrolled, distorted thinking and denial of the disease.

In order to speak of physical and psychological dependence, persons must present three or more of the following criteria in a 12-month period:

  1. A strong desire or need to consume the substance (addiction).

  2. Difficulties in controlling such consumption.

  3. Withdrawal syndrome when discontinuing or reducing consumption.

  4. Tolerance.

  5. Progressive abandonment of interests unrelated to the consumption of the substance (investment of time in activities related to obtaining the substance).

Contrary to popular belief, addiction does not reflect weakness or lack of willpower in the addicted individual. Psychoactive substances act on the brain system, invading it and modifying its functioning. The brain undergoes complex disruptions in its mechanisms, leading to a total loss of control over behavior. It is therefore a neurological disease that must be considered and treated as such. 

Levels of addiction

  1. Experimentation: this is the case where the person, guided by curiosity, is encouraged to try a drug, and may later continue or discontinue use

  2. Use: Drug engagement is low. It is consumed on weekends and in casual opportunities. There is no occupational, social, or family deterioration. There are no episodes of intoxication. The consumer only seeks a change of sensations. However, all drugs progressively generate physical or psychological dependence and it is easy to fall into abuse.

  3. Abuse: use becomes regular almost every week and there are episodes of intoxication. For example alcohol, intoxication is when there is a hangover and mental lapses. The drug progressively directs the life, there is academic, work, social, and family deterioration. The mood is changing (a normal life and an addictive life and unknown most of the time by the family).

  4. Addiction: relationship with friends and family breaks down, academic and work difficulties. The search for the drug is compulsive. Abstinence is difficult. There is organic compromise. There are risk behaviors such as sexual promiscuity, intravenous drug use or a combination of several drugs, the mood depending on the consumer/abstinence stage, and car accidents.

The different types of addiction

Many addictions can fit within three categories, which include the following:

  • Behavioral addiction: Many people associate addiction solely with substances, like alcohol or drugs. But you can also be addicted to specific behaviors. Common addictive behaviors include shopping, sex, gambling, and video gaming. The compulsive behavior gives the user a rush or high similar to what those addicted to a substance experience.

  • Substance addiction: Substance addiction creates a physical dependence on a specific chemical. People can be addicted to prescription medication, such as opioids, or illicit drugs, such as crystal meth, heroin, or cocaine. Alcoholism is also considered a type of substance addiction.

  • Impulse addiction: Impulse control disorders can lead to impulse addiction. Someone with an impulse control disorder struggles to manage their emotions and actions. This disorder may make someone prone to theft, emotional outbursts, or destructive behavior. Approximately 10.5% of people have an impulse control disorder, according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. Behaviors that arise with impulse control disorders can become addictive. Impulse addiction can also intersect with other mental health issues, such as substance abuse.

Specific types of addiction disorders include the following.

What is the difference between addiction and dependency?

Addiction is often confused with dependence, but these two terms define different behaviors when faced with the use of psychoactive substances or activities.

  1. Dependency is due to an imbalance in neurobiological functioning following regular use of a psychoactive substance. This imbalance leads to the desire to use the psychoactive substance again, in order to avoid the unpleasant effects of stopping taking it. The goal is to return to a normal state, not to feel better.

  2. Addiction, on the other hand, defines the inability of the individual to stop using the substance, even though he or she is aware of the negative consequences that will ensue. It is linked to the individual's vulnerability to the pleasure signals sent by a neurotransmitter in his or her brain. It results in uncontrolled and irrational compulsive behaviors, which can therefore apply not only to products but also to activities such as gambling, sex, exercise, or shopping.

The importance of dopamine in addiction

From another corner of neuroscience, we’re learning about a neurotransmitter called dopamine. Though there are more than fifty neurotransmitters (that we know of), scientists studying substance problems have given dopamine much of their attention.

The brain’s reward system and pleasure centers—the areas most impacted by substance use and compulsive behaviors—have a high concentration of dopamine. Some brains have more of it than others, and some people have a capacity to enjoy a range of experiences more than others, owing to a combination of genetics and environment.

The thing about dopamine is that it makes us feel really good. We tend to want more of it. It is naturally generated through ordinary, pleasurable activities like eating and sex, and it is the brain’s way of rewarding us—or nature’s way of rewarding the brain—for activities necessary to our survival, individually or as a species. It is the “mechanism by which ‘instinct’ is manifest.”

Our brains arrange for dopamine levels to rise in anticipation and spike during a pleasurable activity to make sure we do it again. It helps focus our attention on all the cues that contributed to our exposure to whatever felt good.

Dopamine pathways in the brain
Dopamine pathways in the brain

What is the role of the brain in addiction?

Thanks to advances in neuroscience, the neurobiological mechanisms of addiction are increasingly well understood. These are closely linked to the "reward system", a brain circuit responsible for the sensations of pleasure felt after certain actions.

Present in the brain of humans as well as in many animals, it is thanks to this system that we willingly repeat the behaviors that are essential to our survival and that of our species: eating, drinking, having sex, procreating...

In addictive disorders, this fundamental mechanism of life is disrupted, sometimes by the intake of a substance (alcohol, drugs...) that increases the sensation of pleasure, sometimes by an initial dysfunction of the brain, which does not regulate its reward system properly. When these two dimensions are combined, we end up with an addictive disease.

Are we all equal before addiction?

Addiction is a disease of the nervous system to which we are not all equal. Indeed, some of us are more vulnerable to the use of psychoactive substances or to certain behaviors because of our genes but also because of the environment in which we live. The brain of the addicted person combines at least two weaknesses:

  1. A hypertrophied reward system, and therefore an increase in motivation: Dopamine is the neurotransmitter involved in the reward system. When the brain receives a reward that it did not expect as a result of a particular behavior, it "engraves" the positive consequence of that behavior, encouraging its repetition. This will result in an addicted individual not being able to resist using the substance that gave him pleasure when he comes into contact with it. This is also true for non-substance addictions.

  2. A deficit of synaptic plasticity: In some people, the capacity of synapses to decrease their activity under the effect of certain stimulations could be altered, which would no longer allow the development of new memory traces and would explain the shift from behaviors under the control of conscious decisions to automated and compulsive behaviors.

When should addictions be treated?

Addiction is a complex condition caused by multiple factors. In some cases, people can recognize their addiction and break the cycle on their own. In most cases, people need help. There are trained treatment providers out there who can help you get your addiction under control so it no longer harms you.

If your addiction is negatively affecting your quality of life, you need treatment. Whether the negative consequences are physical, emotional, social, financial, or any combination of those, addiction treatment can help you move forward. Treatment may be temporary, or it may be a lifelong process. If you find yourself struggling or failing to stop using a substance or participating in a particular activity, treatment is recommended.

Bottom line: How to avoid the pitfalls of addiction?

Although there are treatments that work, the risk of relapse remains high for an addict: even years after stopping use, the brain remembers the positive sensations, the reward it received - which makes the addict fragile. This is why prevention plays such an important role.

"It allows the general public to be made aware of the problem in order to avoid exposure to the riskiest behaviors. It provides more in-depth knowledge about this real neurological disease, and in the long term, an awareness of its sometimes dramatic consequences."

This is exactly my goal with this newsletter, to warn you of the possible dangers of addictions and help you avoid or overcome them while developing new healthy habits.

If you are interested, join 1000+ people who are already subscribers, in order to receive every week's useful tips that will help you with any addiction.

Disclaimer: This article is purely informative, I have no authority to make a diagnosis or recommend treatment. I invite you to visit a psychologist to treat your particular case.

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