EXPLAINING ADDICTION TO NON-ADDICTS

EXPLAINING ADDICTION TO NON-ADDICTSDrug addiction is a chronic, progressive condition, one that has far-reaching implications for addicts and their loved ones alike, and it’s not easy for non-addicts to fully grasp the destructive and all-consuming cycle of addiction. Often, non-addicts assume that people who are addicted to drugs or alcohol are merely weak or without morals, when in fact they have a legitimate disorder that requires treatment, just like any other chronic medical condition.

UNDERSTANDING ADDICTION AND THE BRAIN

Addiction is a complex disease of the brain and body that involves compulsive use of one or more substances despite serious health and social consequences. Addiction disrupts regions of the brain that are responsible for reward, motivation, learning, judgment and memory. It damages various body systems as well as families, relationships, schools, workplaces and neighborhoods.

The definition of addiction has encountered resistance by most medical associations, including the American Medical Association and the American Society of Addiction Medicine.

Newer definitions describe addiction as a primary disease, meaning that it is not the result of other causes, such as emotional or psychiatric problems, as previous DSM’s would suggest. And like cardiovascular disease and diabetes, addiction is recognized as a chronic disease; so it must be treated, managed and monitored as a disease because it has physical and mental manifestations, is progressive and is chronic.

CHARACTERISTICS OF ADDICTION

Compulsive Use

Compulsive use has three elements: reinforcement, tolerance, and habit.

Reinforcement occurs when the addictive substance or behaviour is first engaged. Being rewarded with pleasure and/or relief from pain and stress reinforces the user. As he or she continues to ingest the substance or engage in the behaviour, tolerance develops and it takes larger doses of the substance or behaviour to obtain the sought-after pleasure or relief. Habit, the third element in compulsive use, results from deeply ingrained patterns in the memory of the nervous system.

Addictive behaviours often involve automatic responses.

Physical Craving

Means that the body and brain send intense signals that the drug or behaviour is needed. Using drugs on an ongoing basis alters the chemical balance of the brain. Withdrawal symptoms are unpleasant physical symptoms (the opposite of the drug effects) and may kick in when the drug(s) or behaviours are withheld. Psychological cravings related to the experience of taking the drug or engaging in the behaviour can also occur.

Loss of Control

Typically, addicts cannot predict or determine how much of the drug they will use or when they will use it. However, once they begin, they cannot stop. This may be due in part to impairment of the brain and memory. This same loss of control also applies to other addictive behaviours such as compulsive gambling or sex. Research on alcohol addiction has shown that intoxication can cause “alcohol myopia,” a condition that decreases judgment, decision making, and planning and negatively affects the perception and skills necessary to effectively evaluate one’s environment.

Continued Use Despite Adverse Consequences

Addictive behaviour has negative consequences. Addicts may not be aware of these consequences although those persons associated with the users are aware of these consequences (i.e Family). This is also referred to as “Denial”. Addicts, if they are aware, may feel that the pleasurable or pain-relieving features of drug use outweigh the problems.

Tolerance

When a drug is used continually, the body adapts to—and begins to tolerate the drug’s pharmacological effects. As a result, the user needs more and more of the substance or the behaviour to achieve the intensity and duration of the initial experience. The continual user must also take more drugs to avoid the physical discomfort and psychological distress that accompany withdrawal. A researcher named Doweiko indicates two types of tolerance: (1) metabolic tolerance (also called pharmacokinetic tolerance) when the body increases its efficiency in breaking down chemicals for elimination and (2) pharmacodynamic tolerance (also called functional tolerance) when the central nervous system becomes less sensitive to the effects of the drug of choice.

Withdrawal

When drug use is stopped, the addict suffers unpleasant effects that are usually the opposite of those induced by the chemical. Because the body has adapted to the drug, withdrawal (unless carefully monitored and managed) not only is miserable, but may be life-threatening as well. Withdrawal may create the rebound effect: “The characteristic of a drug to produce reverse effects when the effect of the drug has passed or the patient no longer responds to it”. Alcohol withdrawal without medical assistance can escalate to the point where the client may experience delirium tremens, a condition that can create seizures, disorientation, and even death.

WHY IS WILL POWER OFTEN NOT ENOUGH?

The initial and early decisions to use substances reflect a person’s free or conscious choice. However, once the brain has been changed by addiction, that choice or willpower becomes impaired. Perhaps the most defining symptom of addiction is a loss of control over substance use.

ARE PEOPLE WITH ADDICTION RESPONSIBLE FOR THEIR ACTIONS?

People with addiction should not be blamed for suffering from the disease. All people make choices about whether to use substances. However, people do not choose how their brain and body respond to drugs and alcohol, which is why people with addiction cannot control their use while others can. People with addiction can still stop using – it’s just much harder than it is for someone who has not become addicted.

People with addiction are responsible for seeking treatment and maintaining recovery. Often they need the help and support of family, friends and peers to stay in treatment and increase their chances of survival and recovery.

 

 

RESOURCES:
A Forever Recovery. 2017. Can Non-Addicts Truly Understand When Explaining Addiction to Them. https://aforeverrecovery.com/blog/addiction/can-non-addicts-truly-understand-what-addiction-is/
Coombs, R.H & Howatt, W.A. 2005. The Addiction Counselor’s Desk Reference. Wiley: New Jersey.