Article
What Is Addiction? Understanding Causes, Types, and Treatment Options
Addiction is a chronic condition that can have serious negative impacts on individuals, families and society. Addiction can significantly impact your physical and mental health, relationships, and overall quality of life.
It is a complex medical disorder, ultimately caused by a change in brain chemistry. Addiction falls into two categories:
- Substance use disorders (SUD)
- Behavioral addictions
Addiction is treatable, and there are various recovery options available that have proven efficacy.
What Is Addiction?
Addiction is a condition that causes dependence on a substance or behavior or activity. It involves intense, persistent, and compulsive urges to seek out substances, like alcohol or opioids, or perform a behavior or activity, such as gambling or gaming. People keep using the substance or engaging in the behavior despite knowing it is harmful.
Addiction is considered a chronic medical disorder. According to The American Society of Addiction Medicine (ASAM), addiction is a chronic brain disorder. Brain chemistry changes with addiction. The primary center of the brain affected includes the neurotransmission of dopamine and its impact on the reward system, motivation, and mood regulation. Additional factors are also involved, such as genetics, the environment, and a person’s life experiences.
Addiction is treatable. It’s important to address addiction early on, as it can greatly affect your health, relationships, and overall quality of life. Seeking help at the first sign of addiction is essential. It’s not necessary to wait until you “hit bottom” or experience significant negative consequences, you can reach out for help to prevent those things from happening.
Types of Addiction
Addiction is a medical disorder that affects the brain’s chemistry. When a substance or activity stimulates the brain’s reward system and produces feelings of pleasure, it can lead to a lack of control over its use.
Addiction can be categorized into two different types:
- Alcohol and substance-based addiction
- Behavioral addictions
Substance-Based Addiction
An inability to control the use of a substance is known as a substance use disorder (SUD). The most common SUD is alcohol use disorder. Opioids and marijuana or cannabis are also common. In fact, the Department of Health and Human Services recently renewed the declaration that the US continues to be in the midst of an opioid crisis.
According to The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), SUDs have specific diagnostic criteria, which include cravings, unsuccessful attempts to cut back, using more than intended, and continued use despite negative consequences.
Common types of substance use addictions include:
- Alcohol
- Opioids, both prescription (i.e.: oxycodone, codeine) and non-prescription (i.e.: heroin, fentanyl)
- Stimulants, both prescription (i.e.: diet pills, Adderall) and non-prescription (i.e.: cocaine, methamphetamine or crystal
- Marijuana/Cannabis
- Hallucinogens (i.e.: LSD, Ecstasy/Molly, 2CB, )
- Sedatives (i.e.: sleeping pills, anti-anxiety drugs, benzodiazepines, barbiturates)
- Inhalants (i.e.: aerosol sprays, nitrous oxide, gases, paint thinner)
- Caffeine
- Tobacco and nicotine, including cigarettes, vaping, chewing tobacco, nicotine pouches
The use of these substances increases the risk of developing a physical and psychological dependence on them. They may also produce withdrawal symptoms, which cause varying degrees of physical discomfort.
Behavioral Addiction
Any behavior that over-stimulates the brain’s reward system can result in a behavioral addiction over time. Just as substance use can trigger the brain’s reward system and become addictive, certain behaviors can also do the same.
Common behavioral addictions include:
- Gambling
- Gaming
- Internet Use
- Out of Control Sexual
- Behavior
- Pornography
- Shopping
- Shoplifting
The only behavioral addiction recognized by the DSM-5 is gambling disorder. Other behavioral addictions are not included because there is a lack of research about them. However, studies are emerging that show behavioral health and activities that become habit-forming can have a significant negative impact on mental and physical health, and overall health and wellbeing.
The Science Behind Addiction
Addiction is a complex disorder of the brain’s neuroplasticity, meaning, the actual structure and function of the brain changes. Neuroplasticity refers to our brain’s ability to change and adapt in function and structure based on life experiences. It helps us modify behaviors and create new habits.
Neuroplasticity is helpful and makes it possible to learn new languages, acquire new skills, problem-solve, and adapt to new life situations and challenges. It becomes problematic when we develop behaviors that are dangerous and unhealthy.
Research shows the function and structure of certain areas of the brain become severely disrupted by addiction.
- The basal ganglia
- The amygdala
- The prefrontal cortex
- The reward center
Disruptions to these areas cause problems with judgment, decision-making, impulse control, memory, stress and emotional regulation. This shows that addiction is not conscious or rational. It is driven by habits caused by changes to the brain structure and chemistry.
The brain’s reward center enables human survival by encouraging beneficial behaviors and discouraging harmful ones. This part of the brain encourages behavior by activating the chemical dopamine (a neurotransmitter). When dopamine is released, it makes us feel good. This release motivates you to repeat the behavior that brought on the pleasure again in the future.
This reward system is part of our primitive brain. It works great when we are searching for food or safety. However, addictive substances and behaviors can overwhelm this system, leading to an excess of dopamine that disrupts our inherent ability to feel reward.
The brain quickly adapts to the high level of dopamine by reducing the number of dopamine receptors. This makes it difficult to experience pleasure from natural rewards and can lead to cravings for more of the addictive substance to get the same level of dopamine as the first time. Eventually, this leads to an inability to control the use of the addictive substance or behavior.
Causes and Risk Factors
There is no single cause of addiction. Although studies show there are many risk factors that can lead to it, the complexity of addiction makes predictability difficult since in large part, addiction develops because brain chemistry is altered.
However, many factors can influence the risk of addiction. Risk factors include:
- Genetics
- Trauma/environmental
- Mental Health
Genetics
A person’s biology, family history, and genetics increase addiction risk. It is estimated that genetic expression can increase a person’s risk of addiction by 40 to 60%.
Other biological factors that can predispose a person to addiction include gender, ethnicity, and stage of development – research shows that the younger a person is when they begin to use drugs, the greater their chances are of developing significant problems with addiction later on.
Environmental/Trauma
A person’s quality of life, such as family life, neighborhood, and economic influences can contribute to a person’s risk of developing an addiction. These environmental factors can also affect a person’s ability to recover from an addiction:
- An unstable home, particularly in childhood, plays a crucial role. Adverse Childhood Experiences (ACEs), such as childhood trauma, physical and sexual abuse, neglect, and early exposure to addictive behavior can greatly contribute to addiction.
- Family influences, such as parents, aunts, or uncles who engage in addictive behaviors, increase the likelihood of a child succumbing to addiction in the future.
- Friends or peers who use substances can increase the likelihood of using them, especially during the teen years, and especially if school or social situations are a struggle.
- Living in a community where drug use is prevalent can increase the risk of developing an addiction.
Mental Health
A strong link exists between mental health and addiction. Addiction and other mental disorders have common risk factors. ACEs, trauma, stress, or unhealthy environments lead to an increased risk for both addiction and other mental health disorders, like depression, anxiety, or PTSD. This is sometimes referred to as dual diagnosis or co-occurring disorders.
Individuals struggling with mental health conditions often use substances as a way to cope, which can lead to the development of an addiction. Conversely, addiction can trigger mental health issues or worsen an existing condition. The relationship is complex, as the two disorders tend to reinforce each other.
Approximately half of people who experience a mental health condition will also face a substance use disorder, and the same applies to people with addiction issues who are likely also to have a diagnosed mental health condition.
Signs and Symptoms
Everyone is different in how they may experience symptoms of addiction. Signs and symptoms will also differ depending on the type of addiction.
Experts agree that the inability to stop or control using a substance or a behavior is the most common symptom shared among all individuals with any type of addiction, regardless of whether it’s a substance use disorder or behavioral addiction. Everyone is different in how they may experience symptoms of addiction. Signs and symptoms will also differ depending on the type of addiction.
- Inability to stop, even if they want to stop, and even if they’ve tried.
- Lying, secretive, or making excuses about their behavior, substance use, or trying to hide it.
- Increased tolerance. To feel the same reward as they did before, they need more of the substance or activity to feel the same, and don’t often get it.
- Intense cravings or urges
- Lack of control and helplessness over their substance use or behavior.
- Physical and emotional withdrawal symptoms when they try to stop, such as shaking, vomiting, sweating. They may also become irritable, anxious, or nervous.
- Preoccupation with the substance or activity.
- Worry about when they can get their next fix.
- Withdrawing from family, and friends, or changing social patterns, putting themselves in risky or dangerous situations in order to get a fix.
- Trouble keeping up with work, home, or school, and apathy towards these responsibilities.
- Problems with physical health, and mental health.
- Neglect of personal appearance.
- Stealing.
Treatment Options
Addiction treatment is a personalized process that can include a combination of medications, individual, group, couples, and family therapy, and support groups. The goal is to help people understand their addiction and increase each patient’s internal motivation, develop healthy coping skills, and make positive, long-term changes, and live a healthier life.
Addiction affects nearly every part of a person’s life. Research supports that effective treatment should be comprehensive and treat the needs of the whole person.
Rehabilitation support will encompass several areas specific to each patient, including,
-
- Medical health
- Mental health
- Family and social health
- Occupational health
- Financial health
- Legal needs
Inpatient and Outpatient Programs
Options for addiction treatment include inpatient programs, where you live at a rehabilitation (rehab) facility, or outpatient, where you have appointments for therapy sessions, but you leave when they’re done.
Both types of programs offer support through various forms of structured counseling and education for patients, and, if needed, to help manage physical dependence on a substance. Some patients may start with one type of treatment and shift to another, depending on their needs.
Inpatient Treatment Programs
An inpatient treatment program is one where you live at the rehab facility and receive 24-hour medical and emotional support. Inpatient treatment programs are intensive and are used for more serious addictions. Treatment is long-term, usually lasting for weeks or months.
Inpatient care may occur in a hospital setting, or at a residential treatment facility.
Inpatient care may occur in a hospital setting, or at a residential treatment facility.
Outpatient treatment Program
Outpatient care falls into 2 categories:
- Standard outpatient care is more part-time, and is similar to having doctor’s visits where patients come and go depending on their scheduled appointments. Frequency and length of appointments depends on the type of care needed for each person. This type of treatment is less intense and works well for those who can make and keep regular appointments. Telehealth is often an option for outpatient care.
- Intensive outpatient program (IOP) is more intensive, full-time treatment where a patient may spend several hours at a facility, but they go home in the evenings and return in the mornings.
Inpatient and Outpatient Programs
Options for addiction treatment include inpatient programs, where you live at a rehabilitation (rehab) facility, or outpatient, where you have appointments for therapy sessions, but you leave when they’re done.
Both types of programs offer support through various forms of structured counseling and education for patients, and, if needed, to help manage physical dependence on a substance. Some patients may start with one type of treatment and shift to another, depending on their needs.
Inpatient Treatment Programs
An inpatient treatment program is one where you live at the rehab facility and receive 24-hour medical and emotional support. Inpatient treatment programs are intensive and are used for more serious addictions. Treatment is long-term, usually lasting for weeks or months.
Inpatient care may occur in a hospital setting, or at a residential treatment facility.
Inpatient care may occur in a hospital setting, or at a residential treatment facility.
Outpatient treatment Program
Outpatient care falls into 2 categories:
- Standard outpatient care is more part-time, and is similar to having doctor’s visits where patients come and go depending on their scheduled appointments. Frequency and length of appointments depends on the type of care needed for each person. This type of treatment is less intense and works well for those who can make and keep regular appointments. Telehealth is often an option for outpatient care.
- Intensive outpatient program (IOP) is more intensive, full-time treatment where a patient may spend several hours at a facility, but they go home in the evenings and return in the mornings.
Comprehensive Addiction Treatment
Addiction Treatment Centre in New York Outpatient Programs
Medication-Assisted Treatment (MAT)
Medication-Assisted Treatment (MAT) is when medications are used alongside counseling and behavioral therapies to treat substance use disorders. MAT is tailored to each patient’s needs for a whole-person approach. When used in combination with other support therapies, MAT has been proven to be a useful tool for effectively treating and preventing relapse of substance use disorders, such as alcohol or opioids.
Each medication offers its own benefit, including:
- Reducing the symptoms of withdrawal
- Decreasing cravings
- Blocking the euphoric effects of intoxication
- Lessening physical dependence
- Reversing effects of overdose
According to SAMHSA, the following medications are currently approved for MAT for certain substance use disorders, like alcohol use disorders (AUD) and opioid use disorder (OUD):
- Methadone (for OUD)
- Naltrexone (for AUD and OUD)
- Naloxone (for overdose from opioids)
- Acamprosate (for AUD)
- Disulfiram (for AUD)
- Naltrexone (for OUD and AUD)
- Buprenorphine (for OUD)
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a type of behavioral therapy that helps patients identify and examine negative or distorted thoughts, feelings, and behaviors. CBT has become the gold standard for treating addictive disorders. This valuable therapeutic tool helps to support a range of problematic disorders including addiction and a wide variety of other mental health issues.
The therapist guides the patient in challenging unhelpful thoughts to better understand their motivations and behaviors. As a result, the therapist and patient work together to create new, more constructive thought and behavior patterns and develop new coping skills.
CBT helps patients create new neural pathways in the brain by teaching them new ways of thinking and behaving. Essentially, CBT is a method of rewiring the brain to establish healthier neural connections and patterns over time, taking advantage of the brain’s natural neuroplasticity. This approach helps lessen symptoms and helps patients to make strides in recovery and progress towards health and well-being.
The therapist guides the patient in challenging unhelpful thoughts to better understand their motivations and behaviors. As a result, the therapist and patient work together to create new, more constructive thought and behavior patterns and develop new coping skills.
CBT helps patients create new neural pathways in the brain by teaching them new ways of thinking and behaving. Essentially, CBT is a method of rewiring the brain to establish healthier neural connections and patterns over time, taking advantage of the brain’s natural neuroplasticity. This approach helps lessen symptoms and helps patients to make strides in recovery and progress towards health and well-being.
Group Therapy
Group therapy is a therapeutic technique whereby a group of patients meet to discuss their recovery together under the supervision of a therapist.
The goal of group counseling is to help people learn and practice recovery strategies. Benefits of group therapy include:
- Promotes and reinforces social and emotional support
- Reduces isolation and stigma
- Builds effective communication and interpersonal skills
- Practices recovery-oriented coping strategies
- Provides education and awareness
- Offers strength and encouragement
Mutual Support Groups
Assistance can also be found in the form of support groups, such as 12-step programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), or Al-Anon for friends and family of people with addiction.
Support groups are a great option for ongoing support. These groups provide space to share experiences in a safe setting. It gives patients, family, and friends space to gain hope and develop supportive relationships and find fellowship. Support groups allow your voice to be heard and provide an opportunity for your personal needs to be met. It encourages empathy, productive discussion, and a sense of community.
Relapse and Recovery
Because substance use disorders and other addictions are chronic medical conditions, it is important to emphasize the importance of aftercare programs and ongoing support.
Recovering from substance use disorders and behavioral addictions is a process. But, with comprehensive, patient-centered treatment, long-term recovery is possible. Many people can manage their addiction and live a full and healthy life.
Aftercare, and a support team that includes friends, family, mutual support groups and providers make treatment and recovery more effective and manageable.
Relapse or recurrence is common with addiction. The structural and functional brain alterations that persist in people with addiction make relapse a real possibility and something that should be planned for.
A relapse prevention plan is a crucial component to aftercare for anyone in recovery.
A relapse prevention plan employs strategies that help you recognize your own personal behaviors that may put you at risk for future relapse in the future.
An emergency plan can provide a roadmap and a course of action for responding to triggers, cravings, and behaviors and a plan to get back on track.
Setbacks are normal.
Setbacks are normal.
Conclusion
Addiction is a chronic disease that causes changes in the function and structure of the brain and interferes with the natural reward system. These changes interfere with the brain’s natural reward system, self-control, and decision-making.
Without treatment, addiction can cause serious health issues, including death. Addiction can also lead to the deterioration of relationships, legal issues, and financial difficulties.
Addiction can be treated. Overcoming addiction requires commitment and dedication to comprehensive care for rewiring the brain and creating new neural pathways for new thoughts, behaviors, and responses. It might feel daunting, but you don’t have to face it alone.
Wholeview Wellness in NYC offers compassionate, high-level addiction treatment to anyone – no matter who you are, throughout NY State. Our services are available in-person and online.
If you or someone you know is struggling with addiction, contact Wholeview Wellness to explore your treatment options and start recovering today.
At Wholeview, our medical providers use pharmacogenetic testing to help personalize medication plans for patients with mental health conditions. This process begins with a simple cheek swab collected at home, which is then analyzed in a lab to identify genetic variations that affect how patients metabolize and respond to medications. The resulting report categorizes medications into groups based on their likely effectiveness and risk of side effects.
Pharmacogenetic testing can speed up the process of finding the right psychiatric medication, which is especially valuable for patients with both substance use and mental health disorders. By reducing the trial-and-error period, patients may experience quicker symptom stabilization and improved adherence to treatment. However, genetic testing is used as a supplementary tool alongside thorough clinical evaluations and is not a standalone solution. At Wholeview, we integrate this testing into a broader care approach, including therapy and behavioral interventions, and ensure patients are fully informed about its benefits and limitations before proceeding. Read More
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