Addiction is a concept that is difficult to understand, for both addicts and non-addicts alike. However, like all illnesses, understanding addiction is essential for finding effective treatment. On the one hand, scientists obviously need to understand the mechanism of the disease in order to determine how to counteract it. On the other hand, people in charge of funding for both addiction research and treatment need to be convinced that the disease is more than just a character defect or lack of will power, two situations that often garner disdain rather than sympathy.
The fact is that few of us are entirely without some level of addiction. If we think of addiction in terms of the Pavlovian response, human beings are no less susceptible than dogs to repeating certain behaviors which are known to result in things we find pleasing. The difference between addicts and non-addicts, however, is the ability to resist the temptation when we become aware of potential negative consequences.
For example, two individuals may begin to use cocaine together on the weekends. They are both trying to escape the pressures of their high powered jobs. The more they use, however, the more money they spend (the body’s tolerance requires more and more of the drug to experience the same level of euphoria). One of them stops the behavior, concerned that his finances will suffer. The other realizes that his finances are suffering but any inclination to remedy the situation is overtaken by the need for the next feeling of euphoria. What separates these two individuals? Quite simply, one is susceptible to a disease called “addiction”; the other is not.
In order to understand addiction, it is necessary to have a basic understanding of how the brain works. Neurotransmitters are responsible for telling individual brain cells what to do and when to do it by either introducing or blocking certain chemicals at a cell’s neuroreceptor. The drugs we think of as “addictive” are almost always made of chemicals that affect this system, either by mimicking the brain’s neurotransmitters and tricking the cells into doing something they wouldn’t normally do, or by overstimulating the brain’s reward structure.
For example, researchers have determined that dopamine is the most important chemical in the brain’s reward response. Drugs like cocaine or amphetamine can trick the brain into releasing an overabundance of dopamine and, thus, overstimulate the areas of the brain responsible for pleasure, emotion, motivation and physical movement. The overstimulation causes the person to feel euphoric. Repeated doses will eventually teach the person that taking these drugs will produce euphoria. The need to feel the euphoria is called a “craving” and translates into a craving for the drug itself.
Unfortunately, addiction’s affect on the brain does not end there. As the addict continues to take the drug, the brain decides it can reduce its own production of dopamine. As a result, the user will need to compensate for the reduction in the brain’s natural dopamine by taking more of the drug to achieve the same effect. This phenomenon is typically known as “tolerance”. Tolerance can progress to such a degree that the person will ingest a lethal amount of the drug.
Should an addicted individual stop taking the drug, his body will almost immediately protest and produce negative symptoms. These “withdrawal” symptoms, such as nausea, vomiting, and chills, can be very painful and quite debilitating. Because one of the few ways to stop the withdrawal symptoms quickly is to resume ingesting the drug, a person attempting stop taking drugs will be faced with the choice of suffering through the withdrawal stage (which can last a number of days) or resuming use of the addictive substance.
The good news is that treatment does exist for addiction. For patients who would relapse rather than suffer through painful withdrawal, medications can be administered to lessen the negative symptoms. This gives the patient the opportunity to become sober and try to address the issues underlying his addiction. A combination of counseling and psychological therapy can be applied to help the patient learn to cope with cravings and avoid situations that typically lead to using drugs.