Addiction a brain disease?
“No way,” or some variation thereof, is the typical reaction, I hear. Followed by something along the lines of, “Cancer is a disease. All they have to do is put down the bottle [or stop using the drug]!”
Recent Research Identifies Why/How Addiction is a Brain Disease
Thanks in large part to new imaging technologies of the past 10-15 years (such as fMRI, SPECT and PET), neuroscientists and medical professionals have now identified addiction (to illegal or prescription drugs or alcohol) as a chronic, often relapsing brain disease. Who says? The following is a sampling of the agencies conducting and/or reporting on this research:
- National Institute on Drug Abuse (NIDA)
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- Centers for Disease Control and Public Health (CDC)
- Substance Abuse & Mental Health Services Agency (SAMHSA),
- The Addiction Project (NIAAA, NIDA, Robert Wood Johnson Foundation, HBO collaboration)
How is Addiction a Brain Disease?
By its simplest definition, a disease is something that changes cells in a negative way. Addiction changes cells in the brain. It starts with substance abuse – meaning to use more of a drug (which includes alcohol, prescription or illegal drugs) than is prescribed or considered “low-risk” use. (See #1 below.)
All substances of abuse reach the brain through the bloodstream. Drugs contain chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs cause this disruption: (1) by imitating the brain’s natural chemical messengers and (2) by over-stimulating the “reward circuit” of the brain. [NIDA]
When substances are abused, they actually change the structure of our brain cells and the way the brain functions. To view the Amen Clinics SPECT scans showing brain impacts of drug and alcohol abuse, click here. When the abuse crosses the line to addiction, it becomes a chronic, relapsing disease – like diabetes, asthma or heart disease. In the case of addiction, it happens to change cells in the brain, which is what makes it a brain disease.
Like the other diseases mentioned, addiction can be successfully managed (treated). A person with addiction can live a wonderful, productive, enjoyable life when they treat their disease. (See #3 below.)
For more information, check out The Addiction Project: Understanding Addiction.
How Does a Person Get the Brain Disease of Addiction?
As mentioned above, it starts with substance abuse. That is what chemically and structurally changes the brain. This in turn makes the brain more susceptible to the risk factors for developing the disease. Notice I said, “developing the disease.” People are not born addicts/alcoholics. Rather there are a number of “entry points” – risk factors – that contribute to the reason one person who abuses substances crosses the line to addiction and another person does not. These risk factors include:
- genetics (it’s not that there is an “addiction gene,” but rather there are approximately 25K genes in our DNA – how those go together can result in genetic predispositions to substance abuse / addiction, such as lower levels of the liver enzyme that breaks down alcohol or higher or lower levels of neurotransmitters or receptors — similar to how we carry genetic differences that predispose us to eye, hair or skin color or certain illnesses);
- mental illness (such as ADHD, depression, PTSD, anxiety which also cause brain changes and often motivate a person to abuse a substance in order to self-medicate the mental illness);
- childhood trauma (such as verbal, physical or emotional abuse, which is now understood to actually change the brain’s circuitry as it’s developing from birth);
- social environment (such as a home or school environment where heavy drinking is viewed as normal and therefore modeled – a drinking pattern that may be especially problematic for one’s brain – especially if there are brain changes caused by the other risk factors, as well); and
- early use (heavy drinking during the brain developmental years of ages 12 through early 20s, when the brain is wiring neural networks related to puberty, cerebral cortex development and the strengthening and pruning process — the young brain is not the brain of an adult and is especially vulnerable to substance abuse).
For more information, check out The Addiction Project: Why Do Some People Become Addicted?
How Can Addiction Be Avoided?
1. Stay within low-risk limits.
- For alcohol, this is defined as:
For women: no more than 7 standard drinks/week, with no more than 3 of the 7 in a day
For men: no more than 14 standard drinks/week, with no more than 4 of the 14 in a day
A standard drink is defined as 5 ounces of wine or 12 ounces of regular beer or 1.5ounces of 80-proof hard liquor. For more info, check out NIAAA’s website, Rethinking Drinking
- For prescription drugs, this is staying within the prescribed dosage at all times.
- For illegal drugs – zero
2. Inventory your possible risk factors. Using the list of risk factor descriptions above, look at your family history and your own history. If you are abusing drugs or alcohol and have some of these risk factors, the chances of your substance abuse crossing the line to addiction are greater.
3. If you’re worried, seek help. All addicts/alcoholics go through a period of substance abuse but not all abusers will become addicts/alcoholics. Addiction is a developmental disease. NIDA offers a free, excellent resource that can help with what to look for in a treatment program, titled: “Principles of Drug Addiction Treatment: A Research-Based Guide (Second Edition).”
4. Know that treatment – successful, life-long recovery – is absolutely possible.
5. Understand that no one chooses to become a drug addict/alcoholic. Yes, they choose to start using, but they do not choose to become addicted. That is what happens as the substance chemically, structurally and functionally changes the brain.