What is at the Core of Addiction

I am asked this question – What is at the Core of Addiction (aka Severe Substance Use Disorder)? – in some form or another, over and over and over, again. And typically, by the time a person is asking me, they are at their wits end. For they, like tens of millions of other Americans and hundreds of millions of people worldwide, have been fighting to change something that’s deeply shrouded in stigma, misinformation and shame.

So What is at the Core of Addiction?

What is at the core of addiction? A person. A person who happens to have the chronic, often relapsing brain disease of addiction

What is at the core of addiction? A person. A person who happens to have the chronic, often relapsing brain disease of addiction

First and foremost – a person. A person who happens to have the chronic, often relapsing brain disease of addiction (aka severe Substance Use Disorder), whether that be a dependence on alcohol or other drugs.

You see, by its simplest definition, a disease is something that changes cells in a negative way. Addiction changes the way cells in the brain communicate with one another.

Just as colon cancer changes cells in the colon, thereby changing the health and function of the colon, so too does addiction change the health and function of the brain. Given the brain controls EVERYTHING a person thinks, feels, says and does (controls that are mapped as the brain develops and further mapped as the brain copes and processes that which comes at it throughout its day / life, such as those mapped around an addiction), it is the disease, itself – not the person – in control.

Thus, understanding that at the core of addiction is a person, a person who happens to have the chronic, often relapsing brain disease of addiction, frees us to set aside stereotypical beliefs about addiction and those who “keep drinking or drugging in spite of the heartache and havoc their behaviors cause,” and it is that which frees us to change. For addiction not only affects the person with the disease, it affects the physical and emotional health of everyone who has had to cope with that person’s addiction-related behaviors.

Reaching that Core aka How Do You “Fix” Them

To answer this, I’ve updated this post from its original publication date of January 31, 2014 to share the Table of Contents from my latest book, 10th Anniversary Edition If You Loved Me, You’d Stop! (2019) – a book I encourage you to read. I encourage you to read it not so I can sell books but so you’ll know the research advances that more fully explain what is at the core of addiction. And not only that, but what happens to the family members and friends who love them.

PART 1 – How Things Got So Bad
Chapter 1         “If You Loved Me, You’d Stop!”

Chapter 2         You’re Not Crazy, Something Really Is Wrong

Chapter 3         How Much is “Too” Much?

PART 2 – The Human Brain Key to Understanding a Loved One’s Drinking and Its Impact on Family Members and Friends
Chapter 4         Basic Brain Facts

PART 3 – How Alcohol “Hijacks” the Brain & What Can Be Done to Stop It
Chapter 5         How Alcohol “Hijacks” the Brain

Chapter 6         Crossing the Line From Alcohol Abuse to Alcoholism

Chapter 7         Is There a Cure?

PART 4 – The Family Member’s Experience
Chapter 8         Now What?

Chapter 9         How Toxic Stress “Hijacks” the Brain

Chapter 10       Finding Your Own Recovery

PART 5 – Reclaiming Your Life
Chapter 11       Practical Tools and Tips to Help With Reclaiming Your Life

Chapter 12       More Tools and Tips

Chapter 13       Changing Your Relationship With Your Loved One

Chapter 14       What to Say to Children, Extended Family, and Friends, Plus Other Concerns

A Few Final Words…

Acknowledgments

About the Author

Bibliography & Resources

Endnotes

When a loved one understands that addiction is a brain disease (brain disorder) and as such is a medical condition that needs tailored treatment, they gain a whole new understanding of what it takes to treat this disease/disorder. Check out NIDA’s Treatment Approach for Drug Addiction (FYI – alcohol is considered a drug.]. Here are the first two principles listed in this resource:

  1. Addiction is a complex but treatable disease that affects brain function and behavior.  Drugs of abuse alter the brain’s structure and function, resulting in changes that persist long after drug use has ceased. This may explain why drug abusers are at risk for relapse even after long periods of abstinence and despite the potentially devastating consequences.
  2. No single treatment is appropriate for everyone.  Treatment varies depending on the type of drug and the characteristics of the patients. Matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society.

They’ll also gain key insights that help them realize just how deeply their physical and emotional health has been affected over the years they’ve been trying to help their loved one.

And, as always…

If you have questions, please send me an email at lisaf@breakingthecycles.com to arrange a phone call. There is no charge.

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Note: This post was originally published in July 2014. It was updated in December 2020 and July 2022.

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.
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2 Comments

  1. Cathy Taughinbaugh on August 4, 2014 at 10:48 am

    Hi Lisa,

    Great information and links here. This is definitely a post to keep and reread. I always like your videos as well. Number 5 – “No single treatment is appropriate for everyone.” is one that keeps coming up for me. Too many people feel that the answer to addiction for everyone is the 12 Step program. While it has helped many, there are other options that may support a person who is struggling in better ways. The more we get this information out there, like you have in the excellent post, the better for everyone.

    • Lisa Frederiksen on August 4, 2014 at 10:50 am

      So appreciate your input, Cathy – I agree – that #5 is such a road block for people. Thanks for sharing this one!

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