“It’s All in Your Head”


For centuries, addiction was viewed as a psychological problem, all just in someone’s head. To be “cured” someone simply needed to want to quit. Addiction is, in fact, in a person’s head, but not in the way many believed. It is in people’s heads because addiction alters the brain.

Addiction is a chronic disease that afflicts millions of people across the country and millions more around the globe. It does not discriminate against an individual’s socioeconomic status, gender, sexual orientation, race, etc. It affects people of all backgrounds across all generations. It collaterally affects the families and loved ones of those battling this disease.

Addiction is an extremely complex disease that is misunderstood by many people to this day. Though much progress has been made regarding the stigma around addiction, many still view addiction as a moral failing. Unlike many other diseases, there is a sense of blame that is placed on those that have addictions.  As a whole, society has demonized addiction and made it so that those who are battling the disease have a hard time speaking out and seeking out the necessary treatment for the fear of being ashamed and judged.

Addiction, however, is not a moral failing. It is, instead, a chronic disease that often requires medical and professional help. Much like other diseases, addiction can destroy relationships with loved ones, it can cause many health and financial problems. Even with all of the negative consequences, addiction is hard to break because there is no simple solution or cure.

While no one decides or chooses to have a substance use disorder, some are more genetically predisposed to addiction than others. Through various research regarding addiction, genetics have been found to play a role in the disease. Studies conducted on twins and adopted children show that about 40 to 60 percent of susceptibility to addiction is hereditary. While it is not clear why some people become addicted and others do not, there are some factors such as genetics and environment that increase a person’s susceptibility to having an addiction.

But what is clear is the use of alcohol and drugs alters the brain and makes it harder for those with substance use disorders to quit. The brain starts to rely on the substance. Though the initial decision to try a substance may be voluntary, after a while it becomes compulsive – people begin to lose the ability to say no.

After continued substance use, the part of the brain that controls judgment becomes impaired. Once the brain becomes impaired, the person struggles to have the control he or she needs to say no. Addictive substances flood the brain’s reward circuit with dopamine. Dopamine is a chemical messenger that signals pleasure. Once dopamine is released, the brain begins to associate the substance with that feeling of pleasure, the “high.” This leads to the individual wanting to use that substance over and over again to chase that same feeling.

However, the feeling of pleasure diminishes as the brain adjusts to the excess dopamine; as a result, more of the substance is required in order for the individual to experience the same amount of pleasure. This leads to individuals developing a tolerance, needing more to feel the pleasure they once experienced. In many cases, individuals begin to take more of the substance in order to achieve that high and it becomes more difficult to break the addiction. Long-term use of drugs and/or alcohol leads to sometimes permanent changes in the brain, depending on the frequency and amount the individual used. The repeated use of drugs and/or alcohol begins to affect functions in the brain like learning, judgment, decision-making, and memory.

In addition, this excess dopamine can also lessen the pleasure an individual feels when they begin to do other things that once brought them pleasure, such as spending time with friend or eating their favorite dessert.

After someone stops using, they face withdrawals. Withdrawal symptoms include anxiety, shaking, fatigue, among many more effects. The only way to get immediate relief from the symptoms is to use the substance. Wanting a release from these unpleasant symptoms and to temporarily experience the “high” once again, the individual oftentimes turns to the substance. The brain has already associated said substance with pleasure and learned that this is the way to feel good. The brain is wired to seek pleasure, and once it has associated a certain action with pleasure, it is begins to seek out the source of the pleasure.

Since addiction affects learning and memory, people may be in danger of relapsing after seeing a beer bottle, for instance if they have alcohol use disorder. Because of conditioned learning, they will begin to crave the alcohol and feel compulsion try to take over – even if they haven’t had alcohol in a long time. The hippocampus and amygdala are the two parts of the brain that store environmental cues and even when an individual no longer wants to continue seeking out the source of their pleasure, the brain still associates the source with pleasure – they develop cravings when they are around the substance.

Many individuals battling addiction feel that they have to go through this fight by themselves, and to carry that burden solely on their shoulders. It is not an easy topic to discuss, but it is one that needs to be addressed differently. Instead of blame, empathy and acceptance needs to be shown towards those who are struggling. The stigma of addiction puts blame solely on those who have it. While breaking the vicious cycle of addiction does indeed take a lot of willpower and inner strength, it is not as easy as an individual deciding to quit.

Much like many other diseases, addiction can be treated and managed. It is important to remember that relapses do occur, but it does not mean that the individual cannot successfully manage their addiction. Having specialized treatment programs and seeking out professional help is the best way to start towards a life of sobriety. Attempting to go “cold-turkey” without professional supervision can be dangerous. There are instances of death and other life-threatening occurrences. Which is why seeking out professional help is the safest and most reliable way to begin the journey to recovery.

Addiction: A Disease Delegitimized by Stigma

Professional medical associheroinations, such as the American Society of Addiction Medicine and American Medical Association, define addiction as a disease just like diabetes, cancer, or heart disease. Articulating a usable definition of what “disease” actually is can be surprisingly difficult, as notions of health vary by context. Dorland’s Medical Dictionary generally defines disease as any condition that causes pain, dysfunction, distress, social problems, or death to the person afflicted.

Dr. Thomas Britton, CEO of Gateway Foundation, wrote in his article “Releasing Stigma’s Grip” that the many facets of drugs and alcohol addiction make it a unique disease. In comparison to cancer or diabetes, addiction strongly affects spiritual and mental wellness—not just physical wellness. Dr. Britton explains that this cumulative approach generates internal battles in those inflicted and seeking help. He writes, “Many people are simply overcome with feelings of inadequacy, shame and embarrassment.”

Perhaps this is due to society’s disillusioned notions of addiction. Stereotypes of dependency disrupt society at large from truly understanding the legitimacy of the disease. Drug and alcohol abuse are commonly associated with crime, broken homes, laziness, violence, and moral failing. Dr. Britton explains that fear of judgment may prevent those suffering from seeking the treatment they need.

According to the Center of Addiction, up to 25 percent of people with substance abuse problems appear to have a chronic disorder, meaning that their disease is a long-lasting condition that can be controlled but not cured. For chronic sufferers, addiction is a progressive, relapsing disease that requires intensive treatments and continuing aftercare, monitoring, and support to manage recovery.

You may find Dr. Thomas Britton’s full article, “Releasing Stigma’s Grip,” here. If you or someone you know is suffering from substance abuse disorder, do not let shame or judgment impede pursuit of treatment. To get your or your loved one’s life back on track, learn more about treatment options at RecoverGateway.org.


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