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Is addiction a disease? Why is it people just can’t stop?

Friends and family members sometimes become confounded by their loved ones chronic use of substances, despite there being a lot of evidence that those very substances are causing harm.  Addictive behaviour is best viewed as a chronic relapsing disease of the brain.

When using a lot of a substance, a person can become intoxicated or impaired.  This often results in the inability to think clearly, or make rational decisions of right and wrong, or good choice vs. bad choice. From a  medical perspective, this happens because the activity in their frontal cortex (part of the brain) which provides this ability is turned OFF by the use of the substance.

We’re going to get a bit technical here.  When not using the substance the person’s emotional centres in the midbrain area are typically hyperactive and causing dysphoria (big word meaning state of unease or general dissatisfaction with life).   This is when we may see somebody being very irritable and agitated.  This means that when we use a lot of substances, the brain is still impaired even if at that very moment they might appear “clean” from alcohol and drugs.

We also now know that addictive behaviour often has a genetic component.  This person’s brain is primed to be captured by a substance even before they have been exposed to it.  Therefore, some of us are pre-primed to be stimulated and rewarded by substance use in a way that others are not.  If you are in this category, the brain fires off the strongest levels of dopamine into the reward centres.

Once stimulated strongly with the rewarding substance the person craves and seeks out that reward again and again. They are not fully in control of this using behaviour because of the dopamine drive. Their midbrain has been down-regulated by their compulsive use (ie – not working  so well). The rest of life becomes not as stimulating and other rewards lose their strength because of this down-regulation. Sometimes people can experience constant craving that is not under the person’s control.

Once again a person’s ability to feel, see, think, make decisions and resist cravings all become impaired. The person then acts on what has become wired in the midbrain as the strongest drive. This is not a logical decision and it results in compulsive uncontrolled behavior that can often lead to behaviour that is unhealthy, self destructive, isolating and soul destroying.

Question – If we are able to prove from a medical science perspective that addiction is an illness, why do we continue to judge people that are struggling with using  substances in an adverse way?

Want to know more or seek help for your substance use?   Give us a call – we are here to help people wanting to change their use and friends and family who are struggling with someone that is using.