Understanding Addiction

Understanding the disease of addiction

Addiction is a complex chronic disease, affecting both the brain and body. The disease of addiction disturbs the brain's healthy reward circuitry, leading to the unhealthy pursuit of substances or behaviors that trigger those reward circuits.

Addiction is characterized by:

the inability to consistently abstain from pursuing substances or behaviors that trigger the brain's reward circuits
impaired behavioral control
craving
diminished recognition of significant problems with one's behaviors and interpersonal relationships
dysfunctional emotional response

View the American Society of Addiction Medicine Definition

Substance Use Disorder

Substance use disorder (SUD) is the compulsive use of drugs despite harmful consequences. A person may have a substance use disorder but not be addicted. Currently, 21 million Americans suffer from some form of substance use disorder. Symptoms of SUD include:

Using more of a substance than planned, or using a substance for longer than intended
Inability to reduce substance use despite wanting to do so
Spending a substantial portion of one’s time obtaining, using, or recovering from substance use
Cravings and intense desire to use substances
An inability to meet personal or professional obligations because of substance use
Continuing to use substances even knowing that doing so is causing problems
Giving up important activities because of substance use
Using in dangerous or harmful situations
Continuing to use substances even when you know that use is causing or increasing physical or mental problems
Developing tolerance, so that you need to use more of a substance to have the same effect
Withdrawal: experiencing negative physical effects when you have less of the substance in your system.

Understanding drug use and addiction

Information pertaining to drug use and addiction from the National Institute on Drug Abuse; National Institutes of Health; and the U.S. Department of Health and Human Services

Types of drugs; signs and symptoms of abuse

Information from the Mayo Clinic on symptoms, causes, diagnoses, treatments, and links regarding care for someone going through addiction

The science of addiction

A publication from the National Institute on Drug Abuse detailing substance use disorders and the science behind the effects of substance misuse on our brains

Substance use and mental illness

Substance use often coincides with other health issues such as mental illness. When multiple illnesses are present, their effects can be amplified by substance use. All illnesses should be taken into account when diagnosing and treating SUDs.

Learn more about illnesses that commonly occur with substance use disorders

Opioid use disorder

Approximately 11.5 million Americans misused opioids in 2016. About 1.8 million have an opioid use disorder. Opioids are a class of drugs chemically similar to opium poppies. These drugs have been proven to help treat acute pain and are often prescribed for chronic pain as well. The most well-known opioids are oxycodone, hydrocodone, fentanyl, and morphine. While these drugs have been proven to help with acute pain, they are highly addictive.

Read the National Institute on Drug Abuse discussion of opioids

Causes of addiction

Genetics, brain development, and numerous other factors contribute to the development of addiction and substance use disorders.

For instance, an individual with certain biological or genetic tendencies may be more likely to engage in substance misuse if they are isolated from supportive family and social networks. An individual who suffers from addiction in a community where addiction is stigmatized is less likely to seek treatment or stay in recovery than someone whose community supports their efforts to manage their disease through treatment and long-term recovery.

To fully understand addiction, it is important to recognize the potential of all these factors to contribute to, or guard against, the development of addiction and substance use disorders. Efforts to promote prevention, treatment, and recovery need to take all these levels into consideration.

A socio-ecological model of substance use disorder

The socio-ecological model of addiction and substance use disorders recognizes the mosaic of interactions that play a role in addiction, including society and public policy (laws and regulations); communities; organizations and personal networks; and our own individual biological, genetic, and psychological makeup. Successful efforts to reduce addiction and substance use disorder must address factors at all these levels.

This model of substance use disorder shows four concentric circles illustrating how the following factors contributing to the disorder are all interrelated: society and public policy (laws and regulations); communities; organizations and personal networks; and our own individual biological, genetic, and psychological makeup.

Effects of addiction

Overdoses

More than 115 Americans die every day from opioid overdoses. Users develop tolerance for the drug over time, requiring higher doses to feel the same effects. A majority of deaths are unintentional, caused by respiratory depression. Users develop mental tolerance for the drug's rewarding effects faster than a tolerance for the effects on the respiratory system. To counteract the crisis, physicians have begun prescribing fewer opioids, which has pushed many users to the streets for drugs. Street opioids, such as heroin and fentanyl, are currently responsible for a majority of overdose deaths. These street drugs are cheaper than prescription opioids and significantly more powerful — fentanyl is 50-100 times stronger than morphine.

The following graph shows how synthetic opioid overdoses have increased from 2000 to 2016, with especially steep increase in the past five years compared to overdoses from other drugs such as cocaine and methamphetamine.

A graph depicting the number of overdose related deaths within the US between 2000 and 2016.

Naloxone is the main drug used to treat opioid overdoses. It reverses the effects of opioids. Naloxone needs to be administered as fast as possible once an overdose occurs.

CDC

Centers for Disease Control and Prevention data on prescription opioids

Identifying an overdose

Information on recognizing opioid overdose from the Harm Reduction Collective

Opioid overdoses

Information and resources on causes, risks, and signs of opioid overdose from MedlinePlus, the National Institutes of Health's website for patients and their families and friends

Neonatal abstinence syndrome

Neonatal abstinence syndrome is caused when a newborn withdraws from exposure to addictive drugs in the womb before birth. NAS is most commonly caused by a mother’s opioid use during pregnancy. Opioids pass through the placenta to the baby, making the baby dependent on the drug. After birth, withdrawal symptoms begin. NAS can lead to poor intrauterine growth, premature birth, seizures, and birth defects.

Learn more about NAS Learn more about opioid use and pregnancy

Alternatives to opioids

Opioids are currently the best way to treat short-term pain. Researchers are currently exploring alternatives for pain management and identifying substitutes for opioids.

Learn more about opioid alternatives

Visit the Indiana Addiction Hotline