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 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.

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