Is addiction a disease?

Yes, addiction is a disease — it’s a chronic condition. The American Society of Addiction Medicine (ASAM) defines addiction as a chronic brain disorder. Addiction doesn’t happen from having a lack of willpower or as a result of making bad decisions. Your brain chemistry changes with addiction.
Addiction, now often referred to as a substance use disorder (SUD), is a disease that involves the continued use of one or more substances even though there may be serious health and social consequences.

What causes addiction?

There’s not a single cause of addiction — it’s a very complex condition. A significant part of how addiction develops is through changes in your brain chemistry.
Substances and certain activities affect your brain, especially the reward center of your brain.
Humans are biologically motivated to seek rewards. Often, these rewards come from healthy behaviors. When you spend time with a loved one or eat a delicious meal, your body releases a chemical called dopamine, which makes you feel pleasure. It becomes a cycle: You seek out these experiences because they reward you with good feelings.
Substances send massive surges of dopamine through your brain, too, as well as certain activities, like having sex or spending money. But instead of motivating you to do the things you need to do to survive (eat, work and spend time with loved ones), such massive dopamine levels can have damaging effects on your thoughts, feelings and behavior.
This can create an unhealthy drive to seek more pleasure from the substance or activity and less from healthier activities.
Over time, the substances or activities change your brain chemistry, and you become desensitized to their effects. You then need more to produce the same effect.
For some substances, such as opioids, the withdrawal symptoms are so severe that they create significant motivation to continue using them.

Other factors that contribute to the development of addictions include:

• Genetics: Studies show that genetic factors are responsible for 40% to 60% of the vulnerability to any SUD. If you have a first-degree relative (biological sibling or parent) with a substance abuse disorder, you’re more likely to develop one. Scientists are working to locate specific genes that may contribute to this vulnerability.
  
• Mental health conditions: There’s a strong link between addiction and mental health conditions, such as depression, post-traumatic stress disorder (PTSD) and bipolar disorder. About half of the people who experience a mental health condition will also experience a substance abuse disorder SUD and vice versa.
  
• Environmental factors: Access to substances is a particularly significant environmental risk factor. Factors that increase the extent of exposure and the opportunity for substance use include the use of substances by a member of your household or your peers and being prescribed medications that can be misused, such as opioids or stimulants. Adverse childhood experiences (ACEs) also play a role. ACEs are stressful or traumatic events during childhood. ACEs are strongly related to the development of a wide range of health problems throughout a person’s lifespan, including addiction.
  

Management and Treatment

How are addictions treated?
Your healthcare provider may recommend a combination of treatment options, including:

• Hospital management: Certain substances can create withdrawal that can be dangerous. Special hospital units practice monitoring and therapy to care for you while you go through substance withdrawal.
  
• Medications: Certain medications can reduce urges, cravings and ongoing withdrawal symptoms. If you have another mental health condition, such as bipolar disorder or depression, your provider may treat those with medications as well.
  
• Rehabilitation (rehab): This is also called “sober living” or “residential treatment.” Providers offer structured counseling, education, support and encouragement during rehab. You may live at a rehab facility (inpatient rehab) or visit one for scheduled sessions (outpatient rehab). Rehab services focus on helping you manage addiction long-term and live a healthier life.
  
• Therapy: Several types of therapy help people with addiction gain new perspectives and change their behavior. Your provider may recommend types of psychotherapy (talk therapy), like cognitive behavioral therapy or group therapy.
  
• Support groups: Many people manage addiction with the help of a support group, such as Alcoholics Anonymous or Narcotics Anonymous. Groups like Al-Anon support family members and friends of people with substance use disorders. These groups offer people the opportunity to share experiences and find ongoing support.
  

Prevention

Can I prevent developing an addiction?
There are steps you can take to reduce your risk of developing an addiction, including:

• Avoiding or limiting substances that have addiction potential: Try to avoid or limit your use of non-medical substances, and always follow your provider’s orders for prescription medication use. If you feel like you’re developing a dependence on prescription medication, contact your provider immediately.
  
• Knowing your family history: If you have a family history of substance use disorders or behavioral addictions, you may be more vulnerable. Talk to your healthcare provider about ways to lower your risk.
  
• Healthily managing stress: The risk of substance use increases greatly during times of stress and change. It’s important to turn to healthy coping mechanisms during these times, such as exercising, meditating or learning a new hobby. Consider seeing a mental health professional if you’re having issues managing your stress.
  

Outlook / Prognosis

What is the outlook for addiction?
With treatment, many people manage addiction and live full, healthy lives. But recovering from substance use disorders and behavioral addictions isn’t easy. Supportive friends, family members and healthcare providers play an essential role in effective treatment as well. Without treatment, addiction can cause serious health issues, even death. It can damage personal relationships, lead to financial difficulties and cause legal problems. Untreated addiction also harms family members, and the effects can last for generations.

Living With

How can I help someone with an addiction?
It can be very challenging and stressful to learn that someone you love may have a behavioral addiction or substance use disorder. Here are some tips to help your loved one and yourself:

• Speak up sooner rather than later: The earlier a person with addiction receives treatment, the better. Address your concerns and help them find treatment as soon as possible. Suggest calling a helpline, talking to a healthcare provider or mental health professional, entering a treatment program or going to a 12-step program. Offer your help and support without being judgmental.
• Practice empathy: Even when you don’t agree with your loved one, listen thoughtfully to them. The more your loved one feels heard, the more they’ll see you as someone they can trust.
• Be patient: Don’t expect a single conversation or action to fix your loved one’s addiction. Substance abuse disorders and behavioral addictions are complex chronic conditions, and there’s no quick fix to overcoming them.
• Take care of yourself: The friends and family members of people with addiction often experience stress, depression, grief and isolation. It’s important to take care of your mental health and seek help if you’re experiencing these symptoms. Consider joining a support group or organization in your community.