Addiction: Disease or Behavior?
Is Addiction a Disease or a Bad Behavior?
“Why do I keep using drugs or drinking?” If you found this website because you are trying to solve that problem, you may be out of answers. As you can imagine, many have tried to solve this riddle. One theory that is still prevalent among some is that addiction is merely a behavioral issue, or more specifically, a moral issue. “’Good’ people don’t use drugs or drink. ‘Bad’ people do. So, if you want to stop, simply stop behaving that way, and make good choices.” Certainly, reaching for the next drink or pill is a behavior.
Addiction Is Both a Disease and a Behavior
On the other hand, advances in medicine seem to confirm that addiction is more complicated than that. Many have proposed that it is actually a disease. A disease is a disruption in a part or parts of the body causing them to function incorrectly. Substance abuse is a disease which affects that part of your brain that determines what is necessary for survival. A part of your brain was designed to learn what is necessary for survival and to release pleasurable and rewarding chemicals (already stored in the brain) to let you know that, “This action is good. Do it again.” For someone who has become addicted, the brain (an organ) begins to believe that your drug of choice or alcohol is required for survival. Since your drug of choice or alcohol are not necessary for survival, this is known as an “abnormal symptom,” and this is why addiction is considered a disease.
This is why it is so difficult for some people to stop using or drinking; they are fighting against their own brain.
Continuing to use the drug or alcohol will tend to exaggerate this distortion, which is why stopping—a behavior—is necessary to reverse the disease. Eventually, your brain prioritizes your drug of choice higher than even food. Therefore, it is so difficult for some people to stop using or drinking; they are fighting against their own brain. This is illustrated in the video, “Pleasure Unwoven.” Kevin McCauley, M.D. explains that dopamine plays a major role. Dopamine is released in your brain to teach it that something you did or ingested is better than expected, so it might be important for survival. Dopamine also plays a role in memory, attention, problem solving, and in anticipation of pleasure. Dopamine is also released during adverse circumstances or stimuli. That might explain why when you are hungry, angry, lonely, or tired—all stressful circumstances—you reach for the solution that you remember that relieved the stress before: your drug of choice or alcohol. Taking your drug of choice or drinking then results in more dopamine release, leaving you to feel better, and “teaching” you that you did the “right thing” to relieve your stress. But we know that the consequences which have resulted from drinking and using drugs are often too much to bear. So, in this case, your brain is telling you the wrong thing.
For the addict now, the drug or the drink IS survival.
Dopamine in your brain is naturally released during activities such as eating and sex, placing them on a priority list for survival. Drugs and alcohol cause a much higher than normal release of dopamine, raising your brain’s expectation level. That means when you stop using or drinking, you become unsatisfied: “Why don’t I feel as happy as I used to feel? Something seems wrong.” Fortunately, when you quit using or drinking, eventually your brain lowers this expectation to your own body’s normal level, so that normal activities without drugs and alcohol will feel satisfying. In the meantime, you should add other activities to your life that stimulate this reward system which might be missing. Examples are physical exercise and meditation. Also, it is believed that certain foods might help dopamine production (though a direct connection to dopamine release has not been established), such as almonds, chocolate, green tea, and other foods. For more information, it’s best to consult with your doctor, a nutritionist or dietitian.
In the end, addiction is probably a combination of a disease and a matter of behavior. So how do I change my behavior? We’ll cover that in our next article.