Addiction is a chronic debilitating brain disease
Addiction is a chronic, often fatal disease that causes obsessive and compulsive drug seeking behaviors, and use despite harmful consequences to the addict and to those around them. Drug addiction is a brain disease simply because the abuse of drugs leads to changes in the structure and function of the brain. There are many biological factors that are involved with the addicted brain. “The addicted brain is distinctly different from the non-addicted brain, as manifested by changes in brain metabolic activity, receptor availability, gene expression, and responsiveness to environmental cues” (Leshner, 1997). In the brain, there are many changes that take place when drugs enter a persons blood stream. The pathway in the brain that the drugs take is first to the ventral tegmentum to the nucleus accumbens, and the drugs also go to the limbic system and the orbitofrontal cortex, which is called the mesolimbic reward system. ???The activation of this reward system seems to be the common element in what hooks drug users on drugs??? (Leshner,
It is because of these changes in the brain that it is so challenging for a person who is addicted to stop abusing drugs. Fortunately, there are treatments that help people to counteract addiction??™s powerful disruptive effects and regain control. Treatment approaches that are tailored to each patient??™s drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse.
Similar to other chronic relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. As with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal failure rather, it indicates that treatment should be reinstated, adjusted, or that alternate treatment is needed to help the individual regain control and recover.
Drug addiction is a disabling disease and can ruin a persons life. By taking drugs, a persons brain becomes “rewired” to tolerate high amounts of dopamine neurotransmitters, but once those high amounts of dopamine cease to exist, the person experiences withdrawal symptoms. However, there are ways drug addicts can control their drug intake by using classical conditioning techniques, which allows them to associate drugs with negative attributes.
Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person??™s self-control and ability to make sound decisions, and at the same time the brain sends intense impulses to take drugs.
Addiction is a brain disease-and it matters??™ (National Institute of Justice, US). Addictive behavior has been discussed and researched upon by many scientists as to its association or relationship with brain basis. This piece of findings seeks to provide evidence that addictive behavior has brain basis.
To start with, any activity, substance, object, or behavior that has become the major focus of a persons life to the exclusion of other activities, or that has begun to harm the individual or others physically, mentally, or socially is considered an addictive behavior. (Altman et al.1996).
Addiction as a whole may be either substance addiction such as drug, alcohol, nicotine and other psychoactive drugs and stimulants or behavioral addictions.
The type of behaviors which some people have identified as being addictive include gambling, food, sex, pornography, use of computers, playing video games, use of the internet, work, exercise, spiritual obsession (as opposed to religious devotion), cutting, and shopping.
Behaviors like gambling have been linked to the new found idea of the brain??™s capacity to predict rewards. The reward system can be triggered by early detectors of the behavior, and trigger dopamine neurons to begin stimulating behaviors. But in some cases, it can lead to many issues due to error, or reward-prediction errors.
When analyzing the addiction to food for example, a published study in 2009 from The Scripps Research Institute have shown for the first time that the same molecular mechanisms that drive people into drug addiction are behind the compulsion to overeat, pushing people into obesity. In this study, scientists focused on a particular receptor in the brain known to play an important role in vulnerability to drug addiction??”the dopamine D2 receptor. The D2 receptor responds to dopamine, a neurotransmitter that is released in the brain by pleasurable experiences like food or sex or drugs like cocaine
Natural rewarding behaviors such as sex and food, and all drugs of abuse have a common neurotransmitter; dopamine, which have the ability to increase the levels of extracellular dopamine in the brain. Dopamine is increased in the NA, which is part of the common reward mesolimbic pathway from the VTA to the NA
Despite the causes of these addictive behaviors such as deficit in serotonin have been postulated as causing the disorders in ADHD in children and Tourette Syndrome (TS) in children.
All addictive behaviors have certain traits in common that is the ability to impact neurochemicals changes in the brain chemistry. For instance Dopamine and Norepinephrine are chiefly responsibly to creating the ???brain high??™ that makes one feel so good.
Dopamine, being the second major neurotransmitter in the brain and known for controlling muscle movement, crucial neurotransmitter for reward, cocaine administration increases metabolism in the Substantia Nigra (SN)
The various evidence includes the following studies
Firstly, study on neural mechanisms of animals??™ preference: Animals show preference for the environment that associate with the rewarding effect of chemical substances and/or events. They choose the environment more frequently and stay longer time in it. This well known behavior is called ???conditioned place preference??? and the brain ???reward??? system relates to this behavior. However, the very basic question, why an animals??™ body moves toward the ???preferred??? side has not been answered. This is a type of spatial learning where neural systems including hippocampus are thought to play important roles. Dopamine and neural mechanisms that integrate information about environmental cues, rewarding events, spatial memory, and those that generate the motor commands
Also, study on regulating mechanisms of substance intake: The intake of natural reward, such as food and water, is usually regulated by the homeostatic mechanisms. However, binge intake of addictive substances occurs when such homeostatic mechanisms become aberrant. Recent studies show such aberration is related to cyclic up and down of mood and putative neural substrates of the cycle have been proposed. And the development of a model behavior of binge intake using drug self-administration technique, monitoring neural activity and/or dynamism of neurotransmitters in the brain, then feedback them to the animals??™ brain and examine the influence on behavior.
More so, study on sensory reward: Many abused chemical substances produce sensory modification in humans, sensitizing specific sensory experiences, causing hallucinations, or distorting time perception. These sensory modifications produce a hedonistic mood and the mood reinforces compulsive access to these substances. However, due to technical difficulties in examining sensory experience in animals, the role of sensory modification in addiction has not been well documented. Recent advancement of studies on cannabinoid receptors and their endogenous ligands opened the way to examine modulating roles of cannabinoid system on the sensory experience. Their development of a behavioral technique to evaluate sensory modification and explore the interaction between cannabinoid and other neurotransmitter systems.
The awareness of addictions is growing at an alarming rate in the United States. Many health care professionals are working overtime in treating people with disabling addictions. But within the mental health care profession, many are divided as to the arising issue and cause of addiction. My goal in writing this paper is to research addictions and their causes: are addictions genetic Are addictions a learned behavior What environmental influences make people susceptible to addictions What causes someone to develop an addictive personality
Since 1980, deaths caused by drug overdoses have risen over 540 percent (Drug addiction, 2008). Many health care and drug treatment professionals are working overtime in treating people with disabling addictions. Within the mental health care profession, many are divided as to the arising issue and cause of addiction. Are drug addictions simply genetic It is possible that an individual may be genetically susceptible to addiction; but it does not mean it is inevitable. In answer to this question and the question of the causes of addiction, it is important to know that ?????¦someone??™s genetic makeup will never doom them to inevitably become an addict. Remember, environment makes up a large part of addiction risk??? (Genetics is an Important Factor, 2008). While there is evidence that addiction can follow genetic paths in families, even where there is no interactions between generations of addicts, a person??™s environment can have just as much of an influence on their addiction and behavior.
Francis J. White, a member of the Department of Cellular and Molecular Pharmacology at Finch University of Health Sciences in Chicago, states, ???Drug addiction is most often defined as a chronically relapsing disorder in which the addict experiences uncontrollable compulsion to take drugs, while simultaneously the repertoire of behaviors not related to drug seeking, taking, and recovery declines dramatically??? [ (White, 2002) ].
Current research has found alarming relationships between both addiction and genetics, and addiction and environmental influences. Once a person begins using drugs, there are dramatic changes in brain chemistry and physiology, strengthening the cycle of addiction (White, 2002). As the cycle strengthens, the behavior affects the brain more. This is an extreme situation where free will and decision making are severely affected (White, 2002). This paper will examine the cause and effect of addiction on genetics and environment.
A single gene does not cause addiction, but multiple genes have been shown to contribute to the illness of addiction.
Alcoholics and cocaine addicts often express the A1 allele of the dopamine
receptor gene DRD2 and lack the serotonin receptor gene Htr1b. These genes
both fit into the pleasure-response category, but there are numerous ways in which
other genes affect an individual??™s response to drugs, from tolerance of the
substance to the severity of withdrawal. (Drugs Alter the Brain, 2009)
But do these genetic factors exist before the addict experiences the first use of drugs Are the genes simply turned on like a light switch upon first use Is it possible to see these predispositions through other behaviors before the addiction becomes active Specialists refer to addictive behavior as being more than the use of drugs and that there is much more to addiction. Can we say for sure that the addictive behavior is solely a result of genetics or learned behavior; or is it a combination of both
Examples of environmental influences include access to education, income levels and crime rates. These can all affect both when the addict begins using and the severity of usage. Although all of these can affect usage, no one area can specifically be blamed as the cause. For example, drug usage is not discriminative between users such as those in rural versus urban areas. This lies merely in the area??™s drug of choice and the accessibility of drugs in these areas. These risk factors can be very difficult to isolate (NIDA InfoFacts, 2008) due to the fact that addicts do their best to hide their addictions; particualary to family, friends, and co-workers. Looking beyond genetics and the environment, which is a major contributor to addiction, is the change in the brain??™s physiology, or structural functions, caused by drug use and addiction.
Effects on the Brain??™s Physiology
Another major contributor to addiction is the change in the brain??™s physiology, or structural functions, caused by drug use and addiction. Pleasure responses in the brain are a reward system where dopamine receptors are activated, thus encouraging repetition of the behavior. Drug addiction hyper-activates the natural cycle of dopamine by altering ???neural function in such a way as to render the brain circuits mediating various behavioral effects of these drugs more, or less, responsive to those effects??? [ (White, 2002) ]. There are several neurotransmitter systems that have been shown to interfere with the brain??™s circuits controlling mood, which affects the underlying addiction. Addiction retards the individual??™s decision making process and inhibits free will, along with affecting cognition such as problem solving and decision making. These two basic cognition skills are compromised through biochemical changes in the brain that encourage and sustain usage. This sustained usage, leading to addiction, directly influences self regulation. For example, addiction may cause the addict to not be able to stop or control usage, neglect family obligations, affect work ethics, and more.
In adolescent addicts, these biochemical changes are complicated; the brain??™s physiology is affected and underdeveloped by early drug use (More People in Treatment, 2006). The frontal cortex, which is responsible for reasoning, personality, and self-esteem, matures during the teen years, becoming less oriented toward risk taking behavior during this time (Genetics is an Important Factor, 2008). During addiction, the normal maturation process is replaced by an imbalance between the reward response pathway, which becomes overactive, and the logic area of the frontal cortex is overridden by the drug abuse.
Connecting natural rewards to drug addiction can explain how addiction overtakes the brain and affects an individual??™s ability to perform basic tasks, such as eating and sleeping.
Indeed, a recurring theme in modern addiction research is the extent to which
neuroadaptations responsible for various aspects of the addiction process are
similar to those responsible for other forms of neural plasticity studied in cellular
models of learning, such as long term potentiation and long term
depression. [ (White, 2002) ]
We must understand that drugs do not replace components in the brain, but only alter them. If the brain??™s natural state could be replaced with addiction, the addiction must be an inherent part of the brain??™s infrastructure; thus showing evidence that addiction has genetic pathways, or that the addiction at least uses them.
But drug addiction is a combination of both genetic and environmental factors. However, when the addict has a genetic pre-disposition, environmental factors will have more of an influence than if the individual had no genetic pre-disposition. Some will argue that one only becomes an addict by learning the behavior and does not posses a genetic pre-disposition. But those who are predisposed may show evidence of it through other types of behavior. For example, they may find it harder to refrain from watching too much television or may find it harder to break a bad habit. Although this cannot in itself be a determining factor of genetic pre-disposition, it may be an indication of it.
How It Begins
Addiction is not rigid, but continually changing. As a person??™s addiction develops, it becomes their way of life. And as it does, it inflicts changes on the people suffering from their addiction.
There are three states of addiction and the addictive lifestyle: internal change, lifestyle change, and life breakdown.
The first stage or the lifestyle change is the first solidifying stage of the addiction process. In his book ???The addictive Personality???, Craig Nakken writes, ???Long before anyone suspects or knows there is a problem, many changes will have taken place deep within the addict??? [ (Nakken, 1996) ].
The addict??™s journey begins when he experiences the high, or mood change. Even those who are not addicts experience this mood change, but, to the addict, ?????¦it is new, intense knowledge??? [ (Nakken, 1996) ]. An illusion of control, comfort, and perfection exists in this mood change. Perhaps the fact that ?????¦intoxicating experiences bring the knowledge that through a relationship with an object or event??¦??? [ (Nakken, 1996) ] is the basis for the actual addiction when it comes to the addict??™s behavior and personality.
Over a period of time, the addict??™s logic develops into a system that will direct his life. Although he may fight this, it will eventually take control, becoming a wall that surrounds him. There are two functions of this wall: first, to keep himself locked in; secondly, to keep people away that will endanger his addictive relationship [ (Nakken, 1996) ].
The second stage in the developing addictive lifestyle is the actual lifestyle change. ???Once the addictive personality is firmly in place, the behavioral aspects of addiction become more prevalent??? [ (Nakken, 1996) ]. The addictive lifestyle only becomes solid after the development of the addictive personality. In understanding this, we must first understand that there are contributing factors to developing the addictive behavior or lifestyle. This is where the combination of genetics and learned behavior become cohesive.
Within the lifestyle change, the addict begins to re-arrange their life and relationships with addictive logic as their guide. This is the time when their commitment to addiction encompasses their whole life. In solidifying their behavior, the addict will not only betray themselves, but others as well. They lie to others, blame others, and begin to ritualize their behavior and withdrawing from others. In this stage the retreat now is not only emotional, but mental and physical as well [ (Nakken, 1996) ].
Once the addict is securely in their addictive lifestyle, people around them will begin to label them. Examples of this labeling may include: irresponsible, troubled, sick in the head, weak, or other labels. When the addict hears this, it only sets them deeper in their addiction and addictive lifestyle, thus increasing the addictive process.
The third and final stage of the development of the addictive lifestyle is life breakdown. This stage occurs when the addiction produces pain, fear, shame, loneliness, and anger. By this stage, the addictive personality is in complete control. Because of this, the addict cares nothing about others or the problems that his addiction causes. All he cares about is getting high and acting out. This is the point when the addict will break down emotionally, mentally, and physically [ (Nakken, 1996) ].
Testing and Diagnosis
Addiction is a chronic disorder that is prone to relapsing behaviors; even after treatment the addict may tend to fall back into addictive behaviors [ (Drug Addiction, 2007) ]. The sooner the addict seeks treatment, the less likely he or she will fall back into the addictive behaviors.
Diagnosing drug addiction often starts at the family practice level. The doctor may ask a series of questions such as: frequency of use, criticism from family or friends about their decisions and asking the addict if they feel he or she has a problem. Although a diagnosis cannot be definitive, except if made by a healthcare professional or addiction counselor, blood tests may be performed; though they typically cannot diagnose an addiction. They can only provide information if the individual has recently used [ (Drug Addiction, 2007) ].
Treatment and Drugs
Drug addiction treatment involves steps to help the addict end the addiction. Included in these steps are counseling, therapy, and self-help groups.
Withdrawal therapy or detoxification is designed to help the addict stop the use of drugs as safely and quickly as possible. This may include either substituting an illicit drug with other drugs (such as methadone), or cut out the illicit drug use all together depending on the severity of the addiction and usage. This often requires inpatient treatment status [ (Drug Addiction, 2007) ]. After detoxification it is imperative that the addict continues treatment, which may include counseling, self-help groups or a combination of the two.
Counseling is typically executed with a psychologist or psychiatrist. This is the point when the addict may undergo behavior therapies. These therapies can teach the addict ways and methods to cope with the addiction and its symptoms; for example, cravings, temptation to relapse, and what to do if the addict does relapse. The counseling will be more successful if it involves the addict??™s friends and family as well [ (Drug Addiction, 2007) ].
Self-help groups often assist the addict because he or she is involved in treatment with others struggling with the same issue. These groups may include the 12-step model based on Alcoholics Anonymous or one led by a drug counselor, or groups sponsored by a religious organization. ???The message is that addiction is a chronic disorder with a danger of relapse and that ongoing maintenance treatment??”which may include medications, counseling and attending self-help group meetings??”is necessary to prevent a relapse??? [ (Drug Addiction, 2007) ]. One of the main reasons that self-help groups have a high success rate is that, even though the addict often succumbed to peer pressure in the addiction process, the addict will succumb to positive peer pressure in the self-help group.
As with any other type of psychological and physiological treatments, drug addiction treatment will only be as effective as the addict is honest; if the addict is involved with a counselor or self-help group and the addict has relapsed, he or she may be filled with shame which provokes lying. It is not that the addict does not want to be successful, but due to the shame of relapse, they may not be honest or even stop the treatment all together. A good counselor and support system involved in the addict??™s treatment is imperative to combat the addict??™s treatment failure.
The fact that it is now well known and accepted that addictions have the two primary contributing causes (genetic and environmental influences) may assist in the improvement of drug addiction treatment. And although there is no definitive physiological testing available to identify those genetically susceptible, mental health care professionals can identify an addiction probability using other methods. It is important to know that drug addiction, as well as any addiction, is not just a psychological disorder. Addiction is a disease that develops with the combination of genetic and environmental influences and this means it can be prevented.
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In conclusion, it can be inferred from the various enumerated points that evidently addictive behavior has a strong brain basis
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