Understanding addictionPosted on: March 21, 2022
by David Diaz
Addiction, in all its many forms, has the power to destroy people’s lives. The NHS defines it as not having control over doing, taking or using something to the point where it could be harmful to you.
From drugs and alcohol use to gambling and smoking, addiction can adversely alter people’s relationships, their physical and mental health, and can even prematurely steal their lives.
Take, for example, drug and alcohol addiction. The UK government’s Adult Substance Misuse Treatment Statistics report for 2020 to 2021 states that there were more than 275,000 adults in contact with drug and alcohol services between April 2020 and March 2021. Sadly, it also states that drug abuse is a significant cause of premature death in England, with 2,830 deaths from drug misuse registered in 2020 – the highest level since records began.
Addictions come in all different forms – you can become addicted to just about anything you can think of. But some of the most commonly known addictions are:
Cannabis, amphetamines, opioids, stimulants – they’re all drugs, and they can all give you a release of dopamine.
Dopamine, a type of neurotransmitter, is produced by your body and used by your nervous system to send messages between nerve cells. Drug-taking is linked with what’s known as the reward system, a group of structures activated by ‘rewarding’ stimuli, such as drugs. Research suggests that when dopamine hits the mesolimbic pathway – which begins in the ventral tegmental area and transports dopamine to the nucleus accumbens, amygdala, hippocampus, and prefrontal cortex – it plays an important role in the ‘rewarding’ effects of drugs as described by drug users.
Alcohol abuse can lead to a number of health problems, such as heart disease, not to mention the significant consequences that can arise from alcohol impairment and the poor decision-making it can enable.
According to Alcohol Change UK, there are more than 600,000 dependent drinkers in England, with only 18% of these individuals receiving treatment. The organisation also reports that:
- 24% of adults in England and Scotland regularly drink over the chief medical officer’s low-risk guidelines.
- 27% of drinkers in Great Britain binge drink on their heaviest drinking days.
- In England and Wales, provisional data shows that in 2020 there were 7,423 alcohol-specific deaths – an 19.6% increase in deaths from 2019.
Is addiction psychological or biological?
With addiction playing such a negative role in so many people’s lives, it’s essential to better understand its causes, risk factors, and the theories of addiction, so that those who are suffering through it have more effective solutions and treatments available to them.
It’s also important to remember that addiction isn’t a moral problem – people suffering from addiction aren’t inherently lazy, or weak, or bad. And while some may argue that it’s a biological problem, and others believe it’s a psychological one, the truth is a bit more complicated.
In fact, there are both biological and psychological factors that play into addiction, along with a whole host of other contributing factors, such as neurobiological, social and environmental ones. The disease model of addiction, for example, suggests that addiction is a disease with biological, neurological, genetic, and environmental causes.
The field of biological psychology studies the biology of behaviour. With a focus on genetics, hormones and other aspects of human biology, it examines the relationship between mind and body, and is an important field of study when looking at addiction.
What biological factors contribute to addiction?
According to the American Psychological Association, about half of the risk for addiction is genetic. This is because our genes affect the degree of reward a person will experience when first trying a substance, such as drugs, or a behaviour like gambling. Genes also dictate the way a body will process substances.
So if you’re genetically predisposed towards addictive behaviour, when you misuse alcohol or drugs, the increased dopamine released in your biological ‘reward’ pathways may be even stronger than someone without the same genetic blueprint. Even worse, neuroscience research has found that repeatedly using that substance can cause long-term changes in your ‘reward’ pathways, which can alter responses and increase the likelihood of future substance abuse, drug seeking, and drug dependence.
Brain changes can include alterations in cortical (prefrontal cortex) and subcortical (limbic system) regions, which involve the neurocircuitry of reward, memory, judgement, motivation, and impulse control. In turn, this can lead to significant craving increases, and impair a person’s ability to control their impulses, even when they fully appreciate the consequences of their actions. Other brain structures and brain regions that may be altered include the cerebral cortex, which can lead to impaired decision-making, impulsivity and compulsivity, not to mention that as the brain adjusts to dopamine surges from repeated drug use, neurons may begin to reduce the number of dopamine receptors, or make less dopamine altogether, which means future dopamine signals will be lessened – and more drugs will be required to achieve the same high.
Simply put, some people are more susceptible to addictive behaviour because of their individual biology (including their genetics and physiology), and brain chemistry and structure.
What psychological factors contribute to addiction?
Psychology also plays a significant role in addiction. Psychological factors such as stress and trauma, for example, can increase a person’s desire to abuse drugs or alcohol, or participate in a behaviour such as gambling. There are also environmental factors, such as family and economic structures, and social factors, such as peer pressure.
Addiction can be a learned behaviour, and research has also found evidence of naturally addictive personalities – indicators of these personality types are issues with impulsivity and emotional regulation.
Understanding both the biological and psychological factors that can contribute to addictions have meant more effective treatments for people struggling with the disorder.
Through understanding brain function and the biology of addiction, pharmacological treatments such as medicine have been developed to help people tackle cravings and withdrawal symptoms when dealing with substance use disorders. This is done by replacing or blocking the receptors that substances would interact with.
There’s also research being conducted into gamma-aminobutyric acid (GABA) that suggests it may play a role in mediating or inhibiting addictive responses to drugs. Similarly, there’s research into glutamate receptor subtypes, which have also been found to regulate and inhibit dopamine release and the effects of drugs.
From a psychiatry perspective, we must not underestimate the psychology of addiction. Remember that only about half of the risk for addiction is genetic, which means that psychology has a huge part to play in treating addiction, and in helping to eliminate or reduce the risk of addiction before it even starts.
For example, the NHS uses cognitive behavioural therapy and counselling to help treat a number of different addictions, such as gambling.
Some have also successfully tackled addiction through an understanding of classical conditioning. If a person tends to smoke in the car, the two things – smoking and the car – become linked in the mind of the smoker. Therefore, getting into the car triggers the need to smoke. But by understanding where these links exist, the smoker can work to break the link, perhaps through something like exposure therapy.
Dig deeper into the causes of addiction
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