The Oxford Dictionary defines ‘Addiction’ as “The fact or condition of being addicted to a particular substance or activity.” This, however, does not capture what an addiction entails, why people get addicted, and the effects imposed on an addicted individual.
I feel that the American Society of Addiction Medicine captures these missing pieces, with a pretty detailed definition of ‘Addiction’:
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviours.
Addiction is characterized by inability to consistently abstain, impairment in behavioural control, craving, diminished recognition of significant problems with one’s behaviours and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
Let us start from the basics: the causes of addiction.
Some may say that addiction is a choice, that people deliberately impose on themselves this “chronic disease”. Gene Heyman in his book ‘Addiction: A Disorder of Choice’ argues that portraying addiction as this “chronic disease”, placing it in the same category as schizophrenia and diabetes, is misleading. He places an emphasis on choice, and how addicts choose to become addicted.
In line with the biological model of addiction, addicts may have poorer impulse control, making one genetically vulnerable to developing an addiction. Our genes influence how our body reacts to the different drugs out there, which can either speed up or slow down the development of an addiction. In fact, according to the National Institutes of Health (NIH), genes account for 50% of one’s risk to developing an addiction.
On the other hand, the temperance model of addiction states that the mere exposure to addictive substances puts someone at greater risk of developing an addiction. Absence of social support, socioeconomic status, family situation, the use of drugs amongst peers, the ability of coping with stress and history of neglect or compulsive behaviours are all factors that play a role in the escalation of and commitment to an addiction. This highlights the social causes of an addiction, which many times are out of the individual’s control. The presence of a blood relative who had or has an addiction, and mental health problems within the individual also puts someone at further risk.
One’s life experiences may have formed certain cognitive beliefs that compel an individual to further addiction.
The self-fulfilling prophecy hinders individuals with an addiction from seeking or completing treatment. These individuals may go to treatment with the preconceived idea that recovery will not work for them or that they are not capable of recovering. The role of the therapist would them be to uncover these beliefs and change them to promote growth. This is a further indication of how addiction stems from deeper roots within one’s cognition.
The biological, social, cognitive and familial influences on addiction all point to the fact that addiction is caused by certain factors that, most of the time, are out of an individual’s control. These various factors, such as genetic predisposition and upbringing, interact to either decrease or increase the likelihood of developing an addiction.
