Whether it is illegal drug use or alcoholism, addiction is an issue prevalent throughout society. It is not a new issue by any means, but we still lack an adequate solution. Society maintains an overall negative perception of addicts. While addiction causes many health and social problems, criticizing and judging those suffering from addiction only makes it more difficult to help them. An important first step is to understand what addiction is exactly.
When somebody drinks or uses drugs, they interact with chemical messengers throughout the body but most importantly with the brain. These interactions cause dopamine release in the brain along neural pathways identical to natural rewards, such as food or comfort. Excessive use causes lasting changes visible in functional magnetic resonance imaging (fMRI) scans. From these images, we can see that addiction involves both physical and psychological changes. The cognitive deficits observed with addiction further reinforce this idea. Addiction can cause short-term memory problems, an inability to adapt during problem-solving, and a loss of impulse control. These symptoms are similar to individuals suffering brain damage.
Addiction is characterized by seven criteria: Tolerance, withdrawal, excess use, persistent desire, spending disproportionate amounts of time to acquire a substance, giving up activities for substance use, and continuing substance use even if one knows it is a problem. One common example of people spending an extreme amount of time to obtain drugs is patients who drive from physician to physician trying to get them to sign off on more prescription medications. There are measures in place against such practices, but that does not stop people from trying.
Treating addiction is difficult due to it having aspects of both psychological and physical dependences. On a psychological level, one may feel an overwhelming, compulsive need to take a drug in order to feel “normal.” The underlying cause of this is the increase in dopamine activity they experience upon taking the drug. The brain associates dopamine with reward and exposing it to an extremely high level of dopamine likely makes it crave an identical level of stimulation. Physical dependence comes from the need for continued use of the drug to prevent withdrawal symptoms.
Treating addiction is difficult because it usually involves treating other underlying issues that the patient is facing. It also often involves participation and patience from family or friends of the addicted individual. At the extreme, treatment may include court-ordered probations or employer sanctions. So, perhaps it is unfair to say we do not have an adequate solution, the most effective solutions require a personalized approach for each individual, depending on his or her needs and current situation. This approach requires time and dedication that is difficult to provide to each person suffering from addiction. A large portion of the treatment also depends on the addicted individual wanting to change.
Some facts and definitions taken from a lecture by Dr. Sean Nordt for the class Drugs and the Brain at the University of Southern California.