A substance use disorder (SUD) is a complex condition that occurs when regular drug or alcohol use results in “clinically and functionally significant impairment” that includes physical and mental health problems and failure to attend to major responsibilities regarding work, school, home, or relationships.
SUD is a broad term that also refers to conditions such as substance abuse and drug or alcohol addiction (alcoholism.) Traditionally, these disorders have been widely viewed as moral failings, under the presumption that those dependent upon psychoactive substances lack willpower or moral fortitude.
Today, most researchers, scientists, physicians and addiction specialists view substance use disorder as a disease – or at least believe that it should be addressed as one. Moreover, it is a chronic, incurable condition that can, however, be effectively treated using various evidence-based therapies and counseling.
What is Addiction?
Addiction is considered to be a lifelong disease characterized by compulsive drug-seeking behavior that persists despite adverse consequences. Initial use is almost always voluntary, but repeated use leads to changes in the brain that impair self-control when it comes to substance use.
These changes are persistent and sometimes permanent, which is why people with addictions are at a very high risk of relapse and returning to substance abuse, sometimes after years of sobriety.
How Substance Abuse Affects the Brain
Substance abuse impacts the reward center of the brain by acting on neurotransmitters releasing mass amounts of “feel good” chemical messengers such as dopamine and serotonin.
This system manages the body’s ability to feel pleasure and increases motivation to repeat behaviors that lead to pleasurable feelings, such as eating or having sex.
However, overstimulation of the brain’s reward center results in a “high” -euphoric feelings that hijack the brain and compel people to continue using substances.
Over time, the brain becomes desensitized to the presence of drugs or alcohol by adjusting itself to the excess dopamine and reducing the corresponding response. This effect is known as tolerance, and when it occurs, the individual is forced to use increasing amounts of the substance in order to achieve the desired effect. Pleasure obtained from otherwise enjoyable activities such as socializing can be adversely affected, as well.
Chronic substance abuse also results in changes to other brain systems and can affect critical functions, including learning, judgment, decision-making, problem-solving memory, stress level, and behavior.
Factors That Contribute to Addiction
Addiction, like most diseases, does not develop in a vacuum. Moreover, there are multiple factors that may contribute to one’s risk of becoming addicted to a psychoactive substance. These include biological, developmental, and environmental determinants.
Biological factors include genetic predispositions that may account for as much as half of a person’s risk for addiction. Also, ethnicity, gender, and co-occurring mental health conditions may also increase one’s risk of drug abuse.
Environmental factors include external influences such as family dynamics, socioeconomic status, early exposure to drugs or alcohol in the home, and the existence of traumatic childhood experiences such as physical or sexual abuse.
Environmental and biological determinants, when combined with developmental stages also affect a person’s risk of substance abuse. Moreover, the earlier the drug or alcohol use is initiating, the greater the chance that it may lead to addiction.
Addiction is Incurable but Treatable
SUDs are not curable, and most recovering substance abusers will be at risk of a relapse for the rest of their lives. However, addiction disorders can be effectively treated and successfully managed long-term.
Research has shown that patients being treated with a combination of behavioral therapy, counseling, group support, and medication-assisted therapy have the best chance of achieving long-term sobriety.
Treatment approaches customized to each patient’s individual factors such as mental health conditions, family and developmental history, and drug use patterns can result in improved outcomes and contribute to a successful, ongoing recovery.
Addiction is Preventable
Critically, substance abuse and addiction are not inevitable, and programs aimed at prevention that involve families, communities, schools, and the media are helpful for reducing drug abuse and addiction.
Although individual and environmental factors tend to affect drug abuse trends, research has shown that drug use is more often avoided when perceived as harmful or unacceptable by society. Indeed, education is crucial to helping people understand the risk of drug abuse. – especially those persons at a heightened risk of addiction, teens and young adults.