Why is addiction called a disease?

Why is addiction called a disease?

The controversy on whether addiction is a disease or not has continued for a long time and is unlikely to end soon. It is one of the most popular ways of conceptualizing addiction nowadays and it is one that research has shown some very positive results in support of. However, it is worth considering why is addiction considered a disease rather than something else.

Historically, addiction used to be conceptualized from a moral perspective. It involved looking on the addict as lacking in moral fiber and having deep, intrinsic personality defects that led them to become addicted. There was a strong religious component to this idea as well. Addicts themselves were viewed with disdain, an attitude that often appears even today. However, the issue with this concept was that it did not allow for treatment or had only inhumane or ineffective treatment options. After all, there would be no point in treating someone who is lacking in morality and who is, by nature, doomed.

Thankfully, there was a shift from this paradigm, but for a very long time the moral component stayed strong. Addicts were seen as flawed human beings, so many treatments or programs were focused on shaming the individual and working solely with the issue of willpower. This approach, in general, was not effective, because it did not consider the different mechanisms of addiction and the process that real recovery necesitates.

With time and with the development of psychiatry and psychology, new and better treatments became available. More and more was discovered on addiction until the present concept of addiction as a disease was developed.

So, where did it the idea of addiction as a disease originate?

Why is addiction called a disease? Well, it has to do with the idea of mental health disorders and of physiological elements of these disorders. There is a neurobiological mechanism for addiction, involving the brain’s reward system and neurotransmitters such as dopamine. There are also changes in the brain, some of which are irrversible or at least long-lasting, that occur due to substance use and substance abuse. In short, addiction was found to have a strong neurobiological element and a mechanism for addiction that occurred in the brain.

The reward circuit of the brain releases dopamine, which makes us feel pleasure and happiness. A drug like cocaine prevents the dopamine from being reabsorbed, leading to very high dopamine levels which induce a state of euphoria. However, as time passes and the person continues to use drugs, the brain starts producing less dopamine on its own and requires the drug to feel happiness. A mechanism known as tolerance begins to act and the person’s nervous system becomes accustomed to smaller doses. The person starts taking larger doses, which does more damage and eventually may end up in a tragic outcome, such as an overdose. Different substances can affect the brain differently, but heavy use can end up in brain damage, cardio-pulmonary collapse, kidney/liver failure and so on.

So, addiction has a biological mechanism.

The person might choose to use the substance at first, but at a certain point the individual’s will power or judgment are significantly reduced due to the effects of the use.

Some studies have suggested that addiction is also genetically predisposed. This means that some individuals who consume alcohol or try a drug will not get addicted, while others have a higher likelihood of developing this disorder. A genetic component can also support the idea that addiction is a disease.

However, the element that many argue about is that addiction has a lot to do with a person’s choice and with a person’s way of thinking. Some people argue that many addicts consciously begin using substances they knew were dangerous, so can we really call it a disease?

This is the aspect in which addiction is closer to other mental disorders. While problems like depression or anxiety also have a genetic element and a chemical imbalance, emotional and cognitive aspects also play a role. Mindfulness Cognitive-Behavioral Therapy (MCBT) can be used to improve the symptoms of these issues, because they change the way a person thinks. In a way, the thought process and irrational decisions and cognitions can be linked to other mental disorders, as well as to addiction. In general, it can be said that even though addiction involves distorted thinking and decision making, often starting with poor choices, that does not mean it should be considered as a wholly different mental disorder nor that it in any way needs to be considered from a moral perspective. A person with addiction needs to receive medical and psychological help, as well as a treatment that is confidential and adequate to the person’s individual needs.

Today’s model of addiction as a disease, while strongly supported, is not without its problems and will continue to change in the future. At the moment, however, it is a model that does take into account the neurobiological elements of addiction, as well as the processes involved in this condition that make it such a dangerous problem. Specifically, the concept of addiction as a brain disease can explain why addiction occurs and why people can not overcome it without help in most cases. Looking at addiction as a disease with biological, social, emotional and psychological components, it’s possible to develop an integral treatment model that recognizes that addiction is not a choice and that it involves a problem which can not be overcome with sheer will power. The model of addiction as a disease can be used to study addiction, to understand how it appears and develops and to provide treatment, which is why it is a widely used model today.

Why is addiction called a disease? / Live Better Live Now / Houston, Texas

Opiate Addiction and the Brain

Opiate Addiction and the Brain

As human beings we have a long history of using opiate drugs, such as morphine. And if a person gains unlimited access to opiates, they can easily and quickly become tolerant and addicted to it. The drugs have an intense effect on the human brain. Prescription opiates are after all intentionally designed and created to make a person feel good within a short period of time. The drugs increase the level of dopamine released in the brain and copy the effects of endogenous opioids. More often than not, people who have taken opiates with consistency often have difficulty feeling normal without taking the drugs.

Our brains produce a natural morphine known as endorphins. They stimulate the opioid receptors to lift our mood when we are under stress; helping us feel more motivated and relieving pain when there is an injury. These hormones are produced during excitement, exercise, feeling loved, orgasm, pain, or even eating spicy food.

The production of endorphins also leads to the discharge of dopamine, which is the chemical that activates the reward system of our brain. Dopamine acts as natural “go system” that helps humans pursue stuff that we need to survive. Our brain also has a “stop system” found in the prefrontal cortex at the front of our brain. It helps us determine the consequences of our impulses. When a person is addicted to opiates, the “go system” of the brain acts on its own, and the “stop system” can no longer control it.

What Do Opiates Do to the Brain?

Opiate drugs activate the dopamine pathway (also known as the reward pathway) that sends out a rush of pleasure chemicals to the brain. Opiates are much more stimulating than natural endorphins, which is partly why they are so addictive. Once a person uses opiates, the brain stops creating natural endorphins because the body thinks that there are already enough levels of it in the brain. Within six to 12 months of using opiate drugs, the cells that produce endorphins are reduced in size and die.

One of the most commonly abused opiate drugs is heroin. When it is injected into a vein, heroin reaches the vein within 15 to 20 seconds. Then it binds to the opiate receptors found in the different parts of the brain that include the reward pathway. When the receptors in the reward pathway are activated, the person feels a brief rush and very intense rush of euphoria. This is followed by several hours of contented and relaxed state. This feeling of euphoria is what draws people back to opiates again and again.

The effects of opiates are similar to the ones from naturally occurring opioid peptides. When used for medical purposes, opiates can stop diarrhea, depress breathing, and relieve pain. They come with side effects that include vomiting and nausea. But when used in large doses, they can make breathing shallow or even make it stop altogether. Thousands of opiate addicts have died due to overdose. And mixing alcohol with opiates only increases the risk of death.

Opiate Addiction vs. Dependence

Dependence happens due to the normal adaptations to prolonged exposure to opiates. People should not confuse the term dependence with addiction because they are not the same. Addiction is described to be the compulsive seeking (psychological) and use of the drug that results to deadly consequences. Addiction can include some type of dependence (physical) as well.

Another way to understand it is this: dependence is typically acute and holds the potential to be resolved or cured. Addiction on the other hand can be acute or in remssion – but it is always chronic and life long (ie it is not cured or removed). This is why we say a clean/sober person is “in recovery” and not that they are “recovered”.

A person who is dependent on opiates will experience some type of withdrawal symptoms when the use of the drug is suddenly stopped or reduced. The symptoms can be mild to severe. Withdrawal symptom includes flu-like discomfort, stomach cramps, unpleasant mood, diarrhea, and severe muscle pain, just to name a few. The withdrawal symptoms are most commonly managed medically through the use of a slow drug taper.

Dependence is often accompanied by tolerance, which is the need to take higher doses of the drug in order to get the same effect. Once a person experiences tolerance, it can be difficult for the health care provider to evaluate whether the patient has a drug problem or if there is really a need for higher doses to control one’s symptoms. This is the reason physicians are attentive and vigilant to their patients’ symptoms, as well as the level of functioning to provide them with the most accurate information needed to prescribe the appropriate treatment.

Connection of Opiate Addiction and Brain Damage

While it has already established that opiate overdose can result to slow breathing, its effects on brain function are still being studied by researchers. Depressed respiration can affect the oxygen level in the brain. Researchers are still trying to determine the long-term effects of opiate addiction on the brain. Previous studies have shown that there is some deterioration of the white matter among heroin users that affect their ability to respond during stress situations, regulate behavior, as well as their decision-making abilities.

Quitting Opiate Addiction in Houston

Once a person stops using opiates, the natural chemical system of the body can’t turn on right away. It has already been damaged, and it will take a while to recover. The person will go through severe withdrawal that can last up to a week. Then the person will also undergo a long process called post-acute withdrawal syndrome that can last several months or even years.

When the person is suffering from withdrawal, they are typically depressed and with no motivation to do anything. Removing opiates from their system will suddenly bring lots of pain because there is no base level of endorphin found in their system.

Treatment for Opiate Addiction in Houston, Texas

In the past, the standard treatment for opiate addiction involved the use of methadone. (Even in the face of better options methadone is still widely used today for treatment of opiate addiction.) Methadone is a long-acting opioid that is used to keep the withdrawal symptoms at bay. It also controls the craving and relapse of the patient. Whether methadone treatment is actually an effective tool for rehabilitation remains a subject of great controversy.

Another medication used in the rehabilitation of opiate addicts is buprenorphine. It contains a partial agonist opiate, has a weaker effect on the receptors in the brain than some newer medications and has a limited high, which some health care providers believe can deter the addict from abusing the medication. This medication is also surrounded by controversy – some have suggested it is due to improper use, others suggest negligent monitoring by treating physicians.

Naltrexone and Naloxone are used as antagonists at opioid receptors to block the pleasurable effects of the opiates. These do not contain opiates nor do they produce a high. When coupled with counseling or other therapeutic treatments these blockers have more recently been reported to help people quit their opiate addiction. There is an intramuscular injectable (IM) version called Vivitrol which lasts approximately 30 days and has been reported to successfully block highs and help to control not only opiate cravings but alcohol as well.

Succeeding in Recovery from Opiate Addiction

For addiction recovery to be successful over a lifetime requires a great deal of desire, commitment, persistence, humility and support. One of the most widely available community-based support organizations is 12 Step with meetings across the globe and in nearly every city in the United States. Churches, community centers and many other venues are also available depending on your area.

A seasoned and experienced counselor who specializes in chemical addiction can also help the recovering addict through the challenges that arise in the recovery process. If the counselor is also licensed and experienced in mental health, they can also assist with issues such grief, anxiety or relationship conflicts that may come up during treatment and recovery. Counseling or psychotherapy is helpful not just for the addict but also for the partners, friends and family who love them.

Change is hard and for many it can also be a bit scary. Patience and compassion, but not coddling or excusing, is necessary. Learning how to set good boundaries – new boundaries – is important for everyone involved. Remember – getting better doesn’t mean back to how things were. It will never be the way it was in the past. That was the past. But it can be better, more than better. It can be really good. If you or someone you know is struggling with opiates, or any drug or alcohol, reach out and Get Help. A better life is possible and attainable.

Stop. Take a moment. Breathe.

You can do this.