Addiction Drug Use When Does Drug Use Become an Addiction? By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on May 06, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print Stockbyte / Getty Images Drug addiction is a complex and chronic brain disease. People who have a drug addiction experience compulsive, sometimes uncontrollable, craving for their drug of choice. Typically, they will continue to seek and use drugs in spite of experiencing extremely negative consequences as a result of using. What Is Substance Dependence? Characteristics of Addiction According to the National Institute on Drug Abuse (NIDA), addiction is a chronic, relapsing disorder characterized by: Compulsive drug-seekingContinued use despite harmful consequencesLong-lasting changes in the brain NIDA also notes that addiction is both a mental illness and a complex brain disorder. Diagnosing addiction requires an assessment by a trained and certified professional. Talk to a doctor or mental health professional if you feel that you may have an addiction or substance abuse problem. Symptoms of Addiction Behavioral Manifestations of Addiction When friends and family members are dealing with a loved one who is addicted, it is usually the outward behaviors of the person that are the obvious symptoms of addiction. Those behaviors are primarily centered around the addict's impaired control: The excessive frequency of drug use in spite of attempts to controlIncreased time using or recovering from drug effectsContinued use in spite of persistent problemsA narrowing of focus on rewards linked to addictionAn inability to take steps to address the problems The Inability to Abstain Research has shown that prolonged drug use causes a chemical change in the brain of the addict that alters the brain's reward system that prompts compulsive drug seeking in the face of growing negative consequences. This state of addiction, when the activity continues in spite of negative consequences and despite the fact it is no longer rewarding, is termed by addiction experts the "pathological pursuit of rewards." It is the result of chemical changes in the reward circuitry of the brain. How Addiction Gets Started The reason that people engage in activity that can become addictive in the first place is to experiment, because of the social environment, or achieve a feeling of euphoria or to relieve an emotional state of dysphoria. When people drink, take drugs, or participate in other reward-seeking behavior (such as gambling, eating, or having sex) they experience a "high" that gives them the reward or relief they are seeking. Genetic Factors Addiction also has a genetic component that may make some people more susceptible to becoming addicted to drugs. Some people have described feeling addicted from the first time they use a substance. Researchers have found that the heritability of addictions is around 40—60% and that genetics "provide pre-existing vulnerabilities to addiction [and] increased susceptibility to environmental risk factors." Changes in the Brain A high is the result of increased dopamine and opioid peptide activity in the brain's reward circuits. But after the high they experience, there is a neurochemical rebound which causes the reward function of the brain to drop below the original normal level. When the activity is repeated, the same level of euphoria or relief is not achieved. Simply put, the person never really gets as high as they did that first time. Does Stress Cause Addiction? Lower Highs and Lower Lows Added to the fact that the addicted person develops a tolerance to the high—requiring more to try to achieve the same level of euphoria—is the fact that the person does not develop a tolerance to the emotional low they feel afterward. Rather than return to "normal," the person reverts to a deeper state of dysphoria. When becoming addicted, the person increases the amount of drugs, alcohol, or the frequency of the addictive behaviors in an effort to get back to that initial euphoric state. But the person ends up experiencing a deeper and deeper low as the brain's reward circuitry reacts to the cycle of intoxication and withdrawal. When Reward-Seeking Becomes Pathological According to the American Society of Addiction Medicine (ASAM), this is the point at which the pursuit of rewards becomes pathological:Reward-seeking becomes compulsive or impulsiveThe behavior ceases to be pleasurableThe behavior no longer provides relief No Longer a Function of Choice To put it another way, the addicted person finds himself compelled—despite his own intentions to stop—to repeat behaviors that are no longer rewarding to try to escape an overwhelming feeling of being ill at ease but find no relief. According to ASAM, at this point addiction is no longer solely a function of choice. Consequently, the state of addiction is a miserable place to be, for the addict and for those around him. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Chronic Disease and Relapses For many addicts, addiction can become a chronic illness, meaning that they can have relapses similar to relapses that can happen with other chronic diseases—such as diabetes, asthma, and hypertension—when patients fail to comply with their treatment. These relapses can occur even after long periods of abstinence. The addict can take action to enter remission again. But he remains at risk of another relapse. The ASAM notes "Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death." Why Addiction Is Considered a Chronic Brain Disease 9 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute on Drug Abuse. The science of drug use and addiction: The basics. Ouzir M, Errami M. Etiological theories of addiction: A comprehensive update on neurobiological, genetic and behavioural vulnerability. Pharmacol Biochem Behav. 2016;148:59–68. doi:10.1016/j.pbb.2016.06.005 Hyman SE. Addiction: a disease of learning and memory. Am J Psychiatry. 2005;162(8):1414–1422. doi:10.1176/appi.ajp.162.8.1414 Evans CJ, Cahill CM. Neurobiology of opioid dependence in creating addiction vulnerability. F1000Res. 2016;5:F1000 Faculty Rev-1748. doi:10.12688/f1000research.8369.1 Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry. 2016;3(8):760‐773. doi:10.1016/S2215-0366(16)00104-8 Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry. 2016;3(8):760–773. doi:10.1016/S2215-0366(16)00104-8 American Society of Addiction Medicine. Description of addiction. Morse ED. Addiction is a chronic medical illness. N C Med J. 2018;79(3):163-165. doi:10.18043/ncm.79.3.163 American Society of Addiction Medicine. American Society of Addiction Medicine recognizes National Recovery Month. Additional Reading The Definition of Addiction (Long Version). American Society of Addiction Medicine. Frequently Asked Questions. National Institute on Drug Abuse. By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. 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