The biology of addiction SpringerLink

But from the biological camp’s perspective, the changes are driven by your biopharmacological processes. There is absolutely no way to examine this entire question, and I’ve written about this extensively in previous articles (HERE and HERE for example). But drawing on the biological theories of addiction, we’ll look at some of the biological impact of drug use and its effects on addiction. When substance use progresses to the point of addiction, a person no longer chooses to use; they are now dependent on substances. Alcohol dependence or abuse rates were shown to have no correspondence with any person’s education level when populations were surveyed in varying degrees of education from ages 26 and older. However, when it came to illicit drug use, there was a correlation in which those that graduated from college had the lowest rates.

• First, people may appear to remit spontaneously because they actually do, but also because of limited test–retest reliability of the diagnosis [31].
• Treatment provides education that helps people to understand and accept their genetic predisposition.
• This pathway towards addiction, which is opened through stressful experiences during childhood, can be avoided by a change in environmental factors throughout an individual’s life and opportunities of professional help.
• Gender is one of the leading indicators of addiction potential, drawing a few interesting lines in the sand regarding the different risk factors facing men and women.
• Not all individuals consuming substances at hazardous levels have an SUD, but a subgroup do.

This approach considers that multiple factors, including multiple gene variations, likely contribute to psychiatric disorders like addictions, and that these disorders represent heterogeneous groupings. Intermediary phenotypes or endophenotypes represent constructs that are not readily visible but represent sober house measurable constructs that may more closely link to biological factors (and by extension their prevention and treatment) than do the heterogeneous diagnostic groupings. Endophenotypes also are proposed to be identifiable, albeit to a lesser extent, in unaffected family members of people with the disorder.

Neurobiology of addiction

While Khantzian takes a psychodynamic approach to self-medication, David Duncan proposed a self-medication model that focuses on behavioral factors. While earlier behavioral formulations of drug dependence using operant conditioning maintained that positive and negative reinforcement were necessary for drug dependence, Duncan maintained that drug dependence was not maintained by positive reinforcement, but rather by negative reinforcement. Duncan applied a public health model to drug dependence, where the agent (the drug of choice) infects the host (the drug user) through a vector (e.g., peers), while the environment supports the disease process through stressors and lack of support. A crucial determinant of whether a drug user develops drug abuse is the presence or absence of negative reinforcement, which is experienced by problematic users, but not by recreational users.

• As research in this area continues, we may learn that some models are more applicable to specific addictions.
• It becomes more important to think about the constant activities with the help of which a person may achieve the required control and cope with the dependence that has genetic roots.
• The fact that significant numbers of individuals exhibit a chronic relapsing course does not negate that even larger numbers of individuals with SUD according to current diagnostic criteria do not.

But when you’re becoming addicted to a substance, that normal hardwiring of helpful brain processes can begin to work against you. Drugs or alcohol can hijack the pleasure/reward circuits in your brain and hook you into wanting more and more. Addiction can also send your emotional danger-sensing circuits into overdrive, making you feel anxious and stressed when you’re not using the drugs or alcohol. At this stage, people often use drugs or alcohol to keep from feeling bad rather than for their pleasurable effects.

Treating Substance-Related Disorders: Biological, Behavioral and Psychodynamic Approaches

This is in important ways different from the meaning of compulsivity as commonly used in addiction theories. In the addiction field, compulsive drug use typically refers to inflexible, drug-centered behavior in which substance use is insensitive to adverse consequences [100]. Although this phenomenon is not necessarily present in every patient, it reflects important symptoms of clinical addiction, and is captured by several DSM-5 criteria for SUD [101]. Examples are needle-sharing despite knowledge of a risk to contract HIV or Hepatitis C, drinking despite a knowledge of having liver cirrhosis, but also the neglect of social and professional activities that previously were more important than substance use. While these behaviors do show similarities with the compulsions of OCD, there are also important differences. For example, “compulsive” substance use is not necessarily accompanied by a conscious desire to withhold the behavior, nor is addictive behavior consistently impervious to change.

As of 2016, about 22 million people in the United States need treatment for an addiction to alcohol, nicotine, or other drugs. Only about 10%, or a little over two million, receive any form of treatment, and those that do generally do not receive evidence-based care. One-third of inpatient hospital costs and 20% of all deaths in the United States every year are the result of untreated addictions and risky substance use.

Alcohol and Drug Abuse Around the World

Factors related to culture, race and ethnicity also warrant consideration in the propensity to develop addictions. Differences in genetic compositions may vary according to race and in part explain differences observed in rates of addictions across racial and ethnic groups [138, 139]. Environmental factors related to differences in acculturation, cultural expectations, socioeconomics, stress exposure and other domains also warrant consideration as these might differ across cultural groups [137, 140]. As such, disentangling the precise contributions to addictions amongst different racial/ethnic groups is both an important and complex undertaking. Adverse childhood experiences (ACEs) are various forms of maltreatment and household dysfunction experienced in childhood.

For instance, in many countries, the highest prevalence of substance use problems is found among young adults, aged 18–25 [36], and a majority of these ‘age out’ of excessive substance use [37]. It is also well documented that many individuals with SUD achieve longstanding remission, in many cases without any formal treatment (see e.g., [27, 30, 38]). Statistics have shown that those who start to drink alcohol at a younger age are more likely to become dependent later on. About 33% of the population tasted their first alcohol between the ages of 15 and 17, while 18% experienced it prior to this.

Each of these intermediary phenotypes has potential relevance for adolescent addiction vulnerability, particularly given the neurobiological and behavioral changes during this developmental epoch. In this article, we provide a narrative review of current biological models for addictions with a goal of placing existing data and theories within a translational and developmental framework targeting the advancement of prevention, treatment and policy strategies. Attempts to resist these compulsions result in increasing and ultimately intractable anxiety [99].

Every person, and every personal situation, is different, and any number of factors may impact us in different ways.

No level has primacy in what is called addiction: “addiction is a social disease” would be just as tenable

In other words, the genetic model does provide people with a kind of hope that addiction may be controlled due to the investigation of the particular factors, and the biological model does not provide such a chance. This is why the chosen models identify an idea of medical treatment and group support during the whole life. It becomes more important to think about the constant activities with the help of which a person may achieve the required control and cope with the dependence that has genetic roots. Hazardous (risky) substance use refers to quantitative levels of consumption that increase an individual’s risk for adverse health consequences. Clinically, alcohol consumption that exceeds guidelines for moderate drinking has been used to prompt brief interventions or referral for specialist care [112].