Drug Addiction: Causes, Prevention, and Treatment

Introduction to Addiction

Addiction can be considered a physical and psychological inability to avoid the consumption of drugs, chemicals, or substances — or to stop participating in certain activities — even when doing so causes both physical and psychological harm (Nutt, 2018). The term "addiction" is not limited to cocaine or heroin use. Any person who cannot function normally without taking a specific chemical or drug is considered to be substance dependent (Nutt, 2018). Obsessive engagement in activities such as working, eating, and gambling is also considered an addiction (Clark & Limbrick-Oldfield, 2013). This type of addiction is commonly referred to as behavioral addiction. As noted by Robbins and Clark (2015), behavioral addictions have gradually become recognized as a psychiatric disorder. Recently, pathological gambling has been allocated to the DSM-5 category (American Psychiatric Association, 2013).

Several other disorders have been suggested as belonging to the behavioral addiction category, although they have yet to receive formal DSM-5 recognition (American Psychiatric Association, 2013). Addiction is essentially a chronic disease that may originate from the intake of medication. Overuse of medication such as opioid painkillers can trigger addiction in the user. In the U.S., there are 115 deaths annually directly associated with the misuse of opioids (Nutt, 2018). Whenever a person experiences addiction, they lose their ability to control substance use or participation in a given activity — as in the case of behavioral addiction (Robbins & Clark, 2015). Addiction makes the individual dependent on the substance or activity in order to manage their daily life.

The American government spends over $740 billion as a result of illicit drugs, tobacco, prescription opioids, and alcohol abuse. The amount spent goes toward treatment of addictions, lost productivity, and the consequences of crime. Initially, drug use or participation in activities like gambling begins voluntarily. Addiction eventually takes over, forcing the addict to lose self-control (Levy, 2013). It is clear that addiction undermines the neurological ability of the addict to govern their cravings for a drug or activity. In the words of Goldstein and Volkow (2011), drug addiction can be considered a neurological disorder because it involves functional changes in brain circuits — specifically those governing self-control, stress, and reward. These changes can persist for long periods after the addict has ceased drug consumption.

Addiction is not fundamentally different from other diseases such as heart disease or diabetes. In all these conditions, normal body function is disturbed, organs lose their optimal capacity, and harmful effects are induced on the body. Most diseases are treatable and preventable, just as drug addiction is. If drug addiction and other diseases are left untreated, they can inflict lasting effects and possibly result in death (Koob, Arends, & Le, 2014). Koob, Arends, and Le (2014) explored the neurological, cellular, and molecular systems of the brain in an attempt to identify the mechanisms responsible for drug addiction. The brain is the mediator that controls the rewarding effects of drug use and the changes that occur when transitioning from initial drug use to compulsive addiction. Persistent drug use interferes with the neurological reward system, which ultimately produces compulsive drug-seeking behavior.

Why People Engage in Drug Use

There are several reasons why people engage in drug use, including:

• To perform better
• To feel better
• To feel good
• Social pressure and curiosity

A good number of people fail to understand how or why others become drug addicts. Some believe that people who misuse drugs lack moral principles or the willpower to stop (National Institute on Drug Abuse, 2016). Some assume that all drug addicts need is the will to resist their urges. The reality, however, is different. Addiction to substances and drugs is a complex topic that involves the neurological system and its responses (Koob, Arends, & Le, 2014). Quitting drug addiction is a demanding undertaking that typically requires more than willpower and good intention. Drug use alters brain responses in various ways that make quitting difficult even for addicts who sincerely want to stop (National Institute on Drug Abuse, 2016). Fortunately, research has uncovered more about the effects of drugs on brain function, and studies have identified treatments that are useful in helping addicts quit and restore normalcy in their lives.

Drug addiction has been described by the National Institute on Drug Abuse (2016) as a persistent disease illustrated by compulsive, obsessive, or difficult-to-control drug usage and drug-seeking behavior. The consequences of addiction are harmful to the addict. Early stages of drug use are typically voluntary, but recurrent and frequent use produces changes in the brain. These changes compromise the addict's capacity for self-control and make it harder to resist drug use. The neurological changes can persist to such a degree that the condition becomes prone to relapse. Recovering drug addicts are at a higher risk of returning to drug use even after extended periods of abstinence (National Institute on Drug Abuse, 2016). Although relapses may be observed in recovering addicts, this does not mean that treatment is ineffective. As with other chronic health conditions, treatment for drug addiction must be continuous and adjusted according to the patient's response.

Differences in Drug Addiction

There are no specific parameters that can definitively determine whether someone will become a drug addict. Addiction risk is shaped by several factors including social environment, biology, developmental stage, and age (National Institute on Drug Abuse, 2016). The greater the number of risk factors, the higher the likelihood that someone will use drugs and become addicted. The biology of a person encompasses the genes they are born with; when combined with environmental factors, biology accounts for approximately half of addiction vulnerability. Other factors such as gender, co-occurring mental disorders, and ethnicity are also likely to influence addiction and abuse risks (National Institute on Drug Abuse, 2016).

The environment encompasses a range of influences including friends and family, quality of life, and socioeconomic conditions. Additional influences such as peer pressure, parenting quality, and sexual abuse may affect the probability of drug abuse and may also accelerate the escalation of addiction.

Regarding development, environmental and genetic factors may interact with key developmental stages in a person's life to affect their vulnerability to addiction. Drug use at any age can result in addiction; however, the younger the age at which someone begins using drugs, the higher the probability of serious addiction (National Institute on Drug Abuse, 2016). This is why adolescence is a particularly critical period. Adolescents have portions of their neurobiological system that are still developing — specifically the brain faculties that govern judgment, self-control, and decision-making. Because these systems are not yet fully developed, adolescents are more susceptible to risk-taking behavior and therefore more likely to try drugs at this age.