There are many imperfect theories surrounding the causes of addiction. Addiction exerts a powerful influence on the brain and this influence manifests in three distinct ways: craving for the object of addiction, loss of control over its use, and continuing involvement with it despite adverse consequences.
Addiction as a chronic disease that changes brain structure and brain function. Just as cardiovascular disease damages the heart and diabetes impairs the pancreas, addiction hijacks the brain. This happens as the brain goes through a series of changes, beginning with recognition of pleasure and ending with a drive toward compulsive behaviour.
Eating disorders, which are considered addictions and primarily affect women, offer a clear illustration of the self-regulation mechanism gone haywire. If the inability to soothe oneself is due to a distant or rejecting parent, compulsive eating is an attempt to make up for the loss, to construct a substitute attachment to a nurturing parent, with a primitive form of self-medication â€” food â€” one of the few things (in addition to love) that can calm a distressed child.
According to Robert B. Millman, a renowned addiction expert at New York Hospital-Cornell Medical School, locus of control is another influential factor in addiction vulnerability. â€œAddicts tend to believe that they are not the masters of their own fate, that control lies outside of them,â€ he says.
Narcissists are also well represented within drug-addicted populations: their self-absorption is so profound they donâ€™t understand that the world outside them, which includes drugs, is real â€” and dangerous. Risk-takers are also vulnerable. â€œBut thereâ€™s no way to tell which adrenaline junkie will get hooked on bungee jumping, venture capitalization or heroin,â€ says Millman.
Drug use is also often thought of as an escape â€” but becomes so in ways the abuser hadnâ€™t planned on. Just as a compulsive gamblerâ€™s hyper-involvement in the betting process blocks out his personal problems, an addictâ€™s pursuit of his drug becomes so monomaniacal that everything else, including the psychological pain that drove him to the drug, is forgotten.
Dr. George Koob of the Scripps Research Institute has a surprising new finding, cocaine does not just make users feel euphoric, but it simultaneously releases brain chemicals related to fear and stress â€” bad feelings that linger after the euphoria fades. â€œThe only way to treat the bad feelings,â€ explains Koob, â€œIs to take the drug that makes you feel good again. But this becomes a vicious cycle.â€
Behavioural therapy and counselling are important elements of treatment. Cognitive behavioral therapy is often used to help patients identify, avoid, and cope with situations in which they are most likely to abuse drugs or activities. The technique of motivational interviewing is often employed to remind people of their values, as a way of avoiding use. Family therapy may be provided to help the patient maintain a supportive environment and improve family functioning.
Rehabilitation programs are often needed to help patients regain necessary job and other skills.
What people often underestimate is the complexity of drug addiction — that it is a disease that impacts the brain, and because of that, stopping drug abuse is not simply a matter of willpower. Through scientific advances we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and resume productive lives.