An Overview of Addiction as a Medical Condition, Not a Choice

Addiction as a Medical Condition

What is addiction? For most of human history, it was seen as a personal failing. However, modern medicine has proven that addiction is a medical condition.

For most people with a loved one suffering with a substance use disorder, it can be difficult to show empathy. People addicted to substances impact everyone around them, often lying and manipulating in order to support the addiction. As such, it may seem understandable that there is still a stigma surrounding addiction.

However, the healthcare field has considered addiction to be a medical condition for decades. As hard as it is on families, this can be true of many illnesses which create emotional and financial pressure for all involved. The problem when it comes to addiction is that misconceptions and moral judgments are still promoted in many contexts.

In order to counter this misinformation, and to better understand yourself or your loved one, here is what you need to know about addiction as a medical condition, not a choice.

Understanding Addiction as a Disease

While addiction was once considered a character failing, science tells a different story. It is in fact a complex medical condition that can severely affect the brain and body. The American Society of Addiction Medicine (ASAM) defines addiction as a chronic, relapsing disorder characterized by compulsive substance use despite harmful consequences. In other words, it is similar to diseases like diabetes or heart disease, where certain risk factors, both genetic and environmental, increase its likelihood.

This is called the disease model of addiction and is built on an understanding of addiction and the brain. Addiction causes structural and functional changes in the brain, particularly in areas related to reward, motivation, and memory. These changes make it extremely difficult for individuals to control their substance use, even when they recognize the harm it’s causing in their lives.

Initially, the person makes a choice to use substances. Many people do so, especially with alcohol, but do not become addicted. For others, the urge to use substances becomes uncontrollable. This is why treatment is necessary.

The Brain’s Role in Addiction

The most significant factor to know about the disease model of addiction is how it affects the brain’s reward system. Substances like drugs or alcohol flood the brain with dopamine, the chemical responsible for feelings of pleasure. Over time, the association between the substance and pleasure drives the person to seek it out repeatedly.

The brain becomes dependent on the substance to feel pleasure and no longer produces dopamine naturally in response to everyday experiences. The prefrontal cortex, which is responsible for decision-making and impulse control, suffers impairment as well. Even when a person wants to stop using the substance, their brain works against them. This is one reason it is notoriously difficult to break the cycle of addiction.

With long-term substance use, these changes in brain structure and chemistry become more difficult to reverse. The decrease in the brain’s plasticity, or ability to adapt and change, is the reason people experience intense cravings and relapses, even after periods of abstinence.

Neuroscientific studies have demonstrated that addiction alters other key areas of the brain, such as the basal ganglia (associated with reward and motivation), the amygdala (involved in stress and emotions), and the prefrontal cortex. As our understanding of the brain’s role in addiction increases, treatment options become more effective and accessible.

Risk Factors Contributing to Addiction

Brain chemistry is not the only factor in the development of addiction, which is why some people are more prone to addiction than others. Genetic, environmental, and psychological factors increase the likelihood of addiction in certain individuals.

Genetic Factors:

Genetics account for about 40% to 60% of a person’s risk for developing addiction, according to the National Institute on Drug Abuse (NIDA). If a close relative, such as a parent or sibling, struggles with addiction, there is a higher chance that others in the family may also develop similar issues. This predisposition is linked to specific genes that regulate the brain’s reward pathways and how individuals respond to stress and environmental influences.

Environmental Factors:

Environmental influences, such as exposure to drugs or alcohol at an early age, significantly increase the likelihood of developing an addiction. People raised in households where substance use is normalized or who experience high levels of stress, trauma, or instability may turn to substances as a way to cope. Peer pressure, poverty, and lack of access to education or healthcare also heighten vulnerability, especially when combined with easy availability of substances.

Psychological Factors:

Co-occurring mental health conditions, such as depression, anxiety, or post-traumatic stress disorder (PTSD), are also linked to addiction. People struggling with these conditions might turn to substances to self-medicate. Since the substance’s effects are temporary, this leads to a cycle where its use actually worsens mental health symptoms. As mental health deteriorates, the person becomes more reliant on the substance for a brief reprieve.

Addressing the Stigma Surrounding Addiction

The stigma surrounding addiction can paint those who suffer from the illness as people who simply lack the willpower to stop using substances. As a result, those who need help may fear seeking it, not wanting to be labeled as irresponsible or immoral.

Unfortunately, stigma still exists in some parts of the healthcare system, where individuals with addiction may face bias or insufficient treatment due to the belief that their condition is self-inflicted. However, there are many great rehab centers which treat addiction like any other disease, with empathy and care.

Treatment for Addiction as a Medical Condition

Just as diseases like diabetes or hypertension require comprehensive treatment plans, addiction needs a holistic approach that addresses both the physical and behavioral aspects of the condition.

Medication-assisted treatment (MAT) involves the use of medications like methadone, buprenorphine, and naltrexone to help manage cravings and withdrawal symptoms. When combined with therapies like cognitive-behavioral therapy (CBT) the person receives a structured and evidence-based route to recovery.

Like other chronic conditions, addiction requires ongoing care and support. This includes counseling, peer support groups, and follow-up care that focuses on maintaining sobriety, managing stress, and addressing any co-occurring mental health conditions.

Empathy is crucial throughout, whether from those treating the physical or psychological aspects of the condition. Ignorance is no excuse for poor treatment and you should always choose a rehab center that is not punitive.

Conclusion

There is still stigma surrounding addiction, but the medical field understands that it is an illness like any other. To ensure the best treatment, choose a rehab that shows empathy and care towards residents, understanding that they are going through a tough time that they have not chosen.