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Addiction (cont.)

Addiction Causes

Addiction or substance abuse is a complex brain disease. A person with an addiction experiences cravings that persist even in the face of extremely negative consequences. During a craving, a person with an addiction misses the habit-forming drug terribly, and often he or she experiences symptoms of withdrawal.

Evidence strongly suggests that genetic susceptibilities and biological traits play a role in addictions; however, the development of an addiction is also shaped by a person's environment (for example, a person with alcoholism cannot become addicted without access to alcohol). The "addictiveness" of a drug is related to how strongly the drug activates the reward circuits in the brain. For instance, when the methamphetamine found on the street is purer (meaning that it stimulates the dopamine reward circuits more), then the number of first-time drug users who become drug abusers is higher.

Addictive substances or behaviors change the reward circuits in the brain. In other words, the brain responds to the addictive substance in the same way that it responds to very pleasurable experiences. This explains, in a general sense, why people with addictions sometimes forsake all other life activities and obligations and even their own health in pursuit of the addictive substance.

Addiction Symptoms

Patient Comments

According to the Diagnostic and Statistical Manual of Mental Disorders, substance use is considered abusive or addictive if the person has experienced three or more of the following signs during a 12-month period:

  • Tolerance is evident when (1) a need exists for increased amounts of a substance to achieve intoxication or desired effects or (2) the effect of a substance is diminished with continued use of the same amount of the substance.
  • Withdrawal is evident when (1) characteristic, uncomfortable symptoms occur with abstinence from the particular substance or (2) taking the same (or closely related) substance relieves or avoids the withdrawal symptoms.
  • The substance is used in greater quantities or for longer periods than intended.
  • The person has a persistent desire to cut down on use of the substance, or the person's efforts to cut down on use of the substance have failed.
  • Considerable time and effort are spent obtaining or using the substance or recovering from its effects.
  • Important social, employment, and recreational activities are given up or reduced because of an intense preoccupation with substance use.
  • Substance use is continued even though some other persistent physical or psychological problem is likely to have been caused or worsened by the substance (for example, an ulcer made worse by alcohol consumption or emphysema caused by smoking).

Drug abuse can occur with or without tolerance or withdrawal. Tolerance and withdrawal indicate physical dependence. A key issue in evaluating addiction is if a person is unable to stop using the harmful substance (loss of control). Often people who are addicted to a drug do not have insight into their inability to stop drug use and falsely believe they could stop if they "wanted to." This is called denial.

No single event or criterion is indicative of an addictive disorder; drug use becomes addiction (drug abuse) only after a pattern of behavior that takes place over time. In many ways, current definitions of addiction are limited and mostly incorporate behavioral symptoms in the definition.

Medically Reviewed by a Doctor on 1/4/2016
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Patient Comments & Reviews

The eMedicineHealth doctors ask about Addiction:

Addiction - Patient Experience

Have you or a loved on suffered from addiction? Please describe your experience.

Addiction - Treatment

Was the addiction of you or a loved one treated successfully? What treatment methods were most important in recovery?


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