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The Disease of Addiction

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The disease of addiction and its effects on the brain.
The disease of addiction and its effects on the brain.

If you’re dealing with the disease of addiction, you may be frustrated by your family’s certainty that you are willfully taking drugs and putting yourself at risk. They don’t understand the nature of addiction and, to be honest, you don’t really know much about it yourself. How can it be a medical condition when it involves such risky and often shameful behavior? Why can’t you stop yourself from getting up each and every day and using drugs once again?

We once heard about a young Brit named Ben, who videotaped his actions daily for the last two years of his life. Each day, he woke believing that he had just begun the first day of his recovery from the disease of addiction. But each day found him no closer to recovery. He bugged his family for on-camera interviews, ignoring the despair in their faces because they felt his recovery was hopeless. His stints in recovery exhausted his father’s retirement fund. His father became ill with cancer and died…just a month before Ben finally died from his addiction.

The key to overcoming any medical illness is education, and it’s important for both the person addicted to opiates as well as their family to learn everything they can about the disease of addiction. Ben’s mother, in fact, allowed Ben’s story to be told so that other people could learn.

The Disease of Addiction

Nora Volkow, head of the National Institute of Drug Abuse, whose father committed suicide because of the shame brought on by alcoholism, has provided clear evidence that links diminished brain functioning with the disease of addiction. Neurobiologic Advances from the Brain Disease Model of Addiction appears in the January 2016 of the prestigious New England Journal of Medicine.

Most families remain convinced that addiction is a behavioral disorder and not an illness because when a person does drugs day in and day out, they repeatedly display behaviors that appear to be voluntary, irresponsible, and self-indulgent. “Why don’t you just stop?” family members have begged—a plea that most addicted persons have heard more than once and a question that they just don’t know how to answer.

They wonder, themselves, why they can’t stop. Most of them reach a stage when use of the drug does not even supply the euphoric feeling it once did—but they just keep taking it to maintain minimal function throughout the day. The crawling skin, slurred voice, nausea and vomiting, mood swings and changes in appearance, are all characteristic of the disease of addiction. The family members who have to watch an addicted loved one display the bad behaviors and frightening physical characteristics feel everything from fear to disgust.

Understanding Neuroplasticity

In her article, Volkow describes that addictions including occur when the drug of choice stimulates the brain to produce dopamine. The dopamine in turn causes changes in the signals that pass through the brain. The neurons that travel from one cell to another do not properly communicate, and the one message that gets through to the person suffering with the disease of addiction is that using drugs made them feel good. The affected neurons are involved with the brain’s processes involving learning, memory, and decision-making.

The person’s continued drug use causes the signals between neurons to become depressed, a condition called neuroplasticity. We also know from other research that as the brain increasingly relies on drugs to stimulate dopamine production, it produces lesser amounts on its own. Decreased amounts of dopamine present a double-pronged danger: First, they no longer feel the same amount of pleasure in life, whether they are doing drugs or taking part in some pleasurable activity. Second, their ambivalence toward life in general causes increased frustration—in themselves and also in their family members.

If you are thinking about beginning a recovery program, you may be wondering: Why you? The fact is that susceptibility to the disease of addiction varies from person to person. Volkow tells us that environmental, genetic, and developmental factors affect the likelihood of a person’s becoming addicted.

Contributing factors include a family history of addiction to alcohol or drugs of any kind. If you’re battling the disease of addiction, consider every type of addiction as you look at the relatives perched on the branches of your family tree. Most people who develop addictions who explore their lifeline also discover that they first began using drugs of some kind during their adolescence. The teen years represent the time when a person is most vulnerable to effects of alcohol or drugs. Further, Volkow describes that in a family culture where substance abuse is prevalent and emotions spill out onto everyone in the family, there are poor family supports and permissive attitudes. A person growing up in such an atmosphere is more susceptible to emotional disorders and the disease of addiction.

Wash, Rinse, Repeat

Ultimately Volkow divides the cycle of addiction into three stages: “…binge and intoxication; withdrawal and negative affect; and preoccupation and anticipation.” In the binge stage, the individual learns that taking the drugs will stimulate euphoric feelings. During withdrawal and negative affect, the person notices that taking the drugs provides a diminished reward or result in negative consequences. The rewards from their drug use lessen and they become depressed—so they take more drugs, a vicious cycle. During the third stage of preoccupation and anticipation the person is sick of the life and they truly want to stop using drugs. However, the brain has been altered by the neuroplasticity. Cravings and physical withdrawals are unbearable, and they are unable to maintain their commitment to recovery. They relapse, over and over again, each and every day, just like Ben.

A Chance to Heal

There are many programs, treatment facilities and medications available to treat the disease of addiction. Opiate addiction in particular has grown to epidemic proportions in recent years. Volkow teaches people with addictions and their families that treatment with methadone or buprenorphine may provide the single best option for recovery from opiate use. The old stigma against methadone—that it is just switching one addiction for another—no longer holds water. Those medications are the only ones that can control cravings and withdrawal symptoms so that a person can get through the third stage of addiction without relapse. The longer they can successfully control their disease, the better chance that their brain will heal with restored decision-making capabilities and normal emotional function.

Volkow did not learn until adulthood of her father’s alcoholism and suicide. She has spent the years educating people to the fact that addiction is a medical condition that can be treated with medication and therapy and managed just like asthma or diabetes. If you haven’t considered methadone or buprenorphine as an option for treating your opiate addiction, it’s time to call your local medication-assisted treatment program and get started.


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