Addiction is a complex disorder – a multifaceted condition that affects millions of people worldwide. Addiction can take many forms, from substance abuse, such as the chronic misuse of alcohol and drugs, to behavioural addictions, such as gambling, eating, and internet use.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the 2021 National Survey on Drug Use and Health (NSDUH) revealed that 61.2 million people aged 12 or older had used illicit drugs in the preceding year, with marijuana being the most commonly used substance; this survey also highlighted that 9.2 million people in the same age group misused opioids within the same timeframe. Furthermore, 46.3 million individuals met the criteria for having a substance use disorder, including significant numbers for both alcohol and drug use disorders.
Addiction is characterised by the compulsive use of substances or engagement in behaviours that are harmful to the individual. It’s not just a lack of willpower or moral failing; addiction involves intricate interactions between the brain, genetics, environment, and an individual’s psychological state. The American Psychiatric Association defines addiction as a complex condition – a brain disorder that is manifested by compulsive substance use despite harmful consequences.
Psychological factors contributing to addiction
Several psychological factors play a significant role in the development and maintenance of addiction:
- Mental health disorders. There’s a strong link between addiction and mental health disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD). Individuals may use substances or engage in addictive behaviours as a way to self-medicate and cope with the symptoms of their mental health condition.
- Stress. Chronic stress can lead to addiction as individuals seek relief or escape from stressors in their life. The relief provided by substances or addictive behaviours can reinforce the behaviour, creating a cycle of addiction.
- Trauma and emotional pain. Experiences of trauma, especially in childhood, increase the risk of developing addiction. Traumatic events can lead to feelings of helplessness, fear, and a need for control, which can be temporarily alleviated by addictive substances or behaviors. Steve Carleton, a licensed clinical social worker at Porch Light Health, reflects on the emotional underpinnings of addiction and how emotional pain and unresolved trauma frequently set the stage for a myriad of addictive behaviours. “Many individuals grappling with addiction are, in essence, in a battle with their own emotional suffering. The substance or behaviour becomes a temporary sanctuary from distressing feelings,” Carleton shares, “therapeutic interventions that prioritise emotional healing and resilience, aiming to resolve the core issues that fuel addiction, are a crucial component of holistic recovery.”
- Social and environmental factors. A family history of addiction, peer pressure, and exposure to high-risk environments can all contribute to the development of addictive behaviours, as they can all influence attitudes towards substance use and risk-taking behaviours. In combination, it’s a disaster waiting to happen. Elvis Rosales, licensed clinical social worker and clinical director at Align Recovery Centers, explores the significant impact of social and environmental factors regarding addiction, emphasising the role of social connections – or the lack thereof – in both the development of and recovery from addiction. “Addiction doesn’t occur in a vacuum; it’s often influenced by one’s social environment, including relationships, community, and societal norms,” Rosales points out. “Building a supportive recovery environment that nurtures positive relationships and community engagement is essential to fostering resilience and promoting sustainable recovery; people need people.”
- Brain chemistry. Addiction alters the brain’s natural reward system, leading to increased tolerance and dependence. The brain becomes accustomed to the substance or behaviour, requiring more to achieve the same effect, and withdrawal symptoms occur without it.
The behavioural cycle of addiction
Raul Haro, a licensed marriage and family therapist at Pathways Recovery, focuses on the behavioural dynamics that sustain addiction. He explains the psychological mechanism of negative reinforcement, where the temporary alleviation of discomfort by addictive behaviours reinforces those very behaviours. Haro explains, “The cycle of addiction is perpetuated by a short-term escape from pain, leading to a long-term entrapment in the very behaviours and feelings one seeks to escape from. Interventions that break this cycle by teaching individuals healthier coping mechanisms and strategies for dealing with life’s challenges are pivotal to long-term recovery – there is transformational power in behavioural change.”
Cognitive distortions and addiction
Michelle King, a licensed marriage and family therapist at Ocean Recovery, examines the cognitive dimensions of addiction, discussing how distorted thinking patterns, such as beliefs about one’s inability to cope without substances or engaging in harmful behaviours, contribute enormously to the persistence of addiction in many cases. “Challenging these cognitive distortions is essential in the journey towards recovery. Cognitive behavioural therapy, for example, offers tools for individuals to rewrite their narrative, giving them the space in which to foster new-found beliefs in their capacity for change. The power of thought in shaping our reality and behaviours cannot be understated,” King explains.
The impact on the brain
Addiction fundamentally alters the brain’s structure and function, affecting areas involved in reward, motivation, learning, judgement, and memory. Substances and addictive behaviours stimulate the brain’s reward system, releasing neurotransmitters like dopamine, which creates feelings of pleasure and satisfaction. Over time, the brain adapts to the excess dopamine, diminishing the individual’s ability to feel pleasure from other activities and leading to a cycle of addiction.
Pathways to recovery
Recovery from addiction involves addressing the psychological factors that contribute to the disorder. Treatment often includes a combination of therapy, medication, and support groups. Cognitive behavioural therapy (CBT) is particularly effective, too, helping individuals to recognise and change negative thought patterns and behaviours associated with their addiction; support from family, friends, and recovery communities can also provide the motivation and encouragement needed to overcome addiction.
Tim Williamson, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.