Addiction can be a hard disease for non-addicts to understand. Often there is the expectation that if an addict really wanted to stop using, they just would stop purchasing and using substances. At the same time, an addict’s behavior and thought patterns often seem random and incongruent, leaving family members and loved ones confused as to how they can help.
If you are supporting a loved one who is an addict, one of the best steps you can take is becoming more educated on the disease and how it affects your loved ones’ thinking and behavior.
One of the most important aspects to understand about substance abuse is that it doesn’t happen because someone has an immoral character, a “weak mind,” or because they purposefully choose to abuse substances and neglect other aspects of their life.
Addiction is a disease. It takes over the brain’s neurological circuits and becomes an ingrained solution to cope with the world. Often non-addicts believe that if their loved one really cared about their life, they would just stop using. What’s overlooked in this belief is the disconnect between judgment and action that becomes more and more apparent as addiction worsens.
For example, Maia Szalavitz, recovering addict and the author of the book Unbroken Brain, writes, “I can remember many, many times driving down to the projects telling myself, ‘You don’t want this! You don’t want to do this!’ But I’d do it anyway.” This speaks to the power that addiction holds. Many addicts may intend to stop abusing substances but struggle with the hold such substances have over their brains. In these cases, stopping without proper help can be futile.
Research led by Kent Berridge, a neuroscientist at the University of Michigan, highlights an area of the brain that is extremely affected by addiction, which he calls the “wanting system”. This “wanting system” helps regulate our functioning and cravings for pleasurable activities like sex and eating, but can become hijacked once drugs or other addictive substances are introduced to the brain.
Once this area of the brain becomes hijacked, the pleasurable neurotransmitter known as dopamine is triggered into overdrive production. In turn, this “wanting system” is altered significantly and neurologically changes the duration and intensity of a craving, which in turn changes the behaviors around getting this craving satisfied.
Manipulating dopamine directly through substance abuse causes far stronger cravings than those normally experienced by most people, resulting in an addict’s conscious part of their mind saying one thing (“I want to stop using”) while their wanting system says something else (“I want to keep using and generate more dopamine.”) Understanding this might help shed some light onto why an addict’s actions and behaviors might always appear incongruent.
Although the addicted brain is neurologically different than the non-addict, people can recover from addiction. Recovery can be hard to explain as addiction is messy and complex and researchers still do not know that much about how we overcome it.
Addiction can be best characterized as a disease that operates initially by choice (usually to cope with strong or negative emotions) and then later turns into extremely intense compulsions (which make the cravings significantly harder and harder to resist).
Recovery is possible but often comes in layers. Detoxing (ridding the body of all substances) is usually the first step and often the most intense, as stopping substance abuse comes with many physical and psychological symptoms. The more reliant the body is on the substance, the more intense the detox symptoms. Once substances are gone and the body starts to operate on its own again, inpatient, outpatient or long-term treatment may become helpful in maintaining recovery.
Even during the recovery process, building long-term tools takes work. An addict needs to create a whole new system in thinking patterns and behaviors in order to help counteract the physical changes they have made to their brain. Once the “wanting system” has been introduced and hooked on substances, these areas of the brain may never go back to how they were before the drugs altered them, so gaining tools on how to manage this area of the brain without the drugs becomes vital. Support and treatment are often suggested as help that a recovering addict can access in order to learn these new skills. After these skills are built, the brain can function once again in becoming congruent with actions and behaviors.