define drug addiction essay

Substance Use Disorders and Addiction: Mechanisms, Trends, and Treatment Implications

Information & authors, metrics & citations, view options, insights into mechanisms related to cocaine addiction using a novel imaging method for dopamine neurons, treatment implications of understanding brain function during early abstinence in patients with alcohol use disorder, relatively low amounts of alcohol intake during pregnancy are associated with subtle neurodevelopmental effects in preadolescent offspring, increased comorbidity between substance use and psychiatric disorders in sexual identity minorities, trends in nicotine use and dependence from 2001–2002 to 2012–2013, conclusions, information, published in.

• Substance-Related and Addictive Disorders
• Addiction Psychiatry
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Forms of Drug Abuse and Their Effects

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What Is Addiction?

Luis Alvarez/DigitalVision/Getty

Addiction is a complex, chronic brain condition influenced by genes and the environment that is characterized by substance use or compulsive actions that continue despite harmful consequences.

For a long time, addiction meant an uncontrollable habit of using alcohol or other drugs . More recently, the concept of addiction has expanded to include behaviors, such as gambling , as well as substances, and even ordinary and necessary activities, such as exercise and eating .

Types of Addiction

While addiction to substances has often appeared clear-cut, there's some controversy about what substances are truly addictive. Current guidelines in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic tool used to diagnose different types of mental health conditions, indicate that most psychoactive substances, including medications, have the potential to be addictive.

Addictions vs. Substance Use Disorders

The term addiction is used to describe compulsive drug-seeking behaviors that continue in spite of negative outcomes, but it is important to note that addiction is not considered an official diagnosis in the DSM-5.

Rather than using the term "addiction," the DSM-5 classifies substance use disorders. While the diagnostic criteria vary for each type, the DSM-5 describes these disorders as a problematic pattern of use of intoxicating substances that leads to significant impairment and distress. These symptoms can result in impaired control, social impairment, risky use, and tolerance/withdrawal. 

While these conditions might be informally referred to as addictions, your doctor will officially diagnose you with some form of substance use disorder or one of the two behavioral addiction disorders that are officially recognized by the American Psychiatric Association (APA).

Substance Use Disorders

There are different substance use disorders found in the DSM-5:  

• Alcohol-related disorders
• Caffeine-related disorders
• Cannabis-related disorders
• Hallucinogen-related disorders
• Opioid-related disorders
• Sedative-, hypnotic-, or anxiolytic-related disorders
• Stimulant-related disorders
• Tobacco-related disorders

Behavioral Addictions

The DSM-5 also recognizes two types of behavioral addiction :

• Gambling addiction
• Internet gaming disorder

There is still much debate about whether many behavioral addictions are “true” addictions. More research is needed to clarify this issue. While shopping addiction , sex addiction , and exercise addiction are often noted as behavioral addictions, the DSM-5 does not officially recognize these as distinct disorders.

Addiction Symptoms

The signs and symptoms vary from one addiction type to another, but some common symptoms of addiction include:

• An inability to stop
• Changes in mood, appetite, and sleep
• Continuing despite negative consequences
• Engaging in risky behaviors
• Feeling preoccupied with the substance or behavior
• Legal and financial problems
• Losing interest in other things you used to enjoy
• Putting the substance or behavior ahead of other parts of life including family, work, and other responsibilities
• Using increasingly larger amounts of a substance
• Taking more of the substance than you intended
• Withdrawal symptoms

Defining Features of Addiction

Two aspects that all addictions have in common:

• The addictive behavior is maladaptive. The behavior causes problems for the individual or those around them. So instead of helping the person cope with situations or overcome problems, it tends to undermine these abilities.
• The behavior is persistent. When people are addicted, they will continue to engage in the addictive behavior despite the trouble it causes. So an occasional weekend of self-indulgence is not an addiction, although it may cause different kinds of problems. Addiction is characterized by frequent engagement in the behavior.

Addiction vs. Dependence

It is important to distinguish between dependence and addiction. When people become dependent on a substance, it means that they experience drug tolerance and drug withdrawal:

• Tolerance means that the body has adapted to the presence of the drug so that it takes more of the drug to produce the same effects.
• Withdrawal occurs when people experience certain physical and psychological symptoms if the use of the substance is suddenly decreased or halted.

A person can become dependent on a drug without being addicted, although the two often occur together. Addiction occurs when people continue to compulsively use a drug despite harmful consequences.

Addiction diagnosis usually requires recognizing that there is a problem and seeking help. Substance use is not always an indication of addiction, although drug use carries numerous health and social risks in addition to the risk of addiction.

Once a person has decided that they have a problem and need help, the next step is an examination by a healthcare professional. This involves questions about behaviors or substance use, an examination to assess overall health, and the development of a treatment plan that works best for the individual's specific addiction. 

The exact diagnosis a person receives will depend on the nature of their addiction. Commonly misused substances that can lead to addiction include:

• Hallucinogens
• MDMA and other club drugs
• Methamphetamine
• Prescription drugs
• Tobacco/nicotine

Because some substances have the potential to cause dangerous withdrawal symptoms , it is important to receive an appropriate diagnosis in order to get the best treatment.

If You Think You Might Have an Addiction

It is common, if not normal, to go through a stage of engaging in substance use or an addictive behavior without believing you are addicted. This is so common, in fact, that it has a name, the pre-contemplation stage.

If you are starting to think you might have an addiction, you have probably moved into the contemplation stage. This is a great time to find out more about the substance or behavior that you have been engaging in and to reflect honestly on whether you are experiencing any signs or symptoms of addiction.

Many people then decide to make changes. For some people, this is easy and manageable. For many others, quitting can lead to unpleasant withdrawal symptoms, even with behaviors, and can open up uncomfortable feelings that were being soothed or suppressed by the addictive behavior.

If this happens, or if you have been drinking or using drugs, such as opioids—illicit or prescribed, other prescription medications, stimulants, cocaine, or meth—you should seek medical help immediately.

Stopping some drugs then relapsing can heighten your risk of overdose, mental health problems, or other life-threatening medical complications, and should be done under medical supervision.

Substances and behaviors can create a physical and psychological high. Over time, people develop a tolerance, meaning it takes more of something to achieve those same initial effects. Some of the factors that can contribute to addiction include:

• The brain : Addiction leads to changes in the brain's reward circuits over time.
• Family history : You may be more likely to become addicted if you have family members who also have addictions.
• Genetics : Research suggests that genetics increases the likelihood of developing an addiction    
• Environment : Exposure to addictive substances, social pressure, lack of social support, and poor coping skills can also contribute to the development of addictions.
• Frequency and duration of use : The more someone uses a substance the more likely they will become addicted to it.

Addictions take time to develop. It is unlikely that a person will become addicted after using a substance once, although it is possible to develop a mental health problem or to die of an overdose or another complication after one use of some substances.

Addiction is treatable, but not all routes to recovery are the same. Relapses are not uncommon, so the journey may take time. Some of the common treatment approaches that may be used include:

• Psychotherapy : Cognitive behavioral therapy (CBT) may be used to address thought and behavior patterns that contribute to addictions. Other therapies that might be used including contingency management, family therapy, and group therapy.
• Medications : This may include medications to help treat craving and withdrawal symptoms as well as other drugs to treat underlying mental disorders such as anxiety or depression. Medications that may be prescribed include methadone, buprenorphine, nicotine replacement therapies, and naltrexone.
• Hospitalization : In some cases, people may need to be hospitalized in order to treat potentially serious complications while they detox from a substance.
• Support groups and self-help : In-person and online support groups can be a great resource for education and social support as people learn new ways to cope during recovery.

Although there are some schools of thought that stress the need for complete abstinence , many people are able to learn to control addictive behaviors, such as drinking, eating, shopping, and sex. The approach that will be best for you depends on many factors and is best decided in collaboration with your doctor or therapist.

Coping With an Addiction

In addition to getting appropriate treatment, there are things that you can do that will make it easier to cope and aid in your recovery.

• Recognize the signs. Often people’s addictions become ingrained in their lifestyle, to the point where they never or rarely feel withdrawal symptoms. Or they may not recognize their withdrawal symptoms for what they are, putting them down to aging, working too hard, or just not liking mornings. People can go for years without realizing how dependent they are on their addiction.
• Learn about addiction. Remember help is always available. Educating yourself is a good start. You can greatly reduce the amount of harm to yourself and those around you, and maybe one day, you will be ready to change for good.
• Develop coping skills. The harm caused by addiction is particularly difficult to recognize when addiction is the person’s main way of coping with other problems. Sometimes other problems are directly related to the addiction, such as health problems, and sometimes they are indirectly related to the addiction, for example, relationship problems . Developing new coping skills can help you handle life's stresses without relying on substances or behaviors.
• Get support. Social support from friends and family is important. Joining a support group can be a great way to connect with people with shared experiences.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database .

What This Means For You

Many people fear the term addiction and believe it is an indication of failure or worthlessness . People with addictions often carry stigma about their behavior, leading to shame and fear of seeking help. The world is changing, and you may find that getting help for your addiction is the best thing you ever do for yourself. In the meantime, we hope that educating yourself will help on your journey to wellness.

American Society of Addiction Medicine. Definition of addiction .

National Institute on Drug Abuse. The science of drug use and addiction: the basics ..

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th Edition), Washington DC, American Psychiatric Association. 2013.

National Institute on Drug Abuse. Is there a difference between physical dependence and addiction? .

Cleveland Clinic. Addictions: An overview .

Ducci F, Goldman D. The genetic basis of addictive disorders .  Psychiatr Clin North Am . 2012;35(2):495‐519. doi:10.1016/j.psc.2012.03.010

National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction - Treatment and Recovery .

Hilton TF, Pilkonis PA. The key to individualized addiction treatment is comprehensive assessment and monitoring of symptoms and behavioral change .  Behav Sci (Basel) . 2015;5(4):477‐495. Published 2015 Oct 30. doi:10.3390/bs5040477

By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. 

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Substance Abuse and Public Health: A Multilevel Perspective and Multiple Responses

Substance abuse has been a thorny public health concern throughout human history. Manifestly, prevention and treatment are the two main strategies commonly adopted to tackle the problem of substance abuse. They are in fact cross-disciplinary, and they relate to the various domains of heredity, biology, psychology, cognitive science, family, social development and cultural structures. This special issue, “Substance Abuse, Environment and Public Health,” has published empirical studies from different regions and countries globally to enhance the international exchange of latest views and findings on the etiology, processes and influences of substance abuse across different domains, through which a multilevel perspective is considered more helpful for analyzing its complex nature, courses and consequences. This in turn suggests the possible need to employ multiple responses dynamically and integratively in the prevention and treatment of substance abuse.

1. Introduction

It is apparent that substance abuse is a cross-disciplinary topic of research and concern [ 1 , 2 ], which involves the need to employ concomitantly various theoretical explications and empirical evidence in collaborative efforts to strive for more optimal solutions to limit its contagiousness, and to curb any direct and indirect harm [ 3 , 4 ]. Substance abuse has been described as a “chronic relapsing disease”, with extremely high relapse rates that range from 56.8% to 81.8% [ 5 , 6 ]. Recently, the United Nations reported that “(i)n 2017, an estimated 271 million people, or 5.5 per cent of the global population aged 15–64, had used substances in the previous year” ([ 7 ], p.7). This is 11.5% higher than the estimated number of substance-using people in 2012 [ 8 ]. Due to the nature of recurrence and the rising number of substance users globally, a continuing upsurge in human, social, health and economic costs in the form of substance-related violence, criminal acts, health care needs, legal orders, rehabilitative services, reduced labor productivity and judicial expenditure is evident [ 4 , 6 , 9 ]. Undoubtedly, prevention and treatment are two main intervention approaches that have been commonly adopted to tackle substance abuse [ 2 , 10 ], in which the former focuses primarily on enhancing public awareness of the dangers of substance misuse and addiction, and the latter mainly emphasizes helping substance abusers to attain complete abstinence and avoid relapse. Both prevention and treatment of substance abuse are pertinent to public health, as the two approaches need to employ a multilevel perspective to conceptualize and solve fallout generated from drug trafficking, misuse and harm [ 11 , 12 ]. This points to the need to investigate human hereditary, biological, and psychological needs, cognitive and mental conditions, social development and cultural structures simultaneously and interactively.

For a comprehensive understanding of the nature, processes and impact of substance abuse on human individuals and societies as a whole, an international exchange of the latest scholarly views and empirical research findings is needed. This special issue, “Substance Abuse, Environment and Public Health,” aims to promote international exchange of empirical academic works on substance abuse and its related concerns. It includes 14 empirical research articles and one intervention paper from Bosnia, Croatia, Hong Kong, Italy, mainland China, Norway, Poland, Singapore, South Korea, Spain, Slovenia, Sweden and the United States, and covers the topics of substance misuse and addiction amongst various social groups, different types and forms of illicit and legally approved substances and multiple research methods and designs. Importantly, the scholarly works published in this special issue are expected to present an opportunity to enhance the international exchange of cross-disciplinary research and academic inquiries in the prevention and treatment of substance abuse.

2. Substance Abuse and Different Social Groups

When researching substance abuse and its harmful effects, researchers predominantly focus on certain social groups with a higher tendency towards substance taking and misuse, such as adolescents and male adults [ 13 , 14 , 15 , 16 , 17 , 18 ]. This is valid, as they may encounter various demanding life and social challenges, expectations, interpersonal alienation and biological impulses, all of which are relevant to the triggering of their initiation into drug experimentation as a form of self-medication. Substances may also act as a comforting “soul mate” to help users evade hard realities [ 19 , 20 ]. In this special issue, Zubak et al. [ 21 ] examined the effects of scholastic factors—for example, grade point averages, school and other unexcused absences and poor behavior—in relation to illicit drug misuse (IDM) and its initiation among adolescents in Bosnia and Herzegovina. Jee et al. [ 22 ] investigated the trajectories of different smoking groups of young South Korean male adults and the implication of the habit in their atherosclerotic cardiovascular disease (ASCVD) in middle age. However, substance takers are never restricted to any specific social groups; they can be found in communities of professionals, social talents, elders and university students. Devcic et al. [ 23 ] examined socio-demographics, sports-related factors, factors of hesitation, doping-related factors, consumption of dietary supplements, knowledge of doping and predictors of doping behavior in terms of misusing performance-enhancing substances among high-level competitive swimmers in Slovenia. Wang et al. [ 24 ] investigated how gender, residential areas and study majors were related to misconceptions about antibiotic use among Chinese university students, which in turn linked to their antibiotic misuse behavior. Through the use of a community-based participatory research design, Walter et al. [ 25 ] inquired how work-related musculoskeletal disorders (MSDs) and injuries among US fishing industry workers affected their use of prescription opioids to treat their pain, which in turn exposed them to increased risk of developing substance disorders. Apparently, different social groups are equally susceptible to the risk of substance abuse and addiction [ 3 , 4 , 12 ], and this is likely to be affected by their specific personal characteristics and environmental conditions. Hence, there is a need for researchers to discover both common and unique precursors germane to different social groups which lead to their substance using behavior.

3. Substance Abuse and Its Types and Forms

Substances that are misused or abused can be categorized into two forms. These include illicit and legally approved substances of various types. The most common illicit types of substances include cannabis, amphetamines, ketamine, methamphetamines, cocaine, ecstasy and heroin [ 2 , 6 ], which are largely banned in most countries. However, marijuana products have recently been legalized and commercialized in some northern American and Western states and regions under the umbrella of “control of reasonable use,” which casts a contemplative doubt over the original intent of reducing cannabis-related criminality and public health problems; hence, more research is needed on this subject [ 26 , 27 , 28 ]. Tobacco and alcohol are two legally approved types of substances that have been widely used by different social groups across different societies and cultures [ 6 , 11 , 29 ]. Some legally prescribed drugs, such as cough medications and the antibiotics mentioned above, can also be easily misused and abused by the general public, and these too merit the further attention of researchers [ 2 , 30 ].

In this special issue, Lo et al. [ 31 ] explored how far using illicit drugs, smoking cigarettes and drinking alcohol predicted sexual misconduct among Macau youths, while simultaneously adjusting for the effects of susceptibility to peer influence and school attachment/commitment. Assari et al. [ 32 ] attempted to assess the impact of subjective and objective socioeconomic status on the cigarette smoking and alcohol use of older African Americans by controlling the effects of pertinent covariates, which included demographic factors (age and gender), living arrangement and family type, health insurance status, chronic medical conditions, self-rated health, sick days, depression and chronic pain. Muller et al. [ 33 ] investigated changes in exercise and nicotine use among 1464 Norwegian prison inmates by classifying them into harmful and non-harmful substance use pre-incarceration groups, according to the Drug Use Disorders Identification Test (DUDIT) and the Alcohol Use Disorders Identification Test (AUDIT), both of which are commonly used by healthcare practitioners and researchers to assess the severity of illicit drug and intoxicant use. Wang et al. [ 34 ] analyzed the sources of antibiotics leftovers in the home and the risk factors of keeping them in relation to antibiotic self-medication among Chinese university students. Taken together, the relationships between the use of illicit drugs and legally approved substances are complex and intertwined or mutually reinforcing [ 35 , 36 ]. They may be affected by the personal circumstances and environmental conditions of the abusers, and may cause other forms of behavioral maladjustment [ 17 , 37 , 38 ]. Nevertheless, our current understanding of this complicated phenomenon of substance abuse is limited, and so more cross-disciplinary research is again recommended.

4. Researching Substance Abuse: Methods and Designs

As has been mentioned, substance abuse is a public health concern that involves human biological and physical needs, psychosocial demands, cognitive and spiritual fulfillment, and environmental formulations. Therefore, cross-disciplinary research using different methodologies and designs is much needed to scrutinize substance abuse in respect of etiology, maintenance, consequences, abstinence and relapse. Generally speaking, empirical studies using quantitative methods are more common than research involving qualitative inquiry, analysis of secondary data and/or documentary inspection [ 16 , 39 , 40 ]. In fact, research based on a range of methods and designs is useful in enhancing our comprehension of the nature and impact of substance abuse from different perspectives. This special issue incorporates empirical studies conducted by quantitative, qualitative and documentary methods. For quantitative research designs, study findings based on a representative sample or any of the random sampling procedures are desirable, and can strengthen empirical evidence and provide greater external validity [ 41 ]. For example, Oh et al. [ 42 ] investigated whether those who had current or previous experience of facial flushing would drink for different primary reasons, compared with those who had no experience of facial flushing. The sample comprised 4590 college students who were recruited by stratified random sampling procedures proportionately in 82 colleges in South Korea. There are other empirical studies in this special issue that similarly used a representative sample [ 21 , 24 , 31 , 34 ]. However, using quantitative methods to survey empirically the attitudes and behaviors of certain health and human service professional groups is less likely to require a representative sample, and so it is necessary to use non-probabilistic sampling procedures such as quota, purposive or snowballing sampling designs. Molina-Mula et al. [ 43 ] analyzed the attitudes and perceptions of emergency and mental health nurses with regard to alcoholics. Their findings will hopefully help to develop appropriate professional and clinical responses to substance abuse.

Qualitative research methods can help reveal in-depth and formative information related to the processes and development of substance abuse. For their qualitative study, Chan et al. [ 44 ] interviewed 67 drug abusers to explore how their psychological experiences—with special emphasis on interpersonal relatedness—affected their drug taking and relapse behaviors. Walter et al. [ 25 ] used qualitative interviewing to examine knowledge of and attitudes towards opioid use among 21 fishing industry workers in the US. In addition, use of secondary data or documentary information can efficiently and objectively assist in the transition processes of substance users. For example, Asharani et al. [ 45 ] employed and analyzed recorded data from the Registry of Birth and Death, Immigration and Checkpoint Authority of Singapore to investigate the unnatural deaths of 42 treatment seekers of substance addiction between 2011–2015. Their findings provide evidence of the lethal consequences of substance abuse in an unobtrusive manner. Moreover, Chmielowiec et al. [ 46 ] examined the relationship between the mesolimbic dopamine system and addiction in a group of 299 addicted subjects and another group of 301 non-addict controls by analyzing two polymorphisms in their genes (a variable number of tandem repeats in DRD4 and DAT1), which are mainly responsible for dopaminergic transmission, representing a human reward system that is closely related to substance abuse and misuse. It is clear that research using different methods and designs is useful in fortifying and enhancing currently established concepts and knowledge of substance abuse. Therefore, more novel research methods and designs should be encouraged, so that patterns of substance abuse can be more efficiently dissected.

5. Conclusions

Substance abuse has been an issue of public health for hundreds of years [ 47 ]. Nevertheless, professionals and researchers of different domains tend to adopt a one-dimensional view based on their particular expertise when examining, explaining and trying to find solutions to this complex problem [ 10 , 48 , 49 ]. Thus, various and often competing perspectives rooted in the paradigms of heredity, biology, psychology, cognitive science, family, social development and cultural structures can exist simultaneously, thereby unwittingly compounding the problem [ 1 , 2 , 39 , 50 ]. However, as substance abuse is composed of layers of individual development, family and social influences, cultural values and environmental conditions, a multilevel perspective is needed to analyze its etiology, maintenance and consequences. Various theories and models from different scholarly paradigms at different levels of social systems should be employed concomitantly to help examine and resolve the issues as part of a dynamic and comprehensive process [ 2 , 3 , 12 ]. Employing such a multilevel perspective requires researchers and practitioners to explore the interaction of hereditary, physical, psychological, cognitive, mental, family, social, cultural and environmental factors, and to show exactly how such synergy leads to and/or maintains substance use and addiction. Doing so will help in the design of improved multiple responses to the fallout from substance abuse.

As substance abuse is never limited to particular social groups in human societies, it is essential to understand the unique psychological, personality, cognitive, socioeconomic, familial and cultural differences of various social groups, and to explore what common and unique characteristics they hold in terms of the initiation, processes and consequences of substance abuse [ 4 , 6 ]. If researchers, service practitioners, educators and policy makers were able to understand the common and unique etiological causes and stimulants that incur experimentation and the subsequent maintenance of substance abuse, more effective prevention and treatment strategies and programs could be introduced. Furthermore, because each society or nation is comprised of multiple differing social groups, a knowledge and understanding of their unique cultural and ethnic structures would be empirically useful for researchers trying to unearth the common and distinct etiological causes and stimulants of substance use and abuse. This is a largely unchartered area of research.

The abuse of different types and forms of substances may generate different levels of addiction and harm [ 2 , 51 ], which in turn may trigger distinct social maladjustment and craving behaviors [ 12 , 52 ]. Therefore, future research should discern and clarify the effects of different types and forms of substances on the progress, abstinence and relapse of addicts; this would lead to a better comprehension of the nature and impact of substance abuse. Quantitative methods and designs should be adopted to this end, in addition to other methods and designs that will broaden our perspectives on the topic. In other words, future addiction research should consider the employment of mixed-method designs to investigate the nature of different types and forms of substances and their effects on different social groups. Furthermore, the interaction between the biological, individual, family, social and cultural factors that lead to substance abuse is worthy of research, but will require more advanced methodological designs and mathematical and statistical procedures.

The processes and consequences of substance abuse can be seen to evolve in step with social, technological and cultural developments [ 4 , 39 ]. The patterns and forms of substance abuse can vary according to different social groups. Therefore, comparative and longitudinal research is more useful and insightful in helping to reveal its precarious and dynamic influences. In fact, polysubstance abuse—in which substance addicts expect to achieve higher substance-synergy effects of enjoyability by simultaneously abusing multiple types of drugs and substances—has become more common in the past decade [ 53 , 54 ]. This apparently presents an even greater challenge to treatment and healthcare services. In the face of this new phenomenon, the role of empirical research becomes more pivotal in helping to configure effective approaches and solutions.

In conclusion, substance abuse has long been a thorny public health problem, and it continues to evolve. Multiple responses supported by the employment of a multilevel research perspective are needed. Cross-disciplinary collaboration and concerted research are urgently required if we are to optimize our current strategies and remediation.

Author Contributions

T.W.L., J.W.K.Y., and C.H.L.T. conceived the topic for the Special Issue and were the guest editors. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

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• Drug addiction (substance use disorder)

Drug addiction, also called substance use disorder, is a disease that affects a person's brain and behavior and leads to an inability to control the use of a legal or illegal drug or medicine. Substances such as alcohol, marijuana and nicotine also are considered drugs. When you're addicted, you may continue using the drug despite the harm it causes.

Drug addiction can start with experimental use of a recreational drug in social situations, and, for some people, the drug use becomes more frequent. For others, particularly with opioids, drug addiction begins when they take prescribed medicines or receive them from others who have prescriptions.

The risk of addiction and how fast you become addicted varies by drug. Some drugs, such as opioid painkillers, have a higher risk and cause addiction more quickly than others.

As time passes, you may need larger doses of the drug to get high. Soon you may need the drug just to feel good. As your drug use increases, you may find that it's increasingly difficult to go without the drug. Attempts to stop drug use may cause intense cravings and make you feel physically ill. These are called withdrawal symptoms.

Help from your health care provider, family, friends, support groups or an organized treatment program can help you overcome your drug addiction and stay drug-free.

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Drug addiction symptoms or behaviors include, among others:

• Feeling that you have to use the drug regularly — daily or even several times a day
• Having intense urges for the drug that block out any other thoughts
• Over time, needing more of the drug to get the same effect
• Taking larger amounts of the drug over a longer period of time than you intended
• Making certain that you maintain a supply of the drug
• Spending money on the drug, even though you can't afford it
• Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use
• Continuing to use the drug, even though you know it's causing problems in your life or causing you physical or psychological harm
• Doing things to get the drug that you normally wouldn't do, such as stealing
• Driving or doing other risky activities when you're under the influence of the drug
• Spending a good deal of time getting the drug, using the drug or recovering from the effects of the drug
• Failing in your attempts to stop using the drug
• Experiencing withdrawal symptoms when you attempt to stop taking the drug

Recognizing unhealthy drug use in family members

Sometimes it's difficult to distinguish normal teenage moodiness or anxiety from signs of drug use. Possible signs that your teenager or other family member is using drugs include:

• Problems at school or work — frequently missing school or work, a sudden disinterest in school activities or work, or a drop in grades or work performance
• Physical health issues — lack of energy and motivation, weight loss or gain, or red eyes
• Neglected appearance — lack of interest in clothing, grooming or looks
• Changes in behavior — major efforts to bar family members from entering the teenager's room or being secretive about going out with friends; or drastic changes in behavior and in relationships with family and friends
• Money issues — sudden requests for money without a reasonable explanation; or your discovery that money is missing or has been stolen or that items have disappeared from your home, indicating maybe they're being sold to support drug use

Recognizing signs of drug use or intoxication

Signs and symptoms of drug use or intoxication may vary, depending on the type of drug. Below you'll find several examples.

Marijuana, hashish and other cannabis-containing substances

People use cannabis by smoking, eating or inhaling a vaporized form of the drug. Cannabis often precedes or is used along with other substances, such as alcohol or illegal drugs, and is often the first drug tried.

Signs and symptoms of recent use can include:

• A sense of euphoria or feeling "high"
• A heightened sense of visual, auditory and taste perception
• Increased blood pressure and heart rate
• Decreased coordination
• Difficulty concentrating or remembering
• Slowed reaction time
• Anxiety or paranoid thinking
• Cannabis odor on clothes or yellow fingertips
• Major cravings for certain foods at unusual times

Long-term use is often associated with:

• Decreased mental sharpness
• Poor performance at school or at work
• Ongoing cough and frequent lung infections

K2, Spice and bath salts

Two groups of synthetic drugs — synthetic cannabinoids and substituted or synthetic cathinones — are illegal in most states. The effects of these drugs can be dangerous and unpredictable, as there is no quality control and some ingredients may not be known.

Synthetic cannabinoids, also called K2 or Spice, are sprayed on dried herbs and then smoked, but can be prepared as an herbal tea. A liquid form can be vaporized in electronic cigarettes. Despite manufacturer claims, these are chemical compounds rather than "natural" or harmless products. These drugs can produce a "high" similar to marijuana and have become a popular but dangerous alternative.

• Elevated mood
• An altered sense of visual, auditory and taste perception
• Extreme anxiety or agitation
• Hallucinations
• Increased heart rate and blood pressure or heart attack
• Violent behavior

Substituted cathinones, also called "bath salts," are mind-altering (psychoactive) substances similar to amphetamines such as ecstasy (MDMA) and cocaine. Packages are often labeled as other products to avoid detection.

Despite the name, these are not bath products such as Epsom salts. Substituted cathinones can be eaten, snorted, inhaled or injected and are highly addictive. These drugs can cause severe intoxication, which results in dangerous health effects or even death.

• Feeling "high"
• Increased sociability
• Increased energy and agitation
• Increased sex drive
• Increased heart rate and blood pressure
• Problems thinking clearly
• Loss of muscle control
• Panic attacks
• Psychotic and violent behavior

Barbiturates, benzodiazepines and hypnotics

Barbiturates, benzodiazepines and hypnotics are prescription central nervous system depressants. They're often used and misused in search for a sense of relaxation or a desire to "switch off" or forget stress-related thoughts or feelings.

• Barbiturates. An example is phenobarbital.
• Benzodiazepines. Examples include sedatives, such as diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin) and chlordiazepoxide (Librium).
• Hypnotics. Examples include prescription sleeping medicines such as zolpidem (Ambien) and zaleplon (Sonata).
• Slurred speech
• Lack of coordination
• Irritability or changes in mood
• Problems concentrating or thinking clearly
• Memory problems
• Involuntary eye movements
• Lack of inhibition
• Slowed breathing and reduced blood pressure
• Falls or accidents

Meth, cocaine and other stimulants

Stimulants include amphetamines, meth (methamphetamine), cocaine, methylphenidate (Ritalin, Concerta, others) and amphetamine-dextroamphetamine (Adderall XR, Mydayis). They're often used and misused in search of a "high," or to boost energy, to improve performance at work or school, or to lose weight or control appetite.

• Feeling of happy excitement and too much confidence
• Increased alertness
• Increased energy and restlessness
• Behavior changes or aggression
• Rapid or rambling speech
• Larger than usual pupils, the black circles in the middle of the eyes
• Confusion, delusions and hallucinations
• Irritability, anxiety or paranoia
• Changes in heart rate, blood pressure and body temperature
• Nausea or vomiting with weight loss
• Poor judgment
• Nasal congestion and damage to the mucous membrane of the nose (if snorting drugs)
• Mouth sores, gum disease and tooth decay from smoking drugs ("meth mouth")
• Depression as the drug wears off

Club drugs are commonly used at clubs, concerts and parties. Examples include methylenedioxymethamphetamine, also called MDMA, ecstasy or molly, and gamma-hydroxybutyric acid, known as GHB. Other examples include ketamine and flunitrazepam or Rohypnol — a brand used outside the U.S. — also called roofie. These drugs are not all in the same category, but they share some similar effects and dangers, including long-term harmful effects.

Because GHB and flunitrazepam can cause sedation, muscle relaxation, confusion and memory loss, the potential for sexual misconduct or sexual assault is associated with the use of these drugs.

Signs and symptoms of use of club drugs can include:

• Larger than usual pupils
• Chills and sweating
• Involuntary shaking (tremors)
• Behavior changes
• Muscle cramping and teeth clenching
• Muscle relaxation, poor coordination or problems moving
• Reduced inhibitions
• Heightened or altered sense of sight, sound and taste
• Memory problems or loss of memory
• Reduced consciousness
• Increased or decreased heart rate and blood pressure

Hallucinogens

Use of hallucinogens can produce different signs and symptoms, depending on the drug. The most common hallucinogens are lysergic acid diethylamide (LSD) and phencyclidine (PCP).

LSD use may cause:

• Greatly reduced perception of reality, for example, interpreting input from one of your senses as another, such as hearing colors
• Impulsive behavior
• Rapid shifts in emotions
• Permanent mental changes in perception
• Rapid heart rate and high blood pressure
• Flashbacks, a reexperience of the hallucinations — even years later

PCP use may cause:

• A feeling of being separated from your body and surroundings
• Problems with coordination and movement
• Aggressive, possibly violent behavior
• Lack of pain sensation
• Increase in blood pressure and heart rate
• Problems with thinking and memory
• Problems speaking
• Intolerance to loud noise
• Sometimes seizures or coma

Signs and symptoms of inhalant use vary, depending on the substance. Some commonly inhaled substances include glue, paint thinners, correction fluid, felt tip marker fluid, gasoline, cleaning fluids and household aerosol products. Due to the toxic nature of these substances, users may develop brain damage or sudden death.

Signs and symptoms of use can include:

• Possessing an inhalant substance without a reasonable explanation
• Brief happy excitement
• Behaving as if drunk
• Reduced ability to keep impulses under control
• Aggressive behavior or eagerness to fight
• Nausea or vomiting
• Appearing under the influence of drugs, with slurred speech, slow movements and poor coordination
• Irregular heartbeats
• Lingering odor of inhalant material
• Rash around the nose and mouth

Opioid painkillers

Opioids are narcotic, painkilling drugs produced from opium or made synthetically. This class of drugs includes, among others, heroin, morphine, codeine, methadone, fentanyl and oxycodone.

Sometimes called the "opioid epidemic," addiction to opioid prescription pain medicines has reached an alarming rate across the United States. Some people who've been using opioids over a long period of time may need physician-prescribed temporary or long-term drug substitution during treatment.

Signs and symptoms of narcotic use and dependence can include:

• A sense of feeling "high"
• Reduced sense of pain
• Agitation, drowsiness or sedation
• Problems with attention and memory
• Pupils that are smaller than usual
• Lack of awareness or inattention to surrounding people and things
• Problems with coordination
• Constipation
• Runny nose or nose sores (if snorting drugs)
• Needle marks (if injecting drugs)

When to see a doctor

If your drug use is out of control or causing problems, get help. The sooner you seek help, the greater your chances for a long-term recovery. Talk with your health care provider or see a mental health provider, such as a doctor who specializes in addiction medicine or addiction psychiatry, or a licensed alcohol and drug counselor.

Make an appointment to see a provider if:

• You can't stop using a drug
• You continue using the drug despite the harm it causes
• Your drug use has led to unsafe behavior, such as sharing needles or unprotected sex
• You think you may be having withdrawal symptoms after stopping drug use

If you're not ready to approach a health care provider or mental health professional, help lines or hotlines may be a good place to learn about treatment. You can find these lines listed on the internet or in the phone book.

When to seek emergency help

Seek emergency help if you or someone you know has taken a drug and:

• May have overdosed
• Shows changes in consciousness
• Has trouble breathing
• Has seizures or convulsions
• Has signs of a possible heart attack, such as chest pain or pressure
• Has any other troublesome physical or psychological reaction to use of the drug

Staging an intervention

People struggling with addiction usually deny they have a problem and hesitate to seek treatment. An intervention presents a loved one with a structured opportunity to make changes before things get even worse and can motivate someone to seek or accept help.

It's important to plan an intervention carefully. It may be done by family and friends in consultation with a health care provider or mental health professional such as a licensed alcohol and drug counselor, or directed by an intervention professional. It involves family and friends and sometimes co-workers, clergy or others who care about the person struggling with addiction.

During the intervention, these people gather together to have a direct, heart-to-heart conversation with the person about the consequences of addiction. Then they ask the person to accept treatment.

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Like many mental health disorders, several factors may contribute to development of drug addiction. The main factors are:

• Environment. Environmental factors, including your family's beliefs and attitudes and exposure to a peer group that encourages drug use, seem to play a role in initial drug use.
• Genetics. Once you've started using a drug, the development into addiction may be influenced by inherited (genetic) traits, which may delay or speed up the disease progression.

Changes in the brain

Physical addiction appears to occur when repeated use of a drug changes the way your brain feels pleasure. The addicting drug causes physical changes to some nerve cells (neurons) in your brain. Neurons use chemicals called neurotransmitters to communicate. These changes can remain long after you stop using the drug.

Risk factors

People of any age, sex or economic status can become addicted to a drug. Certain factors can affect the likelihood and speed of developing an addiction:

• Family history of addiction. Drug addiction is more common in some families and likely involves an increased risk based on genes. If you have a blood relative, such as a parent or sibling, with alcohol or drug addiction, you're at greater risk of developing a drug addiction.
• Mental health disorder. If you have a mental health disorder such as depression, attention-deficit/hyperactivity disorder (ADHD) or post-traumatic stress disorder, you're more likely to become addicted to drugs. Using drugs can become a way of coping with painful feelings, such as anxiety, depression and loneliness, and can make these problems even worse.
• Peer pressure. Peer pressure is a strong factor in starting to use and misuse drugs, particularly for young people.
• Lack of family involvement. Difficult family situations or lack of a bond with your parents or siblings may increase the risk of addiction, as can a lack of parental supervision.
• Early use. Using drugs at an early age can cause changes in the developing brain and increase the likelihood of progressing to drug addiction.
• Taking a highly addictive drug. Some drugs, such as stimulants, cocaine or opioid painkillers, may result in faster development of addiction than other drugs. Smoking or injecting drugs can increase the potential for addiction. Taking drugs considered less addicting — so-called "light drugs" — can start you on a pathway of drug use and addiction.

Complications

Drug use can have significant and damaging short-term and long-term effects. Taking some drugs can be particularly risky, especially if you take high doses or combine them with other drugs or alcohol. Here are some examples.

• Methamphetamine, opiates and cocaine are highly addictive and cause multiple short-term and long-term health consequences, including psychotic behavior, seizures or death due to overdose. Opioid drugs affect the part of the brain that controls breathing, and overdose can result in death. Taking opioids with alcohol increases this risk.
• GHB and flunitrazepam may cause sedation, confusion and memory loss. These so-called "date rape drugs" are known to impair the ability to resist unwanted contact and recollection of the event. At high doses, they can cause seizures, coma and death. The danger increases when these drugs are taken with alcohol.
• MDMA — also known as molly or ecstasy — can interfere with the body's ability to regulate temperature. A severe spike in body temperature can result in liver, kidney or heart failure and death. Other complications can include severe dehydration, leading to seizures. Long-term, MDMA can damage the brain.
• One particular danger of club drugs is that the liquid, pill or powder forms of these drugs available on the street often contain unknown substances that can be harmful, including other illegally manufactured or pharmaceutical drugs.
• Due to the toxic nature of inhalants, users may develop brain damage of different levels of severity. Sudden death can occur even after a single exposure.

Other life-changing complications

Dependence on drugs can create a number of dangerous and damaging complications, including:

• Getting an infectious disease. People who are addicted to a drug are more likely to get an infectious disease, such as HIV , either through unsafe sex or by sharing needles with others.
• Other health problems. Drug addiction can lead to a range of both short-term and long-term mental and physical health problems. These depend on what drug is taken.
• Accidents. People who are addicted to drugs are more likely to drive or do other dangerous activities while under the influence.
• Suicide. People who are addicted to drugs die by suicide more often than people who aren't addicted.
• Family problems. Behavioral changes may cause relationship or family conflict and custody issues.
• Work issues. Drug use can cause declining performance at work, absenteeism and eventual loss of employment.
• Problems at school. Drug use can negatively affect academic performance and motivation to excel in school.
• Legal issues. Legal problems are common for drug users and can stem from buying or possessing illegal drugs, stealing to support the drug addiction, driving while under the influence of drugs or alcohol, or disputes over child custody.
• Financial problems. Spending money to support drug use takes away money from other needs, could lead to debt, and can lead to illegal or unethical behaviors.

The best way to prevent an addiction to a drug is not to take the drug at all. If your health care provider prescribes a drug with the potential for addiction, use care when taking the drug and follow instructions.

Health care providers should prescribe these medicines at safe doses and amounts and monitor their use so that you're not given too great a dose or for too long a time. If you feel you need to take more than the prescribed dose of a medicine, talk to your health care provider.

Preventing drug misuse in children and teenagers

Take these steps to help prevent drug misuse in your children and teenagers:

• Communicate. Talk to your children about the risks of drug use and misuse.
• Listen. Be a good listener when your children talk about peer pressure and be supportive of their efforts to resist it.
• Set a good example. Don't misuse alcohol or addictive drugs. Children of parents who misuse drugs are at greater risk of drug addiction.
• Strengthen the bond. Work on your relationship with your children. A strong, stable bond between you and your child will reduce your child's risk of using or misusing drugs.

Preventing a relapse

Once you've been addicted to a drug, you're at high risk of falling back into a pattern of addiction. If you do start using the drug, it's likely you'll lose control over its use again — even if you've had treatment and you haven't used the drug for some time.

• Follow your treatment plan. Monitor your cravings. It may seem like you've recovered and you don't need to keep taking steps to stay drug-free. But your chances of staying drug-free will be much higher if you continue seeing your therapist or counselor, going to support group meetings and taking prescribed medicine.
• Avoid high-risk situations. Don't go back to the neighborhood where you used to get your drugs. And stay away from your old drug crowd.
• Get help immediately if you use the drug again. If you start using the drug again, talk to your health care provider, your mental health provider or someone else who can help you right away.

Drug addiction (substance use disorder) care at Mayo Clinic

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• Brown AY. Allscripts EPSi. Mayo Clinic. April 13, 2021.
• DrugFacts: Understanding drug use and addiction. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction. Accessed Aug. 15, 2022.
• American Psychiatric Association. What is a substance use disorder? https://psychiatry.org/patients-families/addiction-substance-use-disorders/what-is-a-substance-use-disorder. Accessed Sept. 2, 2022.
• Eddie D, et al. Lived experience in new models of care for substance use disorder: A systematic review of peer recovery support services and recovery coaching. Frontiers in Psychology. 2019; doi:10.3389/fpsyg.2019.01052.
• Commonly used drugs charts. National Institute on Drug Abuse. https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts. Accessed Aug. 16, 2022.
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• Drugs of abuse: A DEA resource guide/2020 edition. United States Drug Enforcement Administration. https://admin.dea.gov/documents/2020/2020-04/2020-04-13/drugs-abuse. Accessed Aug. 31, 2022.
• Misuse of prescription drugs research report. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/overview. Accessed Aug. 17, 2022.
• Principles of drug addiction treatment: A research-based guide. 3rd ed. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/preface. Accessed Aug. 17, 2022.
• The science of drug use: A resource for the justice sector. National Institute on Drug Abuse. https://nida.nih.gov/drug-topics/criminal-justice/science-drug-use-resource-justice-sector. Accessed Sept. 2, 2022.
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• DrugFacts: Synthetic cannabinoids (K2/Spice). National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/synthetic-cannabinoids-k2spice. Accessed Aug. 18, 2022.
• Hall-Flavin DK (expert opinion). Mayo Clinic. March 5, 2021.
• Poppy seed tea: Beneficial or dangerous?

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The Concept of Addiction Essay

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Introduction

The correlation between the legal system and addiction, the involvement of laws and government agencies in lowering addiction.

Generally, addiction refers to the habitual psychological and physiologic reliance on a substance/drug that cannot be controlled. Alternatively, it may also refer to when an individual participates in a pleasurable activity of which a sustained use might be compulsive hence distorting the normal life routines.

Generally, addiction has led to broken morals, malpractices, distorted relationships, as well as significant health problems. It is notable that most addicts might not be aware of their deviant characters. Contextually, physical addiction incorporates a biological condition where an individual adjusts to the presence and continuous use of a given drug. Consequently, the body develops some tolerance.

The phenomenon involving the overreaction of a person’s brain also includes another potential physical addiction. It is argued that people abuse drugs or develop addiction to contain emotional stress. Because these psychologically-drawn addictions are never based on drug and brain impacts, this explains why individuals often assume addictive behaviours when they consume a specific or a totally distinct type of drug.

Dealing with addiction remains a complex initiative due to myriad of influences it causes in the society. This paper explains the correlation between the legal system and addiction. Additionally, it also discusses if laws and the government agencies dealing with drug control assist in lowering the incidents of addiction.

The recent developments in psychology, as well as intensive studies in the concept of addiction, has drawn considerable debates and concerns on the issue of relationships between the legal system and addiction. Historically, it is observable that the legal system has been an active agent towards the minimization of drug abuse.

Moreover, it has also stood out to be one of the sole actors in the punishment of drug perpetrators, as well as addicts. In US for instance, the justice system has always been influenced since early 1900s through attempts to totally eliminate various drugs. The setup of juvenile, as well as rehabilitation centres by the government for the youth drug addicts, remains a noble initiative catapulted by the legal systems.

Evidently, the struggle by most legal systems to curb the menace is noticed globally. For instance, the first law targeting drugs in US was termed the Harrison Act of 1914. This legislation acted against the consumption, distribution, and trade of illicit drugs within the society. Additionally, it outlawed opiates as well as cocaine. After the emergence of this act, several policies were passed. Consequently, major amendments were also put in place at diverse intervals.

However, it is critical to note that the war on drugs began later during the early 1970s. This was mainly realized after the US Congress passed the Comprehensive Drug Abuse and Control Act in 1970. The country also promoted a movement known as ‘War on Drugs’ fighting against illegal international trade and consumption of illicit drugs.

Generally, despite several loopholes that have existed within the legal system’s mandate to curb the mentioned drug menace, significant effort has been launched to bring drug use under control. Generally, there is an observation that most legal systems remain punitive on drug users. However, they have minimal consideration of the historical, hereditary or psychological factors behind such practices amongst the population, particularly the youth.

There has been much advocacy by other concerned agencies to integrate psychological as well as rehabilitative processes within the legal systems. This is proposed to assist in the rehabilitation and consequent transformation of addicts. For most legal systems, there is follow up and tracing of people engaged in the drug trafficking and selling to various distributors. Particularly, the drug barons have fallen prey of most legal systems.

Since drug use has increasingly spread amongst the youth, there has been an increasing interest to monitor the sources and terminate drug deals by various peddlers. However, the entire monitoring as well as control of the various types of drugs by the legal system have not been realized.

This is for the club drugs that are mostly associated with youth and have consequently led to high addiction rates, as well as deviant behaviours within the society. Additionally, alcohol has potentially remained highly abused even with the younger generation due to lack of proper monitoring and compliance mechanisms to the laws.

The involvement of other government agencies has also not been completely comprehensive. This is because the legal system has increasingly based its rules in the regulation of the alcohol producing industries rather than the largely affected populace. There is a limited prohibitive measure in ensuring the teenagers are not involved in drug and substance abuse.

This is particularly aggravated by the fact that most addicted parents enhance the children’s accessibility to the drugs. Evidently, most elderly persons who suffer from drug or alcohol addiction have confessed to have potentially influenced their kids into the act. Basically, this is because most legal systems have ineffectively executed principal procedures as well as systems of conducting/monitoring domestic drug use among these populations.

The involvement of the laws as well as other government agencies in minimizing cases of drug addiction has been notable for a long time. The legal and government agencies’ involvement in the fight has remained effective in the fight against the problem. It is notable that even though most governments have engaged in this fight, there still remain significant loopholes that need to be addressed comprehensively.

To begin with, it is notable that most key government agencies as well as their top leaders have fallen prey to the drug trafficking industry. The involvement of the government top leaders in drug trafficking as well as trade industry is a serious issue that has compromised total fight on drug addiction.

It is vital to note that this practice has been particularly noted within the developing world where the issue of drug addiction coupled with deviant behaviours is also increasingly becoming a potential challenge. There has been potential observation of increased homicide as well as criminal activities particularly when the legal war on drugs becomes intensive and underway.

The negative effects of excess alcohol as well as tobacco remain eminent to most states. However, it is shocking that the production of alcohol as well as cigarettes have still remained legal. This condition is worsened by the fact that their distribution remains unmonitored with even the underage having access to the dangerous substances.

The legislation for club drug has particularly remained ineffective, and this continues to propel addiction and engagement in the use of other potentially harmful dugs. This is because the access and addiction to a specific type of drug potentially leads into the use of another drug, thus leading to an elongated string of substance abuse. In most legislative systems, it is observable that tobacco, its products, and alcohol remain legally approved for use with people of a particular age.

In other government agencies, there are notable efforts that have occasionally been cited to persuade persons to give up or let away smoking as well as substance abuse. However, these efforts are still rendered useless because tobacco as well as its other products still largely remain legal and accessible to most adults.

Moreover, it is also notable that even the youth and other underage children get access to these substances easily. This occurs through peer pressure, purchasing from local retailers and joints that are interested in profit making, and also through access from the stores of addicted parents.

The public endeavours to influence and prevent the use of drugs and other potentially harmful substances capable of transforming ones moods or enhancing concentration have resulted into mixed reactions and outcomes. It is important to note that the legal prohibition of these substances came to termination majorly due to a massive disobedience.

This was particularly observed in the US following a series of amendments on the drug and other substances abuse acts. In certain ways, the government agencies and the existing laws’ efforts to prohibit or manage the use of drugs as well as substances seems generally inconsistent with the direct harm that is yet to be caused.

Addiction generally refers to the habitual uncontrollable physiologic or psychological dependence on a drug or practice. It is evident that addiction emanates when an individual continuously ingests substances (capable of altering moods/behaviours) such as alcohol, bhang, cocaine, or nicotine among others.

Therefore, it is critical to enact a comprehensive program to alleviate or eradicate the practice of drug abuse and substance dependency. This requires an all rounded approach that investigates psychological implications and influences on the people’s rationale for the practice.

However, governments as well as its other agencies have failed to comprehensively address this concern. So far as observed, government’s interests rest on the ability to use force as well as deterrence through prosecution of offenders and victims to fight this deviant character. However, this approach has often led to high levels of disobedience.

The inability of the legal agencies to completely control the processing as well as the distribution of alcoholic substances within the society perhaps is one critical factor that has consciously led to increased level of drug addictions. The easy access to the youths and teenagers to bar joints propels their exposure to drugs.

Observably, this situation is worsened by the highly seductive, persuasive, and influential advertisement of some drugs in the social media. Considering this point, it is notable that the government has largely failed to control and regulate the advertisement content of the notable drugs within the social media. The situation is propelled presently, given to the increased level of technology as well as globalization.

Conclusively, the issue of drug and substance abuse remains a great public health concern and social challenge particularly in the globalized world. The involvement of legal systems and other government agencies has been critical in curtailing this behaviour. This is critical despite the widely notable limitations recorded by some governments. It is crucial to understand the concepts of addiction in order to unveil its relationships with the established government regulations.

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Substance use, abuse, and addiction

Substance use disorder is a cluster of physiological, behavioral, and cognitive symptoms associated with the continued use of substances despite substance-related problems, distress, and/or impairment, such as impaired control and risky use.

Addiction is a state of psychological and/or physical dependence on the use of drugs or other substances, such as alcohol, or on activities or behaviors, such as sex, exercise, and gambling.

Adapted from the APA Dictionary of Psychology

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Essay on Drug Addiction | Drug Addiction Essay for Students and Children in English

February 12, 2024 by Veerendra

Essay on Drug Addiction: Addiction refers to the harmful need to consume substances that have damaging consequences on the user. Addiction affects not just the body but also on the person’s mental health and soundness of mind. Addiction is one of the most severe health problems faced around the world and is termed as a chronic disease. A widespread disorder ranges from drugs, alcohol addiction to gambling, and even phone addiction.

You can read more  Essay Writing  about articles, events, people, sports, technology many more.

One of the most unfortunate yet common addictions that affect millions today is drug addiction. Also referred to as substance – use disorder, it is the addiction to substances that harm neurological functioning and a person’s behavior. The essay provides relevant information on this topic.

Long and Short Essay on Drug Addiction in English for Students and Kids

There are two essays listed below. The long essay consists of 500 words and a short essay of 200 words.

Long Essay on Drug Addiction in English 500 words

Drug addiction, also known as substance–use disorder, refers to the dangerous and excessive intake of legal and illegal drugs. This leads to many behavioral changes in the person as well as affects brain functions. Drug addiction includes abusing alcohol, cocaine, heroin, opioid, painkillers, and nicotine, among others. Drugs like these help the person feel good about themselves and induce ‘dopamine’ or the happiness hormone. As they continue to use the drug, the brain starts to increase dopamine levels, and the person demands more.

Drug addiction has severe consequences. Some of the signs include anxiety, paranoia, increased heart rate, and red eyes. They are intoxicated and unable to display proper coordination and have difficulty in remembering things. A person who is addicted cannot resist using them and unable to function correctly without ingesting them. It causes damage to the brain, their personal and professional relationships. It affects mental cognition; they are unable to make proper decisions, cannot retain information, and make poor judgments. They tend to engage in reckless activities such as stealing or driving under the influence. They also make sure that there is a constant supply and are willing to pay a lot of money even if they are unable to afford it and tend to have erratic sleep patterns.

Drug addiction also causes a person to isolate themselves and have either intense or no food cravings. They stop taking care of their hygiene. Drug addiction affects a person’s speech and experience hallucinations. They are unable to converse and communicate properly; they speak fast and are hyperactive. Those addicted have extreme mood swings. They can go from feeling happy to feeling sad quickly and are incredibly secretive. They begin to lose interest in activities they once loved. Substance abusers also undergo withdrawal symptoms. Withdrawal symptoms refer to the symptoms that occur when they stop taking the drug. Some withdrawal symptoms include nausea, fatigue, and tremors. They stop and starting using again, an endless cycle that could be life-threatening. Drug addiction can be fatal if not treated timely. It can cause brain damage and seizures as well as overdose, heart diseases, respiratory problems, damage to the liver and kidneys, vomiting, lung diseases, and much more.

Though chronic, treatment is available for drug addiction. Many techniques are used, such as behavioral counseling, medication to treat the addiction, and providing treatment not just for substance abuse but also for many factors that accompany addiction such as stress, anxiety, and depression. Many devices have developed to overcome addiction. There are rehabilitation centers to help people. After treatment, there are numerous follow-ups to ensure that the cycle does not come back. The most important is having family and friends to support the effect. It will help them build confidence and come over their addiction.

The United Nations celebrates International Day against Drug Abuse and Illicit Trafficking on the 26th of June. Drug addiction impacts millions and needs to be treated carefully to prevent further harm to the individual and letting them live a better life.

Short Essay on Drug Addiction in English 250 words

Drug addiction refers to taking substances that are harmful to our bodies. They cause changes to a person’s behavior as well. Many people take these drugs to feel happier and better about themselves. These dangerous substances make the brain produce a chemical that makes us happy, called dopamine. Producing large amounts of these causes the person to take the drug consistently.

Some of the drugs include alcohol, nicotine, and other unhealthy substances. Taking these substances can lead to many symptoms. These include unable to think correctly, cannot remember things, and unable to speak clearly. They steal and keep secrets from their close ones. Those addicted cannot sleep; they become happy and sad quickly. They stop doing the activities that they liked doing. They are not aware of their surroundings. Taking these dangerous substances can cause many health problems such as vomiting, unable to breathe, brain, and lung damage. It also affects their family, friends, and work.

Drug addiction is life-threatening. However, people with this addiction can be treated and helped with therapy, counseling, and taking medicines along with rehab centers. They do follow-ups to ensure that they never retake these drugs. They must have their family and friends to support them as they recover.

10 lines About Drug Addiction Essay in English

• Drug addiction refers to taking harmful substances that affect a person’s brain functions and behavior. It involves taking legal and illegal drugs, and the person is unable to stop using them. It is also referred to as substance- use disorders
• Harmful drugs include alcohol, cocaine, heroin, opioids, painkillers, nicotine, etc.
• The harmful drugs cause an excessive release of dopamine or the happy hormone, which causes the person to take more.
• Drug addiction can affect mental cognition, including decision making, judgments, and memory. It also causes speech problems.
• It can cause anxiety paranoia and increased blood pressure. They have erratic sleep patterns and isolate themselves. It causes problems in their personal and professional relationships.
• Those addicted become moody, hyperactive, and hallucinate. They also engage in reckless activities.
• They experience withdrawal symptoms when they try to stop using substances. These include nausea, fatigue, and tremors.
• It can have many effects on the body, such as brain damage, seizures, liver and kidney damage, respiratory and lung issues.
• Treatment is available. It includes behavioral therapy, medication, rehabilitation, as well as a follow-up to prevent relapse.
• The United Nations celebrates International Day against Drug Abuse and Illicit Trafficking on the 26th of June.

Frequently Asked Questions on Drug Addiction Essay

Question  1. What is drug addiction?

Answer: Drug addiction, also known as substance – use disorder, refers to the dangerous and excessive intake of legal and illegal drugs. This leads to many behavioral changes in the person as well as affects brain functions.

Question 2. Why does drug addiction occur?

Answer: People become addicted to these drugs because they want to feel happier. The drugs cause a chemical called dopamine, which induces happiness to be released. The brain starts to increase dopamine levels, and thus the person becomes addicted to the drug to match the increasing levels.

Question 3. What is the difference between dependence and addiction?

Answer: Dependence and addiction vary. While dependence is an intense craving for the drug by the body, addiction also refers to the changes in behavior and bodily functions due to repeated use of the drug, which has severe consequences.

Question 4. Can we treat drug addiction?

Answer: Yes, drug addiction can be treated. The various treatment methods are behavioral counseling, medication, and treatment of anxiety and depression. There are rehabilitation centers available. This is followed by a check-up to prevent relapse.

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• Published: 22 February 2021

Addiction as a brain disease revised: why it still matters, and the need for consilience

• Markus Heilig 1 ,
• James MacKillop   ORCID: orcid.org/0000-0003-4118-9500 2 , 3 ,
• Diana Martinez 4 ,
• Jürgen Rehm   ORCID: orcid.org/0000-0001-5665-0385 5 , 6 , 7 , 8 ,
• Lorenzo Leggio   ORCID: orcid.org/0000-0001-7284-8754 9 &
• Louk J. M. J. Vanderschuren   ORCID: orcid.org/0000-0002-5379-0363 10  

Neuropsychopharmacology volume  46 ,  pages 1715–1723 ( 2021 ) Cite this article

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A Correspondence to this article was published on 03 May 2021

The view that substance addiction is a brain disease, although widely accepted in the neuroscience community, has become subject to acerbic criticism in recent years. These criticisms state that the brain disease view is deterministic, fails to account for heterogeneity in remission and recovery, places too much emphasis on a compulsive dimension of addiction, and that a specific neural signature of addiction has not been identified. We acknowledge that some of these criticisms have merit, but assert that the foundational premise that addiction has a neurobiological basis is fundamentally sound. We also emphasize that denying that addiction is a brain disease is a harmful standpoint since it contributes to reducing access to healthcare and treatment, the consequences of which are catastrophic. Here, we therefore address these criticisms, and in doing so provide a contemporary update of the brain disease view of addiction. We provide arguments to support this view, discuss why apparently spontaneous remission does not negate it, and how seemingly compulsive behaviors can co-exist with the sensitivity to alternative reinforcement in addiction. Most importantly, we argue that the brain is the biological substrate from which both addiction and the capacity for behavior change arise, arguing for an intensified neuroscientific study of recovery. More broadly, we propose that these disagreements reveal the need for multidisciplinary research that integrates neuroscientific, behavioral, clinical, and sociocultural perspectives.

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Introduction.

Close to a quarter of a century ago, then director of the US National Institute on Drug Abuse Alan Leshner famously asserted that “addiction is a brain disease”, articulated a set of implications of this position, and outlined an agenda for realizing its promise [ 1 ]. The paper, now cited almost 2000 times, put forward a position that has been highly influential in guiding the efforts of researchers, and resource allocation by funding agencies. A subsequent 2000 paper by McLellan et al. [ 2 ] examined whether data justify distinguishing addiction from other conditions for which a disease label is rarely questioned, such as diabetes, hypertension or asthma. It concluded that neither genetic risk, the role of personal choices, nor the influence of environmental factors differentiated addiction in a manner that would warrant viewing it differently; neither did relapse rates, nor compliance with treatment. The authors outlined an agenda closely related to that put forward by Leshner, but with a more clinical focus. Their conclusion was that addiction should be insured, treated, and evaluated like other diseases. This paper, too, has been exceptionally influential by academic standards, as witnessed by its ~3000 citations to date. What may be less appreciated among scientists is that its impact in the real world of addiction treatment has remained more limited, with large numbers of patients still not receiving evidence-based treatments.

In recent years, the conceptualization of addiction as a brain disease has come under increasing criticism. When first put forward, the brain disease view was mainly an attempt to articulate an effective response to prevailing nonscientific, moralizing, and stigmatizing attitudes to addiction. According to these attitudes, addiction was simply the result of a person’s moral failing or weakness of character, rather than a “real” disease [ 3 ]. These attitudes created barriers for people with substance use problems to access evidence-based treatments, both those available at the time, such as opioid agonist maintenance, cognitive behavioral therapy-based relapse prevention, community reinforcement or contingency management, and those that could result from research. To promote patient access to treatments, scientists needed to argue that there is a biological basis beneath the challenging behaviors of individuals suffering from addiction. This argument was particularly targeted to the public, policymakers and health care professionals, many of whom held that since addiction was a misery people brought upon themselves, it fell beyond the scope of medicine, and was neither amenable to treatment, nor warranted the use of taxpayer money.

Present-day criticism directed at the conceptualization of addiction as a brain disease is of a very different nature. It originates from within the scientific community itself, and asserts that this conceptualization is neither supported by data, nor helpful for people with substance use problems [ 4 , 5 , 6 , 7 , 8 ]. Addressing these critiques requires a very different perspective, and is the objective of our paper. We readily acknowledge that in some cases, recent critiques of the notion of addiction as a brain disease as postulated originally have merit, and that those critiques require the postulates to be re-assessed and refined. In other cases, we believe the arguments have less validity, but still provide an opportunity to update the position of addiction as a brain disease. Our overarching concern is that questionable arguments against the notion of addiction as a brain disease may harm patients, by impeding access to care, and slowing development of novel treatments.

A premise of our argument is that any useful conceptualization of addiction requires an understanding both of the brains involved, and of environmental factors that interact with those brains [ 9 ]. These environmental factors critically include availability of drugs, but also of healthy alternative rewards and opportunities. As we will show, stating that brain mechanisms are critical for understanding and treating addiction in no way negates the role of psychological, social and socioeconomic processes as both causes and consequences of substance use. To reflect this complex nature of addiction, we have assembled a team with expertise that spans from molecular neuroscience, through animal models of addiction, human brain imaging, clinical addiction medicine, to epidemiology. What brings us together is a passionate commitment to improving the lives of people with substance use problems through science and science-based treatments, with empirical evidence as the guiding principle.

To achieve this goal, we first discuss the nature of the disease concept itself, and why we believe it is important for the science and treatment of addiction. This is followed by a discussion of the main points raised when the notion of addiction as a brain disease has come under criticism. Key among those are claims that spontaneous remission rates are high; that a specific brain pathology is lacking; and that people suffering from addiction, rather than behaving “compulsively”, in fact show a preserved ability to make informed and advantageous choices. In the process of discussing these issues, we also address the common criticism that viewing addiction as a brain disease is a fully deterministic theory of addiction. For our argument, we use the term “addiction” as originally used by Leshner [ 1 ]; in Box  1 , we map out and discuss how this construct may relate to the current diagnostic categories, such as Substance Use Disorder (SUD) and its different levels of severity (Fig.  1) .

Risky (hazardous) substance use refers to quantity/frequency indicators of consumption; SUD refers to individuals who meet criteria for a DSM-5 diagnosis (mild, moderate, or severe); and addiction refers to individuals who exhibit persistent difficulties with self-regulation of drug consumption. Among high-risk individuals, a subgroup will meet criteria for SUD and, among those who have an SUD, a further subgroup would be considered to be addicted to the drug. However, the boundary for addiction is intentionally blurred to reflect that the dividing line for defining addiction within the category of SUD remains an open empirical question.

Box 1 What’s in a name? Differentiating hazardous use, substance use disorder, and addiction

Although our principal focus is on the brain disease model of addiction, the definition of addiction itself is a source of ambiguity. Here, we provide a perspective on the major forms of terminology in the field.

Hazardous Substance Use

Hazardous (risky) substance use refers to quantitative levels of consumption that increase an individual’s risk for adverse health consequences. In practice, this pertains to alcohol use [ 110 , 111 ]. Clinically, alcohol consumption that exceeds guidelines for moderate drinking has been used to prompt brief interventions or referral for specialist care [ 112 ]. More recently, a reduction in these quantitative levels has been validated as treatment endpoints [ 113 ].

Substance Use Disorder

SUD refers to the DSM-5 diagnosis category that encompasses significant impairment or distress resulting from specific categories of psychoactive drug use. The diagnosis of SUD is operationalized as 2 or more of 11 symptoms over the past year. As a result, the diagnosis is heterogenous, with more than 1100 symptom permutations possible. The diagnosis in DSM-5 is the result of combining two diagnoses from the DSM-IV, abuse and dependence, which proved to be less valid than a single dimensional approach [ 114 ]. Critically, SUD includes three levels of severity: mild (2–3 symptoms), moderate (4–5 symptoms), and severe (6+ symptoms). The International Classification of Diseases (ICD) system retains two diagnoses, harmful use (lower severity) and substance dependence (higher severity).

Addiction is a natural language concept, etymologically meaning enslavement, with the contemporary meaning traceable to the Middle and Late Roman Republic periods [ 115 ]. As a scientific construct, drug addiction can be defined as a state in which an individual exhibits an inability to self-regulate consumption of a substance, although it does not have an operational definition. Regarding clinical diagnosis, as it is typically used in scientific and clinical parlance, addiction is not synonymous with the simple presence of SUD. Nowhere in DSM-5 is it articulated that the diagnostic threshold (or any specific number/type of symptoms) should be interpreted as reflecting addiction, which inherently connotes a high degree of severity. Indeed, concerns were raised about setting the diagnostic standard too low because of the issue of potentially conflating a low-severity SUD with addiction [ 116 ]. In scientific and clinical usage, addiction typically refers to individuals at a moderate or high severity of SUD. This is consistent with the fact that moderate-to-severe SUD has the closest correspondence with the more severe diagnosis in ICD [ 117 , 118 , 119 ]. Nonetheless, akin to the undefined overlap between hazardous use and SUD, the field has not identified the exact thresholds of SUD symptoms above which addiction would be definitively present.

Integration

The ambiguous relationships among these terms contribute to misunderstandings and disagreements. Figure 1 provides a simple working model of how these terms overlap. Fundamentally, we consider that these terms represent successive dimensions of severity, clinical “nesting dolls”. Not all individuals consuming substances at hazardous levels have an SUD, but a subgroup do. Not all individuals with a SUD are addicted to the drug in question, but a subgroup are. At the severe end of the spectrum, these domains converge (heavy consumption, numerous symptoms, the unambiguous presence of addiction), but at low severity, the overlap is more modest. The exact mapping of addiction onto SUD is an open empirical question, warranting systematic study among scientists, clinicians, and patients with lived experience. No less important will be future research situating our definition of SUD using more objective indicators (e.g., [ 55 , 120 ]), brain-based and otherwise, and more precisely in relation to clinical needs [ 121 ]. Finally, such work should ultimately be codified in both the DSM and ICD systems to demarcate clearly where the attribution of addiction belongs within the clinical nosology, and to foster greater clarity and specificity in scientific discourse.

What is a disease?

In his classic 1960 book “The Disease Concept of Alcoholism”, Jellinek noted that in the alcohol field, the debate over the disease concept was plagued by too many definitions of “alcoholism” and too few definitions of “disease” [ 10 ]. He suggested that the addiction field needed to follow the rest of medicine in moving away from viewing disease as an “entity”, i.e., something that has “its own independent existence, apart from other things” [ 11 ]. To modern medicine, he pointed out, a disease is simply a label that is agreed upon to describe a cluster of substantial, deteriorating changes in the structure or function of the human body, and the accompanying deterioration in biopsychosocial functioning. Thus, he concluded that alcoholism can simply be defined as changes in structure or function of the body due to drinking that cause disability or death. A disease label is useful to identify groups of people with commonly co-occurring constellations of problems—syndromes—that significantly impair function, and that lead to clinically significant distress, harm, or both. This convention allows a systematic study of the condition, and of whether group members benefit from a specific intervention.

It is not trivial to delineate the exact category of harmful substance use for which a label such as addiction is warranted (See Box  1 ). Challenges to diagnostic categorization are not unique to addiction, however. Throughout clinical medicine, diagnostic cut-offs are set by consensus, commonly based on an evolving understanding of thresholds above which people tend to benefit from available interventions. Because assessing benefits in large patient groups over time is difficult, diagnostic thresholds are always subject to debate and adjustments. It can be debated whether diagnostic thresholds “merely” capture the extreme of a single underlying population, or actually identify a subpopulation that is at some level distinct. Resolving this issue remains challenging in addiction, but once again, this is not different from other areas of medicine [see e.g., [ 12 ] for type 2 diabetes]. Longitudinal studies that track patient trajectories over time may have a better ability to identify subpopulations than cross-sectional assessments [ 13 ].

By this pragmatic, clinical understanding of the disease concept, it is difficult to argue that “addiction” is unjustified as a disease label. Among people who use drugs or alcohol, some progress to using with a quantity and frequency that results in impaired function and often death, making substance use a major cause of global disease burden [ 14 ]. In these people, use occurs with a pattern that in milder forms may be challenging to capture by current diagnostic criteria (See Box  1 ), but is readily recognized by patients, their families and treatment providers when it reaches a severity that is clinically significant [see [ 15 ] for a classical discussion]. In some cases, such as opioid addiction, those who receive the diagnosis stand to obtain some of the greatest benefits from medical treatments in all of clinical medicine [ 16 , 17 ]. Although effect sizes of available treatments are more modest in nicotine [ 18 ] and alcohol addiction [ 19 ], the evidence supporting their efficacy is also indisputable. A view of addiction as a disease is justified, because it is beneficial: a failure to diagnose addiction drastically increases the risk of a failure to treat it [ 20 ].

Of course, establishing a diagnosis is not a requirement for interventions to be meaningful. People with hazardous or harmful substance use who have not (yet) developed addiction should also be identified, and interventions should be initiated to address their substance-related risks. This is particularly relevant for alcohol, where even in the absence of addiction, use is frequently associated with risks or harm to self, e.g., through cardiovascular disease, liver disease or cancer, and to others, e.g., through accidents or violence [ 21 ]. Interventions to reduce hazardous or harmful substance use in people who have not developed addiction are in fact particularly appealing. In these individuals, limited interventions are able to achieve robust and meaningful benefits [ 22 ], presumably because patterns of misuse have not yet become entrenched.

Thus, as originally pointed out by McLellan and colleagues, most of the criticisms of addiction as a disease could equally be applied to other medical conditions [ 2 ]. This type of criticism could also be applied to other psychiatric disorders, and that has indeed been the case historically [ 23 , 24 ]. Today, there is broad consensus that those criticisms were misguided. Few, if any healthcare professionals continue to maintain that schizophrenia, rather than being a disease, is a normal response to societal conditions. Why, then, do people continue to question if addiction is a disease, but not whether schizophrenia, major depressive disorder or post-traumatic stress disorder are diseases? This is particularly troubling given the decades of data showing high co-morbidity of addiction with these conditions [ 25 , 26 ]. We argue that it comes down to stigma. Dysregulated substance use continues to be perceived as a self-inflicted condition characterized by a lack of willpower, thus falling outside the scope of medicine and into that of morality [ 3 ].

Chronic and relapsing, developmentally-limited, or spontaneously remitting?

Much of the critique targeted at the conceptualization of addiction as a brain disease focuses on its original assertion that addiction is a chronic and relapsing condition. Epidemiological data are cited in support of the notion that large proportions of individuals achieve remission [ 27 ], frequently without any formal treatment [ 28 , 29 ] and in some cases resuming low risk substance use [ 30 ]. For instance, based on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study [ 27 ], it has been pointed out that a significant proportion of people with an addictive disorder quit each year, and that most afflicted individuals ultimately remit. These spontaneous remission rates are argued to invalidate the concept of a chronic, relapsing disease [ 4 ].

Interpreting these and similar data is complicated by several methodological and conceptual issues. First, people may appear to remit spontaneously because they actually do, but also because of limited test–retest reliability of the diagnosis [ 31 ]. For instance, using a validated diagnostic interview and trained interviewers, the Collaborative Studies on Genetics of Alcoholism examined the likelihood that an individual diagnosed with a lifetime history of substance dependence would retain this classification after 5 years. This is obviously a diagnosis that, once met, by definition cannot truly remit. Lifetime alcohol dependence was indeed stable in individuals recruited from addiction treatment units, ~90% for women, and 95% for men. In contrast, in a community-based sample similar to that used in the NESARC [ 27 ], stability was only ~30% and 65% for women and men, respectively. The most important characteristic that determined diagnostic stability was severity. Diagnosis was stable in severe, treatment-seeking cases, but not in general population cases of alcohol dependence.

These data suggest that commonly used diagnostic criteria alone are simply over-inclusive for a reliable, clinically meaningful diagnosis of addiction. They do identify a core group of treatment seeking individuals with a reliable diagnosis, but, if applied to nonclinical populations, also flag as “cases” a considerable halo of individuals for whom the diagnostic categorization is unreliable. Any meaningful discussion of remission rates needs to take this into account, and specify which of these two populations that is being discussed. Unfortunately, the DSM-5 has not made this task easier. With only 2 out of 11 symptoms being sufficient for a diagnosis of SUD, it captures under a single diagnostic label individuals in a “mild” category, whose diagnosis is likely to have very low test–retest reliability, and who are unlikely to exhibit a chronic relapsing course, together with people at the severe end of the spectrum, whose diagnosis is reliable, many of whom do show a chronic relapsing course.

The NESARC data nevertheless show that close to 10% of people in the general population who are diagnosed with alcohol addiction (here equated with DSM-IV “dependence” used in the NESARC study) never remitted throughout their participation in the survey. The base life-time prevalence of alcohol dependence in NESARC was 12.5% [ 32 ]. Thus, the data cited against the concept of addiction as a chronic relapsing disease in fact indicate that over 1% of the US population develops an alcohol-related condition that is associated with high morbidity and mortality, and whose chronic and/or relapsing nature cannot be disputed, since it does not remit.

Secondly, the analysis of NESARC data [ 4 , 27 ] omits opioid addiction, which, together with alcohol and tobacco, is the largest addiction-related public health problem in the US [ 33 ]. This is probably the addictive condition where an analysis of cumulative evidence most strikingly supports the notion of a chronic disorder with frequent relapses in a large proportion of people affected [ 34 ]. Of course, a large number of people with opioid addiction are unable to express the chronic, relapsing course of their disease, because over the long term, their mortality rate is about 15 times greater than that of the general population [ 35 ]. However, even among those who remain alive, the prevalence of stable abstinence from opioid use after 10–30 years of observation is <30%. Remission may not always require abstinence, for instance in the case of alcohol addiction, but is a reasonable proxy for remission with opioids, where return to controlled use is rare. Embedded in these data is a message of literally vital importance: when opioid addiction is diagnosed and treated as a chronic relapsing disease, outcomes are markedly improved, and retention in treatment is associated with a greater likelihood of abstinence.

The fact that significant numbers of individuals exhibit a chronic relapsing course does not negate that even larger numbers of individuals with SUD according to current diagnostic criteria do not. For instance, in many countries, the highest prevalence of substance use problems is found among young adults, aged 18–25 [ 36 ], and a majority of these ‘age out’ of excessive substance use [ 37 ]. It is also well documented that many individuals with SUD achieve longstanding remission, in many cases without any formal treatment (see e.g., [ 27 , 30 , 38 ]).

Collectively, the data show that the course of SUD, as defined by current diagnostic criteria, is highly heterogeneous. Accordingly, we do not maintain that a chronic relapsing course is a defining feature of SUD. When present in a patient, however, such as course is of clinical significance, because it identifies a need for long-term disease management [ 2 ], rather than expectations of a recovery that may not be within the individual’s reach [ 39 ]. From a conceptual standpoint, however, a chronic relapsing course is neither necessary nor implied in a view that addiction is a brain disease. This view also does not mean that it is irreversible and hopeless. Human neuroscience documents restoration of functioning after abstinence [ 40 , 41 ] and reveals predictors of clinical success [ 42 ]. If anything, this evidence suggests a need to increase efforts devoted to neuroscientific research on addiction recovery [ 40 , 43 ].

Lessons from genetics

For alcohol addiction, meta-analysis of twin and adoption studies has estimated heritability at ~50%, while estimates for opioid addiction are even higher [ 44 , 45 ]. Genetic risk factors are to a large extent shared across substances [ 46 ]. It has been argued that a genetic contribution cannot support a disease view of a behavior, because most behavioral traits, including religious and political inclinations, have a genetic contribution [ 4 ]. This statement, while correct in pointing out broad heritability of behavioral traits, misses a fundamental point. Genetic architecture is much like organ structure. The fact that normal anatomy shapes healthy organ function does not negate that an altered structure can contribute to pathophysiology of disease. The structure of the genetic landscape is no different. Critics further state that a “genetic predisposition is not a recipe for compulsion”, but no neuroscientist or geneticist would claim that genetic risk is “a recipe for compulsion”. Genetic risk is probabilistic, not deterministic. However, as we will see below, in the case of addiction, it contributes to large, consistent probability shifts towards maladaptive behavior.

In dismissing the relevance of genetic risk for addiction, Hall writes that “a large number of alleles are involved in the genetic susceptibility to addiction and individually these alleles might very weakly predict a risk of addiction”. He goes on to conclude that “generally, genetic prediction of the risk of disease (even with whole-genome sequencing data) is unlikely to be informative for most people who have a so-called average risk of developing an addiction disorder” [ 7 ]. This reflects a fundamental misunderstanding of polygenic risk. It is true that a large number of risk alleles are involved, and that the explanatory power of currently available polygenic risk scores for addictive disorders lags behind those for e.g., schizophrenia or major depression [ 47 , 48 ]. The only implication of this, however, is that low average effect sizes of risk alleles in addiction necessitate larger study samples to construct polygenic scores that account for a large proportion of the known heritability.

However, a heritability of addiction of ~50% indicates that DNA sequence variation accounts for 50% of the risk for this condition. Once whole genome sequencing is readily available, it is likely that it will be possible to identify most of that DNA variation. For clinical purposes, those polygenic scores will of course not replace an understanding of the intricate web of biological and social factors that promote or prevent expression of addiction in an individual case; rather, they will add to it [ 49 ]. Meanwhile, however, genome-wide association studies in addiction have already provided important information. For instance, they have established that the genetic underpinnings of alcohol addiction only partially overlap with those for alcohol consumption, underscoring the genetic distinction between pathological and nonpathological drinking behaviors [ 50 ].

It thus seems that, rather than negating a rationale for a disease view of addiction, the important implication of the polygenic nature of addiction risk is a very different one. Genome-wide association studies of complex traits have largely confirmed the century old “infinitisemal model” in which Fisher reconciled Mendelian and polygenic traits [ 51 ]. A key implication of this model is that genetic susceptibility for a complex, polygenic trait is continuously distributed in the population. This may seem antithetical to a view of addiction as a distinct disease category, but the contradiction is only apparent, and one that has long been familiar to quantitative genetics. Viewing addiction susceptibility as a polygenic quantitative trait, and addiction as a disease category is entirely in line with Falconer’s theorem, according to which, in a given set of environmental conditions, a certain level of genetic susceptibility will determine a threshold above which disease will arise.

A brain disease? Then show me the brain lesion!

The notion of addiction as a brain disease is commonly criticized with the argument that a specific pathognomonic brain lesion has not been identified. Indeed, brain imaging findings in addiction (perhaps with the exception of extensive neurotoxic gray matter loss in advanced alcohol addiction) are nowhere near the level of specificity and sensitivity required of clinical diagnostic tests. However, this criticism neglects the fact that neuroimaging is not used to diagnose many neurologic and psychiatric disorders, including epilepsy, ALS, migraine, Huntington’s disease, bipolar disorder, or schizophrenia. Even among conditions where signs of disease can be detected using brain imaging, such as Alzheimer’s and Parkinson’s disease, a scan is best used in conjunction with clinical acumen when making the diagnosis. Thus, the requirement that addiction be detectable with a brain scan in order to be classified as a disease does not recognize the role of neuroimaging in the clinic.

For the foreseeable future, the main objective of imaging in addiction research is not to diagnose addiction, but rather to improve our understanding of mechanisms that underlie it. The hope is that mechanistic insights will help bring forward new treatments, by identifying candidate targets for them, by pointing to treatment-responsive biomarkers, or both [ 52 ]. Developing innovative treatments is essential to address unmet treatment needs, in particular in stimulant and cannabis addiction, where no approved medications are currently available. Although the task to develop novel treatments is challenging, promising candidates await evaluation [ 53 ]. A particular opportunity for imaging-based research is related to the complex and heterogeneous nature of addictive disorders. Imaging-based biomarkers hold the promise of allowing this complexity to be deconstructed into specific functional domains, as proposed by the RDoC initiative [ 54 ] and its application to addiction [ 55 , 56 ]. This can ultimately guide the development of personalized medicine strategies to addiction treatment.

Countless imaging studies have reported differences in brain structure and function between people with addictive disorders and those without them. Meta-analyses of structural data show that alcohol addiction is associated with gray matter losses in the prefrontal cortex, dorsal striatum, insula, and posterior cingulate cortex [ 57 ], and similar results have been obtained in stimulant-addicted individuals [ 58 ]. Meta-analysis of functional imaging studies has demonstrated common alterations in dorsal striatal, and frontal circuits engaged in reward and salience processing, habit formation, and executive control, across different substances and task-paradigms [ 59 ]. Molecular imaging studies have shown that large and fast increases in dopamine are associated with the reinforcing effects of drugs of abuse, but that after chronic drug use and during withdrawal, brain dopamine function is markedly decreased and that these decreases are associated with dysfunction of prefrontal regions [ 60 ]. Collectively, these findings have given rise to a widely held view of addiction as a disorder of fronto-striatal circuitry that mediates top-down regulation of behavior [ 61 ].

Critics reply that none of the brain imaging findings are sufficiently specific to distinguish between addiction and its absence, and that they are typically obtained in cross-sectional studies that can at best establish correlative rather than causal links. In this, they are largely right, and an updated version of a conceptualization of addiction as a brain disease needs to acknowledge this. Many of the structural brain findings reported are not specific for addiction, but rather shared across psychiatric disorders [ 62 ]. Also, for now, the most sophisticated tools of human brain imaging remain crude in face of complex neural circuit function. Importantly however, a vast literature from animal studies also documents functional changes in fronto-striatal circuits, as well their limbic and midbrain inputs, associated with addictive behaviors [ 63 , 64 , 65 , 66 , 67 , 68 ]. These are circuits akin to those identified by neuroimaging studies in humans, implicated in positive and negative emotions, learning processes and executive functions, altered function of which is thought to underlie addiction. These animal studies, by virtue of their cellular and molecular level resolution, and their ability to establish causality under experimental control, are therefore an important complement to human neuroimaging work.

Nevertheless, factors that seem remote from the activity of brain circuits, such as policies, substance availability and cost, as well as socioeconomic factors, also are critically important determinants of substance use. In this complex landscape, is the brain really a defensible focal point for research and treatment? The answer is “yes”. As powerfully articulated by Francis Crick [ 69 ], “You, your joys and your sorrows, your memories and your ambitions, your sense of personal identity and free will, are in fact no more than the behavior of a vast assembly of nerve cells and their associated molecules”. Social and interpersonal factors are critically important in addiction, but they can only exert their influences by impacting neural processes. They must be encoded as sensory data, represented together with memories of the past and predictions about the future, and combined with representations of interoceptive and other influences to provide inputs to the valuation machinery of the brain. Collectively, these inputs drive action selection and execution of behavior—say, to drink or not to drink, and then, within an episode, to stop drinking or keep drinking. Stating that the pathophysiology of addiction is largely about the brain does not ignore the role of other influences. It is just the opposite: it is attempting to understand how those important influences contribute to drug seeking and taking in the context of the brain, and vice versa.

But if the criticism is one of emphasis rather than of principle—i.e., too much brain, too little social and environmental factors – then neuroscientists need to acknowledge that they are in part guilty as charged. Brain-centric accounts of addiction have for a long time failed to pay enough attention to the inputs that social factors provide to neural processing behind drug seeking and taking [ 9 ]. This landscape is, however, rapidly changing. For instance, using animal models, scientists are finding that lack of social play early in life increases the motivation to take addictive substances in adulthood [ 70 ]. Others find that the opportunity to interact with a fellow rat is protective against addiction-like behaviors [ 71 ]. In humans, a relationship has been found between perceived social support, socioeconomic status, and the availability of dopamine D2 receptors [ 72 , 73 ], a biological marker of addiction vulnerability. Those findings in turn provided translation of data from nonhuman primates, which showed that D2 receptor availability can be altered by changes in social hierarchy, and that these changes are associated with the motivation to obtain cocaine [ 74 ].

Epidemiologically, it is well established that social determinants of health, including major racial and ethnic disparities, play a significant role in the risk for addiction [ 75 , 76 ]. Contemporary neuroscience is illuminating how those factors penetrate the brain [ 77 ] and, in some cases, reveals pathways of resilience [ 78 ] and how evidence-based prevention can interrupt those adverse consequences [ 79 , 80 ]. In other words, from our perspective, viewing addiction as a brain disease in no way negates the importance of social determinants of health or societal inequalities as critical influences. In fact, as shown by the studies correlating dopamine receptors with social experience, imaging is capable of capturing the impact of the social environment on brain function. This provides a platform for understanding how those influences become embedded in the biology of the brain, which provides a biological roadmap for prevention and intervention.

We therefore argue that a contemporary view of addiction as a brain disease does not deny the influence of social, environmental, developmental, or socioeconomic processes, but rather proposes that the brain is the underlying material substrate upon which those factors impinge and from which the responses originate. Because of this, neurobiology is a critical level of analysis for understanding addiction, although certainly not the only one. It is recognized throughout modern medicine that a host of biological and non-biological factors give rise to disease; understanding the biological pathophysiology is critical for understanding etiology and informing treatment.

Is a view of addiction as a brain disease deterministic?

A common criticism of the notion that addiction is a brain disease is that it is reductionist and in the end therefore deterministic [ 81 , 82 ]. This is a fundamental misrepresentation. As indicated above, viewing addiction as a brain disease simply states that neurobiology is an undeniable component of addiction. A reason for deterministic interpretations may be that modern neuroscience emphasizes an understanding of proximal causality within research designs (e.g., whether an observed link between biological processes is mediated by a specific mechanism). That does not in any way reflect a superordinate assumption that neuroscience will achieve global causality. On the contrary, since we realize that addiction involves interactions between biology, environment and society, ultimate (complete) prediction of behavior based on an understanding of neural processes alone is neither expected, nor a goal.

A fairer representation of a contemporary neuroscience view is that it believes insights from neurobiology allow useful probabilistic models to be developed of the inherently stochastic processes involved in behavior [see [ 83 ] for an elegant recent example]. Changes in brain function and structure in addiction exert a powerful probabilistic influence over a person’s behavior, but one that is highly multifactorial, variable, and thus stochastic. Philosophically, this is best understood as being aligned with indeterminism, a perspective that has a deep history in philosophy and psychology [ 84 ]. In modern neuroscience, it refers to the position that the dynamic complexity of the brain, given the probabilistic threshold-gated nature of its biology (e.g., action potential depolarization, ion channel gating), means that behavior cannot be definitively predicted in any individual instance [ 85 , 86 ].

Driven by compulsion, or free to choose?

A major criticism of the brain disease view of addiction, and one that is related to the issue of determinism vs indeterminism, centers around the term “compulsivity” [ 6 , 87 , 88 , 89 , 90 ] and the different meanings it is given. Prominent addiction theories state that addiction is characterized by a transition from controlled to “compulsive” drug seeking and taking [ 91 , 92 , 93 , 94 , 95 ], but allocate somewhat different meanings to “compulsivity”. By some accounts, compulsive substance use is habitual and insensitive to its outcomes [ 92 , 94 , 96 ]. Others refer to compulsive use as a result of increasing incentive value of drug associated cues [ 97 ], while others view it as driven by a recruitment of systems that encode negative affective states [ 95 , 98 ].

The prototype for compulsive behavior is provided by obsessive-compulsive disorder (OCD), where compulsion refers to repeatedly and stereotypically carrying out actions that in themselves may be meaningful, but lose their purpose and become harmful when performed in excess, such as persistent handwashing until skin injuries result. Crucially, this happens despite a conscious desire to do otherwise. Attempts to resist these compulsions result in increasing and ultimately intractable anxiety [ 99 ]. This is in important ways different from the meaning of compulsivity as commonly used in addiction theories. In the addiction field, compulsive drug use typically refers to inflexible, drug-centered behavior in which substance use is insensitive to adverse consequences [ 100 ]. Although this phenomenon is not necessarily present in every patient, it reflects important symptoms of clinical addiction, and is captured by several DSM-5 criteria for SUD [ 101 ]. Examples are needle-sharing despite knowledge of a risk to contract HIV or Hepatitis C, drinking despite a knowledge of having liver cirrhosis, but also the neglect of social and professional activities that previously were more important than substance use. While these behaviors do show similarities with the compulsions of OCD, there are also important differences. For example, “compulsive” substance use is not necessarily accompanied by a conscious desire to withhold the behavior, nor is addictive behavior consistently impervious to change.

Critics question the existence of compulsivity in addiction altogether [ 5 , 6 , 7 , 89 ], typically using a literal interpretation, i.e., that a person who uses alcohol or drugs simply can not do otherwise. Were that the intended meaning in theories of addiction—which it is not—it would clearly be invalidated by observations of preserved sensitivity of behavior to contingencies in addiction. Indeed, substance use is influenced both by the availability of alternative reinforcers, and the state of the organism. The roots of this insight date back to 1940, when Spragg found that chimpanzees would normally choose a banana over morphine. However, when physically dependent and in a state of withdrawal, their choice preference would reverse [ 102 ]. The critical role of alternative reinforcers was elegantly brought into modern neuroscience by Ahmed et al., who showed that rats extensively trained to self-administer cocaine would readily forego the drug if offered a sweet solution as an alternative [ 103 ]. This was later also found to be the case for heroin [ 103 ], methamphetamine [ 104 ] and alcohol [ 105 ]. Early residential laboratory studies on alcohol use disorder indeed revealed orderly operant control over alcohol consumption [ 106 ]. Furthermore, efficacy of treatment approaches such as contingency management, which provides systematic incentives for abstinence [ 107 ], supports the notion that behavioral choices in patients with addictions remain sensitive to reward contingencies.

Evidence that a capacity for choosing advantageously is preserved in addiction provides a valid argument against a narrow concept of “compulsivity” as rigid, immutable behavior that applies to all patients. It does not, however, provide an argument against addiction as a brain disease. If not from the brain, from where do the healthy and unhealthy choices people make originate? The critical question is whether addictive behaviors—for the most part—result from healthy brains responding normally to externally determined contingencies; or rather from a pathology of brain circuits that, through probabilistic shifts, promotes the likelihood of maladaptive choices even when reward contingencies are within a normal range. To resolve this question, it is critical to understand that the ability to choose advantageously is not an all-or-nothing phenomenon, but rather is about probabilities and their shifts, multiple faculties within human cognition, and their interaction. Yes, it is clear that most people whom we would consider to suffer from addiction remain able to choose advantageously much, if not most, of the time. However, it is also clear that the probability of them choosing to their own disadvantage, even when more salutary options are available and sometimes at the expense of losing their life, is systematically and quantifiably increased. There is a freedom of choice, yet there is a shift of prevailing choices that nevertheless can kill.

Synthesized, the notion of addiction as a disease of choice and addiction as a brain disease can be understood as two sides of the same coin. Both of these perspectives are informative, and they are complementary. Viewed this way, addiction is a brain disease in which a person’s choice faculties become profoundly compromised. To articulate it more specifically, embedded in and principally executed by the central nervous system, addiction can be understood as a disorder of choice preferences, preferences that overvalue immediate reinforcement (both positive and negative), preferences for drug-reinforcement in spite of costs, and preferences that are unstable ( “I’ll never drink like that again;” “this will be my last cigarette” ), prone to reversals in the form of lapses and relapse. From a contemporary neuroscience perspective, pre-existing vulnerabilities and persistent drug use lead to a vicious circle of substantive disruptions in the brain that impair and undermine choice capacities for adaptive behavior, but do not annihilate them. Evidence of generally intact decision making does not fundamentally contradict addiction as a brain disease.

Conclusions

The present paper is a response to the increasing number of criticisms of the view that addiction is a chronic relapsing brain disease. In many cases, we show that those criticisms target tenets that are neither needed nor held by a contemporary version of this view. Common themes are that viewing addiction as a brain disease is criticized for being both too narrow (addiction is only a brain disease; no other perspectives or factors are important) or too far reaching (it purports to discover the final causes of addiction). With regard to disease course, we propose that viewing addiction as a chronic relapsing disease is appropriate for some populations, and much less so for others, simply necessitating better ways of delineating the populations being discussed. We argue that when considering addiction as a disease, the lens of neurobiology is valuable to use. It is not the only lens, and it does not have supremacy over other scientific approaches. We agree that critiques of neuroscience are warranted [ 108 ] and that critical thinking is essential to avoid deterministic language and scientific overreach.

Beyond making the case for a view of addiction as a brain disease, perhaps the more important question is when a specific level of analysis is most useful. For understanding the biology of addiction and designing biological interventions, a neurobiological view is almost certainly the most appropriate level of analysis, in particular when informed by an understanding of the behavioral manifestations. In contrast, for understanding the psychology of addiction and designing psychological interventions, behavioral science is the natural realm, but one that can often benefit from an understanding of the underlying neurobiology. For designing policies, such as taxation and regulation of access, economics and public administration provide the most pertinent perspectives, but these also benefit from biological and behavioral science insights.

Finally, we argue that progress would come from integration of these scientific perspectives and traditions. E.O. Wilson has argued more broadly for greater consilience [ 109 ], unity of knowledge, in science. We believe that addiction is among the areas where consilience is most needed. A plurality of disciplines brings important and trenchant insights to bear on this condition; it is the exclusive remit of no single perspective or field. Addiction inherently and necessarily requires multidisciplinary examination. Moreover, those who suffer from addiction will benefit most from the application of the full armamentarium of scientific perspectives.

Funding and disclosures

Supported by the Swedish Research Council grants 2013-07434, 2019-01138 (MH); Netherlands Organisation for Health Research and Development (ZonMw) under project number 912.14.093 (LJMJV); NIDA and NIAAA intramural research programs (LL; the content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health); the Peter Boris Chair in Addictions Research, Homewood Research Institute, and the National Institute on Alcohol Abuse and Alcoholism grants AA025911, AA024930, AA025849, AA027679 (JM; the content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health).

MH has received consulting fees, research support or other compensation from Indivior, Camurus, BrainsWay, Aelis Farma, and Janssen Pharmaceuticals. JM is a Principal and Senior Scientist at BEAM Diagnostics, Inc. DM, JR, LL, and LJMJV declare no conflict of interest.

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Heilig, M., MacKillop, J., Martinez, D. et al. Addiction as a brain disease revised: why it still matters, and the need for consilience. Neuropsychopharmacol. 46 , 1715–1723 (2021). https://doi.org/10.1038/s41386-020-00950-y

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The Effects of Drug Addiction on the Brain and Body

Signs of drug addiction, effects of drug addiction.

Drug addiction is a treatable, chronic medical disease that involves complex interactions between a person’s environment, brain circuits, genetics, and life experiences.

People with drug addictions continue to use drugs compulsively, despite the negative effects.

Substance abuse has many potential consequences, including overdose and death. Learn about the effects of drug addiction on the mind and body and treatment options that can help.

Verywell / Theresa Chiechi

Drug Abuse vs. Drug Addiction

While the terms “drug abuse” and “drug addiction” are often used interchangeably, they're different. Someone who abuses drugs uses a substance too much, too frequently, or in otherwise unhealthy ways. However, they ultimately have control over their substance use.

Someone with a drug addiction uses drugs in a way that affects many parts of their life and causes major disruptions. They continue to use drugs compulsively despite the negative consequences.

The signs of drug abuse and addiction include changes in behavior, personality, and physical appearance. If you’re concerned about a loved one’s substance use, here are some of the red flags to watch out for:

• Changes in school or work performance
• Secretiveness 
• Relationship problems
• Risk-taking behavior
• Legal problems
• Aggression 
• Mood swings
• Changes in hobbies or friends
• Sudden weight loss or gain
• Unexplained odors on the body or clothing

Drug Addiction in Men and Women

Men and women are equally likely to develop drug addictions. However, men are more likely than women to use illicit drugs, die from a drug overdose, and visit an emergency room for addiction-related health reasons. Women are more susceptible to intense cravings and repeated relapses.

People can become addicted to any psychoactive ("mind-altering") substance. Common addictive substances include alcohol , tobacco ( nicotine ), stimulants, hallucinogens, and opioids .

Many of the effects of drug addiction are similar, no matter what substance someone uses. The following are some of the most common effects of drug addiction.

Effects of Drug Addiction on the Body

Drug addiction can lead to a variety of physical consequences ranging in seriousness from drowsiness to organ damage and death:

• Shallow breathing
• Elevated body temperature
• Rapid heart rate
• Increased blood pressure
• Impaired coordination and slurred speech
• Decreased or increased appetite
• Tooth decay
• Skin damage
• Sexual dysfunction
• Infertility
• Kidney damage
• Liver damage and cirrhosis
• Various forms of cancer
• Cardiovascular problems
• Lung problems
• Overdose and death

If left untreated drug addiction can lead to serious, life-altering effects on the body.

Dependence and withdrawal also affect the body:

• Physical dependence : Refers to the reliance on a substance to function day to day. People can become physically dependent on a substance fairly quickly. Dependence does not always mean someone is addicted, but the longer someone uses drugs, the more likely their dependency is to become an addiction.
• Withdrawal : When someone with a dependence stops using a drug, they can experience withdrawal symptoms like excessive sweating, tremors, panic, difficulty breathing, fatigue , irritability, and flu-like symptoms.

Overdose Deaths in the United States

According to the Centers for Disease Control and Prevention (CDC), over 100,000 people in the U.S. died from a drug overdose in 2021.

Effects of Drug Addiction on the Brain

All basic functions in the body are regulated by the brain. But, more than that, your brain is who you are. It controls how you interpret and respond to life experiences and the ways you behave as a result of undergoing those experiences.

Drugs alter important areas of the brain. When someone continues to use drugs, their health can deteriorate both psychologically and neurologically.

Some of the most common mental effects of drug addiction are:

• Cognitive decline
• Memory loss
• Mood changes and paranoia
• Poor self/impulse control
• Disruption to areas of the brain controlling basic functions (heart rate, breathing, sleep, etc.)

Effects of Drug Addiction on Behavior

Psychoactive substances affect the parts of the brain that involve reward, pleasure, and risk. They produce a sense of euphoria and well-being by flooding the brain with dopamine .

This leads people to compulsively use drugs in search of another euphoric “high.” The consequences of these neurological changes can be either temporary or permanent. 

• Difficulty concentrating
• Irritability 
• Angry outbursts
• Lack of inhibition 
• Decreased pleasure/enjoyment in daily life (e.g., eating, socializing, and sex)
• Hallucinations

Help Someone With Drug Addiction

If you suspect that a loved one is experiencing drug addiction, address your concerns honestly, non-confrontationally, and without judgment. Focus on building trust and maintaining an open line of communication while setting healthy boundaries to keep yourself and others safe. If you need help, contact the SAMHSA National Helpline at 1-800-662-4357.

Effects of Drug Addiction on an Unborn Child

Drug addiction during pregnancy can cause serious negative outcomes for both mother and child, including:

• Preterm birth
• Maternal mortality

Drug addiction during pregnancy can lead to neonatal abstinence syndrome (NAS) . Essentially, the baby goes into withdrawal after birth. Symptoms of NAS differ depending on which drug has been used but can include:

• Excessive crying
• Sleeping and feeding issues

Children exposed to drugs before birth may go on to develop issues with behavior, attention, and thinking. It's unclear whether prenatal drug exposure continues to affect behavior and the brain beyond adolescence.  

While there is no single “cure” for drug addiction, there are ways to treat it. Treatment can help you control your addiction and stay drug-free. The primary methods of treating drug addiction include:

• Psychotherapy : Psychotherapy, such as cognitive behavioral therapy (CBT) or family therapy , can help someone with a drug addiction develop healthier ways of thinking and behaving.
• Behavioral therapy : Common behavioral therapies for drug addiction include motivational enhancement therapy (MET) and contingency management (CM). These therapy approaches build coping skills and provide positive reinforcement.
• Medication : Certain prescribed medications help to ease withdrawal symptoms. Some examples are naltrexone (for alcohol), bupropion (for nicotine), and methadone (for opioids).
• Hospitalization : Some people with drug addiction might need to be hospitalized to detox from a substance before beginning long-term treatment.
• Support groups : Peer support and self-help groups, such as 12-step programs like Alcoholics Anonymous, can help people with drug addictions find support, resources, and accountability.

A combination of medication and behavioral therapy has been found to have the highest success rates in preventing relapse and promoting recovery. Forming an individualized treatment plan with your healthcare provider's help is likely to be the most effective approach.

Drug addiction is a complex, chronic medical disease that results in compulsive use of psychoactive substances despite the negative consequences.

Some effects of drug abuse and addiction include changes in appetite, mood, and sleep patterns. More serious health issues such as cognitive decline, major organ damage, overdose, and death are also risks. Addiction to drugs while pregnant can lead to serious outcomes for both mother and child.

Treatment for drug addiction may involve psychotherapy , medication, hospitalization, support groups, or a combination.

If you or someone you know is experiencing substance abuse or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357.

American Society of Addiction Medicine. Definition of addiction .

HelpGuide.org. Drug Abuse and Addiction .

Tennessee Department of Mental Health & Substance Abuse Services. Warning signs of drug abuse .

National Institute on Drug Abuse. Sex and gender differences in substance use .

Cleveland Clinic. Drug addiction .

National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction Drugs and the Brain .

American Heart Association. Illegal Drugs and Heart Disease .

American Addiction Centers. Get the facts on substance abuse .

Szalavitz M, Rigg KK, Wakeman SE. Drug dependence is not addiction-and it matters . Ann Med . 2021;53(1):1989-1992. doi:10.1080/07853890.2021.1995623

Centers for Disease Control and Prevention. Drug overdose deaths in the U.S. top 100,000 annually .

American Psychological Association. Cognition is central to drug addiction .

National Institute on Drug Abuse. Understanding Drug Use and Addiction DrugFacts .

MedlinePlus. Neonatal abstinence syndrome .

National Institute on Drug Abuse. Treatment and recovery .

Grella CE, Stein JA.  Remission from substance dependence: differences between individuals in a general population longitudinal survey who do and do not seek help . Drug and Alcohol Dependence.  2013;133(1):146-153. doi:10.1016/j.drugalcdep.2013.05.019

By Laura Dorwart Dr. Dorwart has a Ph.D. from UC San Diego and is a health journalist interested in mental health, pregnancy, and disability rights.

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Sean 'Diddy' Combs arrest live updates: Charged with sex trafficking and racketeering

What to know about combs' arrest.

• Music mogul Sean "Diddy" Combs was arrested yesterday at the Park Hyatt hotel on West 57th Street, a representative said.
• In a federal indictment unsealed today, Combs was charged with racketeering, sex trafficking and transportation to engage in prostitution.
• An attorney for Combs said today he plans to plead not guilty and "will fight this with all of his energy."
• Combs has faced a wave of lawsuits — one as recent as last week — accusing him of sexual assault and misconduct in the past year. He has denied any wrongdoing.

Criminal acts date back to 2008, prosecutors say

David K. Li

The three-count indictment against Combs include alleged criminal acts going back 16 years, court documents said.

The racketeering count covers acts allegedly committed by the defendant starting in 2008, while sex trafficking and transportation to engage in prostitution started in 2009, court papers showed.

Combs changed his public name and persona to Diddy in 2005 , dropping the P in "P. Diddy."

1,000 bottles of baby oil, lubricants seized in raid of Combs' homes

Federal agents raided Combs' homes in Miami and Los Angeles in March and came away with supplies allegedly used in sexual assaults, court documents showed.

At the time of the raids, federal officials would only say they “executed law enforcement actions” in New York as part of an ongoing investigation, along with teams in Los Angeles and Miami.

In court papers made public today, government officials revealed that they took supplies Combs allegedly used in "Freak Off" sexual assaults.

Agents "seized various Freak Off supplies, including narcotics and more than 1,000 bottles of baby oil and lubricant."

Combs' business empire key to crimes, prosecutors say

At the height of his power, Combs was more than just a musician: He controlled a vast business empire — including record labels and alcohol and clothing brands — that made him a billionaire.

Now, prosecutors are alleging that Combs' commercial enterprise was a key component of his criminal enterprise. The mogul used his businesses and several of his employees "to carry out, facilitate, and cover up his abuse and commercial sex," according to the indictment unsealed this morning.

"Those employees — including security staff, household staff, personal assistants, and high-ranking supervisors — and other close associates acted as COMBS’ intermediaries, and their conduct was facilitated and assisted by COMBS’ control of the Combs Business," prosecutors added. 

Federal prosecutors seeking to seize assets

The U.S. government is seeking to recover significant financial assets from the famed music mogul through this prosecution, court documents revealed.

Combs could be on the hook for "any and all property, real and personal" and an undetermined "sum of money" involved in these alleged crimes, according to the indictment.

The court document did not specifically list any assets or amount of money it would be seeking to take from Combs.

Drugs fueled dayslong 'freak offs,' videos used to 'ensure ... obedience,' prosecutors say

Sex abuse allegedly directed by Combs was fueled by drugs and often went days at a time, prosecutors said.

Victims were filled with drugs to control them for long stretches of time, authorities said, with participants “typically” having to get “IV fluids to recover from the physical exertion.” 

And once victims were lured into this orbit, they were coerced to keep following the suspect's orders, prosecutors said.

Combs used "the sensitive, embarrassing and incriminating recordings that he made during Freak Offs as collateral to ensure the continued obedience and silence of the victims," according to court documents.

'Freak offs': Combs accused of forcing and recording sex acts

Federal prosecutors accused Combs of forcing victims into sex acts that he allegedly called "freak offs," acts which he recorded for his viewing pleasure.

Combs "used force" to "cause victims to engage in extended sex acts with male commercial sex workers that Combs arranged, directed, masturbated during and often electronically recorded," court documents charged.

The defendant called these acts his "freak offs," prosecutors said.

Combs allegedly used his powers to abuse, coerce and 'fulfill his sexual desires'

The charges against Combs allege he "threatened and coerced women and others around him to fulfill his sexual desires" for years, federal prosecutors said.

Combs created "a criminal enterprise whose members and associates engaged in" various crimes, such as "sex trafficking, forced labor, kidnapping, arson, bribery and obstruction of justice," court documents said.

Combs charged with racketeering, sex trafficking and prostitution transportation

Brittany Kubicko

A federal indictment was unsealed against Combs, charging him with three felony counts.

He's been accused of racketeering, sex trafficking and transportation to engage in prostitution.

The artist and music mogul — referenced in the indictment by his real name, Sean Combs — has entered a New York City courtroom to hear the charges.

Combs' attorney arrives at the courthouse

Carolina Gonzalez

Combs’ attorney, Marc Agnifilo, has arrived at Manhattan federal court and briefly spoke to a large media gathering outside.

"He came to New York to basically engage the court system and start the case, and it will start today and he’s going to plead not guilty," Agnifilo said. "He’s going to fight this with all of his energy and all of his might and the full confidence of his lawyers."

Sean “Diddy” Combs is in custody after being arrested in New York last night by federal authorities under charges that are part of a sealed indictment. Combs' arrest comes amid a wave of lawsuits against him alleging sexual assault and sex trafficking. NBC’s Chloe Melas reports and Laura Jarrett offers analysis on the possible charges.

Sean ‘Diddy’ Combs arrest: Timeline and what to know

Since November 2023, Combs has been hit with a series of lawsuits in New York accusing him of sexual assault, sexual trafficking and engaging in other criminal activity.

Here are the lawsuits that were filed against Combs as well as information about law enforcement investigations. Combs has denied all of the allegations individually through statements by his representatives.

The first big hint that Combs could be facing serious legal issues came in November of last year when the singer Cassie, Combs’ former romantic partner, filed a civil suit against him for alleged sexual and physical abuse. That abuse allegedly ranged from 2007 until Cassie left him in late 2018, according to the civil complaint.

Cassie's action then prompted Joi Dickerson-Neal to come forward  and file a suit against Combs, accusing him of drugging and sexually assaulting her while secretly recording that act in 1991. She was a Syracuse University student at the time.

Then in December of that year, a  Jane Doe filed a lawsuit alleging  that she was gang-raped and sex-trafficked by Combs and his business partner, Harve Pierre. The unnamed victim said the assault happened in 2003, when she was 17 and Combs was 34.

Rodney “Lil Rod” Jones  alleged  in a federal suit in February of this year that, while working as a producer for Combs, he and his associates engaged in “serious illegal activity.”

Combs' homes in Los Angeles and Miami were raided by Homeland Security Investigations in March of this year, NBC News reported at the time, citing three sources familiar with the matter. Those raids were mentioned in the indictment made public today, as "Freak Off supplies, including narcotics and more than 1,000 bottle of baby oil and lubricant" were seized.

Stunning video surfaced on CNN in May of this year, showing Combs attacking Cassie  in a 2016 assault she described in the suit.

And earlier this month, Dawn Richard, a former member the Danity Kane musical group that Combs assembled on MTV reality competition “Making the Band,”  sued Combs in federal court, claiming he groped, assaulted and imprisoned her, and threatened her life when she tried to intervene in defense of Combs’ then-girlfriend Cassie.

Read the full article here