Addiction: A Disease?
Addiction is regarded by most as a social problem to be solved with social solutions, i.e. incarceration. But, scientific evidence argues otherwise: addiction is a brain disease. Interestingly though, this clinical condition has both behavioral and social components that need to be attended to, just as other disorders, such as schizophrenia and Alzheimer’s are treated. Furthermore, researchers argue that addicts should be viewed as victims, suffering from an altered brain state, just as schizophrenics are viewed (1).
Advances in the fields of neural and behavioral sciences have led to this new-found definition of addiction. Researchers have identified physical differences between the structure of an addict’s brain and the brain of a “non-addict,” implying that these habits are behaviors that alter pathways built by neurons and synapses, as well as altering the availability of recently identified receptors, gene expression, and even an addict’s responsiveness to his/her environment. Biologists have also uncovered elements common to all addiction, regardless of the substance that is being abused. Such standardization acts as a great advancement in treating the disease (1).
On that biological note, it is argued that addiction proliferates through the activation of the mesolimbic reward system, a pathway that is affected by all addictive substances, and one that completely mediates reinforcement, including the reinforcement of such artificial substances as drugs (2). This reinforcement does not always act in positive terms, seeing how it can eventually cause a victim to experience withdrawal: the physical effects felt when a substance to which the circuit is repeatedly exposed is absent; addicts respond so violently because that recurring contact with the addict’s substance of choice causes the nervous system to adapt to maintain a kind of homeostasis in the body that is constant when the drug is present. But, as soon as the drug is absent, the nervous system functions abnormally, which results in withdrawal symptoms (1, 2). A common misconception is that the withdrawal symptoms will be more severe for those drugs that are more highly addictive. Though this is not accurate, “the inherent abuse potential of a given substance is likely to reflect it’s ability to activate this reward pathway,” so that a drug’s “addiction level” can be seen directly in the mesolimbic reward pathway (2).
For example, cocaine, a heavy-hitting drug, does not cause typical withdrawal symptoms when in demand. Instead, more complex and delicate symptoms are felt, but they are not as obvious as the symptoms characteristic of withdrawal. First, there is a mood swing of sorts(the crash), and then an energy plummet (withdrawal), which effects motivation and pleasurable experiences (3).
Prolonged abuse of any substance can cause long-lasting, widespread changes in brain function and structure. This fact should then encourage research exploring ways to treat this disease—addiction—because of how universally the effects of substance abuse are felt. Its implications are even felt in the realm of public health, seeing as how drug-use is responsible for the transmission of many diseases (ex: AIDS, hepatitis), and a recognition of this abuse as a brain disorder “characterized by compulsive drug seeking and use” will help lower social costs for the consequences and ineffective treatment of the disease (1).
(1)Addiction is a Brain Disease, Alan I. Leshner
(2)Anatomy of Addiction, Ellen M. Unterwald
(3)Cocaine Addiction, Frank H. Gawin