Addiction: A Disease?

dmckeever's picture

      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).

 

Works Cited:

 

(1)Addiction is a Brain Disease, Alan I. Leshner

(2)Anatomy of Addiction, Ellen M. Unterwald

(3)Cocaine Addiction, Frank  H. Gawin

 

Comments

dmckeever's picture

Some Additions...

Since I wrote and  submitted this paper, I have read some really interesting articles and papers about  nicotine addiction, an addiction that plagues most of my family, and  one that I hope to never battle personally. It is killing my parents, already killed both of my grandfathers, and is on its way to taking my grandmother from me  too. Some of the information seemed very pertinent to my paper,  and the idea that addiction might be a disease helped me to redefine nicotine as a drug. If I were to do this again, I might write a paper  solely on an addiction to cigarettes, but for now, I want to add a paragraph to my paper:

I added a definition to the first paragraph so that the paragraph now reads:

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. The World Health Organization has defined addiction as ‘A state, psychic and sometimes also physical, resulting in the interaction between a living organism and a drug, characterized by behavioral and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects, and sometimes to avoid the discomfort of its absences. Tolerance may or may not be present’” (4). 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).

 

Then, I want to add the paragraph about nicotine between the paragraph about cocaine, and the conclusion. It reads:

Another example of an addictive substance is nicotine. If we accept addiction as a disease, then nicotine should be considered a drug.  Referring to addiction as defined by the World Health Organization, seasoned smokers cannot go long periods of time without a cigarette or they begin to experience withdrawal symptoms: they shake, have headaches, and crave cigarettes. (Long term withdrawal symptoms include a craving for nicotine, irritability, anxiety, difficulty concentrating, restlessness, sleep disturbances, decreased heart rate, and increased appetite or weight gain (4)). This “compulsion to take the drug on a continuous or periodic basis” is well illustrated by chain smokers, who begin smoking a  new  cigarette before completely finishing the old one. These qualities and behaviors support the argument that nicotine should be considered a drug. Furthermore, there is a little known fact about nicotine: it is as addictive as cocaine and heroine (4). Research argues that nicotine’s addictive effect is a  result of its ability to “trigger the release of dopamine” (4). Dopamine is a neurotransmitter that is central to the nervous system’s reward center, or pleasure system. The release of this  chemical  provides feelings of joy and causes reinforcement so that a person is motivated to repeat the action that caused the release of said neurotransmitter.  Further research has  shown that long term consumption of nicotine “depresses the ability of the brain to  experience pleasure” so that smokers consume greater amounts of nicotine to achieve the same effects, which in this student’s eyes makes  nicotine that much more dangerous (4). So then, why are cigarettes available to the public? They are as dangerous, if not more, than illegal narcotics, and their effect arguably is felt so strongly because of their availability: tobacco containing products are the killer of half a million Americans each year; one in every six deaths in the US is smoking related! (5) Even  more interesting, the average time between when most smokers wake up  in the morning and when they light their first cigarette of the day is a half hour. It seems obvious to me that we, as Americans, have a problem on our hands; if cigarettes are this harmful, they should be taken off of the shelves and outlawed, just like their cousins  heroine and cocaine. Addiction is a disease that needs to be treated, but if we cannot recognize those substances as drugs  that are in fact abusive substances, then we cannot begin treatment of this disease that plagues so many Americans.

Addition to Works Cited:

(1)   “Nicotine and Addiction,” Action on Smoking and Health http://www.ash.org.uk/html/factsheets/html/fact09.html 

(2)   “Tobacco Addiction,” Nora D.Volkow, M.D.

http://www.nida.nih.gov/researchreports/nicotine/nicotine.html

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