How is drug addiction a disease

The issue, therefore, seems to be: What is different about the population seeking treatment? Here, too, Heyman suggests an interesting possibility. Epidemiological evidence from a very large survey Regier et al. Heyman concludes Chapter 4 by offering a hypothesis about why most, not otherwise psychiatrically disabled, drug addicts eventually cease their addiction.

The biographical descriptions from recovered addicts frequently point to the role of financial and family concerns, that is, contingencies other than those directly related to procuring and taking drugs, as being major factors in their cessation of drug abuse. That is, the change from abuse to recovery is based on choice alternatives. That, of course, begs the question of how choice can lead to the problem in the first place if choice is, in fact, the avenue to recovery.

That question is addressed in Chapters 6 and 7. In Chapter 5 Heyman addresses the disease model more fully by examining the arguments and data supportive of that perspective. First, those in support of drug abuse as a disease point to the demonstrated role of genetic factors in addiction. Heyman acknowledges genetic contributions, but points out that genetic influence is not a sound basis for concluding that drug abuse is a disease process.

From that, few would conclude that religious choice is a disease. A second class of arguments finds its basis in studies of neural changes associated with drug abuse. There is now an abundance of evidence showing that brain activity and neuronal functions are different in drug abusers than in nonabusers e.

Any persistent change in behavior is going to be associated with changes in the central nervous system because the nervous system participates in behavior. One might as well conclude, say, that reading is a disease because the brains of readers necessarily differ from those of nonreaders. As a final point of the chapter, Heyman seals the fate of the now discredited notion that compulsive, involuntary craving is a characteristic of drug addiction: both that it is a reliable feature and that it somehow indicates that a disease has developed.

But as Heyman notes, if most drug abusers suffer cravings when they quit, then craving cannot be that important in producing relapse because about three-quarters of those who are dependent quit permanently.

Heyman also summarizes sound empirical evidence indicating that reports of craving and actual drug taking may be uncorrelated. He does note, however, that the question remains as to why anyone would voluntarily engage in behavior like incessant drug seeking, given its deleterious effects. He thereby sets up the case for Chapter 6, which is the lynchpin of the book.

In Chapter 6 Heyman argues for the possibility that normal choice processes are at the root of drug abuse. That is, he makes the case that while people do not choose to be drug addicts, they do make choices that lead to addiction. He argues that choice always involves the selection of the better current option, and that under certain circumstances drugs have advantages over other outcomes in that they provide immediate pleasure, their negative effects are delayed, they are not particularly subject to satiation, and they can undermine the value of other options.

These advantages, of course, raise the question: Why isn't everyone a drug addict? Heyman's principal response to this question is that people differ in how they frame a sequence of choices. With lucid examples, he shows convincingly that overall benefit across a series of choices can be maximized by not choosing the immediately local, in his terms better option. A key preventative therefore is framing drug taking not locally but across a series of choices, that is, globally.

Although his argument is convincing on this point, it also displays the major weakness of his exposition. Specifically, there is no clear explanation of exactly what framing is and how it comes to be. Reflection and forethought appear to be types of behavior, and relatively little is said about precisely what those activities are and how they can be developed and maintained.

Do they underlie rational choice? Aren't they choices themselves? Despite the minimal attention paid to the details of framing, Heyman's view strongly encourages a basic research program especially directed toward how to generate global rather than local framing of choices—in my view, a major contribution of this book.

Such a program might be of clear benefit in the prevention and treatment of drug abuse—yet another illustration of how basic research not aimed directly at translation can provide important insights eventually leading to effective practical action. Having made a case for drug abuse as operant choice gone awry, Heyman's last chapter focuses on treatment and prevention of drug abuse.

He begins with another attack on one of the mainstays of the disease model, specifically the overly simplistic idea that dopamine activity in the brain provides an adequate explanation of drug abuse. All reinforcing consequences, not just drugs, are associated with changes in brain dopamine activity.

That is, when we choose things, dopamine activity changes, no matter what it is we are choosing, so those changes cannot be by themselves what is crucial for the development and maintenance of drug abuse. To say dopamine activity is important in drug taking is simply the neuro-pharmacological equivalent of saying that drugs serve as reinforcers, something that has been known for decades. In this chapter Heyman also examines factors related to the incidence of drug abuse and finds several that support his view that drug abuse results from normal choice processes.

For example, he notes that drug abusers tend to be unmarried, with the implication that presence of a marriage partner, that is, a potent source of social consequences, provides alternatives that can compete effectively with other alternatives like drugs. That marriage may be protective for drug abuse is consistent with his view that alternative sources of consequences for choices are crucial.

In the last part of the chapter, Heyman attempts to make a case for the importance of what he calls prudential rules in preventing drug abuse. The case is not particularly compelling. No connection is made between choice processes and rule following, so it is not clear how the major argument about the role of choice in drug abuse connects to the prevalence of rule following.

Heyman argues that most people do not become drug abusers because they follow established societal rules. A problem with that supposition is that it ignores why people follow those rules. Moreover, to suggest that somehow the long-term benefit afforded by following rules reinforces rule following is also glib. The delays are generally far too long to invoke reinforcement as the operative behavioral process. Of course, Heyman is not alone in failing to provide an account of how rule following, whether rational or irrational, develops.

This remains one of the great unsolved mysteries of human behavior. To sum up, Heyman's book is provocative in two major ways. First, it develops a very compelling case that drug abuse should not be considered a disease. Drug Topics. More Drug Topics. Quick Links. About NIDA. Points to Remember Drug addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences.

This is why drug addiction is also a relapsing disease. Relapse is the return to drug use after an attempt to stop. Relapse indicates the need for more or different treatment. Most drugs affect the brain's reward circuit by flooding it with the chemical messenger dopamine. Surges of dopamine in the reward circuit cause the reinforcement of pleasurable but unhealthy activities, leading people to repeat the behavior again and again. Over time, the brain adjusts to the excess dopamine, which reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance.

They might take more of the drug, trying to achieve the same dopamine high. No single factor can predict whether a person will become addicted to drugs. A combination of genetic, environmental, and developmental factors influences risk for addiction.

Drug addiction is treatable and can be successfully managed. June 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.

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.

Stimulants include amphetamines, meth methamphetamine , cocaine, methylphenidate Ritalin, Concerta, others and amphetamine-dextroamphetamine Adderall, Adderall XR, others.

They are 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. Club drugs are commonly used at clubs, concerts and parties. 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.

Use of hallucinogens can produce different signs and symptoms, depending on the drug. 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. Opioids are narcotic, painkilling drugs produced from opium or made synthetically. This class of drugs includes, among others, heroin, morphine, codeine, methadone and oxycodone.

Sometimes called the "opioid epidemic," addiction to opioid prescription pain medications 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. 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 primary doctor or see a mental health professional, such as a doctor who specializes in addiction medicine or addiction psychiatry, or a licensed alcohol and drug counselor.

If you're not ready to approach a doctor, 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.

People struggling with addiction usually deny that their drug use is problematic and are reluctant 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. An intervention should be carefully planned and may be done by family and friends in consultation with a doctor or 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 and ask him or her to accept treatment.

Like many mental health disorders, several factors may contribute to development of drug addiction. The main factors are:. 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. 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:. Drug use can have significant and damaging short-term and long-term effects.