Per the 2017 National Survey on Drug Use and Health, nearly 20 million Americans over the age of 12 are living with a substance use disorder. And despite this significant figure, the psychology behind addiction is still far from common knowledge. For those on the outside looking in, it’s not uncommon for addiction to seem to confound. And for those who have never fallen victim to addictive behaviors, it’s easy to wonder why quitting an addiction isn’t as easy as going cold turkey.
In reality, the mind of someone addicted to drugs or alcohol is very different from someone who isn’t living with addiction. In addition to influencing behavior, the brain can literally change in response to ongoing abuse, leading to a deep desire for continued use that is both behavioral and physical.
Studying the mind and motives of someone with a substance use disorder can be a key part of promoting healthy recovery. The psychology behind addiction teaches that willpower alone isn’t the only force necessary — or safe, depending on the addiction in question — to overcome addiction. Compassion comes with understanding, and that means taking time to learn the whys and hows in order to create an effective and comprehensive approach to care.
The State of an Addicted Mind
Addiction isn’t as simple a concept as it may seem on the surface. From an outside perspective, addiction can be seen as a simple propensity for substance abuse. However, on mental, physical and emotional levels, there’s a lot more to addiction.
From a behavioral perspective, using drugs becomes a way of life. Most friends and social situations revolve around drugs, especially as drugs start to replace former social connections and hobbies. When drugs are eliminated from the equation, many users feel bored, listless or unfulfilled. This can be a driver for continued use, particularly when happiness is tied to chasing a high.
From a physical perspective, drugs can play a significant role in how the brain functions. Many drugs, such as alcohol and opiates, can actually change the chemistry of the brain. For example, when substances like heroin or prescription opioids are consumed, opiates can bind to receptors in the brain, triggering the release of neurotransmitters like dopamine. This provides the high that comes with use. However, after longer periods of use, the body gets used to higher-than-average levels of neurotransmitters, making it hard or impossible to feel the same emotional responses without ongoing drug use.
From an emotional perspective, substance abuse can serve as a way to cope with life. When things like job stress, relationship problems and financial pressures become too much to bear, using drugs can take the edge off. While there are better ways to cope, those who use substance abuse as a crutch may feel they have no other options.
Motivations of Addiction
Ongoing abuse of drugs isn’t driven by a simple desire to stay high; instead, it’s driven by all the factors outlined above. Someone with a substance use disorder doesn’t simply want more drugs; from a biological and mental perspective, they feel they need more drugs. The biological compulsion is overwhelming, and when substance abuse isn’t perpetuated, physical symptoms of withdrawal can manifest. The severity of withdrawal symptoms can range based on the substance of choice, average quantity and duration of use but can involve symptoms including:
- Severe anxiety
- Delirium tremens
- Nausea and vomiting
- Mental fogginess
- Muscle stiffness or shaking
In some cases, withdrawal symptoms are mild, while in others, they’re aggressive and severe. These kinds of side effects are often a primary driver in ongoing use: When withdrawal gets too uncomfortable, additional substance use seems like the only way out.
Depending on the type of addiction, withdrawal symptoms can be deadly when not properly managed, which alone can reduce an individual’s interest in getting clean. For example, alcohol withdrawal can be fatal, so those with an alcohol use disorder often fear the process of recovery.
The Divide Between Understanding and Quality Care
It’s easy to judge someone when you’ve never been in their shoes, and addiction is among the most prevalent sources of unwarranted criticism. Due to the general lack of awareness of the psychology of addiction on a societal level, many people still believe that long-term substance abuse is a choice, not a disease. As such, those who are quick to judge are often not experienced in the world of addiction and addiction medicine, resulting in unhealthy and inappropriate judgment.
When addiction is mischaracterized as a personal failing, it’s easy to see treatment as unnecessary; after all, willpower can accomplish the same thing. This perception can be pervasive in social constructs, such as groups of friends or professional settings. For example, a functional substance abuser holding down a job may be hesitant to ask for time off to attend treatment due to fear of judgment, even though taking time for an illness such as cancer wouldn’t carry the same fear.
Due to the lack of general understanding of the psychology behind addiction, many substance users who require help may share the same beliefs themselves. This can lead even those in desperate need of support to believe that getting help is only for weak-willed people and that strong people should be able to recover on their own.
Addressing the Psychology Behind Addiction
If you have friends or family members living with addiction, there may come a time when a conversation is necessary. However, when speaking to an addicted individual, it’s important to know how to approach a dialogue that isn’t centered around judgment or blame.
When discussing addiction issues or troubling behavior related to substance abuse, be sure to always frame situations as being outside of normal control rather than as a personal failing. Talk about the importance of getting help, how addiction deserves the same resources as any other disease, and how you accept and support your loved one.
It may take more than one discussion to drive the point home — many people with substance use disorders spend a certain amount of time in denial — but whenever the topic does come up, the conversation should always incorporate an understanding of the mindset and motivations of substance users. Pointing fingers can only hurt, not help.
FHE Health is a leading resource in addiction medicine, providing comprehensive treatment for a wide range of substance use disorders and co-occurring mental illnesses. As leaders in the rehabilitation and recovery space, we are well-versed in both the psychology of addiction and treatment methods that address physical and mental needs. Contact us today to learn more about our step-down substance abuse treatment programs.