What Explains Addiction? Theories of Addiction and Drug Abuse

Addiction is a multifaceted issue that about one in 10 U.S. adults experience. It can stem from a range of factors, from environment and personality to genetics and neurological causes. Addressing the root causes of an individual’s substance use is an essential part of addiction treatment. By understanding the different theories of addiction, we can develop targeted treatments and support the individual’s journey to sobriety.

Recovery Is Possible

Before expanding on the numerous theories of addiction and drug abuse that may explain why some people develop substance use disorders, it’s important to note that recovery is always possible. Regardless of why someone is living with an addiction, whether it’s chemical imbalances in the brain or hereditary or personality factors, there is hope for a drug-free lifestyle.

Theories of Addiction and Drug Abuse

Mental health professionals use several theories of addiction to explain why some people become dependent on alcohol or drugs. Understanding what drives someone’s addiction can help healthcare providers develop targeted, effective treatments.

Drug Addiction Is Rooted in the Brain

Neuroscientific theories, or theories that ultimately suggest that drug addiction is rooted in the brain, are among the most common explanations for addiction. Different drugs have different effects on the way the brain functions. In general, substances trigger the brain’s reward system or stimulate endorphin releases, which help relieve pain or cause the individual to experience a sense of well-being.

Drugs such as marijuana and cocaine, for example, cause an increase in dopamine, the brain’s feel-good hormone. In a non-addicted brain, after dopamine is released, it is returned to the cell that released it. However, over time, many drugs impair this recycling process by causing a build-up in the space between two nerve cells and disrupting normal communication.

In the short term, this dopamine surge causes mental alertness, a sense of extreme happiness and boundless energy, along with some less desirable side effects such as paranoia and irritability. The high amounts of dopamine in the brain’s reward center drive the individual to continue taking the substance. After continued use, the reward center gets used to the high level of dopamine. The individual has to take stronger and more frequent doses to get the same high and avoid withdrawal.

Substances such as heroin, morphine, and codeine affect the brain’s endogenous opioid system, which is the system that’s responsible for the body’s pain-relieving response. These substances bind to the brain’s opioid receptors and prevent neurons from being triggered. This prevents the brain from processing pain, and it can also create feelings of euphoria. When the individual uses prescription opioids in a way other than prescribed by their doctor, or when they use stronger drugs such as heroin, they may begin relying on the substance to supply their brain with enough opioids to feel good, or even just normal.

For many people with addictions to opioids or alcohol, opioid antagonist drugs such as naloxone and nalmefene can be an important part of treatment. These drugs attach to opioid receptors and block the effects of certain drugs. Once there’s no chemical reward for taking a substance, it may be easier to break the addiction.

Biology Influences the Likelihood of Developing an Addiction

An individual’s biology can also have a profound impact on whether they develop an addiction. This theory of addiction includes genetic factors that may contribute to substance use disorder, as well as changes in the brain caused by extended use of a drug.

According to extensive family studies that include identical and fraternal twins, siblings and adoptees indicate that as much as half of an individual’s risk for becoming addicted to substances such as nicotine or alcohol depends on genetics. Scientists have studied genetics as they pertain to diseases such as sickle cell anemia and cystic fibrosis and have observed how a mutation in a single cell puts the individual at a much higher risk. Now, they’re studying how certain genes may affect someone’s likelihood of becoming addicted to substances such as marijuana.

Neuroadaptation is a process that mental health professionals also use to explain addiction. With this process, the body gets used to functioning with a given substance in its system. For an individual who uses drugs or alcohol regularly, their brain changes to compensate for the constant presence of the substance. When that substance isn’t in the body, the person begins to experience uncomfortable, painful, and sometimes fatal withdrawal symptoms. Physical symptoms (along with a sense of general unhappiness, depression, anxiety, and irritation) accompany withdrawal and drive many people to continue using drugs or alcohol.

Behavior and Personality May Affect Vulnerability to Substance Use Disorder

Another theory of drug addiction focuses primarily on the behavioral element of addiction. Some mental health specialists see addiction as a type of excessive behavior that’s driven by habit learning. According to this theory of addiction, repeatedly using a drug strengthens the stimulus-response association between using the drug and experiencing certain side effects. In other words, the individual’s brain is trained to understand that when the person uses a certain substance, they experience a specific response. The desire to use a drug may be enforced not only by the effects of the drug but also the social component that may come along with it.

For those who identify with this theory of addiction, a couple therapies may be effective in their journey to sobriety. For some, aversion therapy, where they build negative associations with addictive behaviors, can be helpful. Additionally, contingency management, where the individual is rewarded for abstaining, can be effective for some.

Some theorists believe that some people are more prone to addiction because of their personalities. The addictive behavior, whether it’s drugs or alcohol, excessive gambling, shopping or eating, fulfills a certain purpose related to their personality. Some traits that a so-called addictive personality may include are aggression, coldness, impulsivity, and egocentricity. Traits like these don’t doom an individual to developing an addiction, but some professionals believe that these traits may make the person more likely to engage in certain behaviors.

Understanding the Roots of Addiction Can Support More Effective Treatment

Addiction is complex and the factors that lead to it are as unique as the individual. Some people may identify with one theory of addiction, while others recognize multiple factors that may influence their substance use. For that reason, there’s no one-size-fits-all approach to treatment. Effective treatment doesn’t just address the addiction itself but also the factors that make the individual more vulnerable, whether that’s a mental illness, genetic susceptibility, or chemical imbalance in the brain.

Regardless of the underlying cause of addiction, there’s hope for recovery. Mental health providers specialize in treating co-occurring or related conditions along with the substance use disorder, using a range of research-backed therapies.

At FHE Health, we’ve helped clients successfully overcome their addiction, address underlying causes and build lifestyles that support sobriety. To learn more about our programs or to talk to a counselor, contact us today.