The term ‘addiction’ has been the subject of controversy for quite some time. Some believe that the most accurate and reliable way to distinguish a person who is addicted is by assessing how much and how often the individual uses substances or engages in potentially addictive behavior. Alternatively, addictions can be defined by a distinct pattern of behaviors related to obtaining a substance or activity. Specifically, an addict will relentlessly pursue the substance or behavior even in the face of adverse consequences.

Understanding Addiction

These definitions could apply to both behavioral and substance addictions. Both share the same association with changes in the neural pathway of the reward system in the brain.

General classification of substance use disorder includes the following points:

• Taking the substance in larger amounts or over a longer period of time than was originally intended.
• Expressing a persistent desire to cut down or regulate use with unsuccessful attempts.
• Spending excessive time obtaining the substance, using the substance, or recovering from its effects.
• Craving: an intense desire or urge, especially in certain contexts (e.g., being in the same environment one typically uses the substance).
• Continuing to use despite persistent or recurrent social or interpersonal problems.
• Impaired social, occupational, or recreational ability.
• Risky use of the substance.
• Tolerance and withdrawal symptoms.

Neuroscience vs. Behavior

According to the National Institute on Drug Abuse, substance addiction is a behavior, a state of mind, a way of life–but it is not only these things. It is also a biochemical process. For all their similarities, drugs do have characteristic signatures. They make their own distinctive trails through the reward pathways of the brain.

“The addicted brain is distinctly different from the non-addicted brain,” writes Alan Leshner, the former director of NIDA. “Changes in brain structure and function is what makes it, fundamentally, a brain disease. A metaphorical switch in the brain seems to be thrown as a result of prolonged drug use.”

The initial decision to take drugs is typically voluntary. However, with continued use, a person’s ability to exert self-control can become seriously impaired; this impairment in self-control is the hallmark of addiction. Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of addiction.

Behavior vs. Chemistry

As with any other disease, addiction differs from person to person. No single factor determines whether a person will become addicted or not. In general, the more risk factors a person has, the greater the chance that taking drugs will lead to abuse and addiction. Protective factors, on the other hand, reduce a person’s risk of developing addiction. Risk and protective factors may be either environmental (such as conditions at home, at school, and in the neighborhood) or biological (for instance, a person’s genes, their stage of development, and even their gender or ethnicity).

The influence of the home environment, especially during childhood, is a very important factor. Parents or older family members who abuse alcohol or drugs, or who engage in criminal behavior, can increase children’s risks of developing their own drug problems.

Friends and acquaintances can have an increasingly strong influence during adolescence. Drug-using peers can sway even those without risk factors to try drugs for the first time. Academic failure or poor social skills can put a child at further risk for using or becoming addicted to drugs.