What is addiction?
A person with an addiction uses a substance, or engages in a behavior, for which the rewarding effects provide a compelling incentive to repeat the activity, despite detrimental consequences. Addiction may involve the use of substances such as alcohol, inhalants, opioids, cocaine, and nicotine, or behaviors such as gambling.
Substance use disorder behaviors have an increased likelihood of being accompanied by mental health conditions such as depression and anxiety, or other pre-existing problems. Another distinguishing feature of addiction is that individuals continue to pursue the activity despite the physical or psychological harm it incurs, even if it the harm is exacerbated by repeated use. Typically, one’s tolerance to a substance increases as the body adapts to its presence.
- The substance or activity is used in larger amounts or for a longer period of time than was intended.
- There is a desire to cut down on use or unsuccessful efforts to do so.
- Pursuit of the substance or activity, or recovery from its use, consumes a significant amount of time.
- There is a craving or strong desire to use the substance or engage in the activity.
- Use of the substance or activity disrupts obligations at work, school, or home.
- Use of the substance or activity continues despite the social or interpersonal problems it causes.
- Participation in important social, work, or recreational activities drops or stops.
- Use occurs in situations where it is physically risky.
- Use continues despite knowing it is causing or exacerbating physical or psychological problems.
- Tolerance occurs, indicated either by need for markedly increased amounts of the substance to achieve the desired effect or markedly diminished effect of the same amount of substance.
- Withdrawal occurs, manifest either in the presence of physiological withdrawal symptoms or the taking of a related substance to block them.
All addictions have the capacity to induce a sense of hopelessness and feelings of failure, as well as shame and guilt. There are many routes to recovery. Some individuals can achieve improved physical, psychological, and social functioning on their own—so-called natural recovery. Others benefit from the support of community or peer-based networks. And others opt for clinical-based recovery through the services of credentialed professionals.
The road to recovery is seldom straight: Relapse, or recurrence of substance use, is common—but definitely not the end of the road. Achieving remission or sobriety for a long period of time requires continuous support.