Addiction is a complex disease that can have devastating effects on individuals and their families. Alcohol and drug addiction can affect the whole family, from the individual struggling with substance abuse to their children. Understanding how addiction works, how substance abuse treatment works, and what family interventions can look like is essential for helping those affected by addiction. Think of an experience that makes you feel good.
It could be successfully completing a project at work, eating a hot chocolate chip cookie or having a shot of whiskey. It could be a cigarette puff or a shopping trip. A dose of Vicodin or a heroin stroke. Those experiences don't automatically lead to addiction.
So what makes a particular habit or substance an addiction? What drives some people to seek these experiences, even if they are costly or harmful to their health and relationships? Substance-related and addictive disorders are complex and can often have significant consequences for the individual. Biological processes that cause addiction involve reward pathways in the brain. These circuits provide a burst of positive chemicals and well-being to “reward substance use”. Each substance has slightly different effects on the brain, but all addictive drugs, including alcohol, opioids, and cocaine, produce a pleasant surge of the neurotransmitter dopamine in a region of the brain called the basal ganglia; neurotransmitters are chemicals that transmit messages between cells nervous. This area is responsible for controlling rewards and our ability to learn based on rewards. As substance use increases, these circuits adapt.
They reduce their sensitivity to dopamine, leading to a reduction in the ability of a substance to produce euphoria or the “high” that occurs when consuming it. This is known as tolerance, and it reflects the way the brain maintains balance and adjusts to a “new normal”, the frequent presence of the substance. However, as a result, consumers often increase the amount of the substance they take in order to reach the level of high they are used to. These same circuits control our ability to enjoy ordinary rewards such as food, sex and social interaction, and when interrupted by substance use, the rest of life can become less and less pleasant for the user when they are not using the substance. The initial decision to use drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person's self-control and interfere with their ability to resist intense drug cravings. When tolerance increases along with the need to take a substance to avoid withdrawal symptoms, it often indicates the onset of an addictive disorder.
The most serious expression of the disorder, addiction, is associated with changes in the function of brain circuits involved in pleasure (the reward system), learning, stress, decision-making and self-control. Despite being aware of these detrimental results, many people who use drugs continue to take them, which is the nature of addiction. These can be combined with existing risk factors, such as extreme stress, to produce the behaviors and physical effects of addiction. Once someone becomes addicted, they don't use drugs to feel good; they do it to feel normal. In reality, drug addiction is a complex disease, and quitting smoking usually requires more than good intentions or a strong will. Addiction is highly treatable but that treatment must be based on evidence and scientific best practices. At this stage, the individual may not have a total addiction; however, they may have developed tolerance or dependence.
Anyone who has struggled to overcome an addiction or tried to help someone else do so understands why. They can discover how to improve brain activity, reducing the effects of addiction and unhealthy impulses. As with most other chronic diseases such as diabetes, asthma or heart disease, drug addiction treatment is generally not a cure. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly related to the speed with which it promotes the release of dopamine, the intensity of that release, and the reliability of that release. Research shows that combining medication for addiction treatment with behavioral therapy ensures the highest chance of success for most. A person whose brain reward circuit has not been altered as a result of an addiction experiences positive feelings related to generally rewarding behaviors such as exercising, being with family or consuming delicious foods. Understanding how alcohol and drug addiction affects families is essential for helping those affected by it.
Substance abuse treatment works by addressing both physical and psychological aspects of addiction while family interventions can be an important first step towards recovery. Knowing how to help children from families affected by alcohol and drug abuse is also key in providing support for those struggling with addiction.