This column first appeared in the February 24, 2013 edition of the Grand Rapids Press
By Bruce Springer, MD
What is addiction?
Most health care professionals would agree that addiction is a disease.
Like high blood pressure, diabetes, heart failure, and leukemia, it shares many disease-defining characteristics and like these, if left untreated, is often fatal. Unfortunately, addiction, whether to drugs, alcohol, or even gambling, is a relapsing disease that is all too common.
There are more deaths, illness, and disabilities from substance abuse than from any other preventable health condition. Today, one in four deaths is attributable to alcohol, tobacco and illicit drug use.
Addiction finds its home in some of the deepest parts of the human brain and yet reaches outward to affect all of health, family life, law and even history.
Terms used to describe and differentiate people’s relationship to potentially addictive substances are important to understand. Frequently, these terms are used interchangeably and this adds confusion to an already confounding topic.
Most people using opiates for severe pain relief may develop tolerance and require higher doses for continued pain relief. Some of these same patients may become dependent and experience uncomfortable withdrawal symptoms if the opiates were stopped abruptly. The majority of these patients, however, will not develop the disease of addiction.
A college freshman may abuse alcohol and drink to intoxication frequently throughout his early college experience, but after failing an important course or frequent morning “hangovers,” will decide that moderation and responsibility are important to his health and success. His best friend, however, may lose control over alcohol consumption and develop addiction to alcohol (alcoholism), drinking despite dire consequences.
Addiction is a disease located in the brain
Many view alcoholism and addiction as a moral weakness or disease of the will. We are now learning addiction begins when significant changes take place deep within the human brain.
The brain is made up of billions of individual nerve cells that must be able to communicate with each other. They do this with tiny appendages called axons. These cells send chemical messages back and forth with neurotransmitters such as serotonin, dopamine, and norepinepherine. Many medications and all substances to which human beings become addicted affect the quantities of these chemicals and how they interact with nerve cells.
Within the substance of the brain lie clusters of nerve cells which allow us to feel joy, happiness, and satisfaction. These are known as “pleasure centers” and are connected in a tract of nerve tissue running near the bottom of the brain between the right and left hemispheres.
It is thought that people susceptible to addiction may experience changes in the interaction of these neurotransmitters and their receptors. For persons having a predisposition to addiction, the introduction of a substance bringing a pleasurable feeling may begin to disrupt the receptor / neurotransmitter function of the nerve cells. What once was a source of pleasure becomes a desperate need for the substance bringing pleasure.
The disease of addiction may bring with it distinct molecular and biochemical changes in the human brain. Addiction takes a toll on the addict. Any drug of choice eventually begins to destroy the physical and psychological health of its victim.
It is not difficult to see that if we are not ourselves victims of addiction, we may well care about someone who is. Because it is felt by many to be our number one health problem, it is important to become more familiar with addiction as a disease and not a moral weakness.
People with addiction are in great pain and their suffering can be lessened and even eliminated through treatment. We must be willing to commit ourselves to offering and supporting that treatment.
Bruce C. Springer, MD, specializes in treatment of addictions and is a physician in Pine Rest's Addictions Services. He has more than 30 years of experience. Pine Rest provides a continuum of addiction services, for more information visit our Addiction Services page or call 1-866-852-4001.