Addiction is a complex disease, but nearly a century of scientific study has helped researchers come to a deeper understanding about how it works.
This research has culminated in an important change in how we talk about addiction: Addiction is now classified as a disease that affects the brain, not a personal failing or choice.
Most people think of substance use when they hear about addiction, but that’s not the only type of addiction.
Research suggests that addictions to substances work similarly to patterns of compulsive behavior, like gambling or shopping.
Today, most experts recognize two types of addiction:
Chemical addiction. This refers to addiction that involves the use of substances.
Behavioral addiction. This refers to addiction that involves compulsive behaviors. These are persistent, repeated behaviors that you carry out even if they don’t offer any real benefit.
The reward system
Addiction interferes with normal brain function, particularly in the reward system.
When you do something you find enjoyable, whether that’s hanging out with your best friend, drinking a bottle of wine, or using cocaine, this reward system releases the neurotransmitter dopamine along with other chemicals.
Contrary to popular belief, dopamine doesn’t appear to actually cause feelings of pleasure or euphoria. Instead, it seems to reinforce your brain’s association between certain things and feelings of pleasure, driving you to seek those things out again in the future.
Cravings and tolerance
The desire to experience this euphoria again can trigger cravings for the substance or behavior, especially when you encounter the same cues (like a party where people are drinking, for example). These cravings often serve as the first sign of addiction.
As you continue using a substance or engaging in a behavior, your brain continues to produce larger amounts of dopamine. Eventually, it recognizes that there’s plenty of dopamine in your brain already and starts producing less in response to normal triggers.
There’s one problem, though: Your brain’s reward system still needs the same amount of dopamine to function as it should.
Before long, you need to use more of the substance to make up for what your brain isn’t releasing. This effect is called tolerance.
Loss of control
Addiction usually involves an inability to control substance use or specific behaviors. This can result in job loss, health issues, and relationship concerns, among other things.
In response, you might decide to quit the substance or behavior, only to find that you keep falling short, despite your best efforts.
Some of the more common addictive substances include:
opioids, including both heroin as well as prescription pain medication like oxycodone and morphine
Common behavioral addictions people often seek therapy and other professional support to address include:
Facebook (social media) addiction
internet gaming disorder