What is Addiction?

What Is Addiction?

Addiction is a long-lasting, complex psychiatric disorder of the brain and body. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), defines it as "the recurrent use of alcohol or drugs, which causes significant impairment." ⁽¹⁾ The American Medical Association also defines addiction as a disease. ⁽²⁾

Compulsive supstance use can impact an individual's health—and their ability to work, study, and have healthy relationships. According to the Centers for Disease Control and Prevention, one in seven U.S. citizens reports having a supstance use disorder (SUD). ⁽³⁾

Addiction recovery is challenging, typically requires professional guidance, and isn't a case of using willpower or having a better moral compass. ⁽⁴⁾ As with many diseases, a range of risk factors makes people vulnerable to substance use disorders. ⁽⁵⁾

How Does Addiction Work?

Unhealthy drug-seeking behavior is driven by habit rather than rational decision-making. ⁽⁶⁾ Addiction causes changes to the brain, including the reward circuits that encourage people to repeat survival behaviors such as eating. Substances overwhelm these circuits by delivering ultra-intense hits of dopamine. These hits are stronger and more pleasurable than healthy rewards and trick the brain into prioritizing seeking that substance.

Studies show that people who have all their needs met and who have no trauma are unlikely to develop addictions. ⁽⁷⁾ Individuals with SUDs may have risk factors such as an impulsive personality, exposure to substance use at a young age, and mental illness. ⁽⁸⁾

What Are the Signs of Addiction?

According to the DSM-5, substance use disorders have 11 symptoms. They range in severity based on the number of symptoms present. A severity of two to three represents a mild SUD, four to five indicates a moderate SUD, and six or more points to a severe SUD. ⁽⁹⁾

The 11 criteria are split into four categories: ⁽¹⁰⁾

Impaired control:

• Regularly using a substance in higher quantities or more often than intended
• Intending to cut down but not being able to
• Having intense cravings that are impossible to ignore

Social problems:

• Struggling to complete daily tasks at home, school, and work
• Neglecting personal responsibilities and loved ones
• Giving up hobbies and activities in favor of alcohol or drug abuse
• Spending a disproportionate amount of time seeking and using the substance

Risky use:

• Continuing addictive behaviors despite negative outcomes