Addiction is a disorder which, up until very recently, has been massively misunderstood, underrepresented, and skewed in terms of stereotypes and perceptions in modern media.
Despite many modern developments in our understanding of addiction, it is still a disease which requires extensive ongoing research in order to fully understand and treat effectively.
When an individual is addicted, their brain chemistry is altered, meaning that they often continuously seek out the substance or behaviour that they are addicted to, even if this has adverse effects on their life.
This is why it is essential that individuals who are struggling with addiction seek help as soon as they are able, as this will help to reduce the negative impacts of addiction, as well as giving them the best possible chance at undergoing a full and effective recovery.
This article aims to explore and explain the different ways in which our understanding of addiction has changed over time, including the root causes, the neurology behind this, and the developing treatments that are in place all over the world.
Though addiction was once thought of as the ‘moral failure’ of an individual – i.e., when a person lacked the ‘self-will’ or ‘self-control’ to stop themselves from engaging in addictive behaviours – it is now clearly understood that addiction is a disease of the brain – one that is challenging to overcome for many individuals.
Though many papers and research often question the notion of where ‘normal’ functioning ends and pathology begins, there is now a general consensus that addiction is often out of the individual’s control and therefore can be categorised as a disease of the brain. [1]
This is a modern take on the disease, as it is only recently that this has been widely accepted, with a high level of stigma surrounding addiction and those who struggle with it.
In the past, individuals were often ostracised, highly criticised and blamed completely for their addiction, whereas now it is understood that these individuals require care and support rather than punishment and negative consequences other than those they are already struggling with as a result of their condition.
As addiction is such as personal and unique condition – every individual will display different symptoms and effects depending on the type and duration of their addiction – it means that the diagnosis of addiction is also something that has developed over time and is still an issue in the modern age.
The Diagnostic and Statistics Manual of Mental Disorders (DSM) is an internationally accepted manual that outlines mental health issues and how they can be professionally diagnosed.
However, this manual is not updated as regularly as new research is being conducted, and it still fails to categorise many different forms of addiction.
The two following subheadings outline the different types of addiction: substance addictions (i.e., alcohol and other drugs) and behavioural addictions (i.e., shopping and gambling).
As the most ‘typical’ form of addiction, dependency on alcohol and other drugs can also be referred to as a substance use disorder.
This refers to the continuous and compulsive consumption of substances due to the short-term positive effects with little regard for the long-term issues that can arise.
This covers a wide variety of substances, including:
Drug addiction was the first form of addiction that was categorised in the DSM, though the exact wording and effects that the individuals should display in order to be professionally diagnosed with addiction still lacked massively in terms of inclusion and variety.
Often, individuals would have to report specific symptoms over specific periods of time in order to be diagnosed with addiction by the parameters of the DSM, meaning that many people actually struggling with addiction may not have been diagnosed correctly as a result of their differing symptoms.
Though diagnostic manuals can be beneficial for some mental health issues, substance addictions are still categorised very generally, rather than looking at addiction as a personal and unique disorder, as it should be.
It is only recently that behavioural addictions have been classified as addictions at all in the DSM.
This means that many individuals struggling with behavioural addictions may not have received the crucial diagnosis that they needed in the past, and that this is hopefully something that is beginning to change in this time of ongoing and ever-developing research.
Behavioural addictions were added to the DSM in recognition of the same activation of the brain’s reward system that was recognised in individuals struggling with substance use.
By partaking in activities such as gambling, shopping and even sex (among many other activities), individuals activate their brain’s reward system, sending out chemicals and hormones to the body such as dopamine – ‘the happy hormone’ – that leads to the vicious cycle of continuing that behaviour in the hopes of receiving the same level of gratification each time.
Over time, these dopamine receptors become ‘overworked’ and decrease in their functioning [2] when they are next exposed to the levels of dopamine that they previously have been, resulting in reduced positive feelings and prompting more frequent engagement in the addictive behaviour or behaviours in order to feel good.
The way that the brain is affected by addiction is another newly discovered phenomenon that, only in recent times, have we been truly able to research.
Not only is this due to the increased interest in this field of study, but it is also driven by the increase in technological advancements that allow professionals to analyse the ways in which the brain reacts to and processes addiction and addictive behaviours.
As previously mentioned in this article, addiction has strong neurological impacts, often directly affecting and changing the brain’s everyday functioning and uptake of chemicals and hormones within vital systems of the body.
In recent years, this has been able to be studied on a much larger scale, providing vital information into the effects and issues caused by addiction in both the short-term and the long-term.
In some cases, addiction has been described as a form of unconscious learning; it is something that develops without conscious intervention, and it is a disease that takes advantage of the brain’s natural plasticity and learning capabilities.
The understanding that addiction comes from the activation of the brain’s neural networks (especially those related to reward and gratification), has proven that addiction is more than just a ‘moral failure’ of the individual when it comes to substance consumption.
It is often a far more general and damaging disorder than it was thought to be 20 or 30 years ago.
However, this development alone has caused great discussion and controversy in the medical community. [3]
If we were to begin classifying everyday behaviours as addictions, then there is a risk of medicalising mundane and necessary behaviours.
Sex and food addictions, for example, are at the forefront of this argument due to both behaviours being key aspects in the life of the average individual.
This is something that is still surrounded by debate and more research is needed.
The phenomenon that is the activity of the brain’s reward system during addictive behaviours is an evolutionary strategy that humans have developed over hundreds of thousands of years.
Evolutionarily, this reward system would have provided individuals with the gratification that they need to engage in activities to keep them alive.
For example, eating a tasty meal as an early foraging human would have great benefits to their survival, triggering huge positive internal feedback to the individual to ensure that they seek out this type of behaviour again and again, increasing their survival chances.
In the modern world, however, individuals are constantly faced with opportunities and rewards which may not have required as much survival instinct as our ancestors, meaning that the reward system may be activated too easily and for actions that are not necessarily beneficial, leading to issues such as addiction which are focused around the constant need to be rewarded and gratified for not much activity.
An example of this, in regard to a food and eating addiction, would be the ease of access to fast food and food that is high in fat content and sugars.
Because this is so easily accessible to so many individuals, the body may misinterpret the activation of the reward system (i.e., tasty food) as being as a result of their actions, causing them to engage in this behaviour more and more.
This causes a loop of gratification and reward, which is not always justified and can therefore lead to an addiction to this feeling, resulting in food addiction.
In all cases of addiction, whether substance or behavioural, it is essential that all individuals should seek professional help as soon as they can.
This is because addictions can quickly worsen if left untreated, unsupported or undiagnosed.
For behavioural addictions, this may mean that an individual begins engaging in their addictive behaviour more and more frequently, often having serious financial or social implications.
For substance use disorders, however, a worsening condition can be life-threatening in many cases, often depending on the specific substance that the individual is addicted to.
This can also cause serious and long-term health problems and risks – some of which can take years of serious medical support and care to overcome or live with comfortably.
If you or someone you know is struggling with addiction, contact Rehab 4 Addiction as soon as possible to begin discussing potential treatments and to get the support that is needed.
The following subheadings outline some of the different methods of rehabilitation and recovery, separating them into more traditional methods, as well as highlighting some new techniques that are available due to modern advances and developments in technology and the understanding of addiction.
Traditional addiction treatments, though classed as ‘old’ methods in the context of this article, are still effective for many individuals, though a combination of new and old techniques is always recommended.
Traditionally, individuals are encouraged to go through the three stages of rehabilitation: detoxification, treatment/rehabilitation and aftercare.
These stages are designed to progress from one to another, with each previous stage supporting the individual for the next stage.
Detoxification, for example, prepares the individual physically for the next stages which are more psychologically focused.
By preparing the body, individuals are able to focus to a greater level on typical and traditional treatments, such as:
These methods were all developed with the idea that addiction must be treated at its root cause, meaning that individuals must discover this and work on any other psychological issues at the same time.
This is a very mental health-based approach, which is beneficial for the ongoing and long-term mental health of the individual but can also be combined with more modern techniques focused on general well-being in order to make a full and effective recovery.
However, within the past 10 years, many additional treatments have been developed that individuals all over the world are beginning to see the benefits of.
These treatments can include some methods that may be considered unusual or ‘old-fashioned’ but, in the modern context, can actually be far more effective and long-lasting than traditional methods alone.
One of these modern techniques is known as Transcranial Magnetic Stimulation (TMS).
This technique utilises a conductive rod that is used to stimulate certain areas of the brain, most notably those that are associated with reward and gratification.
This is a non-invasive technique that has been proven to be extremely effective in many cases in which it has been properly assessed and managed for its suitability.
Though still heavily under review and research for its effectivity for the general public, TMS has had many promising studies showing its effectiveness, [4] meaning that the future for these forms of treatment is very positive.
As another modern development in addiction rehabilitation and treatment, mindfulness has been shown to be extremely effective in the management of addiction, its effects, and its impacts on the individual.
At its basis, mindfulness teaches individuals to recognise and note any cravings or triggers that they experience as a result of their addiction, but not to act on them in any way.
This is something that can be incredibly daunting to individuals who first begin these types of treatment, but they are again only suitable in some cases and more research is required.
Though often considered as a traditional form of treatment, mindfulness has been shown to mediate “cognitive, affective, and psychophysiological processes integral to self-regulation and reward processing”, [5] all of which are key elements of an effective addiction recovery journey.
In some cases, mindfulness has been compared to the success rates of programmes such as the 12-step recovery process and has even been found to be more effective, though this is still very much experimental and up for review and further research.
Throughout the changing ideas of what constitutes a ‘good’ or effective recovery programme for those struggling with addiction, there have essentially been two approaches which have always been very much divided in terms of research and evidence to support either side.
These are:
The following subheadings outline these two sides, before making a final comparison of the changing ideals, theories and beliefs behind addiction recovery and rehabilitation.
The neurological basis of addiction recovery focuses on the idea of ‘fixing’ the brain and helping to improve it through a variety of different techniques and methods, some of which overlap the other side of the argument, but generally focus on the physiological effects and neurology of the disorder – in other words, the way it directly effects the brain.
The neurological focus draws attention to the ways in which the brain has been altered as a result of addiction, addictive behaviours, and the long-term nature of this.
This side of the argument would therefore encompass some of the modern treatment techniques such as TMS, as this is a direct treatment of the neurological ‘damage’ that has been caused as a result of addiction.
Despite the focus on the brain, this approach does not often consider the other factors at play beyond just physical brain damage, such as psychological damage and the state of an individual’s mental health after extensive addiction.
Although neurology may be focussed on the physical impacts, it is always essential to consider both physical and mental effects in order to treat an addiction most efficiently, effectively and with the least distress caused to the individual as possible.
On the other side of the argument, the more traditional methods of medication and psychological treatments and therapies is still very much supported, tried and tested.
Often medications may be used to help an individual manage the symptoms of their addiction while they undergo further treatments such as CBT, holistic treatments, or any other form of therapy during drug and alcohol rehab programmes.
Though this approach does have both physical and mental elements, it is still important that individuals are made aware of the seperate neurological treatments that are available at rehab.
They are not suitable for every individual case, and some individuals may even benefit more from medications and therapies, but giving individuals all the information they need is essential for their overall recovery, their mental health and their general well-being.
In short, a combination of techniques will always be the way to provide an ideal recovery process, but this is not always suitable in every case, and a medical professional should always be consulted before any final decisions are made for the future of an individual’s time in rehabilitation and associated recovery process.
Rehab 4 Addiction is dedicated to finding the most suitable form of treatment for any individual struggling with addiction.
Whether you personally are struggling with an addiction, or if you know someone who is, please do not hesitate to get in touch with Rehab 4 Addiction to find out what the next step is.
Our addiction hotline is staffed by professional, friendly and confidential team members who are trained to give the most suitable advice for those who need it.
Call us today for free on 0800 140 4690 to see how we can help you or someone you know start their rehabilitation journey, either for the first time or as a returning recoveree.
Rehab 4 Addiction is here to help, so give us a call today.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC5503469/
[2] https://pubmed.ncbi.nlm.nih.gov/31905114/
[3] https://pubmed.ncbi.nlm.nih.gov/28198052/
[4] https://pubmed.ncbi.nlm.nih.gov/25069523/
[5] https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-018-0115-3
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
