Recognising Drug And Alcohol Addiction As A Medical Condition & Not A Choice Or Moral Failing


One of the difficulties in recognising drug and alcohol addiction as a disease is it just doesn’t seem like one initially in comparison to others such as diabetes, stroke or blindness.

It doesn’t look, sound, smell and it certainly doesn’t act like a disease. To make matters worse, generally, it denies it exists and resists treatment to the very last second before treatment begins.

Drug and alcohol addiction has been recognised for many years by professional medical organisations such as the NHS, research institutions and leading addiction charities, groups and organisations as a primary, chronic, progressive and also unfortunately sometimes a fatal disease too.

The National Council on Alcoholism and Drug Dependence offers a detailed and complete definition of alcoholism, but probably the most simple way to describe it is “a physical and psychological dependency to particular substances that cause withdrawal symptoms if drugs or alcohol aren’t continually used. Addiction is also defined as an ever worsening condition that also affects those around them.”

Overcoming The Myths, Lies & Misinformation Of Addiction

Even in today’s modern age of technology, instant access to information and communication, it still surprises us that so many members of the general public and those without direct or indirect experience of addiction still believe so many of the old myths and misinformation that existed decades ago before we had access to reliable, accurate research and findings.

However, hopefully with time and an ever increasing amount of access to instant information and awareness campaigns from charities, groups, organisations, NHS Trusts and online resources such as blogs, groups and communities, this will change and the old myths will be driven out, and replaced by up to date information to remove the stigma and negativity that unfortunately still surrounds addiction, addicts still actively using or drinking, those already in recovery, it’s treatment and those who provide it.

If we can all play our part to share accurate, current information about addiction, those it affects, it’s treatment options and how successful recovery can be, then we can all take the negativity out of this recognised medical health condition!

When my local community drug and alcohol service moved buildings to allow for more people to access help, support and treatment, the neighbours surrounding the building were kept in the loop about what it’ll be used for and that it is run by an NHS Trust.

Three days after this consultation began, the drug and alcohol Keyworkers and managers found insulin needles outside the front door when they arrived at work the following day.

This was done in an attempt to cause problems for the service to operate in its new location.

Us addicts who have injected drugs know the difference between a needle used for insulin and one used to inject drugs.

The local residents were then welcomed to join in with group sessions, speak to recovering addicts and drop in at any time with any questions or concerns.

To this day, there have been no problems with the neighbours and in fact, they now actively help those addicts looking to enter recovery!

If one service can turn their neighbours opinions and perspectives around the imagine how much work could be done if we all played our small part in the bigger picture!?…

Dave – Founder of Drink ‘n’ Drugs

Typical Traits Of Addiction

Addictions of any form comprise of many traits and tell tale signs, no matter whether the addiction is to drugs, alcohol, gambling, sex, porn or food, just to name a few as discussed below.


The Mental Obsession

Mental obsession? Did you ever wake up in the morning with a song playing over and over in your head? It might have been a commercial jingle you heard on television such as the Coca Cola advert at Christmas or a song on the radio, but it kept playing … and playing and playing.

Remember what that was like? No matter what you did, that silly tune or song kept on playing. You could try to whistle or sing another song or turn off the radio or listen to another tune on a different radio station, but the one in your head just kept on playing!

Think about it. There was something going on in your mind that you didn’t put there and, no matter how hard you tried, you couldn’t get rid of it.

Well this insidious thought is the same with addictions, in this case to drugs and alcohol.

A mental obsession can be defined as a thought process over which you have no control and no matter how hard you try, you simply cannot get that song, thought or idea out of your mind.

Such is the nature of the disease of substance addiction. When the drinking/drug “song” starts playing in the mind of someone addicted to drugs and alcohol, he/she is powerless. They didn’t put the “song” there and the only way to get it to stop is to take another drink, line, hit, sniff or smoke.

The problem is an addicts mental obsession with drugs or alcohol is much more subtle than a song playing in their mind. In fact, they may not even know it’s there. All they know is they suddenly have an urge, craving or temptation to take a drink or drug, that is a physical compulsion to drink or use.


The Neurobiology Of Drug & Alcohol Addiction

In 2016, the U.S. Surgeon General issued a report, “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health,” which details the changes that take place in areas of the brain of someone who is addicted in a section entitled, “The Neurobiology of Substance Use, Misuse and Addiction.”

According to the report, substance use disorders (SUD’s) result from physical and chemical changes in the brain that occur with the repeated use of alcohol or drugs. These changes take place in brain circuits that are involved in perceiving pleasure, learning, stress, decision making and self-control. You can learn more about the science behind addiction and medication assisted treatment (MAT) programs here.


The Reward System Affected By Repeated Use

When someone drinks alcohol or takes drugs like prescription opioids, heroin, meth, cocaine or any other drug, it produces a pleasurable surge of dopamine in the brain’s basal ganglia, an area of the brain responsible for controlling reward and the ability to learn based on rewards.

The Basal Ganglia

With continued use of alcohol or drugs, the nerve cells in the basal ganglia reduce their sensitivity to dopamine, reducing alcohol’s ability to produce the same “high” that it once produced when you first started drinking or using. This is called building up a tolerance to alcohol and it causes drinkers as drug addicts to consume ever increasing amounts to feel the same euphoria (pleasure) they once did.


Their Quality Of Life Is Affected & Those Around Them

These same dopamine neurotransmitters are also involved in the ability to feel pleasure from ordinary pursuits such as eating food, having sex, gambling and engaging in every day social interaction.

When this reward system is disrupted by substance misuse or addiction, it can result in the person getting less and less enjoyment from other areas of life even when they are not drinking or using drugs, according to the Surgeon General’s report, clinical research findings and the NHS.

Also, the lives of close family members and friends are also affected. Not by chemical and physical changes in the brain, but due to their behaviours associated with their addiction. It provides stress, upset, desperation and can even cause the breakdown of relationships or even complete families if help isn’t sought quickly enough by therapists, addiction experts and healthcare professionals.

We previously looked at the roles that family members and close friends adopt when living with an addict. You can view the article here.


Drinking & Drug Used Linked To Other Cues

Another change that chronic drinking and drug use can cause is to “train” the brain to associate the pleasure the person achieves by drinking or drug use with other “cues” in the their life. The friends they drink/use with, the places they go to drink or use, the glass or container they drink from, the pipe they smoke from and any rituals they may practice in connection with their drinking or drug use can all become associated with the pleasure they feel when drinking or using drugs.

Because so many cues in their life are reminders of their drinking or drug use, it becomes more and more difficult for them to not think about drinking or using. They then come in the form of cravings, urges or temptations.


Drive To Avoid Pain Or Other Negative Feelings

While the brain’s dopamine transmitters drive us to seek pleasure, the stress neurotransmitters found in the extended amygdala region of the brain drive us to avoid pain and unpleasant experiences. Together they compel us to act.

Substance use, including alcohol use disorders (SUD’s), can disrupt the normal balance between these two basic drives, research has found.


Avoiding The Pain Of Withdrawal

As drug and alcohol addictions progresses from mild to moderate and then to severe, the individual experiences increasing distress whenever they are not using or drinking. Alcohol or drug withdrawal symptoms can become very uncomfortable, painful and in some cases, can be fatal. This is why it’s recommended that you undergo professional help and supervision when detoxing and the type of symptoms perceived and their intensity and duration vary depending on the substance(s) used, any interactions between substances such as cocaine and alcohol, how long it’s been used for, how much is used, how it’s used and other contributing factors.

This is why it’s important to follow harm reduction strategies and techniques.

Alcohol and drug use progresses to the point that the only thing that can relieve the distress of withdrawal symptoms is to drink more alcohol or use more drugs. This is why medication assisted treatment programs (MAT) are so important within the tools and strategies available to treat addiction.

At this stage, the person is no longer drinking or using to experience pleasure. In fact, drinking or using may not even bring any feeling of pleasure anymore. The drinker or user is drinking or using to avoid the pain and symptoms of withdrawal and not to get high or drunk.


The Cycle Of Addiction

Addicts are no longer able to reach the same high that they once experienced because of their ever increasing tolerance, but the lows they experience when not drinking or using become lower and lower too. Other pursuits in life that once brought pleasure and happiness that then balanced out the lows are no longer able to do so at this point, to the same extend as they one did.

When addicts were still relatively healthy, they could control their impulses to drink or use because the judgment and decision-making circuits of their prefrontal cortex would balance out those impulses. But, their substance use has also disrupted their prefrontal circuits, both physically and chemically.

When that happens, research shows that addicts have a reduced ability to control their powerful impulse to use, even when they are aware that stopping is in their best interest. At this point, their reward system has become pathological, or in other words, “changed and diseased”.

If you, a friend or loved one are struggling with substance misuse or addiction, you can find contact information for a wide range of groups, charities and organisations who can help you or them overcome your/their addiction.

You can find contact information for these on our help and support page here.

You can also find help from your local community based drug and alcohol service, residential rehabilitation facilities, fellowship meetings online or offline, from those who are already in recovery as well as your GP/Doctor and the NHS. Contact information for all of these are on our help and support page, the link for this is at the end of the previous paragraph above.


Compromised Self-Control Explained

An NHS report and clinical findings on the biological and neurobiological effects that are associated with chronic substance misuse and ultimately addiction, explains addicts have an inability to make healthy decisions this way as the physical pathways in the brain, as well as the range and amount of chemicals produced by your brain are also changed. You can learn about the science of addiction and medication assisted treatment programs in our previous article here.

“This explains why substance use disorders (SUD’s) are said to involve compromised self-control,” the findings said. “It is not a complete loss of autonomy however. Addicted individuals are still accountable for their actions but they are much less able to override the powerful drive to seek relief from the physical dependency that has been previously provided by alcohol or drug use.”

“At every turn, people with addictions who try to quit find their resolve challenged. Even if they can resist drug or alcohol use for a while at some point, the constant craving triggered by the many triggers in their life may erode their resolve, resulting in a return to substance use or relapse,” said the findings.


Addiction Is A Progressive Disease

Compounding the problem is the progressive nature of the disease. In its early stages, taking one or two drinks, hits, pipes, spliffs or sniffs may be all it takes to get that metaphorical “song” to stop. But soon it takes six or seven and later maybe ten or twelve. Somewhere down the road, the only time the song stops is when they pass out.

This is where overdoses come into play. Addicts use more and more of their substance(s) to feel the same way they did initially. This continued use of substances take many thousands of lives worldwide each year from overdoses that can be prevented in the first place or reversing the effects of an opioid overdose with the help of emergency Naloxone kits.

The progression of the disease is so subtle and devious that it usually takes place the addicts life over such an extended period of time of months or even years. It wants to take over and rule the individuals life without anyone know, it causes us to lie, cheat or steal from those they love and care about, that even the addict her/himself failed to notice the point at which they lost control and became physically and mentally addicted and dependent to alcohol and drugs.

No wonder denial is an almost universal symptom of the disease. For those who have come to the realization that they do have a problem, help may be as close as the white pages of the telephone directory. But for those who need help and do not want it, intervention may be the only alternative.


Where Can I Get Help & Support For My Addiction Or Someone Else’s?

If you feel that you’re ready to make the necessary changes and determined to succeed, you can find a wide range of groups, charities and organisations who can help you. You can find contact information for them on our help and support page here.


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Published by Drink ’n’ Drugs

Providing useful, relevant, up to date information and support for those suffering from active addiction or those who are in recovery.

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