The scientific study of addiction is very complex. For example, there are more than 65 research journals that focus on addiction, over 30 recognized theories of addiction and over 100 recognized therapies. In spite of this complexity, we can say with some confidence that addiction has four basic components, neurobiological, psychological, social, and meaning, which are detailed below.
Scientific research has shown that addiction has a physical basis in the brain. Although researchers do not agree precisely on how addiction affects the brain, they all agree that chronic drug use is not a mere matter of free choice.
Some psychologists have suggested that those with addictions have certain personality traits, such as impulsiveness. Some even go so far as to suggest chronic drug users have an “addictive personality.” There is, however, little scientific evidence to support such claims. Most research in the past 50 years has shown that those with addictions have personalities that are as varied as what we find in the general population.
Despite this, research has found some shared personality issues. Perhaps the most common psychological condition of those who are addicted (or vulnerable to addiction) is that they are easily bored.
Boredom is also the likely cause of their yearning for emotional intensity. They may live their lives at the level of a soap opera, and it doesn’t appear to matter what the emotion is. As long as it is raised to an extreme level, it’s good. Narcotics Anonymous says that those with addictions are famous for “making mountains out of molehills.”
Guilt is another psychological issue attached to addiction. This is not merely the guilt of hurting others, but also the guilt that they know that they have not lived up to the standards they have set for themselves.
A growing body of research is showing that social factors profoundly affect the initiation and maintenance of an addiction. The famous Rat Park experiments showed that a rat in a cage (an unnatural environment) would choose morphine over water. However, a rat in a community of rats with plenty of food and things to do (a natural environment) would choose water over morphine.
Relationships are part of the social component, and research has indicated that those in active addiction have weak connections with family and friends, at work, and in the community. Much of this lack of connection is related directly to the stigma of addiction, which encourages chronic drug users to hide their drug use. Research has also shown that once a person’s addiction becomes public, all relationships become warped.
Essentially, this component says that a person in active addiction (or vulnerable to addiction) feels that life is meaningless, monotonous, and boring. Intoxication is a response to such a dull life, in which the person finds little significance. This idea was first proposed by the great psychiatrist, Viktor Frankl, and is the basis for SCHC’s definition of addiction. While acknowledging the neurobiological, psychological, and social components, SCHC pays special attention to the idea that addiction is a response to a life that lacks personal meaning.
Based on this scientific interpretation, we can say:
- Addiction is not in the drug, it’s in the person
- Not everybody will become addicted from using drugs or alcohol
- Physical dependence on a drug does not equal addiction
- The type of drug used has little meaning
- Parents are not to blame for addiction
- Addiction can afflict Nobel Prize winners, corporate CEOs, and the homeless
- Drug Cravings
A common condition for those in early recovery is to crave a drug. According to most brain theories of addiction, the brain adapts to drug use. Without the drug, the brain, in a sense, “craves” the drug. In other theories of addiction, the craving arises when a person is triggered. In other words, when a person experiences some cue in the environment that is associated with using. Typical cues or triggers are sitting in a bar, hanging out with drug-using friends, and getting into an argument. Many experts also point out that certain conditions can create cravings, such as working in a high-stress job.
- Post-Acute Withdrawal
There are two stages of withdrawal. The first stage is the Acute Withdrawal, which usually lasts less than a week. Acute withdrawal is a medical concern because it poses risks to the individual’s immediate physical health, such as seizures. During this stage, some may experience symptoms, such as agitation or nausea. The exact symptoms depend on the drug.
The second stage of withdrawal is what some experts have called Post-Acute Withdrawal (PAW). Although the individual is now stable from medical complications, he is still in withdrawal. Recall that the brain adapts to chronic drug use. Once the individual quits the drug, the brain has to re-adapt to not having the drug. Essentially, the brain is in an unbalanced state. This is PAW, and it takes time for the brain to rebalance itself. Typical symptoms of PAW include problems with short-term memory, depression, and anxiety. Other PAW symptoms include mood swings and lack of coordination.
In total, the time the brain needs to rebalance itself is 24 months, but most experts look to the big milestone: 6 months. At 6 months, the brain is not free from PAW, but the individual feels significantly better and has noticeable improvements in mood, emotional stability, thinking, memory and coordination.
Addiction books typically suggest that the psychological struggles of those in early recovery include depression or anxiety, emotional overreaction or numbness, sleeping problems, sensitivity to stress, and mood shifts. As with the changes in the physical brain, these psychological conditions can persist for up to two years.
However, it is more valuable to appreciate that many of the psychological symptoms are related directly to the struggle to feel that life is meaningful and significant. For example, the most common psychological symptom of those suffering from addiction is boredom. One of the most powerful effects of the drug and the drug lifestyle is that they eliminate boredom.
Another big psychological struggle is regaining a sense of hope for the future. And this is often especially difficult because those struggling with addiction know that the “wreckage of the past” is still waiting for them. Many of those suffering from addiction want to fix problems immediately, but this is often impossible. They have to learn to take life slowly, another big challenge.
Finally, those in early recovery struggle to answer the question, Who am I? The reason is that those in active addiction have, in a very real sense, lost themselves. It takes time for the real person to emerge.
- Rebuilding Relationships with Others
Those struggling with addiction need to create an environment where they feel free to be themselves. This is not merely about home life, but also work-life, community activities, and hobbies. Psychologist Rollo May says that those with addictions engage the world by artificially altering their mood and emotions with chemicals. But this is not an authentic connection. Even when not actively intoxicated, those with addiction are likely self-conscious around others, which makes it impossible to have a deep emotional connection. Overcoming old coping skills and learning new coping skills take time.
- Rebuilding Relationships with Family
Those in active addiction have superficial family relationships. Learning to reconnect takes time and effort. It may also be that they have developed a dependency on the family. Recovery demands that they take control of their life. Again, this takes time and effort to overcome.
Recall that Viktor Frankl said addiction is a response to a life that feels meaningless, monotonous, and boring. The solution to addiction is, therefore, to live a life in such a way that you feel alive and vital. This is not a quick or easy fix. Healthy people are anchored within themselves and from that anchor reach out into the world. They understand who they are, what’s important to them, and their strengths and limitations. Those in active addiction, however, have little self-awareness. What is particularly important is the pursuit of meaning, rather than its attainment. Research has shown that the journey toward living a personally meaningful life offers great mental and physical health benefits.
In the general population, mental health conditions such as depression, anxiety, bipolar, trauma, and attention deficit disorders occur on a statistically predictable basis. Those suffering from addiction experience these disorders at similar rates, with a few exceptions. These extra mental disorders present unique obstacles in recovery. Many clients, therefore, suffer from two mental health conditions: addiction and another issue, which is called a “co-occurring disorder.”
At SCHC, we treat both conditions at the same time with, what we call Body & Mind Therapies. Biology, psychology, social, and spiritual factors are all addressed in the treatment of addiction at SCHC. In keeping with current research, we recognize that thoughts and feelings can have a significant impact on physical health. This mind-body connection recognizes that psychological and physical health are interdependent, not separate, factors when achieving overall health.