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Top Questions

What is addiction?

What can people become addicted to?

What factors contribute to addiction?

What role does dopamine play in addiction?

How is addiction treated?

addiction, physical or psychological need for a substance or behavior that is physically, psychologically, or socially harmful. Addiction is accompanied by extreme difficulty in ceasing to use the substance or in ceasing to repeat the behavior, despite detrimental consequences. Substances to which individuals may become addicted include drugs, particularly cocaine, opioids, and methamphetamine. Nicotine, a substance in tobacco, is responsible for the addictive effects of smoking and other forms of tobacco use. Individuals may also become addicted to food or to activities, such as gambling, online gaming, shopping, sex, or interacting with social media.

Addiction vs. other responses to substance use
  • Addiction: Substance use that is driven by compulsive behavior and continues regardless of harmful consequences.
  • Dependence: The body physically adjusts to a substance, resulting in withdrawal when use is halted.
  • Tolerance: A substance becomes less effective with ongoing use, typically requiring increasingly large doses to yield the same effect.
  • Withdrawal: The physical and psychological response that develops when substance use decreases or is stopped in a chemically dependent individual.
  • Craving: A strong urge to use a substance stress, emotions, or other factors can trigger these urges.
  • Substance use disorder (SUD): Problematic substance use, wherein the affected individual experiences significant impairment or distress.

Importantly, tolerance and dependence can develop in the absence of addiction, which is characterized in particular by impaired control and continued use while disregarding harmful outcomes. For more, see: What Is the Difference Between Dependence and Addiction?

The causes of addiction vary. Environmental factors, such as stress, peer pressure, exposure to drugs early in life, and physical or sexual abuse, may play a significant role. Certain genetic factors are suspected of interacting with environmental factors to increase a person’s risk of addiction; in fact, as much as half of an individual’s risk of addiction to substances such as to nicotine is attributed to genetics.

Characteristics

The use of certain drugs heightens the risk of chemical dependence, wherein the body becomes reliant upon the substance, such that if use of the substance is stopped, unpleasant physical symptoms develop. Chemical dependence occurs because neurons in the brain adapt to repetitive exposure to the substance, to the degree that they function normally only when the drug is present in the body. Central to this process is the neurotransmitter dopamine. Substances or behaviors linked to pleasurable or euphoric experiences induce surges of dopamine, which serve to reinforce relationships between those substances or behaviors and such experiences. Over time, the brain develops a craving for the pleasurable or euphoric feeling, driving individuals to use the drug or to carry out the behavior again and again.

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Addiction is often accompanied by depression and anxiety, and affected individuals may be unaware of the impact that addiction is having on their lives, including work, interpersonal relationships, finances, and physical health. Even when addicted individuals are aware of harmful effects, they may be unable to cease drug use or repetition of the behavior. Moreover, in cases of drug addiction and late-stage alcoholism, attempts at abrupt cessation may lead to serious withdrawal symptoms and even death.

Treatment

Treatment depends on the type of addiction. In severe cases of drug abuse, such as opioid addiction, a combination of medication and behavioral intervention may be necessary to manage withdrawal symptoms. Many persons dealing with addiction benefit from various types of psychotherapy, whether individual or group therapy, or from programs that address specific addictions (e.g., Alcoholics Anonymous, Gamblers Anonymous, or Narcotics Anonymous).