Addiction: Types, Symptoms, Causes & Treatment

What Is Addiction?

Addiction is a disease marked by engagement with compulsive drug use or behaviors despite harmful consequences. People cannot stop these addictive activities, possibly failing to meet work, social, or family obligations. Those misusing substances inevitably develop tolerance and physical dependence, eliciting drug-specific withdrawal symptoms when they stop using.

How Common Is Addiction?

According to the National Institutes of Health, 10% of U.S. adults have a substance use disorder at some point in their lives.¹ People decide to try taking addictive substances for many reasons, whether they want to feel better, escape their problems, or fit in with peers. What causes someone to become addicted is influenced by a variety of risk factors, including aggressive behavior in childhood, lack of parental supervision, low peer refusal skills, drug experimentation, availability of drugs at school, and community poverty. Research also shows that the earlier in life a person begins taking drugs, the more likely they are to struggle with addiction.²

Types of Addiction

Addiction comes in many forms. Types of addiction fall into two categories: Substances and behaviors. While most people think of substance use when it comes to addiction, behavioral addictions involving gambling, shopping, or eating are common. Some people may find themselves addicted to love, work, or sex as an escape from reality, while others battle multiple addictions at once, called cross addiction. Addiction can co-occur with other mental health disorders, like depression or PTSD.³

Below are the two types of addictions:

Substance Addictions

Substance addictions, often called substance use disorder, involve the inability to control the use of legal or illegal drugs or other substances. People struggling with substance addiction often find themselves using too much of a given substance, or using it in the wrong way. While the initial use of substances is most often voluntary, the brain undergoes changes with repeated use, making it increasingly difficult to stop using the substance. Examples of addiction in this category might include illegal drugs like heroin and legal substances like caffeine.

Below are examples of addictive substances:

• Alcohol
• Caffeine
• Cannabis
• Hallucinogens
• Inhalants
• Opioids
• Hypnotics, sedatives, and anxiolytics
• Stimulants
• Tobacco/Nicotine

Non-Substance Addictions

While behavioral addictions are commonly experienced, they are not covered in the DSM-5 to the same extent that substance addictions are. However, scientists have found brain similarities between substance additions and non-substance addictions, like gambling.⁴ Examples of addictive behaviors that people often seek help from a therapist to address include internet addiction, sex addiction, food addiction, and more.

Addictive activities or behaviors may include:

• Exercise
• Internet surfing
• Overeating
• Sex
• Shopping
• Stealing
• Video game playing
• Work

Addiction Vs. Abuse

Abuse occurs when excessive use or misuse of a substance goes beyond its intended purpose. Conversely, dependence occurs when someone requires a substance to feel normal or avoid withdrawal. For example, abuse may begin by consistently drinking on weekends before progressing to weekday alcohol consumption. For behavioral disorders, abuse may include a marked increase in gambling, indiscriminate sex, or exercise.

Accordingly, the harmful behavior progresses from something casual to a physiological necessity. As the substance or process is continually positively reinforced, reward pathways in the brain activate, allowing people to feel a rush of pleasure. The more positive reinforcement received, the more dependent individuals become. In turn, chronic abuse may ultimately develop into an addiction.

Signs & Symptoms of Addiction

Addictive behavior can lead to significant observable changes in a person’s life. Signs of addiction to look out for include physical, behavioral, and psychological changes that might indicate a need for intervention. Addiction symptoms related to substance use include physical changes like dilated pupils, slurred speech, or illness. Any type of addiction can cause dysfunction at work, home, or school, and can lead to mood swings, depression, or anxiety. Intrusive thoughts about the substance or behavior and the need to increase use over time are also signs of addiction.⁵

Addiction symptoms and signs may include:

• Inability to cease substance abuse or behavior: Becoming dependent upon a substance or behavior, and unable to stop engaging in it, is a defining factor in addiction.
• Withdrawal symptoms: Experiencing unpleasant physical or mental effects when a person stops using a substance or engaging in a behavior is a hallmark of addiction.
• Increased tolerance: When a person is experiencing addiction, receptors or enzymes in the brain and body are less activated by the substance over time, requiring more of it in order to achieve the same effects.
• Inability to focus on obligations: Someone struggling with addiction will find it increasingly difficult to focus on anything other than the object of their addiction, often thinking only about how to get their next fix.
• Substance or behavior-related problems: Addiction can impact all areas of a person’s life, straining relationships and leading to work or school problems or impacting their ability to care for themselves and their environment.
• Health issues: Addiction can lead to illness and serious health complications over time. Substance addiction can lead to cognitive decline, organ failure, and even death.⁶

What Causes Addiction?

The possible causes of addiction are numerous, but many experts believe that a combination of factors contributes to a predisposition to addiction. Contextual factors, such as internal or external triggers, can help explain how the addiction began and what needs it satisfies.⁷ Additional addiction causes may include biology, physical illness, social factors, and personal psychology.

Possible causes of addiction can include:

Biology & Physiology

Genetic predispositions, physical illness, or disability may partially account for an addiction. Research suggests that addictions occur due to a split combination of genetics and poor coping skills.⁸ Some studies have even indicated specific genes that may increase the likelihood of addiction.

People who are unaware of this predisposition to addictive disorders may fall prey to various seemingly harmless addictive activities. For example, they may consume alcohol to celebrate special occasions or relieve stress. Over time, possessing an addictive genome may put these individuals at risk of developing dependence or addiction.

Physical Illness or Disability

Another cause of addictive behavior may be physical ailments. Those who are ill or disabled may be unable to engage in day-to-day activities such as socializing with friends, exercising, working, or caring for their home. Such limitations may lead to clinical-grade depression or other mental health disorders, possibly resulting in maladaptive coping mechanisms (i.e., drug use, alcohol consumption, etc.).

On the other hand, people may use substances to alleviate painful symptoms. For instance, individuals taking prescribed opiates may unwittingly become trapped in an addiction.

Social Factors

Social or cultural factors may also contribute to different types of addictions. Children raised by parents struggling with drug or alcohol addictions learn that such behavior is standard and acceptable. They may also believe that addiction can serve as an escape from reality.

Peer pressure may also be a persuasive cause of addiction. Substance use becomes normalized when social groups continually engage in addictive behavior. Society virtually expects students to partake in binge drinking and drug use in college, and many young adults may be shocked by the challenges of ‘real life’ once they graduate.

Marginalized communities are those with some of the most challenges. Unfortunately, some families or teens may sell or use substances to supplement income or avoid harm.

Neurotransmitter Imbalances

Neurotransmitter imbalances are a likely cause of addiction, according to researchers. Addiction leads to a dramatic dysregulation of motivational circuits in the brain, providing a shortcut to experiencing a dopamine rush. This shift in a person’s brain can be costly to their physical and mental wellbeing over time. A person’s decision-making center in the prefrontal cortex is also impacted by long-term drug use. Pre-existing chemical imbalances in the brain can serve as a risk factor for addiction.⁹

Adverse Childhood Experiences

Adverse childhood experiences (ACEs) are an underlying trigger associated with addiction. Children who struggle to cope with ACEs often grow up to abuse substances in order to numb the pain of their traumatic past. One study showed that people who experienced five or more ACEs were 7-10 times more likely to engage in illicit drug use.¹⁰ Adverse childhood experiences include parental incarceration, domestic violence, household mental illness or substance use, neighborhood violence, bullying, and more.¹¹

Co-Occurring Mental Health Conditions

Research shows that about half of all people who experience a substance use disorder in their lifetime also have a co-occuring mental health condition.¹² Co-occuring mental health disorders might include depression, anxiety, bipolar disorder, or a personality disorder.

While mental health diagnoses might be considered when discussing signs of addiction, it is important to note that mental health disorders are not direct causes of drug abuse. However, some people might find themselves using harmful substances or behaviors to cope with, or self-medicate, symptoms of a mental health disorder.

How Is Addiction Diagnosed?

Receiving an addiction diagnosis will often entail screening and assessment. There is no “addiction test,” but clinicians typically review previous evaluations, conduct personal interviews, meet with clients’ loved ones, and make treatment recommendations upon diagnosis. Assessment is ongoing, beginning from initial contact with the client throughout therapy and afterward.

Can Addiction Be Prevented?

Addictions can best be prevented by educating young people about the dangers of substance use and addictive behaviors. Because drug use early in life increases a person’s chances of becoming addicted, early intervention is key. Research-based drug prevention programs exist that have been shown to be effective in preventing common addictions in youth.¹³

The risk of drug use also increases during times of major life transitions. During stressful seasons of life, like a divorce, a move, starting a new job or school, it is important to find positive ways to manage stress and avoid engaging in addictive substances or behaviors to cope. Education on the dangers of addiction can often empower people to make healthy choices, even during difficult times.

How to Treat Addiction

Identifying the underlying cause of addiction, incorporating preventative measures, and developing a supportive social network is essential in addiction treatment. While there are no “cures” for addiction, treatment focusing on providing positive reinforcement enhances personal accountability and self-motivation.

Living with addiction is challenging. Some people may benefit solely from outpatient care, while others require more intensive treatment options, such as rehab or hospitalization. Treating addictive disorders is an ongoing, life-long process, but recovery is possible. Help is available for those ready to heal.

Types of addiction treatment include:

Inpatient & Rehab Facilities

One of the most effective solutions for addiction involves inpatient rehab facilities, in which a person receives around-the-clock residential care for a specified time period. Receiving intensive, evidence-based treatment in an inpatient setting has been shown to increase compliance with follow-up outpatient treatment after the person leaves the residential program.¹⁴ While this option is the most costly in terms of time and money, it can be incredibly beneficial for those who can afford it.

Intensive-Outpatient Programs

Studies have shown that intensive-outpatient programs (IOP) improve abstinence rates, reduce severity of symptoms, and decrease substance use.¹⁵ This option is good for those who do not require detoxification or around-the-clock supervision. Intensive-outpatient programs allow patients to continue with their daily lives while attending a combination of frequent, intensive therapy sessions, relapse prevention education, 12-step programs, and support groups to address addiction issues.

Individual Therapy

Individual therapy can be an important piece of a person’s treatment plan when struggling with addiction. Therapy can help a person identify the root cause of their addiction, as well as explore any thoughts and feelings that are related to the addictive behavior or substance use. CBT for addiction is one of the most well-researched therapeutic interventions.¹⁶ EMDR for addiction is sometimes used as a complementary therapy.

Support Groups

Clients can find support groups in the community for a wide range of addictive disorders. Giving and receiving peer support in a group of people who are facing similar challenges with addiction can be instrumental in overcoming substance and behavioral addictions. While more research is needed in learning about the specific benefits of support groups in treating addiction, initial studies suggest that support groups may help to reduce substance use and increase engagement in treatment.¹⁷

Medication-Assisted Treatment

Medication-assisted treatment (MAT) combines the use of medication with therapy and other interventions in order to address addiction. The medications used in MAT are intended to reduce cravings and withdrawal symptoms experienced by the client on their journey to sobriety. This approach has been shown to save lives, prevent drug overdose, decrease drug use, and help clients to gain or maintain employment and remain engaged in treatment.¹⁸

How to Help Someone With an Addiction

If someone you love is struggling to overcome an addictive habit, it is important to listen, be empathic, and supportive. Educate yourself on addiction, and reach out to a professional to learn more about ways to help your loved one.

Below are ways to support someone throughout addiction treatment:

• Stay patient: Ultimately it is their decision when and how to seek treatment. Be patient and offer to listen.
• Remain compassionate: It can be frustrating to see someone you love struggle with addiction. Hold onto compassion for them, knowing that your support is important to their success.
• Encourage treatment: Encourage your loved one to get treatment to address their battle with addiction. Discuss treatment options with them and support them as they decide what path to take.
• Remember to take care of yourself: You can’t pour from an empty cup – take care of your body with healthy food, exercise and rest, and your mind with meditation, prayer or positive affirmations. Make time for the things that are important to you.
• Recognize your boundaries and limits: Healthy boundary-setting is important when it comes to supporting a loved one dealing with addiction. For example, not allowing drugs or intoxicated people into your home is an important boundary to hold for the safety of the people in your household.

Final Thoughts

Addiction is a chronic, life-long disorder that can take many forms. Educating yourself on the risks of addiction can not only aid in prevention, but can also empower people struggling with addiction to seek help. Overcoming addiction is challenging, but possible, especially with the right treatment plan and support.