Understanding Addiction - Massachusetts General Hospital, Boston, MA

What is Addiction?

In order to understand addiction, it is necessary to move past the many emotional responses that both those in recovery and their loved ones have to the word itself. There is no reason to feel guilt, shame or resentment towards a person’s addiction, even if it has caused them to do or say unlikeable things. Rather, it is important to understand addiction for the medical condition that it is.

Research reveals that addiction is a disease of the brain, much like Alzheimer’s disease or a brain tumor. Therefore, people with substance-related problems should actually receive sympathy, rather than anger or blame, just as they would if they had any other medical condition.

Understanding Addiction - Massachusetts General Hospital, Boston, MA

Addictive Substances Take Over

While those with substance-related problems do make the initial decision to start using, the addictive substances soon take over. Alcohol and drugs alter how the brain transmits information, and their ability to remember, make decisions and have normal emotional responses may also be impaired. And, unfortunately, simply removing the substance is not enough to overcome the damage.

The impact on young people’s brains can be even more devastating, as their development is still ongoing. Substance use and addiction can waylay their brain chemistry, delaying normal emotional, psychological and mental growth. For example, a 19-year-old who began using at age 14 can remain emotionally and intellectually stalled at that age, and at times, may need to be understood in that way.

How Addiction Delays Normal Development

Furthermore the frontal areas of the brain are not fully developed until the late 20s, and these underdeveloped areas of the brain are the ones that control decision-making. Other areas that are still developing include impulse control mechanisms and the ability to put long-term goals before decisions that will lead to instant gratification. These limitations can make it extremely difficult for teenagers to make good decisions, particularly during a time when they are naturally drawn to seek new sensations and begin to care more about how they’re perceived by their peers.

Understanding Addiction - Massachusetts General Hospital, Boston, MA

Neurobiology and Addiction

Neurobiology may also impact who is at risk for substance-related problems. Not only is family history a factor in addiction, as has long been known, but when the parts of the brain that control planning skills and impulse control are poorly developed, the brain is more likely to become addicted. Also, some people are biologically inclined to crave more intense stimuli than others, which can make them more likely to use substances.
Exposure to abuse and trauma may also cause substances to impact a young person differently, than they would someone who has not experienced either.

The Impact of Substances on the Brain’s Chemistry

Once the substance takes over the brain’s chemistry, it creates cravings, replaces normal urges and erases memories of bad experiences that happened because of the substance. Successful recovery requires time for the brain to heal and a combination of psychological and behavioral interventions that can help young people to reprogram their urges and set new goals that are in keeping with the kind of life they want to create for themselves.

A Disease of the Brain

Addictive substances alter how the brain transmits information, hijacking areas that transmit pleasure and replacing normal desires and motivations with an overwhelming need for the substance. The brain’s ability to remember, make decisions and have normal emotional responses may also be impacted. And, unfortunately, simply removing the substance is not enough to repair the damage.

While it is true that young people do exercise control over their use of drugs and alcohol, the regular use of addictive substances, including alcohol, nicotine, cocaine, and heroin, can change their brains’ structure and function. After their brains’ normal function has been impaired, teens with substance use problems will do anything to continue using substances, even destroying their relationships, school and work life, and health.

Findings related to the relationship between drug and alcohol abuse and brain chemistry have led scientists and addiction experts to compare addiction to other chronic diseases, including diabetes, heart disease and hypertension. As with those conditions, those with substance use problems must commit to making significant changes to their behavior and lifestyle in order to counter any existing damage that has occurred and prevent their continued decline or death.

The Importance of Support During a Difficult Time

Behavior modification is extremely difficult, particularly for teenagers and young adults, and especially when it requires the elimination of substances that cause immediate gratification and pleasure. During this process, it is crucial for young people with substance-related problems to receive judgment-free support from those around them, including their teachers, families, school administrators, and peers.

Even after a young person has made the commitment to seek treatment for his or her substance related problems, constant vigilance by the individual and those around him or her is required to prevent relapse. ARMS can help to support the recovery process by providing information on relapse warning signs, and helping with relapse prevention and relapse intervention planning.