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Addiction arises from powerful urges to use or do certain things repeatedly and excessively. Fulfilling such urges often provides a release from emotional pain, or an escape from challenging situations linked to stress or anxiety. This enables the individual to feel both emotionally and physically well, which can be very satisfying. However, this moment of satisfaction can trigger a powerful need to continue the habit or activity, over and over, in order to feel that way again. Addiction represents a difficulty in controlling repetitive behaviours, to the extent that they have extremely harmful consequences.

Addictions can develop from what may be innocent or common social habits. Drinking alcohol, gambling, eating, having sex and using the internet can all turn from something that is considered a commonplace activity, to a darker and more destructive compulsion.

In many cases, people with an addiction are unaware of the problem, nor are they aware of the impact it is having on their lives and on the lives of those around them. They are often in denial of their addiction and its consequences as they are not ready to change their behaviour, nor do they wish to see the way their addiction has affected their life negatively. They will also choose not to accept that their behaviour is affecting family and friends, by burying their emotions.

If an addiction has arisen from trauma, such as a past or present disturbing event, bereavement, depression or anxiety, the individual concerned may be unable to break out of the addiction on their own. Support will be needed to address both the addiction and the underlying issue(s).

For many people, recovering from addiction is not as easy as simply stopping the habit. It takes time, patience and a lot of support from professionals and loved ones. The first and biggest step is for an individual to be honest about their addiction. They will then need to take further steps to understand their addiction and the impulsive behaviour accompanying it. A change in lifestyle will be required to overcome the addition and to manage their feelings and actions in the future.

Science and Research on Addiction

All addictions have the capacity to induce a sense of hopelessness and feelings of failure, as well as shame and guilt. Fortunately, research documents that recovery is the rule rather than the exception. There are many routes to recovery. Individuals can achieve improved physical, psychological, and social functioning on their own (this is termed ‘natural recovery’). Others will benefit from the support of community or peer-based networks, while some opt for clinical-based recovery through counselling and the services of accredited professionals.

The road to recovery is seldom straight. Relapse, or recurrence of substance use, is common, but definitely not the end of the road. For those who achieve remission of an addiction disorder for five years, researchers report the likelihood of relapse is no greater than that among the general population. Neuroscientists also report that synaptic density is gradually restored.

There is evidence that addictive behaviours share key neurobiological features. They heavily involve the brain pathways of reward and reinforcement, which includes the neurotransmitter dopamine. And, in keeping with other highly motivated states, they lead to the pruning of synapses in the prefrontal cortex, home of the brain's highest functions, so that attention is highly focused on cues related to the target substance or activity. It is important to know that such brain changes are reversible after the substance use or behaviour is discontinued.

Both substance use disorders and gambling behaviours have an increased likelihood of being accompanied by mental health conditions such as depression and anxiety, or other pre-existing problems. Substance use and gambling disorders not only engage the same brain mechanisms, but respond to many of the same treatment approaches.

Substance use and gambling disorders are complex conditions that affect the reward, reinforcement, motivation, and memory systems of the brain. They are characterized by impaired control over usage, social impairment, involving the disruption of everyday activities such as relationships and cravings. Continuing use is typically harmful to relationships as well as to obligations at work or school.

Another distinguishing feature of addictions is that individuals continue to pursue the activity despite the physical or psychological harm it entails, even if it the harm is exacerbated by repeated use. Typically, one's tolerance to a substance increases as the body adapts to its presence.

Because addiction affects the brain’s executive functions, centred in the prefrontal cortex, the individual who has developed an addiction may not be aware that their behaviour is causing problems for themselves and others. Over time, pursuit of the pleasant effects of the substance or behaviour may dominate an individual’s activities.

Myths About Addiction

The processes that give rise to addictive behaviour do not have a simple explanation. There is not just one cause. Genetics or other biological factors can contribute to a person’s vulnerability to the condition, but social, psychological, and environmental factors also have a powerful influence on substance use.

Some characteristics, such as a lack of ability to tolerate distress or other strong feelings, have been associated with addiction, but there is no one “addictive personality” type that clearly predicts whether a person will face problems regarding addiction. Research shows there is no way to predict who will develop compulsive substance use or gambling behaviour.

Addiction is a multi-faced condition, arising from the confluence of many elements, including exposure to an addictive agent. It is more accurate to think of risk factors for the development of substance abuse disorders, rather than direct causes.