Is addiction a matter of willpower?

We’ve all seen or heard of the power and diversity of addiction. From common addictions of gambling and drugs, to abstract addictions such as eating cat hair featured on the show “My Strange Addiction“. Regardless of the type, addiction has the power to control the lives, for better or worse, of it’s victims. Those who suffer from addiction are “more likely to die a premature death”, “spend an average of $1000 a year for the damages of their addiction”, and are more likely to harm themselves (self-harm/suicide) and those around them. The damage an addiction causes someone depends greatly upon the specific addiction, but all addictions have a direct effect on the victim’s life.

Up until the scientific understanding of addiction was understood, the general stigma behind it was that the willpower of the individual who was suffering was just simply weaker than their peers. This stigma still thrives today, from employers to peers, but addiction within the medical community is “viewed as a disease”, just like the flu, rather than a vice. The American Society of Addiction Medicine defines addiction as:

      “… a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use,           despite harmful consequences. It is considered a brain disease because drugs change the brain;           they change its structure and how it works. These brain changes can be long lasting and can lead         to many harmful, often self-destructive, behaviors.”

Just like cancer, addiction is a disease that is constantly with the patient throughout stages of remission and relapse. An addiction can be classified as a disease because when it take’s hold of it’s victim, it can actually change the function and structure of the brain. So if addiction comes in so many different forms, what makes a gambling addiction different from an addiction to eating cat fur? Surprisingly, these two have a lot more in common than it seems.

All addictions are actually the same in the way they “hijack” the brain. This is due to a concept called the “pleasure principle”. The pleasure principle states that the “brain registers all pleasure in the same way”, whether it be coming from a “psychedelic drug”, “sexual encounter”, or just a tasty cheeseburger. This pleasure is released as the “neurotransmitter dopamine” within the “nuclear accumbens” (which are referred to by neuroscientists as the “pleasure
center”). Therefore, different behaviors that are addictive are not being formed because they affect the brain differently, but because they affect the brain more intensely. This is why addictions can differ between individuals, but also why certain substances and behaviors are the most common addictions. Alcohol and drugs are the leading addictions within the U.S because of the intensity in which they release dopamine. Other factors that affect the frequency of these addictions are the availability and “convenience of consumption” (it’s easier to drink a beer than go out and gamble).

Addiction affects the brain in a series of 3 gradual stages. The first is the “process of learning”. The pleasure, or dopamine, released when a behavior is done or a substance is consumed not only gives the user a feeling of pleasure, but also plays a role in “learning and memory” of that feeling of pleasure. “according to theory”, “dopamine interacts with another neurotransmitter that is responsible for linking activities needed for survival”. This process acts as a “reward system” toward the addiction and encourages the brain to continue seeking out the addiction, transitioning the “act to an addiction”. In this way, an addiction becomes a rewarded behavior in the same way eating and sleeping does.

The second stage is the “development of tolerance” Over time, the “brain reacts in a way that makes the act less pleasurable” than it was at first. This occurs because common addictions such as alcohol and drugs offer a “shortcut” to pleasure. These addictions overflow the brain with dopamine. In fact, drugs and alcohol release “on average 2-10 times as much dopamine as a natural reward”. As a result, the brain reacts by “releasing less dopamine or getting rid of dopamine receptors”. This is why the person feels the need to indulge into their addiction more and more, by doing it more often or increasing their dose. This is also why a person with an addiction will often become depressed, because dopamine no longer triggers the same response as it once did.

The final stage in an addiction is “compulsion”. This is when the pleasure has completely “subsided”, but the memory of the pleasure still remains, and with this memory comes the strong desire to once again feel that pleasure. The “hippocampus and amygdala store environmental cues” about the addiction, “so that it can be located again”. This is because the brain has associated this pleasure within the reward system as necessary, so the mind has been tricked into thinking that the addiction is necessary for survival. These “cues create strong desires to relapse”, which is why it becomes such a struggle within any recovering addicts.

Whether it be a serious addiction to heroin, or one that seems as foolish as eating cat hair, addiction is a serious disease. Once it infiltrates the brain, the way it affects the mind is almost as if the rest of life has been watered down and the only way happiness can be achieved is through that addiction. Sadly, not even that holds true once the addiction persists and a tolerance develops. This is why is it important to take all things in moderation and avoid risky behavior that has a higher potential to form addictions.