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Addiction to alcohol and drugs is a complex phenomenon consisting of biological, psychological, emotional, and spiritual factors. The compulsion to seek and use drugs despite serious legal, familial, financial, and medical consequences is the outward manifestation of addiction. For many generations, an addict’s behavior was viewed through a moral lens, which reflected the addicted person as inadequate at self-restraint. In the absence of a biological view of addiction, an explanation based on moral shortcomings is easy but highly erroneous and misleading.

Addiction is a chronic disorder similar to other chronic disorders such as diabetes and heart disease. A chronic disease is a condition that has no known cure. However, the symptoms of the condition can be arrested with treatment. Since there is no cure, relapse is possible. The symptoms of addiction include but are not limited to the following: a compulsive pattern of seeking and using a drug; an inability to limit intake; physical and/or psychological discomfort related to the sudden withdrawal of the drug.

It takes time to develop a dependence on a drug. The length of time depends on many factors including susceptibility to addictions, environmental and social factors, and gender. Initially, the use of the drug provides a pleasurable experience defined differently for different people. Some individuals prefer sedatives such as alcohol while others prefer stimulants such as cocaine. Regardless of the effect of the drug, initial use is about getting acquainted with the drug and developing a relationship with it. During the initial stage of repeated intake of the drug, the body and the brain begin a process of adapting to the presence of the drug. The adaptation results in significant changes in brain chemistry, which results in changes in its functioning. Our brains have natural chemicals (neurotransmitters) that induce a sense of well being. Drugs disrupt the delicate equilibrium found in the brain. When a drug is introduced in the body, it interferes and disrupts the production of the natural chemicals. Once a pattern of drug use is established, the regular administration of the drug becomes necessary for a sense of comfort and well being.

Withdrawal symptoms occur when a person who is physically and/or psychologically dependent on a drug abruptly stops its use. The pain from the withdrawal necessitates the compulsive search and consumption of the drug. It is the physical and psychological pain of withdrawal that drives the addict to behave in an irrational and destructive manner rather than his/her moral shortcomings. There are many routes that lead to addiction. Some individuals begin to use drugs as a way to socialize with peers or to mange psychological pain. Others develop an addiction to a prescribed medication designed to manage physical pain after surgery. Regardless of the route to addiction, once dependence on the drug sets in, the addicted person’s neurological and biochemical functioning is altered. Hence, we cannot expect the addict to act as if he is not physically dependent on the drug. The addicted body and mind are driven to seek comfort from the pain of withdrawal. Unfortunately, without treatment, the only comfort that works for the addicted individual is the use of the drug.

Abstinence from alcohol and other drugs is difficult for a person who is experiencing major mood swings related to psychological and physical withdrawal. Therefore, the initial stages of treatment are geared toward stabilizing the body into a drug-free state. After physical stabilization, the individual in recovery learns new skills to continue to stay abstinent regardless of his/her environmental and social triggers for relapse. Addressing the psychological, emotional and spiritual (mental) components of addiction are as important as the physical component. Accordingly, the mental side of addiction will be addressed in a future Sober Talk column, thus providing a more comprehensive description of addiction and its treatment.