For most people, controlling their behaviors and what they put into their bodies comes relatively naturally – with experience and fortitude. For others, knowing how to put down the drink, throw away the cigarettes or turn off the internet is a struggle. Addiction can wreak havoc on the lives of those suffering from the illness and others in their lives. But what determines if a simple vice has become a detrimental addiction? This question continues to challenge physicians, judges, clergy, addicts, their loved ones and the public. Here, we delve into some answers.

What is Addiction

In general, addiction is a compulsive need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal.[1] Specifically, drug addiction is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.[2]

Types of Addiction

While drug use and alcoholism are the hallmark of addiction, it is becoming more known that a person can be addicted to non-substance behaviors, often referred to as behavioral addictions, such as gambling, online game playing, sexual activity and exercise. While growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, there is controversy surrounding whether or not certain behavioral addictions are true addictions or rather compulsive behaviors.[3]

Signs of Addiction

Different drugs may have different effects on overall physical and mental health, but the first sign of dangerous drug or alcohol use is when obtaining and using the drug becomes more important than work and loved ones. Another sign is when the physical and emotional consequences of using the drug make it difficult to function. Other signs include the following.[4]

Physical signs:

  • Restlessness, and an inability to sleep
  • Abnormally slow movements, speech or reaction time
  • Confusion and disorientation
  • Cycles of excessive sleep
  • Unexpected changes in clothing and/or wearing long sleeves to hide injection sites
  • Suspected drug paraphernalia such as pipes, roach clips or syringes

Mental and emotional signs:

  • Cycles of being unusually talkative, up and energetic
  • Increased irritability, agitation and anger
  • Unusual calmness, unresponsiveness or looking “spaced out”
  • Apathy and depression
  • Paranoia and delusions
  • Temporary psychosis and hallucinations
  • Lowered threshold for violence

Symptoms of Addiction

When drug use goes beyond casual or social use and turns into an addiction, the following symptoms might occur:

  • Feeling the need to use the drug regularly (daily or even several times a day)
  • Failing in attempts to stop using the drug
  • Making certain to maintain a supply of the drug
  • Spending money on the drug, despite being unable to afford it
  • Doing things out of character, such as stealing, to obtain the drug
  • Feeling dependent on the drug to deal with problems
  • Driving or doing other risky activities while under the influence of the drug
  • Focusing more and more time and energy on getting and using the drug[5]

Causes of Addiction

When drugs enter the brain, they can change how the brain works by causing physical changes to some nerve cells (neurons) in your brain. These changes are what lead to compulsive drug use. Physical addiction appears to occur when repeated use of a drug alters the way your brain feels pleasure. Drug addiction and dependence depends on several things, but below are two main factors:

  • Environment. Family beliefs and attitudes, as well as exposure to a peer group that encourages drug use, seem to play a role in initial drug use.
  • Genes. Once you’ve started using a drug, the development into addiction may be influenced by inherited traits.[6]

Effects of Addiction

On top of family disintegration, loss of employment, failure in school, domestic violence, child abuse, and death, drug abuse and addiction have destructive public health and safety implications. Estimates of the total overall costs of substance abuse in the United States, including productivity and health and crime-related costs exceed $600 billion annually.[7]

Treatments for Addiction

Scientific research since the mid–1970s shows that treatment can help drug addicts stop using, avoid relapse, and successfully recover their lives.[8] Drug addiction treatments include the following:[9]

  • Treatment programs: Include individual or group educational and therapy sessions focused on getting sober and preventing relapse.
  • Counseling: Involve individual or family sessions with a psychologist, psychiatrist or addiction counselor that focus on behavior therapies to develop ways to cope with drug cravings, avoid drugs and prevent and deal with relapse.
  • Self-help groups: Teach that addiction is a chronic disorder with a danger of relapse and that ongoing maintenance treatment is necessary to prevent a relapse.
  • Withdrawal therapy or detoxification: Helps the addicted stop taking the drug by gradually reducing the dose of the drug or temporarily substituting other substances that have less severe side effects.


  1. Merriam-Webster Dictionary. Addiction. Retrieved January 27, 2013, from
  2. National Institute on Drug Abuse. The Science of Addiction: Drugs, Brains, and Behavior. Retrieved January 27, 2013, from
  3. US National Library of Medicine National Institutes of Health. Introduction to behavioral addictions. Retrieved January 27, 2013, from
  4. University of Colorado Hospital. The symptoms and signs of addiction. Retrieved January 27, 2013, from
  5. Mayo Clinic. Drug addiction symptoms. Retrieved January 27, 2013, from
  6. Mayo Clinic. Drug addiction causes. Retrieved January 27, 2013, from
  7. National Institute on Drug Abuse. DrugFacts: Understanding Drub Abuse and Addiction. Retrieved January 27, 2013, from
  8. National Institute on Drug Abuse. DrugFacts: Treatment Approaches for Drug Addiction. Retrieved January 27, 2013, from
  9. Mayo Clinic. Drug addiction treatments and drugs. Retrieved January 27, 2013, from

By C. J. Newton, MA, Editor

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