Addiction Defined

Addiction knows no boundaries.

Opioid addiction can happen to people of every race, ethnicity, income level, and religious background.

Addiction is a chronic, often relapsing, brain disease that causes compulsive drug seeking and use, despite harmful consequences. When a person who uses drugs can't stop taking a drug even if they want to, it's called addiction. The urge is too strong to control, even if you know the drug is causing harm. When people start taking drugs, they don't plan to get addicted. They like how the drug makes them feel. They believe they can control how much and how often they take the drug. However, addiction changes the brain. Those who use drugs start to need the drug just to feel normal. Addiction challenges a person’s self-control and hampers his or her ability to resist intense impulses to take drugs. It has nothing to do with a lack of willpower.

Addiction can quickly take over a person's life. Addiction can become more important than the need to eat or sleep. The urge to get and use the drug can fill every moment of a person's life. Addiction replaces all the things the person used to enjoy. A person who is addicted might do almost anything—lying, stealing or hurting people—to keep taking the drug. This could get the person arrested.

Addiction is a brain disease.
Drugs change how the brain works.
These brain changes can last for a long time.

They can cause problems like mood swings, memory loss, even trouble thinking and making decisions.

Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal treatment failure—rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover.

How Can I Determine If Someone is Addicted to Drugs?

Does the person take the drug in larger amounts or for longer than intended?
Does the person want to cut down or stop using the drug but can’t?
Does he or she spend a lot of time getting, using, or recovering from the drug?
Does he or she have cravings and urges to use the drug?
Is he or she unable to manage responsibilities at work, home, or school because of drug use?
Does he or she continue to use a drug, even when it causes problems in relationships?
Does he or she give up important social, recreational, or work-related activities because of drug use?
Does the person use drugs again and again, even when it puts him or her in danger?
Does he or she continue to use, even while knowing that a physical or mental problem could have been caused or made worse by the drug?
Does he or she take more of the drug to get the wanted effect?
Has he or she developed withdrawal symptoms, which can be relieved by taking more of the drug? (Some withdrawal symptoms can be obvious, but others can be more subtle—like irritability or nervousness.)

If the answer to some or all of these questions is yes, your loved one might have a substance use disorder. In the most severe cases, it is called an addiction.

What Should I Do If I Suspect Someone is Misusing Drugs?

If you think your loved one might be misusing opioids, you cannot fix the problem by yourself, but there are some steps you can take:

Know the symptoms. An individual addicted to opioids may deny having a problem. Learn more about the symptoms of opioid addiction.
Learn about drug addiction. Understand addiction and why someone might be misusing opiates. Don’t judge the person; focus on their behavior and your concern for their wellbeing. Click here to learn more.
Don’t ignore the problem or try to cover it up. This won’t make the problem go away.
Talk to your loved one about his or her drug habit. Honest feelings expressed by people who care can help the loved one face the problem. If you believe that your loved one may be misusing opiates, try to answer the questions below as honestly as possible. If the person is willing, you can include him or her in the discussion. (*"Drugs" is used here to refer to illicit drugs, prescription drugs, or alcohol.)

What happens to your brain when you take drugs?

Drugs are chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs cause this disruption: by imitating the brain’s natural chemical messengers and/or by overstimulating the “reward circuit” of the brain.

Nearly all drugs, directly or indirectly, target the brain's reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this system, which normally responds to natural behaviors that are linked to survival (eating, spending time with loved ones, etc.), produces euphoric effects in response to the drugs.

This reaction sets in motion a pattern that "teaches" people to repeat the behavior of misusing drugs. As a person continues to misuse drugs, the brain adapts to the dopamine surges by producing less dopamine or reducing the number of dopamine receptors. The person must therefore keep misusing drugs to bring his or her dopamine function back to ''normal'' or use more drugs to achieve a dopamine high.

Long-term drug misuse causes changes in other brain chemical systems and circuits, as well. Brain imaging studies of individuals with a substance use disorder show changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control. Together, these changes can drive an individual with a substance use disorder to seek out and take drugs compulsively -- in other words, to become addicted to drugs.

Why do some people become addicted while others do not?

No single factor can predict whether a person will become addicted to drugs. Risk for addiction is influenced by a combination of factors that include individual biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. For example:

Biology: The genes that people are born with, in combination with environmental influences, account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental health disorders may influence risk for drug misuse and addiction.
Environment: A person’s environment includes many different influences, from family and friends to socioeconomic status and quality of life in general. Factors such as peer pressure, physical and sexual abuse, stress, and quality of parenting can greatly influence the occurrence of drug misuse and the escalation to addiction in a person’s life.
Development: Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction vulnerability. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to more serious misuse, which poses a special challenge to adolescents. Because areas in their brains that govern decision-making, judgment, and self-control are still developing, adolescents may be especially prone to risk-taking behaviors, including trying drugs of misuse.