A Comprehensive Look into the Psychology of Addiction

From the facts alone, one can easily jump to quick conclusions about the problem of addiction in the United States. According to statistics from the National Survey on Drug Use and Health (NSDUH), as many as 19.7 million adult Americans battled a substance use disorder in 2017. That same year, 1 in 8 adults said they struggled with drug use and alcohol use disorders at the same time. Addiction is a costly burden to America at large—the country has bled as much as $740 billion on lost workplace productivity, healthcare related to substance abuse, and crime linked to addicted behaviors.

But speaking up about addiction is tricky ground. Among members of the general public, addiction is often coded as a social scourge; to call someone an “addict” means to regard them as dirty, criminal, or subhuman. Seldom does the discussion on addiction broach upon its true nature: as a complex, but treatable disease. As a consequence, those who suffer from the symptoms often spiral even deeper into their addiction, withdraw from their relationships and communities, and lose hope in living life differently.

This article means to delve into the manifold nature of addiction, with knowledge taken from the field of human psychology. It also means to brief you  about the causes, different types, and distinctive symptoms of addiction to a substance or behavior. And last but not least, it means to bring the psychology of recovery to the fore—which may be helpful if you, or someone dear to you, is suffering from addiction. Being kind in a difficult situation—even in simple ways such as through sharing accurate info, admitting your problems to a medical professional, supporting someone through group therapy, or using wearables to motivate yourself—could spur the reversal from addiction to permanent, meaningful recovery.

Here’s a closer look at everything you need to know about the psychology of addiction.

What is Addiction?

The American Psychiatric Association (APA) defines addiction as a brain disease that manifests in repeated and compulsive use of an addictive substance, despite imminently harmful consequences.
This definition can also be expanded to include addictive behaviors, such as gambling. What links gambling to substance abuse is the rewarding effect, which compels a user to repeat consumption or engagement—often to a greater degree than before.

Persons suffering from addiction have difficulty breaking the cycle despite being faced with detrimental consequences. They are hooked on the feeling of intoxication or the relief that comes with the source of their addiction.

Addiction is not synonymous with misuse, or the incorrect, excessive, or non-therapeutic usage of a substance. An instance of misuse cannot always be judged as a lead-in to addiction. But the two are related in that addiction is often a consequence of repeated misuse—in these cases, the escalated misuse results in a long-term inability to cease or moderate substance intake.

What are the Common Types of Addiction, and What Causes Them?

Addiction can be classified into two main categories: addiction to a substance and addiction to a behavior. Common types under the former are the following:

• Alcohol use disorder (for alcoholic substances);
• Caffeine intoxication (for caffeine-laden substances such as coffee or soda);
• Tobacco use disorder (for nicotine-laden products such as cigarettes, cigars, or chewing tobacco);
• Cannabis use disorder (physiological dependence on cannabis);
• Phencyclidine/hallucinogen use disorder (for hallucinogenic drugs such as PCP/“angel dust,” LSD, or psilocybin/“magic mushrooms”);
• Inhalant use disorder (for substances like glue, fuel, and paint whose fumes have psychoactive effects);
• Opioid use disorder (for pain-relieving synthetic substances such as heroin, fentanyl, morphine, and oxycodone—the leading cause of lethal addiction in America);
• Sedative, hypnotic, or anxiolytic use disorder (for sleeping pills or anti-anxiety medications);
• Stimulant use disorder (for stimulating substances such as amphetamines, methylphenidate, and cocaine).

Under the latter, the following are prevalent types of addiction or still being studied as falling under addictive behavior:

• Gambling (compulsive behavior with steep consequences to physical health, emotional health, and financial wellbeing);
• Gaming (compulsive or uncontrolled playing of video games for long hours);
• Other behaviors such as smartphone use, pornography, shopping, and the like.

Addiction induces a highly motivated state that prunes the synapses in the prefrontal cortex, or the part of the human brain that governs the most complex cognitive behaviors. As a result, the brain is wired to focus only on cues that relate to the addictive substance or activity. After repeated engagement, it will seem to block out everything else.

Though it is difficult to predict who will develop a compulsive substance abuse or behavior disorder—one cannot ascribe a singular profile to a so-called “addict”—certain factors may contribute to a person’s risk or susceptibility to addiction. Among them are the following:

• Genetic predisposition (such as possession of a gene with a different makeup of brain receptors for the neurotransmitter dopamine);
• Physiological factors (such as how well one’s liver can metabolize enzymes);
• Personality traits (like innate impulsivity);
• History of trauma or abuse (in which a substance or behavior are used as coping mechanisms);
• Preexistent mental health conditions (such as depression, anxiety, or attention deficit disorder [PTSD]);
• The individual’s upbringing (lack of supervision from family members or exposure to dangerous substances at an early age);
• Peer pressure (from one’s social group);
• Employment status (as a consequence of not having regular means of income).

Suffice to say, people can fall into addiction for myriad reasons—they may want to prolong a high, to relieve stress, to please their peers, or even to improve their performance at work—and as such, judgment calls on their situation are very hard to make.

What are the Major Symptoms of Addiction?

Over time, addiction can wreak havoc over the brain functions that are related to learning, memory, judgment, decision making, and behavior control. But the telltale consequence of addiction is impairment—whether it is over one’s usage or engagement, over one’s relationships, or over one’s daily routine. Overall, there will be impairment over one’s awareness of how big a toll their addiction is taking on them.

If one checks off on at least two of the following symptoms, they may be suffering from a disorder:

1. When the substance is used in larger amounts or when the behavior is engaged for a longer time than is intended;
2. If attempts to cut down have failed;
3. If usage or engagement eats up a significant portion of one’s time;
4. If one develops insatiable cravings;
5. If one’s duties at school, work, or home are disrupted;
6. If one suddenly decreases or stops their participation in a hobby, sport, or interest;
7. If one continues to misuse or engage in isolation despite imminent physical, psychological, or social damages to their everyday lives;
8. If one pursues the addictive substance or behavior in increasingly risky situations;
9. If one develops a tolerance (i.e. previous dosages have a diminished effect and one desires more to achieve the same impact);
10. If one experiences withdrawal when the source of addiction is cut off (with symptoms such as irritability, anxiety, nausea, vomiting, fatigue, tremors, or loss of appetite)

Online magazine and psychology authority Psychology Today cites the presence of 2 to 3 of these symptoms as indicative of a mild addiction; 4 to 5 of these symptoms, a moderate addiction; and 6 or more of these symptoms, a severe addiction.

Debunking Some Myths on the Nature of Addiction

There’s no doubt that addiction is a very serious problem whose ramifications span the user, their families, their romantic partners, their colleagues, and their communities at large. Indeed, many chalk up addiction as something that’s ruined their homes, their social lives, their careers, and their finances. But virulent anger towards those suffering from addiction—such that they are dehumanized or imprinted with a stigma for the rest of their lives—will help no one in the long run. It is only through understanding addiction, and undoing the circumstances that perpetuate it, that we can rid society of it for good.

With that in mind, there are three prevalent myths about addiction that this article seeks to address.

1. Addiction is simply about a person getting hooked. Being addicted to a substance or behavior is seldom a matter of getting hooked and being in a vegetative state. Ongoing research by Dr. Lance Dodes, for example, indicates that complex feelings of rage or helplessness may be simmering under the surface. Pursuing an addictive substance or behavior may grant someone temporary reprieve, give them a brief illusion of empowerment or control, or act as a substitute for another desired behavior that is equally forbidden (for example, taking out one’s frustrations on another human being). In this case, treating addiction will entail not only medical intervention, but a thorough unpacking of the personal circumstances in which the addiction takes place.
2. There is no template personality for someone suffering from addiction. Addiction is often viewed through the lens of one’s socio-political biases, hence a default association of drug or alcohol substance abuse with the poor. But in reality, people from the upper class, middle class, or lower class alike may be susceptible to addiction. Substance abuse of a particular kind may thrive in certain socio-economic conditions—for example, inhalant abuse among the impoverished who want quell their hunger pangs, versus the abuse of expensive stimulants among the moneyed.
3. Addiction is not only about the pursuit of pleasure. As discussed above, addiction may be born out of one’s social, psychological, or environmental problems. The roots that feed addiction may run deep. One may need to be treated not only for a substance or behavioral addiction, but an adjoining condition such as depression or PTSD.

We cannot stigmatize or dehumanize those who experience addiction; neither can we be too hard on ourselves if it is a reality we know well. Luckily, there are many ways to break the cycle. The path to recovery from addiction is a difficult one to walk, but there is room on it for everyone—including you and your loved ones.

The Psychology of Recovery

As grave as the changes in the nervous system may be post-addiction, they are actually reversible after the substance abuse or addictive behavior has stopped. Within about five years of being clean, the synaptic density in one’s brain may be restored, and one can go back to a healthy and productive life.

This is not to say that there will be no bumps in the road. These days, medical professionals acknowledge the frequency of relapses and tailor their rehabilitative approaches accordingly. Full treatment of addiction is geared toward both prevention and management of current use, and may entail the following steps to be done in a clinic, doctor’s office, or inpatient facility:

1. Detoxification under medical supervision;
2. Prescription of meds to counter the substance use, and/or to treat concurrent issues such as depression;
3. Cognitive behavior therapy (CBT) to help individuals identify the triggers for use or engagement;
4. Counseling;
5. Group therapy or peer support sessions;
6. Therapy with family or romantic partner;
7. Relevant life skills training, such as skills for employability.

If a person previously suffering from addiction successfully kicks their habit, returns to their family and community prepared to inhabit their proper social roles, rehabilitates their physical and mental health, and benefits from evidence-based treatment, then there is a high likelihood that they’ve achieved recovery and can sustain it in the long term.

Conclusion: Developing Strength and Maturity while Recovering from Addiction

Recovery from addiction may be a long and arduous journey to make, but it is possible with enough motivation to change one’s life. Among other things, a person recovering from addiction should aim for developmental maturity to curb their impulses. This is a link explored by A. Tom Horvath, Kaushik Misra, Amy K. Epner, and Galen Morgan Cooper in their scholarly work, The Psychology of Addiction and Recovery.

Horvath, Misra, Epner, and Cooper cite this developmental maturity as what makes adults different from children. Unlike children, who are driven by their compulsions, adults are better equipped to align their actions with their values and beliefs. That means that adults who take on the tools to battle their addiction—such as problem solving, coping, and stress reduction skills—can eventually seek to reconcile how they are acting with the laws, institutions, and relationships that they value.

This is a fate that you and your loved ones can believe in: that you will eventually break the physical and psychological chains of addiction and be the strong, healthy, and functional adults that you always wanted to be.