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Many people believe addiction is a choice. They believe people with substance use disorder can simply quit if they would just make up their minds. They believe that people who abuse drugs are weak or morally bankrupt. They just need to make up their minds and get their lives in order!

If it were only that simple.

Unfortunately, people who suffer from the disease of addiction have lost the ability to choose. That’s because they have a disease known as substance use disorder. In 1956, the American Medical Association (AMA) classified alcoholism as a disease and included drug addiction as a disease in 1987. In 2011, the American Society of Addiction Medicine (ASAM) joined the AMA, defining addiction as a chronic brain disorder, not a behavioral problem or just the result of making bad choices.

Alcohol or drug addiction, also known as substance use disorder, is a chronic disease of the brain that can happen to anyone. Severe substance use disorder happens when substance use becomes an uncontrollable habit that impairs a person’s day-to-day life, manifesting as struggles at work or school, conflicts with relationships, legal or money problems.

Addiction changes the way the brain works, rewiring its structure. Drugs and alcohol hack into your brain’s communication system and interfere with how nerve cells send, receive and process information. The brain’s reward system activates when we do something we like —eating sweets, hanging out with friends, or going for a run, for instance. That reward comes in the chemical dopamine. Drugs or alcohol trigger the release of dopamine in the same way.

Dopamine makes us feel good and want to keep doing what we’re doing. It also teaches the brain to repeat the behavior. When a person takes a drug, the brain releases a flood of dopamine, much more than it would when eating a piece of chocolate or pie. The brain overreacts and cuts back on dopamine production to bring it down to a normal level. As a person continues to use drugs, the body produces less dopamine. Things that brought the person pleasure — sweets, friends, and even drugs — don’t anymore. Once addicted, it takes more and more drugs just to feel normal.

Research has shown how addiction changes the areas of the brain in charge of judgment, decision-making, learning and memory, and controlling behavior. Those changes can lead to a good student flunking out, a wife lying about draining the family savings account or an overdose in a grocery store parking lot. Once substance use changes the brain, willpower changes too. If an addicted person tries to quit using substances, their brain tries to protect that person from the pain and intensity of withdrawal symptoms. Addiction fuels the brain’s response to do whatever it takes to stop the cravings and discomfort. That can make it nearly impossible to “just say no.”

Addiction affects everyone – it doesn’t discriminate based on age, race, sex, education or income. No one thing can predict a person’s risk of developing substance use disorder but researchers agree there are a combination of factors involved that can increase your risk, including genetics, environment, and development.

Addiction is a chronic disease that can be treated and managed through treatment and recovery programs but can’t be cured. Just as someone with diabetes or heart disease has to choose to exercise and eat a healthy diet to control their disease, someone with addiction has to choose treatment. Scientists don’t know why some people can successfully quit using drugs on their own, and others can’t. For most people, recovery takes intervention with things like inpatient treatment, behavioral therapy, medications to help control cravings, and recovery support programs.

If you or someone you love suffers from substance use disorder, there is hope. . Treatment and recovery are only a click away. Let today be the first day of the rest of your life! 

SOURCE: Indiana University Health