What Is Alcohol & Substance Addiction?

Addiction is a complex and multi-layered issue that affects millions of individuals worldwide, without regard for age, gender, race, religion or socioeconomic status. From alcohol to drugs, gambling to social media, addictive behaviours can take many forms, exerting a profound impact on individuals, families and communities. 

The reasons for addiction all vary, however more often than not there is an emotional pain or distress that fuels it. As Gabor Maté writes, “Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the centre of all addictive behaviours.” Alongside this Claudia Black, a leading authority in trauma, takes the view that trauma and addiction are two sides of the same coin; an unhealed trauma can easily and very often manifest itself within an addiction, as a way of self-coping and self-soothing. The impact of addiction on the brain and body can have profoundly adverse effects, which are much more complex and go deeper than the surface feelings “relief” or the “feel-good” factor. 

Addiction involves the hijacking of the brain's reward system and neural pathways, which are associated with feelings of pleasure and reinforcement. When a person engages in substance use or addictive behaviours, such as impulse spending or online gaming, the brain releases neurotransmitters like dopamine, which create feelings of pleasure and reward. 

Over time, repeated exposure to these substances or behaviours leads to the desensitisation of dopamine receptors. These receptors then require higher levels of stimulation to experience the same pleasurable effects. So where one glass of wine would be enough, this now has to be increased to two or more glasses to obtain the same sensations and stimulations. This desensitisation contributes to the development of tolerance. It also drives individuals to engage in increasingly compulsive and risky behaviours to achieve the desired reward – one example may be lying or stealing money to pay for a bottle of alcohol, or even stealing the bottle, so that dopamine hit can be felt.  

As addiction progresses, individuals experience intense cravings and urges to engage in substance use or addictive behaviours, even in the face of negative consequences. These cravings are driven by a combination of physical, emotional and environmental factors, including triggers e.g. a stressor or a memory associated with the trauma or distress a person suffered. After few times of using, the brain and body learn that this is substance or behaviour is a good way to numb the perceived pain or shut down the emotions that so badly want to surface. As set out in my article about chronic pain and illness, often we feel an inability to sit with our emotions; a fear that the memories and emotions of a difficult time are too much to process. This can fuel a person’s desire to use as it serves as a method of self-soothing and distracting from the pain. As Patrick Carnes writes, "it is not the drugs that make a drug addict, it is the need to escape reality." 

As a result, the brain's reward circuitry becomes hypersensitive to these triggers, leading to heightened arousal and a strong urge to seek out and consume the substance or engage in the addictive behaviour, despite efforts to resist. This results in a lack of self-regulation; despite trying their best, a person is unable to say no to the behaviour or substance. 

Chronic substance abuse leads to changes in the brain, altering its chemistry and structure in ways that perpetuate addiction and diminish cognitive function such as decision-making, impulse control and emotional regulation. Moreover, these can further reinforce addictive behaviours and undermine attempts at recovery.

Substance addiction takes a toll on the body, contributing to a range of physical health problems and medical complications. For example, chronic alcohol abuse can lead to liver disease, cardiovascular problems and gastrointestinal disorders, while long-term drug use can damage organs such as the heart, lungs, and kidneys. Substance abuse also weakens the immune system, increasing the risk of infections and other health-related issues. These physical health problems exacerbate the cycle of dependence and dysfunction, further compromising an individual's overall well-being and quality of life.

The consequences of addiction extend beyond the individual; affecting families, relationships and even work. Families often bear the brunt, experiencing tension and conflict as they navigate the challenges of living with a loved one struggling with addiction. Financial instability, social isolation and employment difficulties are common consequences of addiction, further exacerbating stress and undermining overall wellbeing. Unfortunately, this can often an individual trapped in a cycle of despair and dysfunction.

Recovery from addiction is a challenging but achievable journey that requires courage, commitment, and support. Recognising the need for help is the first step towards recovery. Gabor Maté highlights the role of compassion, connection and self-awareness in fostering meaningful recovery and long-term sobriety. 

Treatment options vary depending on individual needs and preferences but may include therapy, support groups and even medication-assisted treatment. The therapeutic approaches are very similar to those used in trauma. Please see this article here. As Dan Siegel says "you don't have to get stuck in a negative experience. You don't have to be a victim to external events or internal emotions. You can use your mind to take charge of how you feel and how you act". 

By understanding its origins, acknowledging its impact on the brain and body and recognising its broader implications for quality of life and relationships, individuals can take the first steps towards healing and recovery.