What Causes Addiction? Here's What You Need to Know

Information About the Different Ways That Addiction Can Develop

What causes addiction? The question is simple, but the answer is anything but. You may be familiar with the psychological theory of addiction or the disease model of addiction, but they are not the only explanations for why people end up addicted to alcohol, drugs, or certain behaviors. The causes of addiction are complex. Having a broader perspective of the issues involved can help you understand how you or someone you love came to struggle with addiction.

As you read through the following sections, remember this: You have the power to move toward a more hopeful future. You don't have to deal with addiction on your own. Supportive, well-trained specialists can help you find counseling and treatment options to help you or your loved one break free of your addiction and regain control of your life. A single phone call can help you get started on a rewarding path to better health.

What Is Addiction?

There are many different definitions of addiction. Some focus only on addiction to physical substances like and heroin, while others include compulsive behaviors like gambling and watching porn. People who are addicted often find that taking the substance or engaging in the behavior provides a physical or psychological "high" but ultimately leads to feelings of remorse or despair, and even physical problems. Addicts may be aware of the damaging effects of their actions, but they cannot stop themselves.

In a 2013 report, the European Monitoring Centre for Drugs and Drug Addiction compared several definitions of addiction and found that some referred to withdrawal symptoms, some mentioned tolerance, and many featured loss of control. The report concluded that while all of those things are frequently observed in addiction, they do not apply in every case. It defined addiction as "a repeated powerful motivation to engage in a purposeful behavior that has no survival value, acquired as a result of engaging in that behavior, with significant potential for unintended harm."¹

The report also gave some concrete examples of signs of addiction. A person is addicted if he or she:

• Engages in personally harmful activities in order to be able to take drugs
• Continues to engage in behavior that he or she recognizes as harmful despite having tried to stop
• Regularly experiences a powerful desire to engage in the behavior
• Has his or her life dominated by using drugs and obtaining the money to buy them
• Has not consumed alcohol for three months but still gets strong cravings for it

On the other hand, a person is not considered addicted if he or she:

• Takes a drug for the pleasurable experience but does not have a powerful desire to take the drug when it is not available
• Gains satisfaction from an activity and self-consciously decides that the benefits outweigh the costs
• Takes medication every day to relieve chronic pain
• Drinks heavily but can easily go for several months without drinking

What Are the Causes of Addiction?

Addiction causes are not easy to pin down. Addiction is a complex condition, and there are many theories about how it develops. Today, the most commonly accepted view is that addiction is a chronic disease of the brain, though this view is still somewhat controversial. Many professionals recognize that genetics, the environment, interpersonal relationships, and culture can all influence the development of addiction. There are many different factors that come into play.

Biological theory

This is the disease model of addiction. It holds that taking drugs is what causes addiction in the brain. The disease model suggests that while the initial decision to use drugs is made voluntarily, the neurobiological changes that occur as a result of drug use lessen a person's ability to control his or her behavior. These changes are therefore what causes drug addiction.

The biological theory also suggests that some people may be genetically predisposed to developing an addiction. According to some scientists, genetic factors make up between 40 and 60 percent of a person's vulnerability to addiction.²

Critics of the disease model point out that addiction can sometimes be managed through behavioral or environmental changes; some people recover without treatment, which doesn't jive with the notion of addiction as a disease. For instance, during the war in Vietnam, many American troops used large amounts of heroin, yet 95 percent of them stopped using without treatment within a year of returning to the U.S.³ This suggests that not everyone succumbs to the biological changes wrought by drugs.

Psychological theory

The psychological theory of addiction sees mental disorders such as cognitive problems and mood disturbances as the answer to the question of what causes substance abuse. Addiction and mental health problems often occur together. In fact, about half of the people who seek addiction treatment also have another significant mental disorder.⁴

Traumatic experiences and negative relationships can also be causes of drug abuse or other addictions. Some people turn to substances like alcohol or drugs, or behaviors like gambling or watching porn, to escape from the effects of troubling experiences from their past, to fill a void in their lives, or to soothe or calm themselves in the face of immense stress.

Spiritual theory

This theory suggests that the causes of substance abuse are rooted in a spiritual disconnection from God or another higher power, and that people abuse alcohol and drugs as a way to fill an emptiness in their lives. This is the premise behind Alcoholics Anonymous (AA), Narcotics Anonymous, and other 12-step groups. At AA, people with alcohol addiction are encouraged to admit their powerlessness over their addiction and seek help from a spiritual power.

Moral theory

Before the idea of addiction as a disease became widely accepted, society largely viewed addicts as weak-willed people who were choosing to engage in destructive behavior. Moral failures were the cause of drug abuse. The punish-and-shame model of dealing with addicts in the criminal justice system stems from the idea that people will change their behavior if they are motivated enough to do so.

Morality is also at the heart of the Rational Recovery system, which was created as a counterpoint to 12-step programs. Rational Recovery rejects the idea that addiction is a disease. Instead, it sees addiction as a disorder that can be overcome through willpower and a personal commitment to lifelong abstinence.

Social theory

This theory suggests that social isolation is the cause of drug addiction.

But psychologist Bruce K. Alexander wondered if the environment was the driving factor in the rat's drug use. He created Rat Park, an enormous housing colony with rats of both sexes surrounded by food and tunnels and lots of opportunities for socializing and mating. Alexander's data showed that rats who were living in a more stimulating environment had little desire for the drugs. None of them overdosed when they had happier lives. These findings run contrary to the notion of addiction as a drug-induced disease.

What Makes Drugs Addictive?

Drugs cause changes in the brain that encourage people to keep taking them. Human beings are biologically programmed to repeat life-sustaining activities like eating and having sex because those activities activate reward centers in the brain. In that way, our brains unconsciously teach us to do those same activities over and over again.

Dopamine is a neurotransmitter, a chemical that relays signals in the brain. It is essential to our brain's reward system, helping to regulate emotion, motivation, and feelings of pleasure. When people exercise or have sex, they get a boost in dopamine levels in their brain. The same thing happens when they take certain drugs. The difference is that drugs can release up to 10 times more dopamine than people get from natural rewards. The euphoria that follows strongly motivates people to keep taking those drugs. Many scientists believe this is what causes addiction to drugs.

But this huge release of dopamine actually makes the brain's reward system less sensitive to rewards, making it harder for people to feel pleasure at all. That's why people with drug addictions often lose interest in relationships or activities that they used to enjoy. And over time, people can develop tolerance to certain drugs, meaning they need to take larger doses to achieve the same euphoric effect.

Dopamine is not the only neurotransmitter involved in addiction. Serotonin and glutamate play important roles as well.

• Serotonin regulates mood, appetite, and sleep. Dopamine pushes us to do what we need to do to meet our needs; serotonin helps us feel sated after meeting those needs. Low levels of serotonin can lead to strong cravings and make a person more likely to engage in any activity that boosts dopamine and serotonin levels, such as drinking alcohol, having sex, or gambling.
• Glutamate is associated with learning and memory. It initiates a set of reactions that convert short-term memories into long-term ones. These memories connect the rewards of drug use with the people and places associated with them. That means that even years after a person stops taking drugs, seeing those same people or being in those same places can trigger cravings and result in relapse.

What Makes Certain Behaviors Addictive?

Behavioral addictions are similar to substance addictions in many ways. Research has shown that behavioral addictions can be chronic, relapsing conditions that involve cravings and psychological rewards (e.g., a boost in dopamine levels). Many people who are addicted to gambling or sex report a need to intensify the behavior to achieve the same "high," which is similar to a drug tolerance. And, as is common with drug addicts, some people with behavioral addictions resort to stealing or other illegal acts in order to finance their addiction.⁵

Some of the commonly recognized behavioral addictions are:

• Gambling
• Pornography
• Sex
• Eating
• Shopping

Why Do Some People Become Addicted and Others Don't?

Anyone can become addicted. Just as there is no one single behavioral or drug addiction cause, there is no one single factor that can determine if a person will develop an addiction.

Genetics and environment both play a role. For instance, some people have genetic makeups that cause them to feel the rewards of drugs and alcohol more intensely, making them more prone to addiction. But studies have shown that having an effective system of social support can reduce the risk of drug addiction even for those who are genetically predisposed to it.⁶

The interplay of genetics and environment is unique to each person. That said, there are several factors that can increase the risk of a person becoming addicted:

• Having a family history of addiction
• Using drugs at a young age
• Having mental conditions such as anxiety or depression
• Experiencing peer pressure or bullying
• Suffering from traumatic events such as abuse, particularly in childhood
• Living in an environment where alcohol and drugs are easily available

Find the Help You Need to Break Free

It's not too late to regain control of your life. Recovery from addiction is possible. With help from experienced specialists, you can begin the journey toward a more positive future.