Is Addiction Really a Biological Disease?

Also, this euphoric state may motivate individuals in the future to take the substance again and again, and hence exacerbating the addiction process. Expectancy theory may also explain how some view drug use as “cool,” or that what they perceive as the benefits of drug use outweigh the consequences. Furthermore, some sober house communities are targeted more heavily with alcohol and tobacco advertisements and have more availability of drugs of abuse than others, particularly impoverished communities (Primack et al., 2007; Rose et al., 2019). Therefore, the social environment in which one exists contributes to their risk of addiction.

Fourth, impulsivity represents only one of multiple potential endophenotypes relevant to addictions. Other constructs (e.g., compulsivity, emotional reactivity, stress responsiveness) represent other potential endophenotypes that warrant consideration in understanding the biologies of addictions [2, 63]. Each of these intermediary phenotypes has potential relevance for adolescent addiction vulnerability, particularly given the neurobiological and behavioral changes during this developmental epoch. Data regarding individual differences, intermediary phenotypes, and main and interactive influences of genetic and environmental contributions in the setting of developmental trajectories that may be influenced by addictive drugs or behavior indicate complex underpinnings of addictions. The age when one begins drinking or using a drug is another biological condition that can play a massive part in developing addictive behaviors. Introducing it to a mind-altering substance during this time could affect neurological pathways, making a person that much more susceptible to the possibility of long-term drug and alcohol abuse.

Sensitization and tolerance in the reward circuit

Even our genes themselves can be impacted by outside factors, triggering further biological developments. In addiction research, it’s believed that people misuse alcohol and drugs because of the the chemical reactions these produce in the brain. Most substances increase dopamine release in areas that have become known as our biological “reward” pathways (some people still mistakenly call these our “pleasure centers”). Repeated substance use can cause long-term changes in these reward pathways, altering responses and making future substance use more likely. ΔFosB is a gene transcription factor that gradually builds up with each exposure to a drug. Multiple biological models have been proposed to understand addictions and addiction vulnerability, and many of these models are complementary and not mutually exclusive.

For example, researchers have found a robust association between trauma and addiction (Dube et al., 2002, 2003; Giordano et al., 2016). Indeed, in the original Adverse Childhood Experiences (ACEs) study, Felitti et al. (1998) found that more ACEs increased the odds of subsequent drug and alcohol use. One explanation for this trend is that the toxic stress from trauma leads to a dysregulated stress response.

Changes That Occur in the Brain During Addiction

Endophenotypes also are proposed to be identifiable, albeit to a lesser extent, in unaffected family members of people with the disorder. According to the biological model, each person’s unique physiology and genetics causes addiction. People differ in the degree to which they like or dislike a particular addictive substance or activity. Some people may enjoy a substance or activity so much that it becomes very tempting and difficult to resist. Another person would not experience this difficulty because they do not experience a similar enjoyment.


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