This is a question people commonly ask. The truth is, there is no single answer as there are many factors. It depends on the person and it depends on the drug or behavior. Read on to learn more about addiction, factors that influence it, the stages of addiction and when to seek help.
What Makes Something “Addictive”?
Addiction involves compulsively seeking and taking substances or doing activities despite the negative or harmful consequences. Addiction is now understood to be a brain disease (and not a moral failing). The American Society of Addiction Medicine describes addiction as a “primary, chronic (life long) disease of brain reward, motivation, memory and related circuitry”.
Most people initially take drugs or do certain behaviors voluntarily. But repeated use can lead to brain changes that challenge an addicted person’s self-control and interfere with the ability to resist intense urges or cravings to repeat the activity.
There are two main types of addictions: Substance Use Disorders and Behavioral Addictions. Both types of addiction involve deficiencies, despite negative outcomes, in:
- Control of inhibitions
- Emotion regulation
- Decision-making
The symptoms of each overlap and include:
- Compulsion to accept a reward despite severe consequences
- Having dominance over one’s life
- Euphoric experiences
- Withdrawal symptoms
- Interpersonal conflicts
- Risk of relapse
Stages of Addiction
Behavioral addiction may also affect brain neurotransmitter systems, such as the dopamine system, similar to drugs. The stages of addiction often follow a three-stage cycle consisting of [1]:
Stage 1: Binge/Intoxication
A person consumes an intoxicating substance or carries out a certain behavior. The brain experiences the high or euphoria with an increase in dopamine. Repeated activation of the brain’s basal ganglia reward system reinforces the addictive behavior, increasing the likelihood of increased consumption. This plays an important part in the brain’s motivation, and habit formation, reinforcing compulsive use or behaviors.
Stage 2: Negative Affect/Withdrawal Stage
As the person comes down from the high, a negative emotional state occurs—experienced as unpleasant withdrawal symptoms. This involves both a reward deficit and an increased stress state in the brain. At this stage the person no longer consumes substances or engages in behaviors for the pleasurable effects (the high) but rather to escape the low feelings of chronic substance abuse or behavioral patterns.
Stage 3: Preoccupation (Anticipation)
After a period of abstinence, the person engages in compulsive behaviors and the craving for more intoxication. In pursuit of the high again, the person becomes preoccupied with seeking out more substances, game rooms, chat sites or other behaviors. With continued addictive behaviors, the prefrontal cortex—an area of the brain responsible for executive function, including the ability to organize thoughts and activities, prioritize tasks, manage time and make decisions, is compromised.
Reinforcement plays a key role in each stage. It occurs during the positive experiences of the initial use, negative reinforcement to alleviate withdrawal symptoms, and conditioned reinforcement where cues (people, places, things) trigger intense cravings, perpetuating the addiction.
Addiction hijacks the brain’s reward system which normally encourages you to engage in survival-related activities such as eating, socializing, sex, or achieving goals. Substances or certain behavioral activities create an intense high by flooding the reward system with dopamine, known as a “feelgood” chemical.
Over time, the brain adapts to this surge by dampening its dopamine production and sensitivity to rewards. As a result the person seeks greater quantities of the substance or behavior leading to tolerance and then the dependence of addiction.
Factors That Influence Addiction
There are a variety of factors which influence whether someone becomes addicted. They include [2]:
Biology
About half of a person’s risk of developing an addiction are related to the genes they are born with. Gender, ethnicity and the presence of other mental health conditions also play a role.
Environment
There are many environmental factors from family and friends to economic status and general quality of life. Factors such as peer pressure, physical and sexual abuse, early exposure to drugs, stress and parental guidance affect the likelihood of developing an addiction.
Development
Genetic and environmental factors interact with important developmental stages to affect addiction risk. The earlier drug use begins, the more likely it will progress to addiction. This is especially important for teens as key areas of their brains are still developing, making them particularly prone to risky behaviors, including trying drugs.
Substance Addiction vs Behavioral Addictions
The following table illustrates the main similarities and differences between the two forms of addiction [3].
| Observation | Substance Addiction | Behavioral Addiction |
| Addiction | To substances | To behaviors or feelings |
| Types of addiction | Alcohol, Bath Salts, Cannabis, Cocaine, GMB, Hallucinogens, Heroin, Fentanyl, K2 (Spice), Ketamine, Khat, Kratom, LSD, Methamphetamines, Mescaline, MDMA (Ecstasy/Molly), Nicotine, OTC Medicines, :PCP (Angel Dust), Prescription Opioids (Oxy/Percs), Prescription Stimulants (Speed), Roypnol, Steroids, | Gambling, Chatting, Eating, Exercising, Having Sex, Pornography, Shopping, Shoplifting, Video Gaming, Working |
| Physical signs of substance addiction | Yes | No |
| Hijack brain’s reward system | Yes | Yes |
| Create euphoria | Yes | Yes |
| Activate brain’s reward pathways a network linked to motivation & pleasure | Yes | Yes |
| Changes in neurotransmitters dopamine & serotonin, responsible for regulating mood, impulse control, reward processing | Yes | Yes |
| Can lead to persistent changes in brain structure & functions | Yes | Yes |
| Withdrawal symptoms | Yes | Less likely |
| Visible signs of addiction | Yes | Easily masked |
| Prior Mental health conditions | Possibly: Depression, anxiety, trauma | Frequently: Depression, social anxiety, lack of social support, substance abuse, obsessive tendencies |
| Effects on physical health | Severe | Mild (e.g. fatigue) |
When To Seek Professional Help
Here are some signs that you may need professional help for your addiction:
- Causing harm: If you are causing harm to yourself or others it’s time to seek treatment. Promiscuity, driving under the influence, losing your poker stakes frequently, binge eating all may be signs that your senses are impaired as is your faculties of judgment. Physical symptoms like indigestion or bloodshot eyes may also be signs you need help.
- Unable to quit on your own: If you have repeatedly tried to quit, but just can’t, it’s time to seek help. Due to brain changes with addiction, it can be very challenging to quit. There’s no fault in that but acknowledging your limits is an important first step to get help.
- If you have severe consequences from your addiction: If your addiction is impacting other areas of your life it’s time to seek help. This might be showing up intoxicated at work or school or failing to show up at all which carry severe consequences such as suspension or loss of your job. Or being unable to perform your responsibilities as a caretaker of your children or even the end of a relationship or marriage.
- Your life revolves around your addiction: A telltale sign you need help is if you aren’t able to live your life without substance use or doing the addictive behavior constantly on your mind. Often your friend group changes and consists only of people involved with substances or addictive behaviors.
Rehab For Professionals in Los Angeles
If you or a loved one is seeking a way out of substance abuse, private, confidential help is just a call away. Reach out to our Admissions team at The Encino now.
At the Encino Recovery & Detox Center in Los Angeles we don’t just treat addiction. We nurture the spirit, heal the mind and help you and your spouse or partner to regain your life. All in a safe space. Rehab for professionals will help you understand the root of addiction and the role it plays in your relationship.
We provide medically supervised detox. After detoxing, you may enter our residential treatment center. Trained staff are equipped to offer clinical care. They will provide the support, guidance and interventions necessary for you to reach your treatment goals. Participating in residential care greatly enhances your success rate at avoiding relapses.
Sources
[1] National Institute on Alcohol Abuse and Alcoholism. 2021. The Cycle of Alcohol Addiction.
[2] NIDA. 2018, June 6. Understanding Drug Use and Addiction DrugFacts.
[3 ] Alavi SS et al. 2012. Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views. Int J Prev Med. 2012 Apr;3(4):290-4
