Is Addiction a Disease?

Defining Substance Use Disorders (SUDs)

Addiction remains a serious health concern both within the United States and around the world. Research suggests that the U.S. population consumes 80% of the world’s opioids. 

Given that only 5% of the population on earth resides in the United States, this is a significant issue. The statistics suggest that the United States faces a serious addiction problem.

A person with addiction is not “the problem”—they have a problem.

Many people view addiction as a lack of willpower or moral failing.  After all, they reason, why else would one person become addicted when others don’t? This mentality contributes to negative stigmas associated with terms like “addict” or “alcoholic.” 

Unfortunately, this type of thinking dehumanizes those in need of assistance. The reality is that addiction is a complex and progressive disease. Understanding and compassion help break the stigma surrounding the disease, which encourages those suffering from it to seek help. 

A person with addiction is not “the problem”—they have a problem.  Sequoia Behavioral Health has provided this resource page to define substance abuse disorders (SUDs) and clarify common misconceptions regarding them. 

Defining Substance Use Disorders (SUDs)

Addiction, also known as a substance use disorder (SUD), is a defined mental disease. Like many other mental diseases, SUDs can be caused by a combination of behavioral, psychological, environmental, and biological factors. However, genetic risk factors account for nearly half of the likelihood of developing SUDs. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), SUDs occur when:

The recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.” 

Types of Substance Use Disorders (SUDs)

People are diagnosed with a specific type of SUD based on the primary substance that they misuse. These include:

Alcohol Use Disorder

Alcohol is a psychoactive substance that acts as a central nervous system (CNS) depressant. This means that excessive consumption inhibits CNS activity. Overindulgence can result in slurred speech, impaired coordination, and delayed reaction times. 

Binge drinking increases the risk of heart disease, brain and liver damage, and hypertension. Excessive use of alcohol is a leading cause of premature mortality, according to the Centers for Disease Control and Prevention (CDC).

Hallucinogen Use Disorder

Hallucinogens distort perceptions of reality and can cause users to see or experience things that aren’t there. Hallucinogens can be naturally occurring substances such as psilocybin mushrooms, peyote, or mescaline, or chemically synthesized drugs like MDMA/Ecstasy

Negative health effects of hallucinogens include increased heart rate and blood pressure, depression, anxiety, insomnia, kidney failure, and death. 

Marijuana Use Disorder

Marijuana, or cannabis, is a drug containing the psychoactive cannabinoid THC (delta-9-tetrahydrocannabinol) and the non-psychoactive cannabidiol (CBD). Excessive use can lead to problems with memory, learning, perception, motor coordination, and problem solving. Excessive use of cannabis in adolescence increases the risk of mental illness and permanent cognitive difficulty. 

Nicotine Use Disorder

Nicotine is an addictive substance found in tobacco. It is typically smoked through cigarettes, pipes, and cigars. 

Tobacco use is a leading cause of disease and death in the United States. Smoking can lead to cancer, heart disease, and lung disease. It can also damage the lungs and other tissues of unborn babies, and lead to premature birth, low birthweight, and SIDS.

Opioid Use Disorder

Opioids are substances used to relieve pain by blocking pain-receptors in the brain. They include prescription drugs (hydrocodone, oxycodone, codeine, morphine) as well as illegal substances (heroin). 

Opioid misuse can lead to physical dependence, severe respiratory depression, and death

Sedative Use Disorder

Sedatives are a controlled substance due to their potential for misuse. They are used to treat anxiety and sleep disorders and work by slowing down brain activity. 

Sedatives are misused for euphoric effects or for “chemical coping,” where the drugs are used outside of the intended prescription. Misuse can lead to intoxication or withdrawal, both of which can be fatal. 

Stimulant Use Disorder

Stimulants increase alertness, breathing, blood pressure, and heart rate. They include prescriptions (amphetamines) and illegal substances (methamphetamine and cocaine). 

Stimulant misuse can lead to overly elevated body temperature, seizures, heart failure, hostility, and psychosis. 

Polysubstance Use Disorder

Many people diagnosed with SUD misuse more than one substance. This is known as polysubstance use disorder. 

How Does Addiction Affect the Brain?

The feeling of pleasure a drug user might experience is caused by the release of chemicals in the brain, called neurotransmitters. Neurotransmitters reinforce life-sustaining functions by incentivizing a person to repeat behaviors that produce rewarding feelings (i.e. eating, drinking, sex, etc.). 

Most addictive substances cause the brain to release high levels of neurotransmitters associated with pleasure. Over time, the continued release of these chemicals causes a change in the brain systems involved in memory, motivation, and reward. 

The brain tries to return to a balanced state by minimizing its reaction to neurotransmitters or by releasing stress hormones. As a result, a person might use increased amounts of substance to try to feel normal. Over time, this cycle permanently changes the functioning of the brain and body. 

Brain changes can remain even after a person stops using the substance. Researchers believe these changes make people vulnerable to physical and environmental cues, called triggers, that a person associates with substance use. Triggers increase a person’s risk of relapse, even after months or years without substance use. 

Is Addiction a Choice?

Cultural and environmental factors come into play, but the initial decision to use a substance is largely based on free choice.

A person may start drinking alcohol on special occasions, or begin taking prescription medications to deal with illness or pain. However, once the brain has been changed by addiction, that choice becomes impaired. 

People do not choose how or why their brain responds to substances. This response is why people with addiction cannot control their use even when others can.

Choice does not determine whether or not something is a disease. Diabetes, heart disease, and cancer all involve personal choices like diet, exercise, or sun exposure. However, these choices do not guarantee a person will develop diabetes, heart disease, or cancer. Similarly, the use of a substance does not guarantee a person will develop an addiction to it.  

People do not choose how or why their brain responds to substances. This response is why people with addiction cannot control their use even when others can. This isn’t to say that people with SUDs can’t stop using. It's just much harder for them than it is for someone who has not become addicted. 

People with SUDs should not be blamed for their addiction any more than one would blame a person with cancer. While the disease itself is out of the person’s control, addiction is treatable. With the support of others, treatment increases the chances of recovery and survival. 

Is Addiction Chronic?

Addiction is a chronic disease, not a lack of willpower or moral failing. 

Most people who engage in substance use will not develop an addiction. Unfortunately, others will develop a severe and chronic disorder. A chronic disorder is a condition that can be controlled, but not cured.

SUDs are progressive, relapsing diseases that require intensive treatment, continued aftercare, and social support to manage recovery.

The good news is that even the most severe cases of SUDs are manageable with long-term treatment and recovery support. Sequoia Behavioral Health believes that truly effective mental health treatment should be personal, centering, and grounded in evidence. 

We strive to accommodate personal needs through access to community support groups and responsible medication management. Our small and intimate clinic offers a range of options for anyone struggling with substance use and addiction. 

What are the Symptoms of Substance Use Disorders (SUDs)?

For most people, the use of low or infrequent doses of substances is not uncommon. When used according to medical advice, it's unlikely to result in serious negative effects.

However, when substance use starts to have a negative effect on daily life, it could be a sign of addiction/SUDs. 

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines eleven symptoms of SUDs. These include: 

  1. A persistent desire to stop or reduce using the substance and/or continuously trying to do so
  2. Continuing use of the substance while knowing that a physical/psychological health issue is caused or worsened by use
  3. Use of the substance in larger amounts or longer time periods than intended
  4. Withdrawal symptoms when not using (i.e. insomnia, irritability, mood change, depression, anxiety, body aches, cravings, fatigue, hallucinations, or nausea) 
  5. Significant amounts of time spent attempting to obtain the substance, use it, or recover from using
  6. The stop/decrease of social, work-related, or recreational activities due to use
  7. Building up a tolerance to the substance (i.e. larger amounts are required to experience the same effects)
  8. A strong urge to use the substance
  9. Continuing use even when unable to fulfill work, school, or home responsibilities due to use
  10.  Continued use even when it causes or worsens interpersonal problems
  11. Continued use of the substance even in situations that are risky or dangerous

If you or a loved one are experiencing any of the above symptoms, you may be suffering from an SUD. 

How Can I Get Help For Addiction Recovery?

Dealing with addiction alone can feel like fighting a losing battle. It’s overwhelming to feel a loss of control in life, let alone in your mental and physical health. Taking that first step towards recovery can be hard, but we’ll be with you every step after. 

Sequoia Behavioral Health helps people with addiction by addressing the root causes of the problem, rather than just treating the symptoms. We provide comprehensive care that addresses all aspects of a person’s wellbeing, including mental, emotional, physical, and medical care.

Our experienced and compassionate staff work with you to ensure the best treatment and support, no matter how severe the addiction. Contact us today for a free consultation.