Various theories exist to explain how and why people become addicted to substances. Although there is still much to learn, research has revolutionized our understanding of this phenomenon. This unit examines differing models of addiction and addresses the mechanisms of action of substances in the body.
Drug addiction is a complex illness. Considering that drug addiction, including alcoholism, begins with initial mood-altering experiences that occur when ingesting the substance, the progression to dependence is influenced by a host of factors that are combinations of biology, psychology, and social influences. While opinions vary regarding the exact causes of substance abuse and addiction, there is agreement on the negative effect that unrestrained substance dependence has on health, safety, and well-being (Stevens and Smith, 2001).
Drug addiction starts in the brain, when the drug alters chemical neurotransmission—the process by which brain neurons communicate with one another. Different drugs take hold of the neurotransmission process in different ways. Here are a few examples of how certain drugs affect the normal neuronal process of the brain:
Methamphetamine causes neurotransmitters to be released, oftentimes in greater amounts than what is considered normal.
• PCP prevents neuronal messages from reaching their destination within the brain.
• Cocaine interferes with the molecules that send neurotransmitters back into the neurons that released them.
• Heroin and LSD mimic the effects of the natural neurotransmitter.
When a substance is ingested, the effect on the brain is usually short-lived. But when the substance is ingested regularly, and the substance abuse becomes a part of an individual’s habits, the brain begins to change how it operates. The change in brain function moves the casual drug abuser into the next phase—drug addict. The pathological change in the brain is a crucial component in this change.
Although it is not possible to predict who will develop problems with substances and under what circumstances, it is a general belief that serious problems develop when people become dependent on alcohol, tobacco, and illicit drugs. The process of becoming dependent is complex and is related to a number of factors, including:
• The addictive properties of the substance.
• Family and peer influences.
• Cultural and social factors.
• Existing psychiatric disorders.
The AA model and psychotherapies recognize the role of comorbidity and dual diagnosis with substance abuse and mood disorders in treatment considerations for improved outcome. Genetics also plays a recognized role in explaining individual susceptibility to substance abuse and addiction.
Although addiction is becoming more recognized as a medical condition, there is no consensus as to whether it is a true disease. As noted, a variety of factors, both environmental and social, activate what may be a predisposition toward addiction. Subsequently, various models of addiction continue to exist to explain the complex nature of addiction. In the meantime, research continues to seek a better understanding as to why and how people become addicted.
Kranzler, H. R., & Rosenthal, R. N. (2003). Dual diagnosis: Alcoholism and co-morbid psychiatric disorders. The American Journal on Addictions, 12, S26–S40.
Stevens, P., & Smith, R. L. (2001). Substance abuse counseling: Theory and practice (2nd ed.). Upper Saddle River, NJ: Merrill Prentice Hall.
Zickler, P. (1999). Treating mood disorders in drug abuse patients yields improvement in both conditions. NIDA Notes, 13(6).
To successfully complete this learning unit, you will be expected to:
1. Describe leading theories as to why people use drugs and become addicted.
2. Describe the mechanisms of action of abused substances in the body.
3. Differentiate between the various models of addiction, including solution-focused and motivational therapies
• Use your Concepts of Chemical Dependency textbook to complete the following:
• Read Chapter 25, “The Biopsychosocial Model of the Addictions,” pages 359–389 This chapter discusses models of addiction and their limitations.
• Read Chapter 3, “A Brief Introduction to the Science of Pharmacology,” pages 16–29. This chapter discusses key pharmalogical concepts.
Visit and explore the National Institute on Drug Abuse (NIDA) Web site in preparation for an upcoming discussion.
Optional – Readings
You may choose to read the Galaif and Sussman (1995) article, “For Whom Does Alcoholics Anonymous Work?” from The International Journal of the Addictions, volume 30, pages 161–184.
Discussion 1: 1 page needed with minimum of 250 words and 2 references.
How Drugs Affect the Brain
National Institute on Drug Abuse (NIDA).
Base your response to this discussion on Chapter 3 in the Doweiko text and the NIDA Web site. Follow these steps:
1. Review and provide a description of at least three publications or presentations that describe the effects of drugs on the brain.
2. Briefly describe the effects of drugs on the central nervous system (CNS).
3. Indicate how the publications you reviewed are similar and different.
4. Assess them for clarity and ease in communicating scientific concepts.
5. Indicate how these resources may be useful to you in your professional work with clients.
Discussion 2: 1 page needed with minimum of 250 words and 2 references.
The Definition of Addiction
The text covers many perspectives within the Biopsychosocial Model of Addictions in Chapter 25, providing both the supporting rationale and the limitations of each subpart of the model to explain addiction. Select one of the three parts (biological, psychological or social). Present how an explanation of addiction based solely on that part may be misleading to the public. Explain how a more complex explanation that considers more than one part of the biopsychosocial model could help guide treatment and public policy more effectively. Cite applicable sources.