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In this term paper, I will address the disease of drug addiction, a disease that affects the lives of millions of people worldwide. Drug addiction not only destroys those that use the drugs, but also the lives of people close to the addict. I will give you a look at the disease from the biological standpoint, starting with a definition of an addict. In the fellowship of Narcotics Anonymous, an addict is defined as a man or woman whose life is controlled by drugs. Our whole life is centered in drugs in one form or another, the getting, using, and finding ways and means to get more. We lived to use and used to live. We are people in the grip of a continuing and progressive illness whose ends are always the same: Jails, institutions, and death.

Addiction History

Historically, alcohol and drug dependency was viewed as a sin or a disease. In recent decades, it has been thought to be a maladaptive behavior patterns. (I.e., debilitative habits are overlearned ). I believe that it s a combination of all 3: A disease in which people learn to act in immoral ways. A drug is any chemical agent that affects biological function. Some act in the brain, others in organs, and some in several parts of the body at the same time. A psychotropic drug is one that acts in the brain to alter mood, thought process, or behavior. Addictive drugs are defined by the fact that they are self-administered, without medical prescription: repeatedly, compulsively, and even self-destructively. Drugs have been classified into seven different families and each affects a different part of the brain (See table 1) In the past, drug addiction was viewed as a morally reprehensive behavior that addicts could control if only they made the effort. Today, it is argued that drug addictions are in many ways like infectious diseases; some people are infected, but not everyone. There are differing degrees of immunity. Susceptibility depends typically on a complex set of genetic and environmental factors, ethnicity, degree of crowding / lack of sanitation, and primarily new users transmit the behavior to their peers.

What is Addiction?

Millions of Americans have been trapped by a vicious, biologic phenomenon called addiction. No sane person ever started out intending to become an addict, yet millions of our neighbors are either addicted to chemicals today or may have spent years trying to free themselves from this insidious cycle. Addiction is neither bad nor good . Addiction is a complex disease that involves both biology and behavior. This high-low trap involves the relationship between stimulation and sedation. Stimulants and sedatives trap people on a biological roller coaster before they even recognize they are addicted. The roller coaster ride is a good analogy for understanding addiction. Your bravado, which got you on the ride in the first place, quickly vanishes as you go through a succession of terrifying falls, twists, and turns and you may wish to change your mind. However, once the roller coaster ride has begun, you cannot reverse course or leave the car. Drug addiction is not a character flaw or personality disorder. Its more along the lines of a syndrome swinging between sedation and stimulation, up and down, stringing our bodies and minds along on a path for certain destruction.

Drugs are chemicals that trick the brain s control system. This control center is located at the base of the brain and is where people experience pleasure and pain. Your brain is designed to handle fundamental behaviors such as aggression, feeding, and reproduction. When the brain s pleasure centers are stimulated, it sends out powerful signals to repeat the pleasure-producing behaviors. With respect to these behaviors, the brain is very selfish. It wants what it wants and it wants it now! The brain only knows how to say more or no more . The problems with these automatic mechanisms are they don t take into consideration other people s feelings or needs or know the importance of delayed gratification.

Addiction begins when the brain comes into contact with alcohol or other addicting substance. Without this interaction of the reinforcing chemical and the pleasure centers, there is no addiction. People who have never been addicted find the behavior of addicts to be incomprehensible. Why would anyone spend hundreds of dollars a week to smoke a little white rock? Why would someone want to stick a needle in their arm five or six times a day, every day of their life? Why would a person snort cocaine up their nose to the point that It causes irreversible brain damage and completely deteriorates their nasal and sinus passages? Why would a woman or man sell themselves on the street and eat out of garbage cans just so they can get another fix? The book entitled The Selfish Brain compares the drug addict s behavior with the experience of sex. If you take away the pleasurable sensations associated with sex, it is unbelievable that anyone would engage in such bizarre activity. The explanation for these irrational behaviors can be found in feelings, including sensations and emotions. The feelings that are experienced by drug addicts are very powerful. In the end these feelings completely take over the whole self of addicts. This encompasses what we call Total self centeredness It is the very core of our disease. It is the reason why Alcoholics Anonymous has described this disease as Cunning, Baffling, and Powerful .

So Exactly How Does Addiction Work?

Drug addicts fall in love with the good feelings produced by alcohol and other drugs

They mistakenly think they can use alcohol and other drugs without harming themselves or others.

Addicts stop alcohol and other drug use only when something so painful happens to them as a result of their drug use that they conclude they must stop their use to survive. (We call this hitting bottom ).

A brief note about hitting bottom: Every addict or alcoholics bottom differs from one to the next. Some hit bottom after only months of use, wile others go on for years as functional addicts , some die and never recover.

Laboratory experiments with animals have clearly demonstrated how addiction works. Research scientists gave monkeys cocaine only when the monkeys worked hard enough to get it. The monkeys were also given water, food, and opportunities for sex as alternative rewards after long periods of deprivation. The researchers measured how much work the monkeys would do to get each of these rewards, which stimulated the pleasure centers of the monkey s brains. The monkeys worked harder for cocaine than any of the other stimulants, including sex and food. In fact, when the monkeys were allowed to use as much cocaine as they wanted, they used the drug until they died of convulsions and heart failure. The laboratory experiments made it clear that stimulation of the brain s pleasure centers by drugs is far more rewarding and controlling than the natural stimulation of these same mechanisms by food or sex. This is not to say that the power of food or sex should be minimized because both of these stimulants can be very powerful, even overwhelming. However, they pale in comparison to alcohol or drugs.

How Drugs Affect the Brain

How can chemical in smoke transform a person s behavior so dramatically? Why does it become so overwhelmingly important above everything else in a person s life? Addictive drugs work by mimicking or blocking one of the substances that neurons in the brain use to communicate with each other. The substances are called neurotransmitters, which are the key to understanding how addictive drugs become so powerful in affecting the brain. Our bodies make drugs of their own. Neurotransmitters are a chemical substance that is released by neurons to act on other neurons or on muscles or glands. All biologic behavior has a basis in the brain. The hardware consists of a thousand billion neurons interconnected through a very complex network. The neurotransmitters they create and the specialized areas of tissue on which they act. All of this hardware develops according to the genetic blueprints in the DNA of our genes. The software consists of memories, learning and conditioning that reflect our life s experience from birth to death. Behavior is traditionally studied by psychologists and psychiatrists who once viewed addiction as simply not adapting to life s stresses. However, because the brain is a chemical organ, the software and hardware operate through brain chemistry. Therefore, even psychologic disorders must ultimately stem from a chemical imbalance. So it is not a question of psychology versus biology, rather it actually turns out that psychology is biology.

Risk Factors

People are not equally vulnerable to addiction to drugs or alcohol. Genetic and environmental factors heighten vulnerability. People whose parents and other family members are addicts and people who live in environments relatively accepting of alcohol and other drugs are at increased risk of addiction. People who are oriented towards instant gratification, people who are self-centered rather than concerned with the needs of others, people who lack religious or spiritual values, and people who are impulsive and extroverted are all more at risk of addiction.

Risk of addiction includes many other factors as well such as availability of intoxicating substances, gender, age, drug substance being taken, and route of administration of the drug. For example, addiction to drugs is more common among males and among people ages 15 to 30.Genetic predisposition to drug addiction is; real, important, and is at a high rate of study by some of the world s top research scientists.

Experiments show that some strains of dogs, rats, and other mammals are more likely to drink alcohol than other strains of the same species. This vulnerability in animal strains is passed to offspring without regard to life expectancies. Human studies have shown that the risk of becoming alcoholic is about 15% for the daughters of alcoholics and about 30% for the sons of alcoholics. Studies also show that genetics is not the only factor influencing addiction. The majority of children of alcoholics and addicts do not become addicted themselves. Many addicts do not have families that are addicted to drugs. What actually is inherited or passed from one generation to the next is the predisposition to addiction, not the physical addiction itself.

Development of addiction requires many other forces including those that are environmental and experience related. The Actual substance being used also figures into the picture. Cocaine and heroin are much more likely to produce addiction than alcohol, if the level of use is the same, along with genetic predisposition and social tolerance as factors. Alcohol is much more widely accepted because it s legal. (Note: In Narcotics Anonymous, no distinction is made between alcohol and other addictive drugs. Alcohol is a drug. We make no distinction because in NA we are trying to recover from the disease of addiction and not the symptoms of a particular substance.) In Narcotics Anonymous, we view the disease as three-fold: physical, mental and spiritual. The mental aspect of the disease is the obsession or constant thought of using drugs. The physical aspect of the disease is the compulsion; once you start using, you cannot stop. The spiritual aspect of the disease is the total self-centeredness: doing whatever you need to do; (lying, cheating, stealing, manipulating, self-degradation) in order to get another high or fix .

The misery suffered by addicts and their families is incalculable. The costs to society are also enormous due to loss of productivity, additional costs for medical care, the dangers of drug- induced behaviors, and the burden on the criminal justice system.

If we set aside political bombast, media sensationalism, and ill-informed calls for quick fixes, we can try, calmly to examine what the various scientific disciplines can teach us about addictive drugs and addictive behavior.


Alas, with everything said about this terrible disease, there is hope for those afflicted. The addict reaches a point where he can no longer continue using because of physical, mental, and spiritual pain. When they are finally beaten, they become willing. Recovery is a process, not an event. The process may begin with an event such as entering a treatment center or detoxification clinic. Many people recover from addiction without expert help; others require extensive professional assistance. Because there is so much of a variety of examples of ways that have worked for others, anyone with the desire can get help. First, the person must admit they have a problem and they need help. The two key steps of importance for anyone wanting help are abstinence and desire to change.

Unfortunately, our disease makes us deny our addiction. This is the only disease known to man that will tell you you re not an addict, you could stop if you really wanted to. The disease never sleeps and is always waiting for the recovering addict to let his guard down. Vigilance and awareness are most important to recovery.

Many of us sought help through medicine, religion, and psychiatry. None of these methods was sufficient for us. Our disease always resurfaced or continued to progress until we sought help from each other through the twelve step programs.

The twelve step fellowships have been proven to be the most effective method for helping people stay clean and sober. Less than ten percent of us have the fortitude to remain clean and change our lives, become productive members of society, and live life on life s terms.

Table 1

Drug Families

Drug type/Product Uses Method of Administration

Nicotine Active principle in tobacco leaf Social/peer acceptance Taken into body by smoking, also absorbed through the membranes of the mouth when chewed or used as snuff.

Alcohol and related drugs Beer, wine, distilled liquors. Also barbiturates and benzodiazepines (e.g.valium) Also included are volatile solvents because their pharmacology is similar Legitimate uses in medicine as anesthesia or for the relief of anxiety or insomnia. Taken by mouth or inhaled to produce intoxication

Opiates Products of opium poppies crude opium, morphine and codeine. Heroin, most popular This family has some medicinal uses such as painkillers/cough and cold syrups. Taken by mouth, injected or snorted. Some can be smoked.

Cocaine and Amphetamines Derived from coca leaf, two chemical forms Some medicinal uses Painkillers and diet pills Hydrochloride salt (powder) snorted, Free base (smoked) Dissolved in water and injected

Cannabis(marijuana, hashish, THC) Limited exception for legal use for treatment of glaucoma and nausea associated with chemotherapy. Generally smoked, may be taken by mouth.

Caffeine Added to soft drinks and some over the counter medications Taken by mouth.

Hallucinogens Naturally occurring and synthetic compounds with same effect Natural magic mushrooms , mescaline (cactus) Synthetic LSD, MDMA (ecstasy), PCP(angel dust) Taken by mouth, liquid forms can be absorbed through skin.


Goldstein, Avram, M.D. Addiction From Biology To Drug Policy W.H Freeman and co. New York

Cohen, Irving A., MD, MPH. Addiction The High-Low Trap Health Press. Santa Fe, NM

Thombs, Dennis L., Ph.D. Introduction To Addictive Behaviors The Guilford Press NY, London

DuPont, Robert L. The Selfish Brain, Learning From Addiction American Psychiatric Press, Inc. Washington DC, London, England

Narcotics Anonymous, Fifth Edition World Service Office, Inc. Van Nuys, CA

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