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When considering what drives addiction, there are many misconceptions. Persons with an addiction are not merely lacking will-power. Instead, they are coping with underlying issues through addictive substances or behaviors, causing long-term changes in the brain that make it difficult to escape the cycle of addiction.
As an addiction counselor, this is something I’ve learned both academically and through experience working with clients using addictive substances or engaging in addictive behaviors.
Addiction is driven by neurological changes related to dopamine, the reward center, and the self-regulatory center in the brain. This produces a learned pattern of coping with underlying pain or unmet needs.
Let’s unpack this statement and make sense of what drives addiction in more specific terms.
The Neurological Drives
Although addiction is often called a disease, recent research finds it is more aligned with the brain’s learning mechanisms. Therefore, addiction is a learned behavior, reinforced by the chronic use of a substance or behavior to stimulate pleasure or provide relief from pain.
For example, imagine you regularly carry a high level of stress or anxiety. When getting home from work, you drink a few alcoholic beverages to relax. Over time, this becomes a habit, requiring more alcohol to gain the same effect.
This is an unconsciously learned behavior because your brain discovers that the use of alcohol solves your current problem. The part of your brain learning this short-term adaptive behavior is distinct from the part of your brain in charge of higher reasoning that would rationally know this is not a long-term solution.
Let’s roughly distinguish between two major parts of the brain: the higher brain and the lower brain. This will be a rough neurological sketch, focusing on the main aspects relevant to addiction.
The higher brain is the rational outer layers developed later in evolutionary history. According to research, the most recent area is the pre-frontal cortex, located around the forehead, which is especially developed in humans. This part of the brain regulates emotions, providing impulse control.
The lower parts of the brain are involved in emotions and motivation. The central part involved in motivation is the Ventral Tegmental Area (VTA). The VTA produces dopamine, sending most of it to the pleasure center (Nucleus Accumbens), providing a reward. These rewards are triggered when you solve a problem, reinforcing this particular behavior. This is how behavior is learned and how we can adapt to new or challenging situations.
This learning mechanism in the lower parts of the brain is focused on short-term gains rather than the long-term planning associated with the higher brain. In any area of life, motivation is produced through dopamine production in the VTA when you successfully complete a novel task. This is particularly powerful when the reward is unexpected, as in the case of gambling.
Although this process occurs primarily outside of the upper brain’s higher-order reasoning, the upper brain then gets consulted after the fact. The reward experienced in the lower brain gets communicated to the upper brain, telling it to make sense of this situation and plan for future scenarios where this behavior may need to be drawn on. For example, your upper brain will rationalize why it’s a good idea to continue using alcohol to cope with stress, in addition to planning for continued drinking.
This is a rough outline of the major neurological forces driving addiction. Beyond brain circuitry, the content of thoughts is also important, so let’s consider the cognitive realm.
The Cognitive Drives
Simply put, cognition means the realm of thoughts. This activity occurs in the upper brain and is highly intertwined with the language centers. In the case of addiction, this can refer to the beliefs one has about oneself or one’s behavior.
For example, as previously mentioned, you may develop reasons why addictive behavior is necessary or beneficial. Perhaps drinking after work each evening is justified by the thought that it makes you a better parent since you are less stressed.
Addictions are often based on illusory ideas about unmet needs. For example, alcohol may promise relaxation, gambling may promise hope, opiates may promise love, and cocaine may promise self-esteem. These false promises are reinforced by the short-term effects of the substance or behavior, blinding you from the long-term consequences. Even when these consequences are recognized, the substance or behavior disguises itself as the savior.
Beyond the illusions and rationalizations that drive addiction, one’s thoughts about oneself are also an underlying driver. For example, many people are driven to addictive substances or behaviors to cope with the anxiety produced by the belief that they are not good enough.
These underlying thoughts regarding one’s self-worth may go back to childhood. Whether or not there was a major traumatic experience, many people internalize thoughts about themselves that were reinforced by others around them.
Growing up with the constant thought of not being good enough may escalate throughout one’s life, especially while taking on further responsibilities in adulthood. This can result in underlying anxiety regarding one’s ability to handle future situations, affecting one’s self-esteem as well.
This cascade of negative thoughts regarding oneself can lead to substances or behaviors as a form of short-term coping. As previously discussed, this short-term relief triggers the brain’s reward pathways, reinforcing a long-term pattern of habitual behavior.
The Interpersonal Drives
The interpersonal realm consists of one’s quality of social connection. As discussed in my article, The Impact of Isolation on Addiction, I shared Bruce Alexander’s famous Rat Park Study. He highlights how addiction is a disease of isolation, where substances are used to cope with isolation, producing even more isolation.
Researchers discovered how rats tended to overdose in the Rat Park Study when provided drugs while alone in a cage. These overdoses no longer occurred when rats were kept in the company of other rats.
Human beings are social creatures and isolation causes us deep emotional pain. Social isolation is an often overlooked health concern and recent research suggests it is as dangerous as smoking.
In a TED Talk, Robert Waldinger emphasizes the dangers of social isolation, stating:
“Loneliness kills. It’s as powerful as smoking or alcoholism.”
Physical health issues receive a great deal of attention, while interpersonal health is often neglected. Luckily, social determinates of health have gained traction in the scientific literature. Recent research looked at the impact of loneliness as a risk factor for mortality and found:
“Current evidence indicates that heightened risk for mortality from a lack of social relationships is greater than obesity.”
Coping with isolation through addictive substances or behavior is one-way social isolation can affect one’s physical health. For example, coming home from a stressful day to an empty home may result in coping through consuming alcohol.
Without addressing the underlying isolation and unmet social needs, one’s physical health may deteriorate as the short-term coping results in long-term harm. This can make it increasingly difficult to meet one’s underlying needs in a healthy way in the long-term.
The neurological, cognitive, and interpersonal processes driving addiction are all intertwined. Although it is possible to analyze addiction on multiple levels, addiction is often experienced as a way to gain relief from an underlying source of pain, whether it’s past trauma, anxious thoughts, depressed moods, or the pain of social isolation.
If you want to learn more about the lived experience of addiction, I’ve written more on the topic in the article, What Does Addiction Feel Like?
If you want to learn more about the psychological factors driving addiction, check out my article, What are the Root Causes of Addiction?