Is Drug Addiction a Mental Illness?

In today’s society, addiction is widely accepted as a disease by several major scientific organizations and associations. For example, the American Psychiatric Association (APA) and the National Institute on Drug Abuse (NIDA) both consider addiction as a “brain disease.” On the other hand, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) formally outline specific criteria to help physicians diagnose addiction as a mental health condition, known as substance use disorder. As a result, it’s safe to say that addiction can be considered a mental illness.

According to NIDA, drug addiction is a mental illness that changes a person’s normal behaviors, causing problems at work, school, and within their personal relationships. With more than 20 million Americans struggling with substance use disorder, addiction is one of the biggest mental health issues that the nation is currently facing. Not only that, but nearly 50% of the people with substance use disorder also suffer from a co-occurring mental illness, making the treatment for addiction that much more difficult.[1]

The Stigma Behind Drug Addiction: Choice vs. Disease

Scientists who began studying addictive behaviors in the 1930s blamed addictions on people who were morally flawed and lacking in sufficient willpower. These views then shaped the way future generations viewed drug addicts – as people who were making a bad choice. As a result, early drug abuse interventions involved punishment rather than treatment.

Fortunately, modern science and advancing research have begun to broaden society’s view of drug and alcohol addiction. By discovering how drugs change the brain, what makes certain drugs so addictive, and why some people abuse drugs and get addicted (while others don’t) have helped people view addiction as a mental illness rather than a moral failing. Not only does this research help destigmatize drug addiction, but it also helps people become more willing to seek treatment and provides counselors with a better understanding of how to treat their patients.

How Drug Addiction Changes the Brain

People abuse drugs for two primary reasons:

1. To feel the effects of the drug taken
2. To mask, reduce, or stop feeling unpleasant emotions

Drugs change the way people feel by stimulating the brain’s reward system, which plays a critical role in learning. When the reward system is stimulated by drugs or alcohol, it releases a flood of dopamine – the chemical responsible for feelings of pleasure and motivation. When these systems are impacted by prolonged drug abuse, extreme changes take place.

First, the brain becomes accustomed to having extra dopamine, so the brain stops producing sufficient dopamine without the help of a substance. Then, the brain sends signals to the body that it needs more dopamine – it needs more of the substance to feel good. The body reacts in various ways. Some people may experience withdrawal symptoms while others only experience cravings. Either way, this response often drives people to use the substance again in order to satisfy the brain. When the brain gets the reward it wants, this behavior becomes further ingrained into the person’s physiological needs.

To explain further, when someone uses a drug to mask an emotion or underlying mental illness, this is referred to as “self-medicating.” Taking something might mask these emotions by producing euphoria, but the brain sees this unhealthy behavior as a reward. As continued drug abuse occurs, a person builds up tolerance and their brain is further affected by drugs. Ultimately, this leads to compulsive and uncontrollable urges to keep using despite the consequences.

While a person may choose to use drugs in the first place, the chemical changes that occur in the brain and the involuntary desires that develop in the mind make addiction far more complex than a choice. As a result, drug addiction is widely accepted as a treatable mental illness.

Risk Factors for Drug Addiction

Even though it is evident that long-term substance abuse leads to chemical and functional changes in the brain, some still argue that drug addiction is a choice rather than a mental illness. However, experts argue that several risk factors have been identified that increase a person’s risk of developing a substance use disorder. Some of these risk factors include:[2]

• Environmental factors, such as childhood trauma, peer pressure, or growing up in a low-income neighborhood
• Genetic factors because children of alcoholics and addicts are more likely to use drugs as they get older
• Other factors such as exposure to trauma, abuse, or mental illness/dual diagnosis
• Experimenting with drugs and/or alcohol at an early age

Since there are risk factors and underlying causes of drug addiction, experts have further reasoning to consider drug addiction as a mental illness.

Drug Addiction as a Mental Illness: Diagnosing Substance Use Disorder

Like other mental health conditions, the diagnostic criteria for substance use disorder are laid out in the DSM-V. The DSM-V is the American Psychiatric Association’s latest guidelines outlining the names, symptoms, and features of every mental illness. The 11 different criteria used to formally diagnose substance use disorder are as follows.[3]

1. Taking the drug in greater amounts or for longer lengths of time than intended.
2. Having a desire to stop using or cut back the amount used but being unable to do so.
3. Spending excess time obtaining, using, and recovering from the effects of the substance.
4. Experiencing strong cravings or urges to use the substance.
5. Failing to complete schoolwork or job obligations due to substance abuse.
6. Continuing to use drugs even if it causes problems in relationships.
7. Abandoning social or recreational activities in the wake of substance abuse.
8. Using drugs compulsively despite negative consequences.
9. Continuing to use drugs even when they are making a physical or psychological problem worse.
10. Developing a tolerance on a substance.
11. Experiencing withdrawals when not taking the substance.

Like other mental health conditions, people experience addiction differently and at different severities. People who experience 2-3 symptoms over a one year period of time are said to have a mild substance use disorder, while people who experience 4-5 symptoms are considered moderate and 6 or more symptoms indicate a severe substance use disorder.

Do You Need Help With Drug Addiction?

If you are suffering from drug addiction, know that you’re not a bad person. Drug addiction is an illness that requires treatment. Even better, with the right treatment, you’ll be able to get to the underlying causes of your substance abuse, overcome your drug problem, and begin living a happier, healthier life. The first step is to pick up the phone and ask for help. So, what are you waiting for? Contact us today to get connected with the most skilled mental health and addiction specialists in the nation.

References:

1. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preface
2. https://www.healthline.com/health/addiction/risk-factors#age
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767415/