9 Things to Know About Addiction and Substance Abuse

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Mark Bochkis on November 25, 2021
  • child addicted to pills
    There are many misconceptions about addiction. What really happens?
    Millions of Americans live with the inability to control their consumption of alcohol or use of illegal or prescribed drugs. While addiction is widely recognized by medical professionals as a disease, some still view the condition as a failure of character. The stigma attached to substance abuse is why some sufferers don’t seek help. But professional care is often necessary to overcome the effects of addiction. What makes addiction so powerful?
  • Despondent man
    1. Addiction is not a choice.
    One of addiction’s defining characteristics is the inability to stop self-destructive behavior, despite awareness of negative consequences. While it is a personal choice to use alcohol or drugs, if addiction sets in, the problem goes beyond personal responsibility. In the overwhelming majority of cases, willpower alone is not enough to overcome addiction. Like heart disease and diabetes, addiction is a medical condition that results from several contributing factors. And, like other medical conditions, addiction requires a medical approach to treatment. So, why is it so difficult to kick the habit?
  • man with glass of wisky
    2. Substance abuse changes the brain.
    Habit-forming substances cause changes within the brain, destabilizing normal levels of a brain chemical (neurotransmitter) called dopamine. These changes affect the brain’s pleasure center, impacting the way motivation, reward and memory are processed. The altered brain produces intense desires for the addictive substance, overpowering the instinct for moderation. This leads to a cycle of compulsion and loss of control over personal behavior. The good news is even the most persistent cases of addiction can be treated with long-term care, monitoring and support. 
  • hopeful woman
    3. Sustained treatment is best for recovery.
    As anyone who has overcome a substance abuse problem knows, getting to and staying in recovery is not easy. Recovery is a sustained process through which an addiction-afflicted person learns how to live free from the source of addiction. Staying in recovery often requires long-term management through counseling, self-monitoring, and healthy lifestyle choices. The first step is detoxification, or “drying out.” It’s possible to complete this step alone, but it’s safer and more likely to succeed with supervision. It helps to enroll in a treatment program. Effective programs tailor treatment to individual needs, often relying on a mix of medication and mental health counseling.
  • Teenage Couple Taking Drugs At Home
    4. Relapse is common, but it’s part of the recovery process.
    Many individuals return to abusing drugs or alcohol after going through treatment. Research indicates as many as two-thirds of people who start treatment relapse soon after starting a program. Staying clean is hard, but not impossible. A long-term prevention plan can increase the odds of staying in recovery. A good prevention plans teaches how to recognize the early signs of relapse and apply coping mechanisms. Relapse may feel like failure, but it’s actually considered a part of the recovery process. It’s an indication that more, or different, treatment is necessary.
  • Drinking whilst pregnant
    5. Recognize dependency by these physical symptoms.
    So, what does addiction look like? Be on the lookout for dilated pupils, red or bloodshot eyes, repetitive speech patterns, changes in eating habits, unusual body odors, and lack of hygiene. Intense cravings, growing tolerance, and withdrawal reactions (feeling sick without the abused substance) may also be symptoms of dependency. Additional warning signs include: altered sleeping and eating patterns; weight loss; dental problems; and sores on face, arms or legs. Many people also experience anxiety or depression when they attempt to stop using the habit-forming substance.
  • Sad woman isolated from friends
    6. Certain behaviors can also signal dependency.
    Physical symptoms of substance abuse can sometimes be successfully hidden. In fact, some people resort to elaborate means to conceal their problem. However, recognizing the behavioral patterns of addiction can help to unmask a dependency a loved one or friend is attempting to hide. Uncharacteristic aggressiveness or irritability, forgetfulness, diminished interest in past hobbies or activities, isolation, and avoidance of friends and family can all indicate a problem with substance abuse. Getting drunk or high on a regular basis and lying about the frequency of such behavior is a clear warning sign.
  • Group of friends laughing drinking wine outdoors
    7. Some people become addicted, but not others.
    Why is it that some people react differently to alcohol or drugs? Various biological, environmental and developmental factors influence a person’s susceptibility to addiction. Genes inherited from parents and environmental influences (peer pressure, parental guidance, stress) at important developmental stages play a role in the development of addictive behavior. The more risk factors a person has, the higher the odds of addictive influences on behavior. This means a person’s genetic makeup and certain formative experiences influence predisposition to habit-forming behavior and addiction. It also means two people who enjoy alcohol moderately, or relieve pain with the same dose of pain medication, can have completely different responses.
  • Sad woman with consoling friends
    8. Substance abuse is common, and costly.
    The impact of addiction is widespread. More than 40 million Americans were affected by a substance abuse disorder in 2020—many coping with both alcohol and drug abuse simultaneously. Addictive disorders account for more than 5% of the global disease burden, according to the World Health Organization. In addition to individual suffering, societal consequences of dependency include billions of dollars spent on healthcare and legal and criminal justice costs, as well as countless hours of lost workplace productivity.
  • Mother and son in forest having fun
    9. Substance abuse and addiction can be prevented.
    The most effective way to prevent substance abuse is to educate and communicate with children about alcohol, drug and tobacco use. An open and honest relationship with a parent is important, especially for a teenager to feel comfortable sharing stressful experiences, like peer pressure. Setting a good example of how to use alcohol and prescription medications is also helpful. Children of parents with a substance abuse problem are more likely to develop the same problem. The public conversation about alcohol, tobacco and drugs can also influence the behavior of children and teenagers. Hearing a consistent message about the dangers or substance abuse from several sources can help minimize the likelihood of drug use and dependency.    
Drugs & Alcohol | 9 Things to Know About Addiction & Substance Abuse
  1. Understanding Drug Use and Addiction. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
  2. Addiction As A Disease. The National Center on Addiction and Substance Abuse. https://www.centeronaddiction.org/what-addiction/addiction-disease
  3. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf
  4. Can You Prevent Addiction? The National Center on Addiction and Substance Abuse. https://www.centeronaddiction.org/addiction-preventionds
  5. Prevention. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/drug-addiction/basics/prevention/con-20020970
  6. Treatment and drugs. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/drug-addiction/basics/treatment/con-20020970
  7. Recovery. National Institute on Drug Abuse. https://www.drugabuse.gov/related-topics/recovery
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Last Review Date: 2021 Nov 25
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.