In this post, we’ll answer the fundamental question: how does addiction start? We’ll begin with a discussion on just what addiction is—and what it is not. Then we’ll examine the differences between terms you’ve probably heard used interchangeably, such as tolerance, dependence and addiction. We wrap up with a few psychological red flags that can indicate that addiction may be setting in.
Ready? Let’s go.
What is Addiction?
Addiction is an extremely complex condition. It is a brain disease characterized by compulsive substance abuse. A person struggling with addiction will use compulsively despite the fact that this often causes negative consequences.
People struggling with addiction—also known as severe substance abuse disorder—often have strong cravings for and a focus on their drug of choice. This can manifest as anxiety or even panic attacks if their supply is threatened. As we’ll see, these reactions are due in large part to an aspect of addiction known as chemical dependency. Unfortunately, the goal of getting high as often as possible—satisfying intense cravings—can take over the addict’s life.
As you might imagine, this can have devastating consequences on a person’s personal and professional life.
Many drugs are potentially addictive. Here are but a few:
- Opioids, such as codeine and Opioid Pain Medication
- Inhalants, such as paint thinner
- Cocaine and other stimulants
Researchers have conducted brain imaging studies that show how brain function changes once addiction sets in. These disruptions in normal brain function cause marked changes in cognition and behavior. The brain areas affected influence decision making, judgment, memory, learning and impulse control.
Moreover, drug abuse can create changes in brain function that last long after someone stops abusing the drug. In other words, addiction is a chronic condition. Once it manifests, you can learn to remain in control, but addiction itself may never go away fully.
According to the National Institute on Drug Abuse, there are a variety of reasons that people first experiment with drugs. Among these are:
- To feel better or to relieve stress
- To feel good, or to obtain pleasure
- To fit in, or to avoid or alleviate peer pressure
- To perform better
Summary: addiction is a chronic brain condition that develops over time. Once it manifests, the afflicted individual must learn coping mechanisms in order to remain sober because the brain is unlikely to regain normal functioning, even after drug use has stopped. One of the best ways to do this is to seek the help of an accredited in-patient rehabilitation center.
What Addiction is Not
Addiction is not a moral failing brought on by lack of will power or a desire to ‘get high all the time.’ There are complex changes in brain function that occur as addiction takes hold. Moreover, addiction can develop slowly and in such a way that the person doesn’t realize it’s happening until the damage is done.
Yes, they may have chosen to smoke that first joint or that first line of cocaine, but they did not make the conscious decision to become an addict.
In the next section, we’ll take a deeper look at how addiction starts.
From the First Line of Coke to Overdose
For many, drug use starts as a way to relieve stress. They’ve heard—either from others or from media—that drugs provide an easy way to get a burst of temporary happiness. We’ve all been there. Sometimes, being able to push a figurative button and feel good is a tempting proposition.
Many people think that addiction starts with idle curiosity. But there are plenty of folks who try a drug once, experience the high, and then never try drugs again. For these folks, addiction may not a particularly big threat. For others, though, any level of drug experimentation can be dangerous.
Well, researchers aren’t absolutely sure—yet—but genetics appears to play a large role. If you have immediate family members who struggle with substance abuse or alcohol, you may be well advised to avoid experimentation with drugs. Environmental factors, such as growing up under the poverty line or experiencing abuse early on in life can also contribute.
Whatever the root cause of addiction, it’s unlikely that a person’s first drug use was planned. Many people try drugs for the first time at a party, where cocaine, marijuana and other drugs are frequently available. Let’s look at cocaine use briefly.
Someone who tries cocaine for the first time at a party might feel strangely, but pleasantly, energetic. They might find it easier to converse with other people. The drug might make them feel like the life of the party.
For a while.
Then the effects wear off. You feel sluggish, as if the world is suddenly moving in slow motion. This is the brain’s dopamine levels returning to normal. When you ingest cocaine, the compound makes short-term changes to brain function. In short, it hijacks the brain’s reward pathway, making you feel good. But, of course, the effect is only temporary.
But, and this is key, in some people, the desire to get high again is very strong, even after only one use.
These individuals may be at higher risk of developing addiction.
They may find themselves saying, ‘I’ll just try it this one time.’ That then morphs to, ‘I only do it when I’m in a social situation. It’s no big deal.’ As addiction sets in, they find themselves using as often as possible.
Over time, abusing cocaine leads to noticeable changes in brain function and structure. According to this study, long term cocaine abuse actually shrinks the brain. Other hard drugs affect the brain and body in different ways, but whatever the drug, the changes involved are hardly beneficial.
Because illicit drugs are not regulated, dose strength can vary widely from seller to seller. Sadly, this makes overdose all the more likely. If an addict is accustomed to the strength of one seller’s product, and then they switch to another, they may take too much. This is particularly likely if the first seller was cutting their product with baking powder or some other filler to make their own supply go further. But if the second seller is selling pure product, the buyer won’t be prepared for the stronger dose. They’ll take too much, and they may die.
This is one reason addiction to drugs is a dangerous gambit. It’s not that ‘drugs are bad;’ it’s that illicit drugs are dangerous, period.
Tolerance, Dependence & Addiction
These terms are often used interchangeably, but they have distinct meanings and occur at different phases in the addiction process.
When you use a drug that causes a high, like cocaine, heroin or marijuana, the brain must work to bring itself back into balance. This balance is known as homeostasis. When you do drugs, you force your brain to release feel-good chemicals like dopamine, when it would really rather not. The brain does not have an infinite supply of these neurotransmitters.
If you abuse a drug, therefore, the brain will attempt to become resistant to its effects.
The end result is that you will need to take more of a drug in order to get the high you used to get from it. This may be a source of frustration for the casual drug user, but it’s also a warning sign. It’s like a memo from the brain that says, Hey, this is abnormal. I don’t like this.
Summary: tolerance happens when the brain no longer responds to a drug the way it used to.
If you’re chemically dependent on a drug, your brain has come to depend on it for the release of certain neurotransmitters. The brain exhibits plasticity. That is to say, it changes over time, responding to stimulus. If you establish a new pathway in your brain by doing a drug, and then reinforce that pathway with repeated drug use, this will quite literally change how your brain works.
If you’ve become dependent on a substance, you’ll experience withdrawal if you stop using that substance. The severity of the withdrawal symptoms depends largely on the substance. For instance, most people would consider caffeine withdrawal to be much more tolerable than withdrawal from cocaine or opioids.
Summary: dependence is present when you can no longer stop taking a drug without experiencing withdrawal symptoms.
Tolerance and dependence, then, are physiological responses to drug abuse. Addiction, on the other hand, is the disease itself.
We observe a similar effect in type 2 diabetes. Insulin resistance is a physiological response to chronically elevated blood sugar levels. But type 2 diabetes is a disease characterized by insulin resistance and high blood sugar.
In the same way, we can say that addiction is a disease characterized by tolerance and chemical dependence.
How to Tell If You Might Have an Addiction
There’s absolutely nothing wrong with wanting to have fun or to enjoy yourself. In fact, the brain contains a dedicated reward pathway. It’s there to motivate us. When you feel hungry, you seek food. The act of eating is pleasurable, and so the behavior is rewarded and reinforced.
But when an activity—such as doing drugs—begins to have negative consequences, then you might need to take a hard look at the situation. If your drug use has begun to impact your job or school performance, or if you’ve found yourself disengaging from relationships you used to care about, then you may have a problem.
Also consider the fact that, as we discussed previously, drugs activate the brain’s reward pathway artificially. When you smoke a joint or do a line of cocaine, your brain isn’t rewarding you for that. It has no choice but to release dopamine, a feel-good brain chemical. By taking the drug, you are essentially hacking your brain function.
Consult the following to assess your drug use.
How important has the drug become to you? Has it become part of your identity? Is it important to your sense of self? Can you imagine yourself giving it up? Don’t just think about the drug in terms of how often you’re using it. Think about how often you’re not doing things you used to enjoy. Has the drug started to crowd out other hobbies, interests or goals?
Reward & Regret
How do you feel right after you do drugs? Happy? More in control? But how do you feel a few hours later? Do you feel guilty? Are you caught in a cycle of reward, anticipation, use, guilt and dread? Do you feel as if you can’t stop, and do you worry that you’ll depend on the drug for the rest of your life?
Do you find yourself getting high more often than you used to? Or do you find yourself spending more time recovering from the effects of drug use? Do you now binge when before you only did drugs here and there?
Cessation & Resumption
Have you ‘quit’ several times, telling yourself each time that you’re done with the drug and are never using it again? When you give it up, do you feel a sense of relief that lasts for a while and then slowly tapers off, giving way to an almost uncontrollable urge to use?
Has your drug use had a noticeable impact on your school or work performance, or have you lost friendships that were important to you? Are you having money troubles that you weren’t having before you started using drugs? Or have you had a few run ins with the law because of drug use?
When to Seek Help
If you said yes to any of these, it may be time to consider inpatient treatment in an accredited rehabilitation facility. A qualified facility can help you detox in a safe, medically supervised environment.
Detox is unpleasant, but you’ll have to contend with the onset of acute withdrawal symptoms too. For this reason, attempting detox on your own is not safe.
The good news is, once you’re through the detox phase, you can work with addiction counselors who can teach you powerful therapy modalities such as cognitive behavioral therapy. CBT can help you identify triggers and thought distortions that can drive you to use. Hundreds of thousands of addicts have regained control after learning these powerful strategies.
Addiction doesn’t have to control you. But in order to change, you must take the first step today.