Is drug addiction a disease? In what way? Yes, drug addiction is a disease and in every way any other disease would be defined. A disease is a malfunction of the body. This malfunction may have various causes and a wide variety of symptoms, but it’s still a disease. Drug addiction is a disease mainly of the brain. However, other body changes, such as those in the liver, do contribute to its development. Addictive drugs like opioids, amphetamines, alcohol and benzodiazepines cause profound changes in brain function. Over time, these substances modify and derange brain chemistry and function to the point that the brain can no longer function normally without them. If the substance is suddenly withdrawn, the brain scrambles to fix itself. This period of readjustment is perceived by the user in the form of withdrawal symptoms. Some of these symptoms are just painful and unpleasant, such as muscle aches and nausea. Others, such as grand mal seizures, can be fatal.
The problem of addiction starts with tolerance. This means that the user must take higher and higher doses over time to maintain the same effect. Eventually, the user must take very high doses just to feel normal and avoid withdrawal. At this point, the person typically feels few to none of the original subjective pleasant effects of the drug, such as the euphoria associated with opioids. They just don’t feel sick from withdrawal, which could be compared to the normal state of a non-addicted person. Tolerance to some drugs, especially opioids, can escalate to truly astronomical levels. In fact, some opioid users can take doses that would be fatal to someone with no opioid tolerance. All addictive drugs cause changes in brain chemistry, but opioids can cause physical ones, too.
Changes in the Brain
Opioids work by binding to special cell receptors in the brain called mu, delta and kappa receptors. Most of the analgesic and euphoric effects of opioids are associated with the mu receptor. The mu receptor is also most associated with opioid overdose because it recruits a protein called beta-arrestin, which is linked to overdose and death due to suppression of the breathing reflex. When the brain is exposed to opioids regularly over a period of time, it may grow extra opioid receptors. These receptors are not supposed to be there and probably do contribute to opioid withdrawal symptoms in some way.
Opioids also cause the brain to stop producing endorphins. These are the body’s natural opiates. They elevate mood and dampen everyday aches and pains. Without them, depression and pain may occur. This is all part of the opioid withdrawal syndrome. However, all withdrawal symptoms from all addictive drugs are signs of a distressed brain trying to regain normal function. Some withdrawal symptoms may also be caused by the body ridding itself of toxins, too.
The development of tolerance is also partly caused by the liver. It’s this organ’s job to detoxify foreign substances entering the body as best it can. All drugs taken by mouth must go through the liver before entering the bloodstream, although some alcohol is absorbed directly from the stomach. This routing of oral drugs through the liver is called the first-pass effect. It is here that the liver will attempt to destroy a foreign substance. It can’t do this very well at first, so more of the drug will be able to get into the brain. However, over time, the liver develops enzymes to degrade and eliminate the substance. Less and less of the dose will actually make it to the brain as the liver gets better and better at neutralizing it.
Addiction is a Brain Disease
So we see just some of the scientific reasons why drug addiction is a disease like any other. There should not be any stigma attached to a disease, but society often does this, especially with contagious diseases, sexually-transmitted diseases and the brain and body disease caused by addiction. Acceptance takes time. It takes education and patience.
Many people think of drug addiction as a character flaw or a sign of weakness. It is neither. Addiction can happen to anyone with the genetic or environmental tendency for it. Why some people can take addictive drugs and not become addicted and others cannot is yet unknown.
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