What is addiction?

Addiction affects almost everyone. It is estimated that 25 million Americans struggle with their addictions to drugs and alcohol alone. Millions more face addictions to overeating, gambling and other harmful behaviors. Add in their family members, friends, and coworkers and nearly everyone has been touched by addiction in one way or another.

But while almost everyone might have some experience with addiction, many people don’t understand what it actually means to be an addict. Our common cultural understanding is that an addict is someone who can’t stop drinking or using drugs (addict and alcoholic are terms often used interchangeably). Thats a good definition, but it’s not a complete one.

Let’s add to it. 

Contemporary treatment professionals often describe addiction as a bio-psycho-social-spiritual disease. That’s quite a mouthful, but what it means is that addiction has roots in our bodies, minds, communities and spirits—in all aspects of our being. In other words, addiction is complicated.

Part of what makes it so complicated is that people who struggle with addiction don’t react to drugs and alcohol the way everyone else does. A non-addict who goes out for a drink with friends will reach a point when they feel like they’ve had enough. It might be after one drink on a weeknight or three on a weekend, but eventually, they’ll say “okay, I’m done.” Then they’ll go home, go to bed, and go on with their lives. It might be days or weeks or months before they have another drink (or drug). It’s just not that big of a deal to them. 

It’s a much bigger deal to someone who struggles with addiction, in part because they don’t have that off-switch. Their bodies react to drugs and alcohol differently than everyone else. Addicts experience what the book Alcoholics Anonymous originally called an “allergy of the body” or the bio part of bio-psycho-social-spiritual. What this means is that when an addict takes a drink or a drug, they just want more. They don’t ever really reach the point where they feel like they’ve had enough. 

But addiction is in the mind as well as the body. Almost everyone who struggles with addiction has tried to quit drinking and using. They often make a serious and sincere promise not to pick up another drink or drug.

The problem is that when an addict stops drinking or using for any significant length of time, their minds start talking at them. They quickly get to a point where it becomes difficult to think about anything but having a drink or a drug. This is the psycho (psychological) part of the bio-psycho-social-spiritual model, or what Alcoholics Anonymous called “the obsession of the mind”. 

It’s why quitting drugs and alcohol is so hard. If you’re an addict, it doesn’t matter how much you want to stop. Eventually, your own thinking will convince you that you should start up again.

So addicts have minds that are obsessed with drugs and alcohol and bodies that can’t get enough once they start using. But why do they like drugs and alcohol so much in the first place? 

The answer is really simple: because drugs and alcohol make them feel okay. 

Most people feel good when they use drugs and alcohol, but for addicts, it’s something much more profound. Using drugs and alcohol makes someone who suffers from addiction feel like they’re finally comfortable in their own skin, often after a lifetime of feeling the opposite. People don’t use addictively because they feel amazing on drugs, but because they feel normal when they use them. When they’re high or drunk, they feel like life is livable, maybe even beautiful. When they sober up, they feel like it’s hell.

Alcoholics Anonymous called this the “spiritual malady”. What they meant is that an addict is someone who is both cut off from the very spirit of life and acutely aware of how much that hurts. Drugs and alcohol temporarily make them feel connected again—make them feel at peace with themselves and the universe. Is it any wonder that they can’t stop chasing that feeling, no matter the price?

Some of this feeling of disconnect comes from a lack of real community. Many addicts come from families with a long history of alcoholism and addiction, and experienced the consequences of that growing up. People who don’t get the love and kindness from others that everyone needs, whether as children or as adults, are going to be more likely to turn to the quick fix of drugs and alcohol—because in the short term, it works. 

An important note: if you’re addicted to one drug, you can’t use any of them safely. Addiction is about the way your mind and body react to drugs. If you have an addictive reaction to one, you almost certainly will have that reaction to all them, to one degree or another. You might have one drug that’s your favorite, but using a different drug will trigger the same cycle, and eventually lead you back to your favorite drug.

This is heavy stuff, but there is also hope. Recovery groups, including Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous and Refugee Recovery are free, effective and everywhere. Treatment programs, both inpatient and outpatient, are more likely than ever to take insurance. If you’re looking for a good place to start, make an appointment with a therapist who specializes in addiction. They can help you navigate your options.

I’ve personally seen hundreds of people get clean and sober. If you or a loved one is struggling, ask for help. It’s there for you.

Joan Borsten