What is Addiction?: Signs, Risk Factors, and Treatment

A substance addiction, or substance use disorder, is a chronic, relapsing condition characterized by compulsive drug or alcohol use despite negative consequences. Someone with an addiction may struggle to control or reduce their use and may experience impairment in many areas of their life, such as work, school, relationships, and mental and physical health.

What is Addiction?

The term “addiction” refers to a chronic brain disorder that causes significant changes to brain chemistry and functioning. Many of these neuronal changes last well past someone has stopped drinking or using drugs. Drug or alcohol addiction has many different genetic, environmental, and psychological influences that interact with one another to lead to the development of a substance use disorder.1

Substance addiction is a progressive condition, which means it tends to worsen with time. As such, the sooner you seek treatment, the better. Treatment can help prevent serious health risks, including life-threatening consequences like overdose.

How Does an Addiction Affect Your Brain?

Your brain has something called a reward circuit, and a neurotransmitter called dopamine lies at the center of this circuit. Addiction occurs when you chronically use a substance that increases the release of dopamine in the brain. When dopamine is released, you feel a sense of pleasure. At the same time, some negative feelings, like stress, will be dulled by dopamine. Continued use of the addictive substance can eventually impair the reward circuit’s capacity, causing:2

  • A decreased response to rewards that are not drug-related, such as food
  • Less motivation for actions that are not drug use
  • An increased sensitivity in the emotional stress circuits of the brain
  • An impaired ability to self regulate

This impairment of the reward circuit happens because your brain develops a reduced sensitivity to non-drug rewards, which then produces a lack of interest in non-drug-related activities that you used to enjoy, such as playing a sport or creating art. The result is addiction and a compulsive need to seek and use the substance despite the harm it brings to you and even when you have a strong desire to quit.2

What are the Signs of an Addiction?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes the criteria for a substance use disorder, or addiction. The signs and symptoms of an addiction include:3

  • Using substances for longer or more frequently than intended
  • Failing to cut down or control substance use despite efforts to do so
  • Spending a great deal of time obtaining and using the substance, as well as recovering from its effects
  • Experiencing strong cravings
  • Experiencing social or interpersonal problems caused by substance use
  • Continuing to use substances despite the physical and psychological problems cause by use
  • Continuing to use substances despite failing to meet obligations at work, school, or home
  • Prioritizing substance use over previously enjoyed hobbies or activities
  • Using substances in hazardous situations, such as while driving
  • Needing higher amounts of the substance to experience the desired effects (tolerance)
  • Experiencing withdrawal symptoms when you stop or reduce use (dependence)

A mild addiction may be characterized by two or three symptoms, while four to five symptoms may indicate a moderate addiction. And you may be struggling with a severe substance addiction if you present with six or more symptoms.3
If you are ready to make a positive change in your life and seek treatment, give us a call at 888-647-0051 (Who Answers?) . We are here to help you find the right rehab for you.

What Causes a Drug or Alcohol Addiction?

Many factors contribute to you having an alcohol or drug addiction. You may begin using a substance in order to feel good, to relieve stress, to perform better at a job or sport, or simply out of curiosity or social pressures. The risk that your initial use could turn into addiction may be higher due to some factors.

Biological Factors

Scientists estimate that your genetics account for between 40% and 60% of your risk of addiction.1 If you have a history of substance misuse in your family, this may point to a genetic trait that raises your likelihood. Along with genetics, your stage of development, gender, and ethnicity also play a factor in your risk level. If you have a mental disorder, you are at greater risk of drug use and addiction than others.1

Environmental Factors

Your family environment, school, neighborhood, and social settings all contribute to a potential substance use disorder. Environmental factors that can increase a person’s risk include the following:1

  • Parents or older family members in your home who misuse drugs or alcohol
  • Peer pressure from a social group to try a substance
  • Struggling with schoolwork or having poor social skills
  • Beginning substance use at an early age, which can have a negative effect on your developing brain
  • Experiencing physical or sexual abuse
  • Smoking a drug or injecting it into a vein increases its addictive potential

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Which Substances are the Most Addictive?

Some of the substances found to be the most addictive include opioids, nicotine, cocaine, alcohol, and methamphetamine.


The opioid class includes heroin and prescription opioids like oxycodone, hydrocodone, and fentanyl. Opioids are among the most addictive substances in existence. Heroin is frequently injected, which results in an intense and immediate euphoric rush. This pleasurable high makes people want to continue using it to achieve the same effects.

Prescription opioids are extremely addictive as well, though they are commonly prescribed by doctors. Many people divert and misuse prescription opioids to get high, which can quickly progress to opioid addiction due to the rapid development of tolerance and physiological dependence. Heroin and prescription opioids are chemically similar and cause similar effects, which is why many people who begin misusing prescription opioids may transition to heroin use since it is cheaper and often easier to get.4,5


Nicotine is a highly addictive substance found in cigarettes. Like all addictive substances, nicotine interacts with the dopamine receptors in the brain. Part of what makes this substance so addictive is that the brain gets a dopamine release from nicotine every time you take a puff or inhale from a device that contains nicotine.6 That means if you take 10 or more puffs on 25 cigarettes in a day, you are getting at least 250 dopamine “hits” every day. That repeated dopamine release is what teaches the brain that you should continue using nicotine—ultimately resulting in addiction.6


As expected, dopamine also plays a role in the addictive nature of another drug, cocaine. Typically, dopamine will recycle back into the cell that released it, which shuts off the signal between nerve cells.7 Cocaine actually blocks dopamine from this recycling process, which causes large amounts of the chemical to build up in between nerve cells and inhibits normal communication in the brain.7 This is called a flood of dopamine in your brain, and the feelings will strongly reinforce taking more cocaine to experience that intense rush of pleasure, ultimately resulting in cocaine addiction.


Alcohol addiction is the most common type of addiction in the U.S., so it’s easy to see just how addictive this substance is.8

Alcohol, like all other addictive drugs, affects the brain and causes positive feelings, like relaxation and euphoria. While drinking provides temporary relief from stress and emotional discomfort, research shows that it actually enhances negative emotional states between the instances of drinking over time.9 This can create a cycle in which you drink to cope with negative feelings more often as the feelings increase between drinks.


Methamphetamine or meth is an extremely addictive stimulant drug that is frequently used in a “binge and crash” pattern, which means people use it repeatedly in a short period of time. This is due to its powerful but short-lived high. In extreme cases, some individuals may use meth in a “run,” which means they use it repeatedly for several days, forgoing sleep and food. This pattern of use can increase the risk of developing a meth addiction.10

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What are Treatment Options for Alcohol and Drug Addiction?

Although some people are able to quit using drugs or alcohol on their own, many people require professional substance abuse treatment to obtain and maintain sobriety in the long run. Treatment can occur on an inpatient and outpatient basis, with inpatient rehab being the most intensive option and then outpatient having many levels of care, from partial hospitalization to intensive outpatient and standard outpatient. Outpatient offers recovering individuals more flexibility with their schedule although it provides less structure and oversight.

Addiction treatment includes a combination of evidence-based treatment modalities that can help someone quit using substances and live a substance-free life. Various therapies and services often included in a rehab program include:

  • Individual therapy
  • Group counseling
  • Family therapy
  • Drug education
  • Vocational training
  • Addiction treatment medications
  • Peer support groups
  • Alternative or holistic treatments like meditation

Rehab can empower you to change your life in many ways. At a treatment program, you will learn:

  • Healthy coping skills
  • Drug refusal strategies
  • Impulse control and emotional regulation
  • Sober social skills
  • Mindfulness
  • Boundary setting

If you or someone you know has a substance addiction, please call 888-647-0051 (Who Answers?) to speak to a treatment support specialist about recovery options.


  1. National Institute on Drug Abuse. (2020). Drug Misuse and Addiction.
  2. Volkow, N. D., Michaelides, M., Baler, R. (2019). The Neuroscience of Drug Reward and Addiction. Physiological Reviews, 99(4), 2115-2140.
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). https://doi.org/10.1176/appi.books.9780890425596
  4. National Institute on Drug Abuse. (2021). Heroin DrugFacts.
  5. National Institute on Drug Abuse. (2021). Prescription Opioids DrugFacts.
  6. National Institute on Drug Abuse. (2019). Why Is Nicotine So Addictive?
  7. National Institute on Drug Abuse. (2021). Cocaine DrugFacts.
  8. National Institute on Drug Abuse. (n.d.). Alcohol: Key Takeaways.
  9. National Institute on Alcohol Abuse and Alcoholism. (2021). The Cycle of Alcohol Addiction.
  10. National Institute on Drug Abuse. (2019). Methamphetamine DrugFacts.
  11. Centers for Disease Control and Prevention. (2021). Drinking too much alcohol can harm your health..


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