Addiction is a disorder of an altered cognition

In 2010 Thomas J Gould in his article Addiction and Cognition stated that “From a psychological and neurological perspective, addiction is a disorder of altered cognition”

Let’s understand what is Addiction?

Addiction is a physical or psychological need to do, take or use something, to the point where it becomes harmful for the person OR being addicted to a particular substance or activity, that it takes over their life.

It is defined by a collection of unique characteristics:

• Inability-A chronic inability to abstain from a certain substance or activity
• Control- Loss of Control
• Cravings– Increase cravings for a substance or activity
• Continued use– of a substance, or engagement in an activity despite evident consequences, such as financial ruin, damaged relationships or career loss
• Inappropriate Behavior– When access to substance or activity is removed

Types of Addiction

There are two kinds of Addictions-

• Behavior- Such as Gambling, Eating Disorder, Sex, Internet, Shopping, Work
• Substance- Such as Drugs (Both prescribed & Illegal), Alcohol, Nicotine

Causes Of Addiction

1. Heredity– Having a parent with a history of addiction
2. Environmental Factors– Like Peer Pressure, Poor Parental Supervision, Exposure to substance abuse at a young age
3. Trauma– Severe Trauma or Injury. Psychological trauma, including loss of a loved one or chronic loneliness
4. Mental health– Especially mood disorders such as chronic anxiety and depression

What Happens to the brain with substance abuse?

The brain is made of many parts that works together as a team. Drugs can alter the important parts that are involved in essential cognitive functions, including learning, memory, attention, reasoning, and impulse control. Drugs influence functions that induce cognitive shifts and promote continued drug use

There is a way that the brain communicate through neurotransmitters and drugs physically affects the brain by interfering with this neurotransmitters, especially between the memory and reward areas of the brain.

Nearly all drugs target the brain rewards system directly or indirectly by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in the brain that affects emotions, movements and sensations of pleasure and pain. When activated at normal levels, this system rewards our natural behaviors (like food,sex). Inducing the system with drugs, however, produces euphoric effects, this reaction sets in motion a pattern that compels some people to repeat the behavior or abuse more drugs.

As a person continues to abuse drugs, the brain adjust to the immense flow of dopamine by producing less of its own dopamine or by reducing the number of dopamine receptors in the reward circuit. As a result, there is a decrease in the dopamine’s, reducing the abuser’s ability to enjoy the things that previously brought pleasure. This decrease drives those addicted to keep abusing drugs in an attempt to bring their dopamine function back to normal. And, they may now require larger amounts of the drug than they first did to achieve that initial high—an effect known as tolerance.

Long-term abuse causes changes in other brain chemical systems and circuits as well.

So is Addiction disorder or disease?

There are various thoughts on this, some believe it to be a disorder whereas some believe it to be a disease lead by choice

Addiction does not meet the criteria specified for a core disease. Addiction is self-acquired and is not transmissible, contagious, autoimmune. True diseases worsen if left untreated. A patient with cancer is not cured if locked in a cell, whereas a drug addict is automatically cured. No access to drug means no addiction.

On the other hand, People state that initial use of drug is a choice but later it changes the brain and becomes a chronic diseaese which requires treatment and can’t be healed just by will power.

So, a disorder or disease it does have a lot of complications and does require help.

Complication Of Addiction

1. Health – Addiction leads to mental/emotional as well as physical health problems.
2. Diseases – High chances of diseases like HIV/AIDS or hepatitis if they inject drugs and share needles.
3. Accidental injuries/death – Under the influence of drug/alcohol, there is a higher risk of falling over, or driving dangerously.
4. Child neglect/abuse – the child of an addicted parent, have a traumatic childhood.
5. Unemployment, poverty, and homelessness
6. Coma, unconsciousness or death – Overdose of substance is highly dangerous.
7. Problems with the law – As few drugs are illegal and yet being used, likely to cause imprisonment. The crime rate under the influence of substance increases.
8. Relationship problems – social, family and marital relationships can be severely strained, leading to family breakups, etc.
9. Impairement in Judgement, Decision making, Learning

Prevention Of Addiction

Prevention is the key. The above chart shows that most people start doing Drugs in teenage years. So If teenagers are prevented from experimenting with drugs,  drug addiction can be prevented.

Prevention can be done by

• educating children about harmful effects of substances.
• Through community and social groups.
• Parent supervision

Types Of treatment

The first step of Treatment is Acknowledgement, the person addicted should accept that there is an addiction problem. Once, the person accepts the problem the following treatment as per what suits them can be taken

• Self Help Groups- help the patient meet other people with the same problem, which often boosts motivation.
• Psychotherapy There may be one-to-one (one-on-one) or family sessions with a specialist.
• Addiction treatment programs- It focuses on getting sober and preventing relapses. Depending on the level of addiction, patient behaviors, and type of substance doctor can suggest inpatient or outpatient treatment.

1. Inpatient treatment- this treatment involves staying at a facility and participating in a number of recovery services for a set period of time.
2. Outpatient treatment-  this treatment offers therapy sessions for recovering users a few times per week, depending on the level of care needed.

• Detox– It is a short-term treatment, in this treatment users are closely monitored by medical professionals to ensure a safe and comfortable withdrawal.