Why Can’t Addicts Just Stop?
According to the National Institute on Drug Abuse, “Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her.” If you want to get down to the hard-wired facts, this is absolutely true. Our brains are the control center of every thought, behavior, or emotion and psychoactive substances alter the brain’s normal functions, damage the structures of nerve cells, and cause subsequent responses every time the addict becomes exposed.
Withdrawals, in most cases, are the most compelling conditions that keep addicts using, but, there are many more internal and external factors that can limit their ability to remain abstinent for long despite their best efforts or will to do so. Research has found that there are biological, environmental, social, and a number of other contextual factors that are unique to each individual and for an addict trying to stop using, there is no easy answer as to why they can’t.
Addiction is a Progressive Disease
Study after study shows that the compulsive and uncontrollable use, despite the negative consequences which characterizes addiction, is progressive and chronic in nature. According to The Scripps Research Institute,” From initial, positively reinforcing, pleasurable drug effects, the addictive process progresses over time to being maintained by negatively reinforcing relief from a negative emotional state.”
Like other chronic diseases, such as high blood pressure or diabetes, addiction worsens over time and leaves a residual neural trace that allows for rapid “re-addiction” months, even years, after the last exposure. In many cases, a relapse can be expected within the first 6 months to a year and for most addicts, these perceived failures take a heavy toll on their confidence and motivations to attempt to quit again.
Why is Quitting So Difficult?
People who use drugs become addicted once they develop a physical or psychological dependency as result of repeat exposures. Different drugs cause different effects, but, with any psychoactive substance that has the power to cause euphoria or other rewarding effects, the neurotransmitter, dopamine, is increased. Dopamine is a natural chemical our brains produce to reinforce behaviors that bear repeating such as eating, sleeping, sex, or nurturing our babies and is known to play an important role in regulating brain stress mechanisms that are influential with the tolerance, cravings, withdrawals, and relapse associated with addiction and the ability to stop.
These neuro-adaptations operate independently and in conjunction with conditioned cues or reminders of use to occupy the mind and behaviors of an addict and to minimize the importance of other aspects of their life. The more potent and rewarding a “high” is, the more powerful its effects will be. Consuming drugs via rapid delivery methods allows the chemicals to reach the brain quickly enhancing the power of their effects and subsequently, their addiction potentials. That’s why heroin, cocaine, crack, and meth abusers experience cravings for more from the very beginning because they typically, snort, smoke, or inject the drugs and another reason why these drugs are some of the most difficult to stop using.
With nearly 23 million people in 2013 needing treatment for illicit drug or alcohol abuse according to the most recent National Survey on Drug Use and Health (NSDUH), few ever get the adequate help they need to stop. The more often or frequently an addict consumes a substance is only a part of the many reasons for why addicts just can’t stop. Some people are more vulnerable to addictive behaviors that go on and on for years because of:
- Biological factors including metabolism and brain chemistry (for example; those with attention deficit disorders)
- Genetic or hereditary traits ( Addicts with a substance abusing parent are at a higher risk than others)
- Environmental factors including greater access to drugs and associations with other addicts, lack of social support, socioeconomic status, and culture
- Mental health status (Mental health and addiction often co-exist as one can exacerbate or cause the other)
In every instance, there is a multifaceted combination of risk factors that can make quitting more difficult and without help most addicts will never be able to stop.
Almost every addict gets to the point where they want to stop using the drugs or alcohol they become dependent on and yet, beyond their ability to know why or do so, they just can’t without help to change. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “An individual’s motivation to change can be strongly influenced by family, friends, emotions, and community support. Lack of community support, such as barriers to health care, employment, and public perception of substance abuse, can also affect an individual’s motivation.”
Addiction treatment involves a comprehensive approach to address the multiple needs of an individual, guiding and supporting them as they make the necessary changes in their life to recover. In these programs, an addict can safely and comfortably detox from substances and learn how to identify and avoid problematic areas that would trigger a relapse. Helping the addict to improve their physical, emotional, mental, and social health are key components to recovery and no one can be expected to do this alone.