Addiction is a Brain Disease and Not a Personal Failing

Brain images from functional magnetic resonance imaging (fMRI) clearly show that the brain with addiction has a very different response to drug and alcohol stimuli than one without addiction. Most addiction scientists believe that an addicted brain has actually been altered by the substance.

Not everyone who uses substances becomes addicted to the substance. Scientists have not yet identified the exact reasons why some people become addicted. They instead refer to the risk factors that increase the likelihood of substance use turning into an addiction. The factors include:

• Age of first use. The earlier a person begins drug or alcohol use the greater the risk of addiction. For example, a person who starts drinking alcohol at 14 has a seven times greater chance of developing an addiction versus a person who starts at 21.
• The presence of mental health issues such as anxiety, depression, ADHD, or trauma.
• An environment with permissive or heavy substance use.
• Up to 60% of the risk is believed to be genetic.

It’s clear that my family has a strong genetic pre-disposition. My older brother once said to me: “The first drink I ever had felt like the greatest moment of my entire life. I had always felt unhappy and insignificant. But, for the first time in my life, I felt like King Kong.” At thirteen, my brother had had an unimaginable high that he chased for the next six-years. That chase nearly killed him many times.

Imagine feeling so small and insignificant and then, all of a sudden, feeling supremely powerful. Imagine your brain creating an otherworldly high. There is little doubt in my mind, that Stevie had a similar reaction to alcohol as my brother. He felt depressed, he felt inadequate relative to his older siblings, and he felt significant social anxiety. Drinking made all of his problems go away. Temporarily.

He was the ringleader among his friends. At sixteen, he could see no other way of living.

Now, imagine his parents telling him that he was done drinking, forever. FOR-EVER!

To him, we were insane. Everybody drinks. His parents drink. His siblings drink. His friends all drink. He lashed out at us and our rules. Not only did he think that we were extreme outliers relative to much of the world, but, in his mind, we were also cutting off his only relief from depression, his feelings of inadequacy, and his social anxiety. At one point he said to me: “I will never find a girlfriend if I cannot drink.” To him, we had become the worst parents in the world.

Today, science tells us that the chase for that “incredible high”, the chase for relief, can become a vicious negative cycle. As a person uses drugs or alcohol, their tolerance to the substance increases requiring more and more of the substance to get the desired effects. When the high is gone, the person loses the temporary “relief” and returns to feeling bad again creating the desire to use again. The brain prioritizes getting and using the substance to reduce feeling terrible. At the same time, it crowds out or diminishes the positive effects of other possible means of relief, other more-healthy approaches. In very active addiction, the brain can think of little else but finding ways to get and use the substance. It becomes an obsession. A destructive negative spiral.

My son’s obsession makes sense. He desperately needed relief. But alcohol was a diabolical false choice. His altered brain was telling him that the very thing that was threatening to kill him was his best answer.

Does my son’s drinking sound like a personal or moral failing? Does he sound like a bad kid? Or does his drinking sound like his brain had been hijacked by a powerful substance?