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About Addiction / Substance Use Disorder

Addiction is a Chronic Disease

​Addiction /Substance Use Disorder is not a choice, and it’s not due to a of lack of willpower. Addiction is a CHRONIC BRAIN DISEASE — that can be compared to other chronic diseases like diabetes, heart disease, and high blood pressure.  In the case of addiction, the brain is the organ which is impacted.

Chronic diseases often cannot be prevented by vaccines, nor do they just go away on their own. However, with appropriate treatment, often including medication, many chronic diseases can be managed such that their symptoms do not impact a person’s health and functioning. 

A person does not choose to become addicted, the person’s body responds differently when exposed to alcohol and drugs.  It does not make a person flawed or wrong. They just need help, regular care and attention.

Treating Addiction as a Chronic Disease

​”The people that I know who have lost spouses, children, some of them are so ashamed that they wouldn’t even acknowledge it as a cause of death” says A. Thomas McLellan, co-founder of the Treatment Research Institute.


Source: NPR, published February 26, 2016

The Anatomy of Addiction: ​ How Heroin and Opioids Hijack the Brain

O’Connor is one of an estimated 2.5 million Americans addicted to opioids and heroin, according to the National Institute on Drug Abuse. Over three years, he detoxed from prescription painkillers — and heroin — more than 20 times. Each time, he started using it again. So why is it so hard to quit? You can boil it down to two crucial bits of science: the powerful nature of opioids and the neuroscience behind how addiction hijacks the brain.

Source: NPR, published January 11, 2016

What are the risk factors for addiction?

There are many risk factors or indicators of why the disease of addiction may develop. Two main factors that lead to addiction – is when someone starts using substances and biological factors such as hereditary.

  • The research tells us that those who begin to use substances before the age of 15 are 5 times more likely to develop substance use disorder/addiction in adulthood
  • Children of parents with substance use disorder/addiction are 4 times more likely to develop the disease​.

The Science of Addiction

Many people do not understand why or how other people become addicted to drugs. It is often mistakenly assumed that drug users lack moral principles or willpower and that they could stop using drugs simply by choosing to change their behavior. In reality, drug addiction is a complex disease, and quitting takes more than good intentions or a strong will.

​In fact, because drugs change the brain in ways that foster compulsive drug use, quitting is difficult, even for those who are ready to do so. Through scientific advances, we know more about how drugs work in the brain and we also know that drug addiction can be successfully treated to help people affected.

Addiction is considered a brain disease because drugs change the brain—they change its structure and how it works. These brain changes can be long-lasting, and can lead to the harmful behaviors seen in people who abuse drugs. 

Is Continued Drug Use a Voluntary Behavior?

The initial decision to take drugs is typically voluntary. However, with continued use, a person’s ability to exert self-control can become seriously impaired; this impairment in self-control is the hallmark of addiction. Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of addiction.

Understanding setbacks (or relapse)

Comparison of relapse rates between SUD (40-60%), Hypertension (50-70%) and Asthma (50-70%)

A setback (or relapse) means a deterioration in someone’s state of health after an improvement. Setback rates, or how often symptoms recur, for people with addiction are similar to rates for other well-understood chronic medical illnesses such as diabetes, hypertension, and asthma.

Does a setback mean that treatment has failed? 
No. The chronic nature of the disease means that lapsing back to substance use is not only possible, but expected. When this occurs, treatment needs to be reinstated or adjusted or another treatment should be explored.

Source: JAMA, 284:1689-1695, 2000 
Setback rates for people treated for substance use disorders are compared with those for people with hypertension, or asthma. Setbacks are common and similar across these illnesses (as is adherence/non-adherence to medication).

Take the Online Course - Earn CE Credit

Overdose Lifeline has worked with subject matter experts to develop adult training courses and programs addressing the opioid health crisis and addiction / substance use disorder. Available for individual learning and continuing education or as trainer programs that allow an individual to be trained to deliver within their local community(ies). CE credits availble for healthcare and laypersons through Purdue University.

“I never really understood the science behind addiction, but now I feel that I have more understanding and compassion for those who struggle with the disease of addiction.”

For  more information about the Overdose Lifeline online courses and trainer programs, visit our online learning website

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