What is addiction?
by Dr. Gabriella Kőrösi
The American Medical Association put out a brief in November of 2021 about the increase of drug related overdoses during the Pandemic (AMA, 2021). The brief cites over 100 articles addressing this issue. The Harvard School of Public Health News reported that drug overdose deaths hit record high between May 2020-April 2021 to over 100,000 deaths. (Harvard News, 2021)
Substances can be abused in different ways, depending on the type of drug. Substances can be smoked, inhaled, snorted, injected, taped to the skin like Fentanyl, taken orally and rectally. Pills including prescribed opiates and benzodiazepines can be taken orally, or crush up and hard to keep count how many someone had taken when they are suffering from the disease of addiction. A pill might feel like to someone who is addicted that all the pain in the world will go away. Then addiction kicks in and people want one more and one more and one more. Addiction is even harder when the medication is prescribed and the person thinks it is ok just to take one more, soon it will be more than just one extra pill. It will become two, three, even more, then the prescriptions start to run out. The next time the person needs more the doctor might or might not prescribe more. This will create a conflict.
The brain already learned that they would feel better when they take the medicine creating problems with rational decision making as it is outlined by the article published by the NIH last year Drugs, Brains, and Behavior: The Science of Addiction. The brain is affected in the areas of the basal ganglia, the extended amygdala and the prefrontal cortex (NIH, 2020). People in the addiction cycle will do whatever means necessary to numb their pain. They will ask friends, buy off the streets. I was told by many people, the pills become too expensive and heroin or other substances are cheaper and the cycle begins. If this is all someone knows to numb the pain so of course the brain would say just take one more the pain will be better. They think that they will be happier. They will fall asleep and do not feel what is going on in their life. The pain of living and anxiety, previous trauma, difficulty fitting in, mental health problems, stress can feel real to the people experiencing the suffering.
Every day we can see the young and the old throwing their lives away deep into addiction. The shadows on the street that people do not want to see. People in all of the classes are affected; even middle class and higher who have food on the table can become anxious and depressed over things; life is too much to handle for them at the specific time, or they just want to have fun. Prescription drugs don’t help. According to the NIH Misuse of prescription drugs research report prescription misuse can have serious consequences. (NIH, 2020,a). Many people become addicted after acute or chronic illness. It can be anyone at any time. People see medications around them for example in advertisements, movies, shows, the neighbor’s house. Some people want bigger and better even if they do not need bigger and better. There have been researched studies that concluded more money, and more things will not make people be happier people. Lack of community and support, seeking acceptance creates a major missing component in people's lives creating the anxiety and depression that moves them toward substance abuse.
Addiction can also be coupled with mental health problems where people self-medicate because they cannot or not willing to get mental health care, or the side effects of the medications are intolerable to them. It does not help when the doctors start to prescribe benzodiazepines for anxious patients in the long term. Addiction touches many lives and as many of my patients told me opiates are making them feel good. Everyone wants to feel good. There is no harm in the beginning. Many people just feel good, still have jobs, have their family, house it is all good. But then of course those things will be lost if addiction continues. It is a lifelong journey, many had been down that road it is hard to come back, hard to resist and it is an everyday struggle.
It is a true catastrophe; when someone’s mind is being taken over by a substance so that they don’t have a free will of self anymore. Imagine: Fighting continuously between conscious life and unconsciousness. A struggle between the one place that should fight for someone; their brain turning against them and telling them that all they need is some more drugs to feel better. Sounds like so much fun and happiness. Addiction is a constant fight to survive and say no or yes, every day, from hour to hour, minute by minute for the rest of someone’s life. Only the person affected by addiction knows their horror and what they are going through in their disease process. It is not a choice, it happens, then people get stuck in a terrible cycle and cannot get out.
Addiction is a deadly disease. Addiction is a disease that kills and claims lives. In the beginning of 2021 it was reported by the CDC and in the NIH article "Overdose death rates" that in 2019 70,000 lives were lost to overdose.
Drugs can change the way a person thinks acts and lives their life (NIH, 2020). There is so much more to learn about the neurobiology of addiction and any other type of disease. Positive reinforcement can go a long way.
Change to stop addiction takes time and it would come slowly. One action, one support class, one person can make a difference and change something that gives a spark of hope in recovery. It will take time. Dealing with addiction is a difficult journey. Our minds are a wonder with a lot of unknown properties; every little action or seed can make a difference, because every action is stored in our unconscious mind even if we are aware of it or not. This would be the glutamate system in our brain that is keeping our memories (NIH, 2020). Addiction to anything in this world is not a choice that an individual makes for themselves; it is a disease.
Thank you for reading,
AMA (2021) Issue brief. Nation's drug related overdose and death epidemic continues to worsen. Retrieved from https://www.ama-assn.org/system/files/issue-brief-increases-in-opioid-related-overdose.pdf
CDC (2021) Drug overdose deaths. Retrieved from https://www.cdc.gov/drugoverdose/deaths/index.html
Harvard News (2021) Retrieved from https://www.hsph.harvard.edu/news/hsph-in-the-news/drug-overdose-deaths-hit-record-high/
NIH (2020,a) Misuse of prescription dugs. Retrieved from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/overview
NIH (2020) Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain
NIH (2021) Overdose death rates retrieved from https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
This article is an adaptation of the book Our Society: Addiction and More Uncovered- hear the voices from everyday people – a collection of stories and experiences published in by Gabriella Kőrösi in 2020. The story is dedicated to the memory of Bagóczky József my uncle who died at age 19 – alcohol related car accident and to everyone else who has been hurt or lost related to addiction.