LET’S TALK ABOUT ADDICTION


Addiction is a neurobiological condition that results when a person ingests a substance (e.g. alcohol, nicotine, heroin) or engages in an activity (e.g. gambling) which exerts a long and powerful influence on the brain that manifests in three distinct ways: craving for the object of addiction, loss of control over its use, and continuing involvement with it despite adverse consequences.

Addiction is a type of disability, like any other physical or cognitive impairment. However, with the proper treatment, many individuals can overcome their addiction. There is no reason to be judgmental or discriminatory against individuals in recovery, but rather complimentary and supportive of their recovery efforts. Most importantly, recovering addicts are a protected class under the Americans with Disabilities Act (“ADA”).

Contrary to common belief, addiction and chemical dependency are not the same, although both may be present in the same individual. While dependency is a normal physiological response to the repeated use of a substance, addiction is characterized by a loss of control, where one compulsively uses a substance despite life-threatening consequences. The best example is coffee. Millions are chemically dependent on it, but it does not necessarily result in a life-threatening condition.


THE BRAIN'S REWARD SYSTEM


The brain registers all pleasures in the same way, whether they originate from a psychoactive drug, a monetary reward, an exhilarating experience, or a satisfying meal. In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens –a cluster of nerve cells lying underneath the cerebral cortex. Dopamine release in the nucleus accumbens is so consistently tied with pleasure that neuroscientists refer to the region as the brain’s reward center.

All abused drugs cause a particularly powerful surge of dopamine in the nucleus accumbens. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release.

Addictive drugs provide a shortcut to the brain’s reward system by flooding the nucleus accumbens with dopamine. The hippocampus lays down memories of this rapid sense of satisfaction, and the amygdala creates a conditioned response to certain related stimuli.

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THE COST OF ADDICTION


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Drug abuse costs the United States economy hundreds of billions of dollars in increased health care costs, crime and lost productivity. The total costs of drug abuse/addiction due to use of tobacco, alcohol, and illegal drugs are estimated at $559 billion per year. Illicit drug use alone accounts for $181 billion in health care, productivity loss, crime, incarceration and drug enforcement.

To put the cost of addiction into perspective:

  • The economic burden in the United States for addiction is twice that of any other disease affecting the brain, including Parkinson’s and Alzheimer’ Disease, as well as all the others.

  • 14% of patients admitted to hospitals have alcohol/drug abuse and addiction disorders.

  • 20% of all Medicaid hospital costs and nearly $1 of every $4 Medicare spend on inpatient care is associated with substance abuse.

  • 70% of individuals in state prisons and jails have used illegal drugs regularly. Drug offenders account for more than one-third of the growth in state prison population and more than 80% of the increase in the number of prison inmates since 1985.