Addiction in the context of "Existential crisis"

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⭐ Core Definition: Addiction

Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use can alter brain function in synapses similar to natural rewards like food or falling in love in ways that perpetuate craving and weakens self-control for people with pre-existing vulnerabilities. This phenomenon – drugs reshaping brain function – has led to an understanding of addiction as a brain disorder with a complex variety of psychosocial as well as neurobiological factors that are implicated in the development of addiction. While mice given cocaine showed the compulsive and involuntary nature of addiction, for humans this is more complex, related to behavior or personality traits.

Classic signs of addiction include compulsive engagement in rewarding stimuli, preoccupation with substances or behavior, and continued use despite negative consequences. Habits and patterns associated with addiction are typically characterized by immediate gratification (short-term reward), coupled with delayed deleterious effects (long-term costs).

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In this Dossier

Addiction in the context of Alcoholism

Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic alcohol use has been mentioned in the earliest historical records. The World Health Organization (WHO) estimated there were 283 million people with alcohol use disorders worldwide as of 2016. The term alcoholism was first coined in 1852, but alcoholism and alcoholic are considered stigmatizing and likely to discourage seeking treatment, so diagnostic terms such as alcohol use disorder and alcohol dependence are often used instead in a clinical context. Other terms, some slurs and some informal, have been used to refer to people affected by alcoholism such as tippler, sot, drunk, drunkard, dipsomaniac and souse.

Alcohol is addictive, and heavy long-term use results in many negative health and social consequences. It can damage all organ systems, but especially affects the brain, heart, liver, pancreas, and immune system. Heavy usage can result in trouble sleeping, and severe cognitive issues like dementia, brain damage, or Wernicke–Korsakoff syndrome. Physical effects include irregular heartbeat, impaired immune response, cirrhosis, increased cancer risk, and severe withdrawal symptoms if stopped suddenly.

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Addiction in the context of Euphoria

Euphoria (/juːˈfɔːriə/ yoo-FOR-ee-ə) is the experience (or affect) of pleasure or excitement and intense feelings of well-being and happiness. Certain natural rewards and social activities, such as aerobic exercise, laughter, listening to or making music and dancing, can induce a state of euphoria. Euphoria is also a symptom of certain neurological or neuropsychiatric disorders, such as mania. Romantic love and components of the human sexual response cycle are also associated with the induction of euphoria. Certain drugs, many of which are addictive, can cause euphoria, which at least partially motivates their recreational use.

Hedonic hotspots – i.e., the pleasure centers of the brain – are functionally linked. Activation of one hotspot results in the recruitment of the others. Inhibition of one hotspot results in the blunting of the effects of activating another hotspot. Therefore, the simultaneous activation of every hedonic hotspot within the reward system is believed to be necessary for generating the sensation of an intense euphoria.

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Addiction in the context of Coca

Coca is any of the four cultivated plants in the family Erythroxylaceae, native to western South America. Coca is known worldwide for its psychoactive alkaloid, cocaine. Coca leaves contain cocaine which acts as a mild stimulant when chewed or consumed as tea, with slower absorption than purified cocaine and no evidence of addiction or withdrawal symptoms from natural use.

The coca plant is a shrub-like bush with curved branches, oval leaves featuring distinct curved lines, small yellowish-white flowers that develop into red berries. Genomic analysis reveals that coca, a culturally and economically important plant, was domesticated two or three separate times from the wild species Erythroxylum gracilipes by different South American groups during the Holocene. Chewing coca in South America began at least 8,000 years ago, as evidenced by coca leaves and calcite found in house floors in Peru's Nanchoc Valley, suggesting early communal use alongside the rise of farming. Coca use was subject to widespread use under Inca rule. The Incas deeply integrated coca into their society for labor, religion, and trade, valuing it so highly that they colonized new lands to cultivate it. Despite later Spanish attempts to suppress its use, even they relied on it to sustain enslaved laborers. Coca leaves have been traditionally used across Andean cultures for medicinal, nutritional, religious, and social purposes—serving as a stimulant, remedy for ailments, spiritual tool, and source of sustenance—especially through chewing and tea.

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Addiction in the context of Opium

Opium (also known as poppy tears, or Lachryma papaveris) is the dried latex obtained from the seed capsules of the opium poppy Papaver somniferum. Approximately 12 percent of opium is made up of the analgesic alkaloid morphine, which is processed chemically to produce heroin and other synthetic opioids for medicinal use and for the illegal drug trade. Opium's main psychoactive alkaloids, primarily morphine, act on μ-opioid receptors, causing analgesia and addiction with long-term use leading to tolerance, dependence, and increased cancer risk. The latex also contains the closely related opiates codeine and thebaine, and non-analgesic alkaloids such as papaverine and noscapine. The traditional, labor-intensive method of obtaining the latex is to scratch ("score") the immature seed pods (fruits) by hand; the latex leaks out and dries to a sticky yellowish residue that is later scraped off and dehydrated.

The English word for opium is borrowed from Latin, which in turn comes from Ancient Greek: ὄπιον (ópion), a diminutive of ὀπός (opós, "juice of a plant"). The word meconium (derived from the Greek for "opium-like", but now used to refer to newborn stools) historically referred to related, weaker preparations made from other parts of the opium poppy or different species of poppies. The Mediterranean region holds the earliest archaeological evidence of human use of opium poppies dating back to before 5000 BCE, with cultivation beginning around 3400 BCE in Mesopotamia. Opium was widely used for food, medicine, ritual, and as a painkiller throughout ancient civilizations including Greece, Egypt, and Islamic societies up to medieval times.

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Addiction in the context of Inhibitory control

Inhibitory control, also known as response inhibition, is a cognitive process – and, more specifically, an executive function – that permits an individual to inhibit their impulses and natural, habitual, or dominant behavioral responses to stimuli (a.k.a. prepotent responses) in order to select a more appropriate behavior that is consistent with completing their goals. Self-control is an important aspect of inhibitory control. For example, successfully suppressing the natural behavioral response to eat cake when one is craving it while dieting requires the use of inhibitory control.

The prefrontal cortex, caudate nucleus, and subthalamic nucleus are known to regulate inhibitory control cognition. Inhibitory control is impaired in both addiction and attention deficit hyperactivity disorder. In healthy adults and ADHD individuals, inhibitory control improves over the short term with low (therapeutic) doses of methylphenidate or amphetamine. Inhibitory control may also be improved over the long-term via consistent aerobic exercise.

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Addiction in the context of Smoking cessation

Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is addictive and can cause dependence. As a result, nicotine withdrawal often makes the process of quitting difficult.

Smoking is the leading cause of preventable death and a global public health concern. Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), emphysema, and various types and subtypes of cancers (particularly lung cancer, cancers of the oropharynx, larynx, and mouth, esophageal and pancreatic cancer). Smoking cessation significantly reduces the risk of dying from smoking-related diseases. The risk of heart attack in a smoker decreases by 50% after one year of cessation. Similarly, the risk of lung cancer decreases by 50% in 10 years of cessation

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Addiction in the context of Tobacco smoking

Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or released from the mouth, as is done with pipes and cigars. The practice is believed to have begun as early as 5000–3000 BC in Mesoamerica and South America. Tobacco was introduced to Eurasia in the late 17th century by European colonists, where it followed common trade routes. The practice encountered criticism from its first import into the Western world onward but embedded itself in certain strata of several societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus.

Smoking is the most common method of consuming tobacco, and tobacco is the most common substance smoked. The agricultural product is often mixed with additives and then combusted. The resulting smoke, which contains various active substances, the most significant of which is the addictive psychostimulant drug nicotine (a compound naturally found in tobacco), is absorbed through the alveoli in the lungs or the oral mucosa. Many substances in cigarette smoke, chiefly nicotine, trigger chemical reactions in nerve endings, which heighten heart rate, alertness and reaction time, among other things. Dopamine and endorphins are released, which are often associated with pleasure, leading to addiction.

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Addiction in the context of Alcohol (drug)

Alcohol, sometimes referred to by the chemical name ethanol, is the active ingredient in alcoholic drinks such as beer, wine, and distilled spirits (hard liquor). Alcohol is a central nervous system (CNS) depressant, decreasing electrical activity of neurons in the brain, which causes the characteristic effects of alcohol intoxication ("drunkenness"). Among other effects, alcohol produces euphoria, decreased anxiety, increased sociability, sedation, and impairment of cognitive, memory, motor, and sensory function.

Alcohol has a variety of adverse effects. Short-term adverse effects include generalized impairment of neurocognitive function, dizziness, nausea, vomiting, and symptoms of hangover. Alcohol is addictive and can result in alcohol use disorder, dependence, and withdrawal upon cessation. The long-term effects of alcohol are considered to be a major global public health issue and include liver disease, hepatitis, cardiovascular disease (e.g., cardiomyopathy), polyneuropathy, alcoholic hallucinosis, long-term impact on the brain (e.g., brain damage, dementia, and Marchiafava–Bignami disease), and cancers; alcohol and some of its metabolites (such as acetaldehyde) are IARC group 1 carcinogens. The adverse effects of alcohol on health are most significant when it is used in excessive quantities or with heavy frequency. However, in 2023, the World Health Organization published a statement in The Lancet Public Health that concluded, "no safe amount of alcohol consumption for cancers and health can be established." In high amounts, alcohol may cause loss of consciousness or, in severe cases, death. Many governmental agencies and organizations issue alcohol consumption recommendations.

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