If a loved one suffers from alcoholism or addiction, you may wonder why the person can't or won't stop using a substance that has such negative and dangerous consequences.
Chances are, the ability to stop abusing the substance is no longer in his or her control.
"Most people who develop a drug addiction or become alcoholics begin with occasional use or experimentation," says Marvin Seppala, M.D., chief medical director of Hazelden, an alcohol and drug addiction treatment center in Minnesota.
With continued use, brain structure and function are altered, and they depend on the drug not simply to feel good but to feel normal. "At that point," Dr. Seppala says, "using drugs or alcohol is no longer a choice."
When addicted, the drug user will do just about anything to obtain the drug, the National Institute on Drug Abuse says. The drug becomes the most important part of the person's life, overshadowing any other aspect.
Even so, addiction isn't inevitable for everyone. Drugs differ in their addictive qualities, and people differ in their sensitivity to drugs. Just under one-third of people who try heroin become addicted to it, as will just over one-third of people who try tobacco and 12 to 15 percent of those who drink alcohol.
Genetics and environment are also important. "The sons of alcoholic fathers, daughters of alcoholic mothers, and anyone who has a history of sexual or physical abuse or who grows up in an environment where substance abuse is the norm is more likely to become addicted than someone without these risks," says Dr. Seppala.
Research over the last decade reveals that addictive drugs and alcohol alter the function of the brain and the way cells work. As a result, normal thought processes, memory, and emotions are fundamentally affected and changed permanently.
"Once addicted, people will risk their own survival to use the drug, and their desire becomes stronger than any natural drives, like that for food or sex," says Dr. Seppala. "And at that point, the overpowering drive to drink or use drugs changes what was once a voluntary behavior into an involuntary one."
Desire always there
When the brain has experienced these changes, the desire will always be there.
"Studies have shown that no matter how long people have been clean and sober following active addiction, their brain cells will always have the potential to develop a full-fledged addiction if they ingest any amount of the substance again," warns Dr. Seppala.
That's why addiction is considered a chronic illness that has to be managed for the remainder of a person's life.
"The key to recovery is lifelong monitoring of a person's lifestyle so he or she can avoid triggers, significant stress, and any use of addictive substances," says Dr. Seppala. "Otherwise, the risk for a relapse is virtually guaranteed."