Addiction Theories and Science

“Be very careful, then, how you live—not as unwise but as wise… Do not get drunk on wine, which
leads to debauchery. Instead, be filled with the Spirit.”
Ephesians 5:15 & 18

Addiction has been theorised, debated and defined as many different things. It is a complex issue.
Circle up to 5 things from this list which you feel best describe what addiction is:

Addiction is…

A disease A choice Something you were born with

A social issue A physical issue A series of mistakes and bad choices

An emotional issue A spiritual/moral issue A result of your environment

A behavioural issue A lifestyle A solution to your problems

An expression of pain A lack of self-control A result of failed relationships

THE BIG PICTURE

As we have seen above, there are several ways of viewing and

understanding addiction, and it is evident that there is some truth
and insight to be gained from each. Although it doesn’t directly
provide solutions for a way out of addiction, it is helpful to consider
some of the theories and science around addiction to better
understand the nature of it. This session will introduce you to some
of these issues, including the Nature-Nurture debate, the Disease
Model of addiction, and the physiological effects of drugs and
alcohol on the brain.

NATURE OR NURTURE?

Take a moment to consider whether you believe addiction is more a product of NATURE (your
biological make up that you inherited from your parents) or NURTURE (your environment, social
factors, friends and family). Share your thoughts with the group and have a short debate, looking
at arguments in favour of each side.
It is generally accepted that addiction is the result of a mixture of both nature and nurture, and
these things cannot be separated. Let’s take a look at some of the key facts.

NATURE

 Studies show evidence that children of alcohol-

ics are 3 to 4 times more likely to become alco-
holics themselves, even if they are adopted into
non-alcoholic families.

 Some specific people groups, including Amer-

ican Indians and Asians, are known to be less
tolerant to alcohol, as biologically their bodies
are less able to process it.

 Men are over twice as likely to become addicted to drugs or alcohol as women.

 Mental disorders may also influence someone’s predisposition to addiction.

 The earlier a person starts using drugs or alcohol, the more likely it is for them to become an
addict, because as a child and teenager, the brain is still developing in terms of being able to
make decisions and assert self-control.

NURTURE

 A child’s early life and environment impacts

how they grow up (e.g. early exposure to drugs
and alcohol).

 Peer pressure amongst friends may lead to ex-

perimenting with drugs and alcohol.

 Abuse or abandonment issues may lead to ad-

diction as an escape from pain.

 Availability of drugs and alcohol will have a bearing on whether the person starts using, and
therefore is at risk of becoming addicted.

DISEASE MODEL

Before reading the information on this topic, discuss in pairs and feedback to the group your
thoughts on whether you think addiction should or should not be considered a life-long medical
disease, comparable to other diseases such as diabetes, asthma and epilepsy. Explain your
reasons.
The founders of Alcoholics Anonymous stated
that addiction is a progressive medical disease
which an addict has for life. They stated that the
disease includes damage to the brain, distorted
thinking and loss of control over alcohol (or other
addictive substance). Much like people suffering
from any other disease, such as diabetics
requiring insulin, addicts can treat and manage
their ‘disease’ through abstinence. They claimed that even if an addict stops using, they will never be
completely cured of their addiction.

What do you think could be some of the problems or limitations with the Disease Model?

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Here are some criticisms of the Disease Model:

 It takes away the element of choice, implying that an addict was merely afflicted with the
disease, rather than it being at least in part down to personal choices.

 The Disease Model gives an addict an excuse to continue using, as they are labelled as
having a disease rather than being encouraged to take responsibility for their actions.

 Seeing as the disease is incurable, it could lead to a sense of hopelessness and continued
unhealthy dependency on others for the addict’s wellbeing.

Having said these things, the founders of AA never intended for the addict not to take personal
responsibility. While they asserted that it was a disease, they also held firm to the principles of
accepting responsibility and seeking to make positive choices in the future to maintain sobriety.

ADDICTION AND THE BRAIN

Does anyone have any ideas as to what happens to your brain when you take drugs, and what the
connection is with becoming addicted? If so, share what you already know with the group. If not,
read on!

Taking drugs affects the brain’s ‘reward system’, which controls the body’s ability to experience
pleasure. When drugs are taken, a large amount of dopamine (brain chemical released when we
experience pleasure) is released, causing an intense
‘high’. With increased drug usage, the body adjusts to
the excess dopamine by producing less of it naturally,
meaning the person has to take more and more to try
and attain the same ‘high’ as the first time. The
reduction in natural dopamine production means that
an addict probably won’t get as much pleasure from
other things like food and socialising, which would
normally produce dopamine and be pleasurable.

There’s a lot of information here, so why not make it more interesting and split the group in half –
one group read through the first section of information (dopamine), and the other group read
through the second section (endorphins), and then share what you learned with each other.

1) DOPAMINE: Key Facts

 Dopamine reinforces behaviour that brings pleasure or

reward. So if you do something that your brain is
programmed to enjoy, dopamine is the signal which
influences you to repeat the behaviour.

 Food and sex both release dopamine in the brain.

These are basic human necessities (food for survival
and sex to keep the human race going) – the dopamine
encourages us to repeat these behaviours.

 Drugs, and with particular intensity, cocaine, create a powerful surge of dopamine at the
time of usage, but prevent the natural dopamine cycle from functioning as it should.
Therefore, the ‘low’ that is experienced shortly afterwards leaves the person desperate for
more.

 Over time, the user’s brain requires more dopamine than it can naturally produce, and it
becomes dependent on the drug. As tolerance levels increase in the person, it never
manages to satisfy the need it has created.

2) ENDORPHINS: Key Facts

 Endorphins are chemicals released in the brain as a response to pain (a natural pain-killer) or
to pleasurable triggers such as food, sex, music, exercise, laughter, drugs and gambling
(producing a feeling of happiness or euphoria).
  Endorphins create the warm feeling when we’re in love; numb
physical and emotional pain (e.g. why people might turn to
chocolate when stressed); and enhance the immune system.

 Too much emotional pain reduces our endorphin levels. If we

carry a lot of emotional pain, our endorphin levels can get so
low that we seek to block the pain through drugs, alcohol, or
other substances. However, endorphin bursts produced by
these don’t last long and so the temptation is to continue
more and more, to maintain a level of the ‘feel good’ en-
dorphins.

 When we become deficient in endorphins (possibly through

trauma or pain experienced as a child, requiring excess endorphins to cover the pain), we
stop feeling much pleasure from the simple things in life and we start reaching out to more
extreme sources of endorphin highs, such as drugs and alcohol.

ALCOHOLISM AND THE BRAIN

What do you think too much alcohol does to your brain? And do you think it can be cured if you
stop drinking? Discuss your initial thoughts in pairs, and share with the group.

Here are some key facts surrounding this issue:

 Evidence shows that heavy alcohol use modifies the structure and physiology of the brain.

 Alcohol abuse mostly affects the area of the brain involved with judgement, decision-
making, movement and personality.

 The picture shows a healthy brain of a 40-

year-old male (on the left), and an
alcoholic brain of a 40-year-old male (on
the right), where you can see a decrease
in the brain mass due to the loss of brain
cells.

 The extent of recovery from this damage after years of abstinence from alcohol remains
unclear.

 Several studies have shown that years of abstaining from alcohol can allow brain regions to
be restored and return to their original volume.

 Other reports, however, identify permanent damage, particularly to the brain region that
regulates long-term memory and spatial navigation.
  Although the effects of abstinence on the alcohol-abused brain vary, it appears that
alcoholics display at least some ability to recover from the effects of excessive drinking.

CLOSING RESPONSE

Write down below and share with the group your answers to these two questions:

1) What did you find most interesting or helpful in this group?

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2) How could an awareness of some of these theories and the science help you in your recovery?

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