Understanding addiction to alcohol and other drugs

Substance use disorder affects at least one in four Australian men, yet fewer than one-quarter of those affected seek professional help and when they do, most do so decades after the issue begins. This is driven in large part by our community’s understanding of addiction, and the stigma and shame attached to it.

Addiction has a significant impact on the individual, increasing their risk of injury, illness and death, with consequences for their relationships and work. It can also have far-reaching ripple effects on those around them. It’s likely you, or someone you know, will be impacted by addiction. That’s why it’s critical we all have a better understanding of the condition, can talk honestly about it and know help is available.

What is addiction?

“Addiction is one of the most misunderstood and stigmatised health conditions,” says Professor Dan Lubman AM, Executive Clinical Director at Turning Point and Professor of Addiction Studies and Services at Monash University. 

Addiction is a chronic health condition that occurs when you’re unable to control or stop using a drug or engaging in a certain behaviour, even if it’s causing harm or affecting your life. You can become addicted or dependent on a substance, such as alcohol or drugs, or a behaviour, such as gambling.

It’s a leading cause of injury, illness and death in Australia but instead of recognising it as a complex health condition, addiction has long been viewed as an individual’s moral failure or a character flaw. 

“There’s a misconception that people just can't control themselves, that they're making poor choices, but we now know that addiction is a mental disorder that affects the brain and there is a whole range of genetic, environmental and other factors that make people vulnerable to developing it,” Professor Lubman says.

People don’t choose to become addicted to alcohol or substances.

What causes addiction?

Addiction affects people from all walks of life and there’s no single cause.

“Many people use alcohol, drugs or gambling, without serious harm, but there's a range of biological, environmental and social factors that predispose some people to develop addiction,” Professor Lubman says. “These include genetics, mental health, your home and social environment, stress and trauma. We know that trauma and mental ill health is a major driver of addiction.”

Some of the factors that increase your risk of developing an addiction include:

1. Genetics

If you have a parent or family member who has experienced addiction, then you’re at a higher risk of experiencing addiction too.

2. Environment

Your home, school and social environments can increase your risk of alcohol and substance use, and dependence, especially experiencing trauma including sexual assault, domestic violence and poverty.

3. Development

Genetic and environmental factors interact with critical developmental stages in your life to affect addiction risk. The younger you are when you start using alcohol or substances, the greater your risk of developing dependence down the track.

There are also protective factors that reduce your likelihood of developing alcohol and substance dependence including strong and positive relationships with parents and caregivers, good academic performance, school engagement, healthy peer groups, good social skills and clear and consistent family rules.

“There are a whole range of different factors why people start drinking and start to drink more and more,” says Peter Miller, Professor of Violence Prevention and Addiction Studies at Deakin University School of Psychology. “But as you drink or use drugs regularly, you develop all these body and brain changes that keep you drinking or keep you using drugs.”

Substances and addictive behaviours initially trigger your brain’s reward system, releasing feel-good neurochemicals like dopamine. With ongoing and more frequent use, your body builds up a tolerance and you need more of the addictive thing to feel good. These brain changes can also reduce the enjoyment you once got out of healthier things, like food, sex or social activities. It can also affect your learning, judgement, decision-making and memory, feeding into a vicious cycle of ongoing dependence.

Withdrawal can be quite intense and can be another driver of why it's hard to quit,” Professor Lubman says. “Because if you stop drinking, you get these really overwhelming, unpleasant reactions that make it very difficult to function, so that keeps people drinking and using substances.”

Signs of addiction

Signs of addiction can vary depending on the drug but if these resonate with you, or you’ve noticed them in someone you’re close with, it’s worth talking to someone.

• Repeating a behaviour even though it’s causing problems in your life

• Feeling like you have to use the drug regularly

• Having intense urges for the drug that block out any other thoughts

• Needing more of the drug to have the same effect

• Making sure you can maintain a supply of the drug

• Spending money on the drug, even though you can't afford it

• Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use

• Doing things to get the drug that you normally wouldn't do, such as stealing

• Driving or doing other risky activities when you're under the influence of the drug

• Failing in your attempts to stop using the drug

• Experiencing withdrawal symptoms when you attempt to stop taking the drug

Treatment for addiction

It takes more than willpower to overcome addiction and there are a range of effective treatment options that can help. These include counselling, peer support, supervised detox, rehabilitation programs, care and recovery coordination and medications. The first step is putting aside any shame you feel about the condition and speaking to your doctor, who will help find the right treatment for you.

“People often think that treatment is just about going to detox or going to rehab. We know that is a treatment option for some people, but many people do well with a range of community-based, phone and online interventions, medications that their GP can give them or psychological strategies that they can get from a counsellor or a psychologist,” Professor Lubman says.

You don’t need to wait for a crisis to seek help. Like any other health condition the earlier you get help, the better the outcome.

“When you become aware that you have a problem, seek help. We know it's the hardest thing to do, but I can't emphasise strongly enough how much it's worth doing,” says Professor Miller. “If you don't find the right help, seek other help. If you don't find the answer that's right for you, go somewhere else. Because the reality is our treatment systems and our treatment options are different for different people and different providers.”

Supporting someone who’s struggling with dependence or addiction can be incredibly challenging and take a toll on your own wellbeing. If you aren’t sure whether a person is misusing drugs or alcohol or needs help, start a conversation to see if they’re ok. You can find more information on starting a conversation here.

• If you need support, call the Alcohol and Other Drug Hotline on 1800 250 015
• Counsellingonline.org.au offers alcohol and other drug support and confidential, free, 24/7 counselling
• If you're a friend or family member of someone with addiction, BreakThrough offers a range of resources to support you and your loved one.