Addiction
Addiction is a physical and/or psychological dependence on a substance or behaviour despite harmful consequences. Understanding addiction helps explain why people continue harmful behaviours even when they want to stop.
What Is Addiction?
An addiction is characterised by:
- Compulsion — an overwhelming urge to engage in the behaviour or use the substance
- Loss of control — inability to stop or reduce the behaviour despite wanting to
- Tolerance — needing increasing amounts to achieve the same effect
- Withdrawal symptoms — physical and psychological symptoms when the substance/behaviour is stopped (e.g. anxiety, tremors, irritability, nausea)
- Continued use despite harm — persisting even when it damages health, relationships, finances or work
Physical vs Psychological Dependence
| Physical Dependence | Psychological Dependence |
|---|
| The body has adapted to the substance — it needs it to function normally | The person believes they need the substance/behaviour to cope |
| Stopping causes physical withdrawal symptoms (shaking, sweating, nausea, seizures) | Stopping causes psychological symptoms (anxiety, cravings, depression, irritability) |
| Example: alcohol, heroin, nicotine | Example: gambling, social media, cannabis |
| Often both occur together | Can exist without physical dependence |
Examples of Addiction
| Substance Addictions | Behavioural Addictions |
|---|
| Alcohol | Gambling |
| Nicotine (smoking/vaping) | Gaming |
| Drugs (heroin, cocaine, cannabis) | Social media |
| Prescription medication (painkillers) | Shopping |
Explanations of Addiction
Biological Explanation
- Genetics: addiction runs in families. Twin studies show higher concordance rates for addiction in identical twins than non-identical twins, suggesting a genetic predisposition
- Dopamine: addictive substances and behaviours increase dopamine levels in the brain's reward pathway (mesolimbic pathway). Dopamine creates feelings of pleasure and reward, reinforcing the behaviour
- Tolerance: with repeated use, the brain produces less dopamine naturally, so more of the substance is needed to feel the same effect — this drives escalation
- Withdrawal: when the substance is removed, dopamine levels drop below normal, causing unpleasant symptoms — the person uses again to feel normal
Psychological Explanation — Learning Theory
- Operant conditioning: addiction is maintained through reinforcement
- Positive reinforcement: the substance produces pleasure (a reward), which encourages repetition
- Negative reinforcement: the substance removes unpleasant feelings (withdrawal, stress, anxiety), which also encourages use
- Classical conditioning: environmental cues become associated with the substance through repeated pairing — seeing a pub, smelling cigarette smoke or being with certain people can trigger cravings
- Social learning theory: people may start using substances by observing and imitating role models (peers, family, celebrities) who use — especially if they see the behaviour being rewarded (looking cool, relaxing, being accepted by a group)
Risk Factors for Addiction
| Factor | Explanation |
|---|
| Genetics | Family history of addiction increases risk |
| Peer pressure | Friends who use substances increase the likelihood of starting |
| Stress and trauma | People may use substances to cope with difficult experiences |
| Mental health | Depression, anxiety and other disorders increase vulnerability |
| Age | Starting young increases the risk of developing addiction (the brain is still developing) |
| Availability | Easy access to substances or gambling increases risk |
| Personality | Sensation-seeking, impulsivity and low self-esteem are risk factors |
Treatments for Addiction
| Treatment | How It Works | Strengths | Weaknesses |
|---|
| Drug therapy | Medications reduce cravings or block the effects of the substance (e.g. nicotine patches, methadone for heroin) | Can reduce withdrawal symptoms; allows the person to function normally | Does not address psychological causes; side effects; may create a new dependency |
| CBT | Identifies and challenges thinking patterns that maintain addiction; teaches coping strategies for triggers and cravings | Addresses root causes; teaches lifelong skills | Time-consuming; requires high motivation; high relapse rates |
| Aversion therapy | Pairs the addictive substance with an unpleasant stimulus (e.g. a drug that causes nausea when alcohol is consumed) — creating a negative association | Based on classical conditioning; can be effective short-term | Ethical concerns; unpleasant for the patient; high relapse rates when treatment stops |
| Support groups (e.g. AA, NA) | Peer support, shared experiences, 12-step programmes | Free; ongoing support; sense of community | Not evidence-based in the traditional sense; not effective for everyone; requires commitment |
Exam Tips
- Know the characteristics of addiction — compulsion, tolerance, withdrawal, loss of control
- Be able to explain addiction using both biological (dopamine, genetics) and psychological (learning theory) explanations
- For AO3: Is addiction a disease (biological) or a learned behaviour (psychological)? Most evidence suggests it involves both
- Compare at least two treatments for addiction — strengths and weaknesses of each
- Link to other topics: dopamine links to the brain and neuropsychology; classical and operant conditioning link to learning theory
- For evaluation: Why do some people become addicted and others do not? Consider individual differences, genetics and environment