Free The Anatomy of Addiction by MD Akikur Mohammad Page A

other parts of the brain to help adapt the mind and body to deal with the physical and mental stressors that challenge it. Alcohol interacts in such a way as to acutely reduce CRF levels in the brain; chronic alcoholism does the opposite.
    Research indicates that individuals who are at increased risk of becoming alcoholics are likely to have a genetic makeup causing them to have higher CRF levels than normal. They may be drinking to tame a hyperactive CRF stress system in the brain.
    Unfortunately, CRF and the stress system adjust to the alcohol. In the absence of alcohol, the alcoholic feels ill because his or her body cannot easily reverse the high levels of CRF and low reward neurotransmission. This ill feeling may contribute to the tendency of the alcoholic to overdrink—a danger because of the toxic effect on the brain and body of subjecting oneself to so much alcohol.
    Sadly, the brain often does not perceive the consequences of the short-term relief that the alcohol brings. When a person overdrinks, she feels good while she is boozing. However, this short-term relief makes the whole system worse off.
    Not Either/Or, but Both
    During the last century, a debate raged in academic circles whether addiction was a psychological disorder or a physiological disease. Was it a behavioral problem that arises because of environmental factors in early childhood—the nurture argument? Or was addiction a hereditary disease—the nature argument?
    We now know it’s both. Addiction is a disease with a strong genetic component that also includes aspects of behaviors, cognitions, emotions, and interactions with others, including the addict’s ability to relate to members of her family, to members of her community, to her own psychological state, and to things that transcend her daily experience.
    Behavioral manifestations and complications of addiction, primarily due to impaired control, can include the following:
    â€¢Excessive use and/or engagement in addictive behaviors at higher frequencies and/or quantities than the person intended, often associated with a persistent desire for and unsuccessful attempts at behavioral control.
    â€¢Excessive time lost in substance use or recovering from the effects of substance use and/or engagement in addictive behaviors, with significant adverse impact on social and occupational functioning (for example, the development of interpersonal relationship problems or the neglect of responsibilities at home, school, or work).
    â€¢Continued use and/or engagement in addictive behaviors, despite the presence of persistent or recurrent physical or psychological problems that may have been caused or exacerbated by substance use and/or related addictive behaviors.
    â€¢A narrowing of the behavioral repertoire focusing on rewards that are part of the addiction and an apparent lack of ability and/or readiness to take consistent action toward change, despite recognition of problems.
    Over time, repeated experiences with substance use or addictive behaviors damage the brain’s reward circuit activity and are no longer as subjectively rewarding. Once a person experiences withdrawal from drug use or comparable behaviors, there is an anxious, agitated, and unstable emotional experience related to suboptimal reward and the recruitment of brain and hormonal stress systems, which is associated with withdrawal from virtually all pharmacological classes of addictive drugs.
    While tolerance develops to the high, tolerance does not develop to the emotional low associated with the cycle of intoxication and withdrawal. Thus, in addiction, people repeatedly attempt to create a high. But what they mostly experience is a deeper and deeper low. While anyone may
want
to get high, those with addiction feel a
need
to use the addictive substance or engage in the addictive behavior to try to resolve their uncomfortable emotional state or their physiological symptoms of withdrawal. People with addiction