Addict
Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces an immediate psychological reward, despite substantial harm and other negative consequences. Repeated substance use produces long-lasting changes in brain networks involved in reward, executive function, stress reactivity and mood. These changes underlie both the intense drive to use a substance and the reduced capacity to control that urge. It is therefore understood as a brain disorder arising from a complex mix of psychosocial and neurobiological factors. A number of researchers argue that this framing is incomplete, and that addiction is better understood as learned behavior shaped by choice and social context.
Addiction takes both substance and non-substance forms. Substance addictions include alcoholism, cannabis addiction, amphetamine addiction, cocaine addiction, nicotine addiction, and opioid addiction. The DSM-5-TR recognizes only gambling disorder as a behavioral (non-substance) addiction and lists internet gaming disorder as a condition for further study, while the ICD-11 additionally classifies gaming disorder as a disorder due to addictive behaviors. Other candidate behavioral addictions, and the question of whether food can be addictive, are debated in the research literature but are not recognized in either manual. Across these forms, addiction is defined less by any single symptom than by a pattern: impaired control over the substance or behavior, increasing priority given to it over other activities, and continued use despite harm, accompanied for many substances by tolerance and withdrawal. It carries a substantial risk of further illness and early death, most immediately from overdose, and co-occurring psychiatric conditions are common.
Roughly half of the risk of developing an addiction is genetic: twin and adoption studies estimate the heritability of alcohol use disorder at about 50%, with comparable figures across other substances. Genetic vulnerability is polygenic, reflecting the small combined effects of many common variants rather than any single gene. Environmental contributors include adverse childhood experiences, chronic stress, family and peer influences, socioeconomic constraint and the availability of substances, and adolescence is a period of heightened vulnerability. At the level of mechanism, addiction is described as a recurring cycle in which dopaminergic signaling gives a drug and its associated cues a strong pull on attention and behavior, brain stress systems become overactive as ordinary pleasures are muted, and reduced prefrontal cortex control leaves craving poorly restrained.
Addiction is diagnosed clinically. The DSM-5-TR grades substance use disorder as mild, moderate, or severe and treats severe substance use disorder as synonymous with drug addiction. The ICD-11 instead distinguishes a harmful episode of use, a harmful pattern of use, and dependence. Prevention approaches with the strongest supporting evidence include family skills programs, school-based personal and social skills education, and policies that limit availability and raise price. Addiction is managed as a chronic, relapsing condition, usually combining medication, where an effective one exists, with psychological and social support. Effective medications are available for opioid, alcohol, and tobacco use disorders, but none is approved for stimulant use disorder, for which psychosocial treatment remains the mainstay. Harm reduction measures address the damage associated with continued use. Outcomes vary widely: an estimated 35–54% of people with a substance use disorder reach remission, though typically only after many years. About 163 million people worldwide were estimated to be living with a substance use disorder in 2021, most commonly alcohol use disorder, and drug use was one of only three risk factors whose age-standardized attributable burden rose between 2010 and 2023. Addiction carries substantial economic and social costs, and anthropological and structural accounts situate heavy drug use within cultural norms and unequal distributions of power.
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