The American Society of Addiction Medicine defines an addiction from a physical and systemic point of view as
a primary, chronic disease of brain reward, motivation, memory and related circuitry.
by using the terms "brain reward", the ASAM refers to using of a substance to alter our mood and change our behavior. That is the first stage of addiction: when personal will or skill cannot be summoned to perform a specific activity and, instead, a substance with behavior-altering capacity is used their place.
By "brain reward" the ASAM also entails a type of operant conditioning: people who look forward to the consumption of the addicting agent also train themselves unconsciously to correlate the substance to pleasure, pain, or whatever mood the person wishes to attain. This includes negative pleasure (self-punishment), and traditional positive pleasure.
This being said, motivation is the second factor for addiction: once the addicting substance is identified, the addict starts to go back to use it over and over again. The enthusiasm with which the addict welcomes the mood-changer replicates in each instance of usage which leads to the stage of "related circuitry". Now the addict no longer initiates the usage, now the usage is associated with other things that trigger the need.
For example: cigarette smoking is highly addictive because of the nicotine contained in cigarettes. Since the substance builds in the blood, the smoker will undoubtedly increase the smoking. However, the smoker will want to try the sensation of pleasure that nicotine creates in other scenarios: after eating, when drinking alcohol, while at parties, or because there are more smokers with similar tastes around. This is the related circuitry that solidifies the addiction. Now everything reminds the smoker of when to have a cigarette. Hence, a dysfunction has occurred where cigarette smoking is no longer an isolated practice: now it has to be done as much as possible wherever possible.
ASAM describes how the addiction proliferates
Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behavior.
Therefore the addiction becomes official when the addict begins to use it as both reward and relief; when it is no longer just for entertainment or partial pleasure, but for escapism and for dissociation of reality. This can lead to a very strong connection between the addict and the substance because, as the addict psychologically becomes more attached to the effects of the substance, the substance itself creates resistance for which the addict needs to consume more of it.
Hence, the five factors that identify a true addict are:
- the addict no longer has willpower to control usage
- the addict has put himself/herself in dangerous situations
- the addict cannot lead a normal lifestyle (work, eat well, take care of children)
- usage has increased or is on the rise
- addict has dangerous withdrawals upon trying to quit
Addiction is basically a vicious cycle that is treated with mind and body interventions as the connections placed upon the addictive agent often concern the individual's entire personality traits.