By Dr. Nilsana Charkhande, PsyD, RCC, CCC, ACS — therapist and clinical supervisor with 15+ years treating trauma, anxiety, depression, and family concerns.
Addiction or Substance Use Disorder (SUD) is the repetitive misuse of any substance—usually alcohol or drugs—until you cease having control over your actions. Approximately 21 million Americans currently struggle with addiction to alcohol, opioids, marijuana, or other substances. Although many addictive substances are legal and widely available, addiction has severe long-term consequences for your health, relationships, and quality of life. If allowed to continue, addiction can be disastrous.
Fortunately, addiction is treatable. Research-based methods are available to help people break free of substance abuse and resume healthy, productive lives.
Key points
- Addiction is the regular compulsive urge to use a substance or engage in an unhealthy behavior over which you have no control
- Addictions can develop to substances that are legal (such as alcohol or prescription medications) or illicit.
- Substance use disorders carry serious negative long-term consequences to your health, relationships, and quality of life.
- Professional help can be invaluable in recovering from a substance use disorder.
In this article
Overview
Addiction is a powerful, persistent drive to use substances or engage in behaviours that are harmful or difficult to control. Substance Use Disorder (SUD) specifically refers to problematic use of alcohol or drugs, where a person continues to use despite significant negative consequences.
Addiction often involves a growing loss of control. Even when you are aware that something is hurting your health, relationships, or work, stopping can feel impossible. Many people find themselves returning to substances or behaviours such as alcohol, drugs, gambling, sex, gaming, or excessive internet use to feel relief, escape discomfort, or experience a short-term sense of pleasure. Over time, this cycle becomes more entrenched and harder to break.
For many individuals, addiction begins quietly. It may start with occasional use or experimentation that feels manageable. Without support or early intervention, it can gradually escalate into a pattern that takes over both mental and physical wellbeing. As addiction progresses, the substance or behaviour can begin to feel like it is in control, often leading to serious and lasting consequences.
Symptoms
Addiction is not always obvious from the outside. The clearest signs are often found in the way it impacts your daily life.
A common symptom is difficulty stopping, even when you want to or when you know it is causing harm. You might find yourself using more frequently, for longer periods, or in riskier situations than intended.
Cravings can become intense and may begin to drive your decision-making. For some people, this leads to behaviours they would not normally consider, including actions that feel reckless, unsafe, or out of character. Over time, tolerance often increases, meaning you need more of the substance or behaviour to feel the same effect. In some cases, continued use becomes less about feeling good and more about avoiding withdrawal or simply feeling “normal.”
Addiction can affect physical health, mental health, work or school performance, and close relationships. Even with strong motivation to quit, withdrawal symptoms and emotional distress can make it difficult to stop without support, which can reinforce the cycle of returning to the substance or behaviour again and again.
Additionally, individuals typically experience greater tolerance over time, requiring increasing amounts of the addictive substances to achieve the same effects and, in many cases, even to feel normal.
Unfortunately, addiction has long-term consequences for your physical and mental health, your ability to succeed professionally, your ability to maintain healthy relationships, and your ability to fully enjoy life. Even when you recognize this and really try to quit, the withdrawal symptoms might be too unbearable to endure, driving you to again use the very substance you so badly want to quit.
Causes
Addiction is rarely caused by a single factor. More often, it develops through a combination of biological, psychological, environmental, and social influences.
For many people, substance use or compulsive behaviours begin as a way to cope with stress, trauma, anxiety, depression, or emotional pain. Developing healthier coping strategies and building emotional regulation skills is often a key part of recovery.
Risk factors
It can be difficult to predict who will develop an addiction. Some people with few apparent risk factors struggle with substance use, while others with multiple risk factors do not.
That said, certain factors are associated with a higher likelihood of developing an addiction, including:
Biological and genetic influences: A family history of addiction can increase risk. Research suggests that genetics may play a role in vulnerability, including differences in how the brain processes reward and stress.
Age of exposure: The brain continues developing into the mid-twenties. Earlier exposure to substances can increase vulnerability.
Trauma and chronic stress: Experiences such as violence, poverty, long-term stress, or traumatic events can increase risk significantly.
Marginalization and discrimination: Individuals who belong to marginalized communities, including LGBTQIA+ individuals, may face additional stressors that increase vulnerability.
Co-occurring mental health concerns: Anxiety, depression, bipolar disorder, and other mental health challenges often occur alongside addiction. When both are present, each can intensify the other. This is sometimes referred to as a dual diagnosis.
Taking the first step toward change can feel overwhelming, but you do not have to do it alone. Support is available, and reaching out can be the beginning of lasting recovery.
Diagnosis
A diagnosis of addiction typically involves a combination of medical and psychological assessment. A healthcare provider may ask detailed questions about your substance use, mental health, physical health, and how your use is affecting your daily life.
In some cases, you may be referred to an addiction specialist, a substance use clinic, or a therapist who focuses on Substance Use Disorder. Blood tests or urine testing may also be recommended, especially when assessing health complications related to substance use.
Treatment
Treatment looks different for each person, and the best approach depends on the substance or behaviour involved, the severity of the addiction, and your overall mental and physical health.
Options may include:
Residential rehabilitation or structured treatment programs
Intensive Outpatient Programs (IOP) or community-based treatment
Sober living environments as a supportive step between rehab and independent living
Psychotherapy, including Cognitive Behavioural Therapy (CBT) and other evidence-based approaches
Peer support groups, including 12-step programs such as Alcoholics Anonymous or Narcotics Anonymous
Medication support, depending on the type of addiction and your needs
Medications may be used to support recovery from alcohol or opioid use disorders, particularly to reduce cravings, support withdrawal, or prevent relapse.
It can be difficult to acknowledge an addiction and ask for help. Many people feel shame, fear, or uncertainty when they begin. You may find it helpful to bring a trusted friend or family member to appointments, or to lean on someone you trust for emotional and practical support. Recovery is possible, and you do not have to go through it alone.
Begin your family's healing journey
Taking the first step towards change can be daunting, but you don’t have to do it alone. Dr. Nilsana Charkhande guides your family towards a more harmonious and fulfilling life. If you are ready to begin, please reach out today by calling (604) 500-3443 or filling out the contact form and clicking send. We look forward to hearing from you!
By Dr. Nilsana Charkhande, PsyD, RCC, CCC, ACS.
Her clinical work focuses on trauma, PTSD, anxiety, depression, OCD, addiction, eating concerns, family relationships, and self-harm. Her training includes EMDR, CBT, DBT, hypnotherapy, art therapy, and Safe and Sound Protocol.
Related information and references
Chen, S., Yang, P., Chen, T., Su, H., Jiang, H., & Zhao, M. (2020). Risky decision-making in individuals with substance use disorder: A meta-analysis and meta-regression review. Psychopharmacology, 237, 1893 – 1908.
Lovallo, W. R., Cohoon, A. J., Sorocco, K. H., Vincent, A. S., Acheson, A., Hodgkinson, C. A., & Goldman, D. (2019). Early‐life adversity and blunted stress reactivity as predictors of alcohol and drug use in persons with COMT (rs4680) Val158Met genotypes. Alcoholism: Clinical and Experimental Research, 43(7), 1519-1527.
NIDA. 2022, March 22. Treatment and Recovery. Retrieved from https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery on February 16, 2023.
