The word “addiction” is often used to refer to any behavior that is out of control in some way. People often describe themselves as being addicted to, for example, a TV show or shopping.

Addiction is also used to explain the experience of withdrawal when a substance or behaviour (e.g., gambling) is stopped (e.g., “I must be addicted to coffee: I get a headache when I don’t have my cup in the morning”). However, experiencing enjoyment or going through withdrawal do not in themselves mean a person has an addiction.

Because the term “addiction” is commonly used in such a vague way, there have been many attempts to define it more clearly. The definition used here refers to problematic use of a substance such as alcohol.

One simple way of describing addiction is the presence of the 4 Cs:

• Craving
• loss of Control of amount or frequency of use
• Compulsion to use
• use despite Consequences.

Signs & Symptoms

The harms of substance use can range from mild (e.g., feeling hungover, being late for work) to severe (e.g., homelessness, disease). While each time a person uses a substance may seem to have little impact, the harmful consequences can build up over time. A person who keeps using substances despite the harmful consequences may develop a substance use problem.

The harms of substance use can affect every aspect of a person’s life. They include:

• injuries while under the influence
• feelings of anxiety, irritability or depression
• trouble thinking clearly
• blackouts
• problems with relationships
• spending money on substances rather than on food, rent or other essentials
• legal problems related to substance use
• loss of hope, feelings of emptiness.

Some people may be aware that their substance use causes problems but continue to use, even when they want to stop. They may use more than they intended or in situations where they didn’t want to use.

Some people may not see that their substance use is out of control and is causing problems (denial). This so-called denial, however, may simply be a lack of awareness or insight into the situation. Whether people realize it or not, lack of control is another sign that substance use is a problem.

Causes & Risk Factors

People become addicted because of a combination of factors.

Genetic factors: Some people may inherit a vulnerability to the addictive properties of drugs.

How drugs interact with the brain: People use alcohol and other drugs because they stimulate the brain in ways that "feel good." This immediate rewarding experience makes people want to repeat it. All substances with addictive potential stimulate the release of dopamine, a chemical in the brain that is associated with reward and pleasure.

Environment: Peoples' home and community and the attitude of their peers, family and culture toward substance use can influence whether or not they develop substance use problems. People who experience prejudice or marginalization may use substances to cope with feelings of trauma or social isolation.

Mental health issues: More than 50 per cent of people with substance use disorders have also had mental health problems at some point during their lifetimes. When people have mental health problems, even limited substance use can worsen the problem.

Coping with thoughts and feelings: People may turn to substances as a way of coping with difficult emotions or situations. They start to rely on substances to regulate their emotions

Researchers have tried various ways to sort out the complex causes of substance use problems. One way is to ask which factors put people at risk and which protect them substance use problems. Since substance use often begins in youth, research has focused on this age group.

Risk factors for substance use problems in youth include:

• alcohol or other drug problems among family members
• poor school performance
• poverty, family conflicts, chaos or stress
• having friends who drink or use drugs
• not fitting in socially or being excluded because of factors such as race, ethnicity, gender, or sexual orientation
• emotional, physical or sexual abuse
• experiencing discrimination or oppression.

The protective factors for substance use problems include:

• having a positive adult role model
• good parental or other caregiver supervision
• having a strong attachment to family, school and community
• having goals and dreams
• being involved in meaningful, well-supervised activities (e.g., sports, volunteer work).

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