Understanding Addiction & Recovery

Substance use and addiction are complex issues that affect millions of people, particularly young adults whose brains are still developing. Understanding the nuances between substance use, misuse, and addiction is the first step toward providing effective support and fostering recovery.

This post will clarify these key definitions, explore the science behind addiction, and outline evidence-based strategies to support those on their recovery journey. By gaining a deeper insight into this chronic medical disease, we can better equip ourselves to help adolescents and adults navigate their challenges and build healthier futures.

The Landscape of Substance Use

To understand the scope of the issue, it’s helpful to look at the data. The CDC’s (2023) most recent high school youth risk behavior survey of over 17,000 students revealed that substance use is a significant concern among adolescents:

• 24% of female students and 20% of male students currently drank alcohol.
• 19% of females and 15% of males currently used marijuana.
• 10% of both females and males had ever used illicit drugs.

The National Center for Drug Abuse and the National Institute on Drug Abuse (NIDA) provide further context. In 2020, 40.3 million people in the U.S. had a Substance Use Disorder, yet only 6.5% received treatment. The age of initiation is also a critical factor: 70% of individuals who try an illegal drug before age 13 develop a substance use disorder within seven years, compared to 27% of those who start after age 17.

This data highlights a crucial point: substance use during adolescence is particularly dangerous. Because the adolescent brain is in a heightened state of neuroplasticity, experiences during this time have a profound impact on its wiring.

Defining Substance Use, Misuse, and Addiction

Let’s clarify the terms we use when discussing this topic:

• Substance Use: This refers to any consumption of tobacco, alcohol, illegal substances, or the misuse of prescription drugs.
• Substance Misuse: This involves using these substances in harmful or excessive amounts. For example, 2023 data shows 45.6% of people aged 12+ who used alcohol engaged in binge drinking.
• Addiction: This is the most severe form, characterized by a compulsive need to use a substance despite harmful consequences.

The American Society of Addiction Medicine (2019) defines addiction as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences.” It’s not simply a matter of choice; it’s a complex condition that alters the brain.

The Science of Addiction

To grasp how addiction works, we need to understand homeostasis—our body’s natural tendency to maintain internal stability. When we introduce a substance that creates a pleasant mood state, our body initiates an “opponent process” to counterbalance it and return to equilibrium.

The Opponent-Process Theory

Developed by Richard Solomon and John Corbit, this theory explains that for every primary process (the “high” from a substance), an opposing process is triggered to restore balance. The more intense the positive feeling, the more intense the negative counterbalance. For example, the endorphin release from alcohol is followed by an elevation of the stress hormone cortisol, which can last for weeks.

The Addiction Cycle

Dr. Tracy Sweet (2024), a clinical psychologist, illustrates the addiction cycle, which consists of four main stages:

1. Initiation: The initial use of the substance.
2. Tolerance: Over time, repeated use leads to desensitization, or neuroadaptation. More of the substance is needed to achieve the same initial “high.”
3. Maintenance: The body becomes dependent on the substance to feel “normal” and produce feel-good hormones, as its natural production has been suppressed.
4. Withdrawal: When use is stopped, the body experiences unpleasant and sometimes dangerous symptoms as it struggles to re-establish homeostasis. This discomfort often perpetuates the cycle as the person uses again to avoid withdrawal.

A key insight here is that while people often use substances to alleviate stress, the opponent process actually increases stress hormones in the body over time, leading to higher overall stress levels.

Six Components of Addiction

Psychologist Mark Griffiths (2019) identified six core components that characterize addiction:

1. Salience: The addiction becomes the most important thing in the person’s life.
2. Mood Modification: The substance is used to enhance mood or cope with negative feelings.
3. Tolerance: Needing to increase the amount or frequency to get the desired effect.
4. Withdrawal: Experiencing negative physical or psychological effects when stopping.
5. Conflict: The addiction causes personal and interpersonal problems.
6. Relapse: Returning to the behavior after a period of abstinence.

As Griffiths eloquently put it, “The difference between an excessive healthy enthusiasm and an addiction is that healthy enthusiasms add to life whereas addictions take away from it.”

Supporting Recovery

Supporting someone in recovery requires a multifaceted approach. The American College of Lifestyle Medicine recommends strategies that integrate mental health treatment, lifestyle changes, and evidence-based therapies.

As a recovery coach, you can play a supportive role for clients who want to develop healthier coping skills by:

• Providing Education: Educate clients about addiction, the recovery process, and available resources.
• Using Evidence-Based Strategies: Apply coaching interventions like Motivational Interviewing, Cognitive Behavioral Coaching (CBC), and Acceptance and Commitment Coaching (ACC) to enhance success.
• Supporting Goal-Setting: Help clients set health-focused goals, create action plans, and develop replacement behaviors for substance use.
• Building Life Skills: Support the development of skills in self-care, communication, stress management, and problem-solving.

It is crucial to recognize the limits of coaching. If a client shows signs of heavy substance use or is not making progress, it is your responsibility to refer them to a higher level of care. Building a referral network of treatment centers and professionals like Peer Recovery Specialists, Addiction Counselors, and Psychiatrists is essential.

Principles of Effective Treatment

The National Institute on Drug Abuse (NIDA) outlines 13 principles of effective drug addiction treatment. Key takeaways include:

• Addiction is a treatable disease, but no single treatment is right for everyone.
• Treatment must be readily available and address multiple needs, not just drug use.
• Remaining in treatment for an adequate time is critical.
• Medications, counseling, and behavioral therapies are all important components.
• Treatment plans must be continuously assessed and modified.

How to Empower Recovery

Understanding addiction is the first step toward dismantling stigma and providing meaningful support. By educating ourselves on the science, recognizing the signs, and learning about evidence-based recovery strategies, we can empower individuals to reclaim their lives.

For coaches, this knowledge, combined with specialized training in models like Motivational Interviewing and Cognitive Behavioral Coaching, allows you to become a powerful ally in a client’s recovery journey. If you’re interested in deepening your skills, consider exploring our coach training programs to learn how to apply these recovery-relevant interventions effectively.