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Addiction Explained: Understanding Addiction
Open AccessPublic education resource from the American Society of Addiction Medicine. Addiction is a long-term health condition that affects the brain and can impact daily life. Many factors can play a role, including a person's biology, life experiences, environment, and support system. Like cancer, diabetes, and other chronic diseases, addiction can be treated and managed. Addiction makes it hard to control the use of substances like alcohol, opioids, and nicotine, or behaviors like gambling. About 48.4 million Americans aged 12 or older (1 in 6) are living with a substance use disorder. At the center of addiction is the brain's reward system, which uses dopamine as a 'pay attention to this' signal (ventral tegmental area releases dopamine; nucleus accumbens drives motivation and reward; prefrontal cortex supports decision-making and self-control). Addiction develops in steps: strong activation of the reward system, changes in learning and habits, and brain systems changing over time (tolerance, automatic cravings triggered by people, places, emotions or stress, difficulty pausing, and withdrawal symptoms). Recovery is possible with medications, counseling, therapy and supportive relationships.
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