Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.


“I do not ask the wounded person how he feels, I myself become the wounded person.”

~ Walt Whitman

As a clinician, I have always believed that at the heart of an addiction is a psychological history. I have rarely met an individual who has begun using without a significant history. It is not to say that some addicts are without a psychological predisposition, but I have never encountered an individual who was struggling with an addiction that began the addiction without a catalyst. It is intriguing to me that there seems to always be a critical turning point that an individual finds themselves transforming from a user to an addict.

The user is almost always someone who is struggling with poor self-image, self-esteem and sense of self-worth. Whether the addict is struggling with a substance issue, or a number of other addictive issues- sexual desires, gambling, computer, etc.; the addict almost always finds comfort in his or her addictive habit.


According to the National Institute on Drug Abuse (NIDA) “Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain—they change its structure and how it works.” Arguably, the brain disease is not like other biological and organic brain disorders such as Alzheimer’s, Schizophrenia, Parkinson’s, diabetes, and strokes, rather the brain disorder itself occurs after the use of a substance. It is sort of like the argument of the chicken and the egg: would the brain disorder have occurred if the user had not started using originally?

Originally, the addict is not drawn to a specific substance based on the need for that specific substance, but rather, the substance in most cases is accessible. Thus, the user chooses the substance on a matter of relative convenience, affordability, likability and a personal craving.


Most commonly, the addict enters the realm of addiction without the intent of becoming addicted. The user may find comfort, satisfaction, and a refuge from his or her life. The user is often trying to escape life or a specific element of his or her life. As a clinician, I have never met an individual who chooses to become an addict. In time, the mind of the addict becomes hijacked by the allure and the comfort of the substance. In effect, the user is no longer tempted, but is at the mercy of his or her addiction.

According to the NIDA, “with the continued use, a person’s ability to exert self-control can become seriously impaired; this impairment in self-control is the hallmark of addiction. Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of addiction.”


While we understand that substance addictions can lead to countless deaths and individuals being hooked on drugs, we often neglect to take into account the other variables such as: familial and spousal abuse, criminal activities, child endangerment and neglect, and the overall breakdown of a society. The repercussions of addictive substances are decaying the very fibers and morality of our society.


The psychosocial life of the addict is not only made vulnerable to the addictive habit, but the physiology of the brain is threatened. “Addiction causes hundreds of changes in brain anatomy, chemistry, and cell-to-cell signaling, including in the gaps between neurons called synapses, which are the molecular machinery for learning.”

The restructuring and rewiring of the brain is responsible for drastic personality changes. Over time, the addictions are capable of altering the perceptions, attitudes and worldviews of the addict. The changes can lead to a decrease in productivity and performance as an employee or as a student. Unfortunately, many who are addicted lose primary social supports; while developing social networks that are merely interested in fueling the addictive habit. Thus, the ability to triage the individual and assist them with overcoming the addiction decreases. The probability of recovery diminishes with time and the longevity of use.


As we consider the recovery process, we must remember that the addict’s biopsychosocial makeup has been compromised. For many, the challenge becomes commitment to the treatment process. It is important to recognize that the addict’s makeup has been compromised with creating a plan for care and treatment.


For many, “risks of drug abuse increases greatly during times of transition. For an adult, a divorce or loss of a job may lead to drug abuse; for a teenager, risky times include moving or changing schools. In early adolescence, when children advance from elementary through middle school, they face new and challenging social and academic situations.” While an individual may be at risk, it is not an indication that they will become an addict. There are a number of protective factors that can prevent someone from becoming an addict. The protective factors include: family support; financial stability; steady income; having set ambitions and goals; positive relationships; academic support and success; and a feeling of personal self-worth and value.


Whether or not an individual has developed an addictive habit; it is of critical importance that they have a support system in place. Support systems may not ensure that someone will thrive, but they will act as insulators protecting an individual from compromising situations.

A support system may include anyone interested in the welfare of another. A support system may be comprised of any number of individuals including: family, friends, peers, and professionals. Healthy social support can help an individual maintain sobriety or avoid temptation. When we are receiving such support, we feel empowered, healthier, and capable of managing our lives. Research has shown that healthy social support can reduce features of anxiety and depression. We are enabled to manage our affairs, cope, and make healthier decisions when receiving healthy social support.

Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
References Provided Upon Request