The quick answer is, that it’s both. It’s psychological and physical.
If you have developed an addiction, it means that physical changes have occurred in the circuitry and function of your brain. These are real physical changes to the cells in your brain. Those changes interfere with how your brain functions – your psychology.
This leads to changes in how you think, feel, and what you do. It affects things like your general behaviour, your emotions, your assessment of risk, your impulse control and your decision-making.
These brain changes also include an extreme, abnormal increase in the strength of the desire to continue with your addiction. Most people are unable to resist those abnormally strong temptations without outside help and support.
It’s like a perfect storm – all these physical and psychological changes combine to cause a loss of control over your intake of a drug, or your ability to resist the intense temptation to gamble, or to control your abnormal eating behaviour, or an obsessive need for porn or sex.
These brain changes explain why you can no longer deny the intense drives coming from your body and brain demanding that you give them what they want: which is whatever substance, or behavior, you’ve become addicted to.
Although these brain changes are physical, they are not the same as the unpleasant physical withdrawal symptoms caused by some drugs when they are withdrawn from the body. That is what is called ‘Withdrawal’.
This is usually called ‘Detox’ when this is done at the start of rehab. A Withdrawal reaction is your physical body protesting about being deprived of what it’s got used to – something your body has developed a physical dependency on.
Although this drug withdrawal reaction is physical, like the physical changes that happen in your brain, clearing the drug out of your body and brain does not ‘cure’ you of addiction. The drug itself is not the main driver of the desire to continue with an addiction.
Unfortunately, the complicated drives and other altered brain functions that are Addiction, continue after Detox, even after there is no drug left in the body.
We know this because brain scans show that, unfortunately, the brain’s abnormal functioning still continues even after drug Detox and total abstinence has been achieved.
And the so-called Process Addictions such as gambling or sex addiction don’t involve drugs at all, but they are all still addictions with the same altered brain functions.
Detox and abstinence can be achieved in a relatively short period of time, but to regain control over the abnormal drivers of addiction, the causes of the problem need to be understood by the addicted person themselves, and methods of overcoming and controlling them need to be learned.
That is what happens when someone continues into extended rehabilitation after Detox. These factors show why it’s so important to understand that Detox is just the beginning of the path to recovery, and long-term recovery requires extended Rehabilitation and on-going support as well.
All these factors interact with our genetic inheritance, our personal experiences from the past, and the social and physical environment we live in, to cause what we call Addiction. With help, many of these factors can be changed, and Recovery is possible.
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