October 26, 2021

Understanding drug and alcohol addiction (dependence)

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No one starts using alcohol and other drugs with the intention of becoming dependent - but, we know it affects around 1 in 20 Australians.1

Addiction is both a mental and physical dependence to a substance or behaviour.

People can become addicted or dependent to a substance, such as alcohol or drugs, or a behaviour, such as gambling, shopping or sex.

Addiction is being unable to control or stop using a substance or doing a behaviour, even though it’s causing harm.2

Addiction is a chronic disease – a long-term health condition. But, just like other chronic diseases, such as diabetes or asthma, addiction can be successfully managed and treated. Recovery is possible.

Hijacking the brain’s reward pathways

Dependence changes the parts of the brain that control reward, stress and self-control.3

Most substances and addictive behaviours trigger the brain’s rewards system – releasing a flood of neurochemicals like dopamine that initially make us feel good.4

Over time, with more frequent and continued use, this feel-good factor gets harder to achieve as your brain develops tolerance.5

In order to get the same dopamine ‘high’ your brain’s craving, you need to increase the dose and/or frequency.4,5 This is usually when craving, urges and compulsion to engage in the activity can take over.5 This can become a problem when the behaviour takes place even when it’s harmful to you, your family, and other important areas of your life.

The physical impacts of dependence

While substance and behaviour addictions share many common characteristics, alcohol and other drug dependence carries a unique set of risks - in particular, short and long-term health issues and physical effects on the brain.6

These can include high blood pressure, heart disease, psychosis, stroke, mental illness, blood-borne viruses and overdose6,7 as well as changes to the areas of the brain that control judgement, decision-making and behaviour control.3,6

These changes help explain why behaviours relating to dependence can be difficult for people to control, and why people experiencing addiction find it difficult to stop using.6

Why do some people experience dependence and others don’t?

People use alcohol and other drugs for many reasons – to relax, for enjoyment, to improve focus, to avoid physical or emotional pain, to fit in, or to deal with grief, anxiety or trauma.8 And, the majority of people who use these substances don’t develop a dependence.

While there’s still a lot we don’t know, we do know addiction affects people from all walks of life and there’s no single cause.

We also know there are certain factors that put some people at an increased risk. These include:


Genetics play a major part in a person’s risk of developing alcohol and other drug dependence. If you have a parent or family member who has experienced addiction then you’re at a higher risk of experiencing addiction too.9


Home, school and social environments can also increase your risk of substance use and dependence.  Experiencing childhood trauma such as domestic violence, sexual assault or poverty; low academic achievement and poor social skills; and easy access to alcohol and other drugs through friends and parents can all increase a person’s risk.10


The younger someone is when they begin using alcohol or other drugs, the greater their risk of developing a dependence later in life.3 Young people are particularly at risk as substance use can affect their developing brain.3

More information on why people use alcohol and other drugs.

Factors that reduce your risk of dependence

Just as risk factors can increase the likelihood of substance use and dependence, other factors can reduce these risks. These protective factors include:

  • parental involvement in the child’s life
  • strong and positive bonds with parents and caregivers
  • clear and consistent family rules
  • good academic performance
  • school engagement and positive teacher experience
  • healthy peer groups
  • good social skills and ability to make friends.10,11

Connection as a pathway to recovery

Experiencing addiction can lead to isolation, social withdrawal and abandonment from family and friends.12,13

Increasingly, research also shows a strong link between social isolation, disconnection and loneliness in the beginning of substance use. 12-14

Social connection – feeling loved, like you belong, cared for and connected to others – reduces stress, boosts self-esteem, and improves mental and physical wellbeing.14 Creating connections with others can help bring people out of social isolation and support recovery.

Social and human connection plays an important role in supporting people in their recovery and is one of the key pathways in alcohol and drug treatment.15

Recovery is different for everyone and can take many forms – from harm reduction to quitting completely. However, the endgame is the same: to help people reach their goals and full potential.

If you’re dealing with alcohol or drug use issues, or social isolation due to dependence, COVID restrictions or mental health issues – you’re not alone, help is available.

The support services below are a good first step in getting help.


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  1. Health Direct. Substance abuse [Accessed 29 July 2021].
  2. National Institute of Drug Abuse (NIDA). Understanding Drug Use and Addiction DrugFacts [Accessed 4 August, 2021].
  3. National Institute of Drug Abuse (NIDA). Drug misuse and addiction [Accessed 23 August 2021].
  4. Harvard Health.Understanding addiction - New insights into the cause of addiction [Accessed 23 August 2021].
  5. National Institute of Drug Abuse (NIDA). Drugs and the brain [Accessed 23 August 2021].
  6. National Institute of Drug Abuse (NIDA).The Science of Drug Use: A Resource for the Justice Sector [Accessed 24 August 2021].
  7. National Institute of Drug Abuse (NIDA). Health consequences of drug misuse [Accessed 24 August 2021].
  8. Australian Government Department of Health. Reasons why people use drugs [Accessed 24 August 2021].
  9. National Institute of Drug Abuse (NIDA). Genetics and epigenetics of addiction DrugFacts [Accessed 19 August, 2021].
  10. National Institute of Drug Abuse (NIDA). What are the early signs of risk that may predict later drug abuse? [Accessed 19 August 2021].
  11. Youth.Gov. Risk and protective factors [Accessed 23 August 2021].
  12. Hosseinbor M, Yassini Ardekani SM, Bakhshani S, Bakhshani S. Emotional and social loneliness in individuals with and without substance dependence disorder. Int J High Risk Behav Addict. 2014;3(3):e22688-e.
  13. Johnson BR, Pagano ME, Lee MT, Post SG. Alone on the Inside: The Impact of Social Isolation and Helping Others on AOD Use and Criminal Activity. Youth Soc. 2018;50(4):529-50.
  14. Wilkinson A, Bowen L, Gustavsson E, Håkansson S, Littleton N, McCormick J, et al. Maintenance and Development of Social Connection by People with Long-term Conditions: A Qualitative Study. Int J Environ Res Public Health. 2019;16(11):1875.
  15. Pettersen H, Landheim A, Skeie I, Biong S, Brodahl M, Oute J, et al. How Social Relationships Influence Substance Use Disorder Recovery: A Collaborative Narrative Study. Subst Abuse. 2019;13:1178221819833379-.

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