Why substance addiction is more than just a bad habit

KUALA LUMPUR: Why do some people continue using substances even when they know the harm they are causing to their health, relationships and lives? The answer is not always straightforward, but the scale of the issue is undeniable.

According to this year’s World Drug Report by the United Nations, an estimated 331 million people used drugs in 2024 – a 34% increase from a decade earlier.

Of these, approximately 63 million were living with drug-use disorders. Yet only one in 12 received treatment.

These figures highlight the importance of understanding what addiction really is – a key step towards recognising it early and encouraging people to seek help.

At a recent talk on “Understanding Addiction”, clinical psychologist Ashwin Thind cited physician Dr Gabor Maté’s definition of addiction. Maté is widely known for his work on substance dependence, trauma and mental health.

“He puts it in very simple terms: ‘An addiction is any substance or behaviour that gives temporary relief and pleasure, but in the long term causes harm, has negative consequences and you can’t give it up despite these consequences’,” Thind outlined.

Addiction, he explained, develops progressively and is widely recognised as a disease. Repeated substance use alters the brain’s reward system, which helps people experience pleasure from everyday activities such as eating and drinking.

Over time, the brain begins associating the substance with that same sense of pleasure, making it much harder for a person to stop – even when they want to.

He likened the experience to driving a car with faulty brakes. “You’re pressing the brakes, you’re trying to stop, but the car is still going downhill.”

So, why do people use substances in the first place? The reasons vary, from recreational use and pain relief to performance enhancement, such as in the case of steroids used by athletes.

Substances generally fall into five classes: depressants, stimulants, opioids, hallucinogens, and a fifth category comprising inhalants, ketamine and other substances.

Importantly, Thine noted that just because a person uses substances, it does not automatically mean they have an addiction.

The difference is in the warning signs, which include spending a significant amount of time obtaining, using or recovering from the substance; making unsuccessful attempts to quit; experiencing strong cravings; and neglecting responsibilities at work, school or home.

Recognising these signs early and seeking help can make all the difference. “The sooner they speak to someone or seek treatment, the better,” he stressed.

Thind also offered guidance on how family members and friends should approach someone they suspect may be struggling with addiction.

Rather than confronting them aggressively or trying to force them into treatment, he recommends first opening the door to a conversation.

“It’s about letting them know, ‘Something tells me things are a little off. You know what? I’m going to be here when you’re ready to talk about it.'”

Although resisting the urge to confront a loved one and take immediate action can be hard, Thind cautioned that a direct approach could do more harm than good.

“If I come out directly and say, ‘I know you’re using meth’, the person is going to withdraw. So, it’s about letting them know that the space is safe enough for them to open up in.”