Substance Use

Is Addiction a Mental Illness or Not?

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While some argue whether addiction is a personal choice or a moral failing, others view it as a disease that affects the brain. Similarly, mental illness is often misunderstood, with many misconceptions surrounding it.

The viewpoint of addiction being a mental illness is important because it affects the way society identifies individuals struggling with addiction, the types of treatments available, and the allocation of resources for research and rehabilitation. 

Here, we’ll look at why addiction is a mental illness and learn more about the relationships between addiction and mental illness.

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Understanding Addiction

Addiction is a complex condition, a brain disorder that is manifested by compulsive substance use despite harmful consequences. People with addiction have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point where it takes over their lives.

Addiction changes the brain in fundamental ways, disturbing a person’s normal hierarchy of needs and desires. These brain changes affect the neural circuits involved in reward, stress, and self-control, leading to the compulsive drug use and drug-seeking behavior that defines addiction. 

Not everyone who uses drugs becomes addicted. Various factors play a role in an individual’s vulnerability to addiction, including:

  • Genetic predisposition
  • Environment
  • Developmental stages

The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction.

Understanding Mental Illness

Now, let’s shift your focus to mental illness. Mental illnesses are health conditions involving changes in emotion, thinking, behavior, or a combination of these. They are associated with distress and/or problems functioning in social, work, or family activities. In the U.S., nearly one in five adults experience mental illness per year.

Mental illness is not a result of personal weakness, lack of character, or poor upbringing.

Many factors contribute to mental health problems, including:

  • Biological factors: genetics and chemistry
  • Life experiences: trauma and abuse
  • Family history of mental health problems

People with mental health problems can get better, and many recover completely.

Just like addiction, mental illness is misunderstood. People suffering from mental illnesses often face discrimination and prejudice, which can lead to a reluctance to seek help.

Understanding mental illness is the first step towards breaking down these barriers, promoting empathy, and improving mental health care.

Is Addiction a Mental Illness? The Full Answer

Based on the explanation of the two, it appears that addiction shares many characteristics with mental illness. Both involve changes in brain function, are influenced by genetic and environmental factors, and can be effectively treated.

The American Psychiatric Association (APA) classifies addiction as a mental illness named “substance use disorder.” According to the APA, addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences.

In the Diagnostic and Statistical Manual of Mental Disorders, widely accepted as the authority on mental health diagnoses, substance use disorders are listed alongside other mental illnesses.

While addiction is classified as a mental illness, not all individuals with addiction have another mental illness, and vice versa. The co-occurrence of substance use disorders and mental illness is common, but one does not directly cause the other, even though one can exacerbate the other.

How Addiction Changes the Brain

Substance use can lead to significant alterations in brain structure and function, similar to the changes seen in individuals with mental illnesses.

These changes occur in three stages

  1. Tolerance
  2. Dependency
  3. Addiction


In the initial phase, tolerance develops as your brain becomes accustomed to the substance. You may need to consume larger amounts to achieve the same effects, creating a dangerous cycle that can lead to dependency.


Dependency is the second stage where your brain adapts to the presence of the substance. At this point, you may feel physically unwell or experience withdrawal symptoms without the substance, making it increasingly difficult to stop using.


The final stage, addiction, is when substance use becomes compulsive despite harmful consequences. The brain’s reward system has been so significantly altered that obtaining and using the substance becomes a priority over other aspects of life.

These stages explain the impact that addiction can have on the brain, mirroring the changes seen in various mental illnesses. This, combined with the high rate of comorbidity, gives credit to the fact that addiction is indeed a form of mental illness.

Recognizing a Dual Diagnosis

Dual diagnosis refers to the co-occurrence of a mental health disorder and a substance use disorder. Recognizing a dual diagnosis can be challenging, as the symptoms of one disorder often mimic or mask the symptoms of the other. However, being aware of this possibility can aid in understanding and addressing both conditions.

If the individual with substance use is also experiencing mental health symptoms such as depression, anxiety, or erratic behavior, it may be indicative of a dual diagnosis. It is crucial to seek professional help in such cases, as the treatment needs for co-occurring disorders differ from those of a single disorder.

Dual Diagnosis Treatment

When it comes to treating addiction in the context of a dual diagnosis, a comprehensive, integrated approach is necessary. This means treating both the substance use disorder and the mental health disorder at the same time, rather than in isolation. This approach is more effective in achieving long-term recovery and focuses on the entire person. 

The treatment plan may include:

Seeking Help

Recognizing addiction as a mental illness can help reduce stigma, improve access to treatment, and promote research into effective interventions. Note that each person’s experience with addiction and mental illness is unique. A one-size-fits-all approach is not appropriate, and individualized plans are crucial.

If you or someone you know is struggling with addiction, it’s crucial to seek help. Numerous resources and treatment options are available, and recovery is entirely possible. Contact Zinnia Health 24/7 at (855) 430-9439.

Author: Vanessa Zeilinger, PharmD, BCPS, CPE. Vanessa is a board certified, residency trained pharmacist with experience across multiple health care settings.

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