From all the research that has been done in the field of addiction over the past 30-40 years, we know several factors are involved in the development and continuance of addictive behavior.   Within the disease model of addiction, we understand the development of an addiction stems from the genes we have inherited.  Once these particular genes are activated, the disease progresses, from the point of onset to chronic and often fatal stages, unless it is treated.

Through this medical model, we learn that addiction is a biopsychosocial disease, with many factors contributing to the development of an addiction including our biology or genetics (bio); our thoughts, feelings and emotions (psycho); and our personal histories: the way we were raised, the environmental and cultural cues and messages we are exposed to (social).

Traditional learning theory (specifically operant conditioning) states that we tend to repeat behaviors that are pleasurable, thereby setting up a pattern of action, reward, repeated action.  Our brains are hard-wired to be able to learn this way, as it is critical for our survival.  For example, when we eat, dopamine is released in the brain, sending the message to repeat the behavior.  The concept of making associations is key to learning theory as are the concepts of reinforcement and punishment.   Getting a pleasurable response to a behavior (i.e. feeling satisfied after eating a tasty meal) increases the chance that we will seek opportunities to repeat the behavior.  On the contrary, being punished after doing a behavior (i.e. getting burned from touching a hot stove) drastically reduces the likelihood we will repeat the behavior.

When looked at against the backdrop of addictive behavior, it is easy to understand how one can get caught up in the cycle of repeating certain behaviors.  Although in time, addictive behaviors come with negative consequences (punishments), they are initially paired with the experience of pleasure.  In the case of certain drugs and routes of administration (for example shooting heroin), the behavior is paired with extreme pleasure.  In learning theory, the stronger the experience of pleasure, the stronger the association will be and therefore, the more likely one will want to repeat the behavior.

Classical conditioning, another subset of learning theory, can explain why formerly neutral stimuli become paired with the anticipation of pleasure as they become cues for the target behavior.  Environmental cueing and classical conditioning are theories that account specifically for relapse.  For example, a previously neutral or even negative stimulus such as a needle can in and of itself set off the phenomenon known as craving in an individual who is addicted to heroin or crystal methamphetamine.  In this case, one may experience intense psychological cravings without even coming into contact with the actual drug, only with the stimuli that have become paired associations with the drug.  These intense cravings can easily lead to relapse, if not addressed and dealt with properly.

Further, social learning theory, first explained by Albert Bandura in 1961, also explains addiction in terms of the biopsychosocial model.  Social learning theory posits that we can learn and make associations in a social context, simply by observing and imitating the behaviors of others.  The behavior(s) being observed are most likely to be repeated if reward is part of the observation.  For example, a person watching his/her peers drink, laugh and have fun will pair that association and increase the likelihood that he/she will attempt the behavior as well.  This is known as vicarious reinforcement.

With a pattern of addiction, social learning is often responsible for the initiation of drug/alcohol related behavior.  Once the addictive process has taken over, social factors fade out and become largely irrelevant to the maintenance of the addiction.  As the addiction progresses, opportunities to learn from healthy individuals engaged in healthy or adaptive ways of coping with stress become scarce, as healthy people begin to disengage from the addict and as the addict associates almost exclusively with other addicts or users.

Learning theory, including operant and classical conditioning and social learning can be applied to recovery as well.  In recovery, we re-learn the associations made in the brain during our addiction.  We pair craving and/or stress with picking up the phone and reaching out to our sober network.  We learn to avoid things, people or situations that will lead us back to using.  We make daily associations such as waking up in the morning and praying or meditating.  And finally, we learn socially acceptable behavior from our sober mentors, family and friends.

New Hope Recovery Center is an alcohol and drug rehab treatment center located in Chicago, IL. We provide Partial Hospitalization, Intensive Outpatient, and Aftercare. We also have a LGBTQI specific addiction treatment program entitled "New Hope With Pride.” We offer personalized, holistic treatment by examining the whole person: mind, body and spirit.  Our small intimate setting caters to your specific needs and we provide place of support, nurture and safety leading to hope and healing. If you are interested in a confidential assessment, or you know someone who is, call 888-707-4673 to talk to a staff member.

Written by: New Hope Recovery Center