The explanation of addiction as a habit was the dominant explanation in psychology for the understanding of addictions during the first half of the 20th century. A habit is an automatic response that we have to certain stimuli without paying much attention to it. A habit is a wild card that allows us to save the cognitive expense of analyzing some behaviors that we perform on a daily basis. For example, washing hands, showering, eating, waking up or sleeping at certain times.
The problem is that not all the behaviors we automate are necessarily healthy. The conception of addiction of prescription drug as a bad habit also has its neurological basis in the migration of control of behavior from the nucleus accumbens to the neostriatum. This makes drug use habitual, automatic and resistant to consequences.
This theory goes smoothly until it must explain the motivational aspects of consumption, when difficulties appear to obtain the drug. At this point the person needs all his cognitive resources to achieve the desired drug.
EXCESS MOTIVATION: INCENTIVE AND AWARENESS
The first thing this theory takes into account is that the addict WANTS to use. This is explained by the action of drugs on the reward system that it activates, where desire activates all the motivational springs to obtain the desired drugs. Various studies agree that this desire is exacerbated in response to emotions that increase the reactivity of the mesocoticolimbic system to stimuli of drugs.
However, this theory does not explain why people use drugs, but rather why the desire to consume is maintained once physiological withdrawal has disappeared.
However, not all drug starts are for pleasure. There is a group of people who use them to relieve intense pain. At this point the logic of approach to consumption changes a bit and illustrates the difference between motive and motivation.
PAIN REDUCTION: THE CASE OF OPIOIDS
For many people the road to addiction begins with medications that allow them to relieve their pain. This is the case with opioids that are prescribed postoperatively or to relieve pain caused by certain medical procedures. It has been observed that people who are in need of maintaining opioid treatment for more than 90 days are at risk of developing an addiction.
Although there are similar cortical structures that are activated in the reward system, which involve the positive and negative reinforcements that we have seen previously, any reader will understand that seeking pleasure is not the same as relief.
Another problem is that a habit can be changed by paying attention. In the case of prescription drugs, it is not enough to pay attention to the stimuli. Imagine that a person with an active addiction pays attention to a “pull”, far from gaining resources to suppress it, it is most likely that it will exacerbate. The problem is that motivational resources act on the desire to consume that cannot be explained from the habit scheme. Therefore, the reader should not be surprised that the following theory is entirely motivational.
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