If you’ve been struggling with addiction, or watching someone who has, you might have your own ideas about what addiction is. The problem is, many people have a skewed idea of what it actually is. For years, people experiencing addiction have been stigmatized. How we talk about substance use, recovery, and the treatment process is important, and can even motivate people to find a better way forward.
For this blog, we sat down with Dr. Lantie Jorandby to discuss signs of addiction, what happens to the brain during addiction, risk factors, treatment options, and what the first steps in recovery look like. If you or a loved one is struggling with substance use or addictive behaviors, Gulf Breeze Recovery can help. Call 833.551.2304 or reach out online.
What is addiction? A medical definition
According to the American Society of Addiction Medicine (ASAM), “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”
What does that mean? Addiction isn’t a one-time event; it lasts for a while. It causes repeated use of drugs, alcohol, or behaviors. It stems from your brain, your genetics, where you grew up, where you live now, and what you’ve lived through.
“It’s a compulsiveness to use something, like a chemical or behavior, that’s unhealthy, and it has created a problem in your life,” explains Dr. Lantie Jorandby, MD, CEO of Gulf Breeze Recovery. “It’s affecting a lot of different areas, whether that’s your relationships, your health, your mental health—it’s taken over your life. It replaces all the healthy things you should be doing or engaging in with the chemical or behavior.”
Addiction vs. substance misuse: What’s the difference?
Not all substance use—or even substance misuse—means someone has an addiction. Clinically, addiction exists on a spectrum, and understanding where someone falls on that spectrum helps guide care.
When considering whether someone is struggling with substance abuse vs. addiction, many clinicians think in terms of progression:
- Use: Consuming a substance without significant negative consequences
- Misuse: Using in ways that increase risk or cause problems
- Substance use disorder (addiction): A pattern marked by loss of control, compulsion, and continued use despite harm
“This is where I rely on the diagnostics around addiction,” said Dr. Jorandby. “Mild (addiction) might be someone who’s started to have relationship issues, but their work life is fine, their health is good—they don't seem to have lost complete control. But then it progresses, their use escalates, they start losing control, and then they start to see the creep into the rest of their life.”
Clarity and distinction matter when even talking about addiction, too. Language shapes how people view themselves—and whether they feel safe asking for help.
“It’s not because you’re a bad person, this is not because you have a bad personality, this is not a moral failing. It’s a disease—a brain disease—that can be treated. And so, when people can get past that hump of shame and understand that it’s a disease that has treatment, it helps get them into recovery.”
Types of addiction: Substance vs. behavioral
Broadly speaking, addiction falls into two categories: substance-related addictions and behavioral addictions.
Substance use disorders can involve alcohol, opioids, stimulants, benzodiazepines, and other drugs. These conditions are formally recognized in the DSM-5 (the manual used by healthcare professionals to diagnose mental health conditions) and are commonly treated in medical and clinical settings.
Behavioral addictions, sometimes called “process” addictions, don’t involve drugs or alcohol, but they still follow similar patterns: compulsion, loss of control, and continued behavior despite negative consequences. Gambling disorder is the most widely recognized behavioral addiction, though clinicians also commonly treat compulsive behaviors related to technology use, spending, or sex.
From a clinical perspective, the similarities are significant.
“It is very similar whether it’s chemical or a process. It’s all the same areas of the brain that get affected,” Dr. Jorandby notes.
Signs and symptoms of addiction
Addiction doesn’t look the same for everyone. Signs and symptoms vary depending on the substance or behavior involved, a person’s mental and physical health, and their environment. Still, clinicians look for common patterns.
Behavioral signs of substance abuse and addiction may include:
- Strong cravings or preoccupation with a substance or behavior
- Difficulty cutting back or stopping despite repeated attempts
- Spending increasing amounts of time using, recovering, or planning use
- Neglecting responsibilities at work, school, or home
- Continued use despite harm to health, relationships, or finances
Physical symptoms may include tolerance, withdrawal symptoms when use stops, changes in sleep or appetite, and declining overall health.
Even process addictions can cause noticeable signs. “Withdrawal is one feature, so people get irritable or restless when they try to back off from gambling,” said Dr. Jorandby. “They tend to find themselves needing to gamble more or with larger amounts of money to kind of get the same excitement they got when they initially started.”
What causes addiction? Risk factors and protective factors
There is no single cause of addiction. Instead, it usually develops through a combination of biological, psychological, and social factors interacting over time.
Common risk factors include genetics, trauma, chronic stress, co-occurring mental health conditions, early exposure to substances, and environmental influences.
“Trauma, a stressful childhood or environment growing up, having a genetic disposition, those are the big ones,” she said. Studies have shown that genetic factors, called “heritability,” can vary widely but are highly influential. Just because someone has a “50% genetic risk” of addiction does not mean that they’re destined to develop addiction.
Protective factors—such as strong social support, healthy coping skills, access to mental health care, and early intervention—can significantly reduce risk, improve outcomes, and even prevent substance abuse.
“Protective factors really are around parental involvement. It doesn’t have to be two parents; it doesn’t have to be a traditional household, but they have to have a strong parent involved. Prevention of use before age 21 is also very important because of the way brain development works. And then, just making sure that if there are mental health issues, they get addressed.”
Read more about risk factors: Trauma and addiction
How addiction affects the brain
Addiction changes how the brain processes reward, motivation, and stress. Substances and certain behaviors activate the brain’s reward system, releasing dopamine and reinforcing repeated use.
Over time, the brain adapts, making the substance or behavior more important than other sources of pleasure and connection.
“Addiction will take over the reward center (comprised of the nucleus accumbens) and convince someone that a substance or behavior is all they need, and so they replace everything good with that,” said Dr. Jorandby. “On top of that, the reward center communicates with other parts of the brain, like the frontal lobe or prefrontal cortex, which helps us make good decisions and think things out—and then impulsivity comes into the mix.”
But addiction has such a strong connection with emotions, too. That can also be chalked up to how it affects the brain.
“You also have the reward center communicating with the emotional side of our brains, including the amygdala and the thalamus. When that doesn’t work well, our emotions get dysregulated, and we have problems making good—or even reasonable—decisions. And it just continues to feed itself; it’s like a vicious cycle.”
Is addiction a disease? What clinicians mean by that
In healthcare, addiction is recognized as a chronic medical condition, similar to other long-term conditions like diabetes, asthma, or heart disease. This doesn’t mean recovery isn’t possible. It means that addiction often requires ongoing care, monitoring, and support, rather than a one-time fix.
“People can have months to years of recovery, and then they’ll relapse or have a slip,” she said. “Many people think about addiction as, ‘Okay, you went to treatment for 30 days, now you’re out. Everything should be hunky-dory.’ But you can’t look at it that way. You have to look at it as a lifelong thing to manage, like diabetes.”
The disease model can help families shift the conversation away from shame and toward evidence-based care. At the same time, it leaves room for personal agency, accountability, and growth.
How addiction is diagnosed
Diagnosing addiction is not about labeling someone—it’s about understanding what’s happening beneath the surface and determining what kind of support will be most helpful.
A comprehensive assessment typically looks at patterns of substance use or behavior over time, the impact on daily functioning, physical and mental health history, and any immediate safety concerns such as withdrawal risk or overdose potential. Clinicians also screen for co-occurring mental health conditions, which are common and important to address alongside addiction.
“Usually, the first assessment at Gulf Breeze is with the therapist who will be their primary therapist, so they’ll start building their rapport right away. It’s a long assessment that takes a couple of hours,” she said. “The therapist will give them time to take breaks, and sometimes they don’t complete the whole assessment in a day. They’ll always work to be non-judgmental, open, and compassionate.”
Rather than being a judgment, a diagnosis is a tool for care planning—one that helps ensure people receive treatment that matches their needs.
Treatment options that work for addiction
There is no single treatment approach that works for everyone. Effective addiction care is individualized, flexible, and responsive over time, adjusting as a person’s needs change.
A holistic approach to addiction treatment often includes a combination of:
- Medical support, including detox when withdrawal is a concern
- Individual and group therapy
- Trauma-informed and mental health care
- Family involvement and support
- Relapse prevention planning and aftercare
“When people come into treatment, we try to help them understand that there’s not this disparity of ‘we’re smarter than you,’ because we don’t know everything,” Dr. Jorandby said. “Guests have their own life experiences, and we respect that, and adapt their treatment to help them in whatever way that might be. Individualized treatment is the gold standard. Some people need more time, some people need different levels of care, which is why I feel very good about how we approach that at Gulf Breeze”.
Harm reduction and safer choices
Harm reduction is a practical, compassionate approach focused on reducing immediate risk and preventing death or serious injury, especially for people who may not yet be ready or able to stop using entirely.
This can include education about overdose risk, access to life-saving medications like naloxone, guidance on safer use, and support that keeps people connected to care. Rather than opposing treatment, harm reduction is often a bridge to recovery, helping people stay safe until they’re ready for the next step.
Next steps: Help for you or someone you love
If you’re concerned about your own substance use or worried about someone you love, taking the first step can feel overwhelming. It doesn’t have to be.
For many people, that first step is simply talking with someone to understand options, assess risk, and get guidance without pressure or commitment.
For families and loved ones, approaching the conversation with care rather than confrontation can make a meaningful difference.
“It’s a delicate balance. You have to be compassionate, but you can’t just roll over, either. You have to be very clear about where your boundaries are and not enable someone.”
Prevention and early intervention
Addiction often develops gradually, which means there are opportunities to intervene early—sometimes long before a crisis occurs.
Supporting mental health, teaching coping skills, addressing trauma, and responding early to changes in behavior or substance use patterns can significantly improve outcomes.
Get help for addiction in Gulf Breeze, Florida
At Gulf Breeze Recovery, we know people aren’t broken, and recovery isn’t about shame or punishment. It’s about care, connection, and helping people build lives that no longer revolve around substances.
You can find help for yourself or a loved one right here at our treatment center on the emerald waters of the Santa Rosa Sound. We’re available 24/7.
