Addictions may manifest in numerous ways, but generally they share three common characteristics – often referred to as the three C’s of compulsive use, loss of control and continued use. In this post we’ll focus on the role compulsive use plays in addictive behaviour.

Compulsive use has three elements: reinforcement, craving and habit. Reinforcement refers to a process in which the behaviour to use is strengthened based on previous experience Such experience as relief from pain or stress, increased pleasure, and/or becoming more sociable, may strengthen the desire to use the substance (Coombs & Howatt, 2005). Being rewarded with pleasure or relief from stress and pain encourages substance use (Koob & Simon, 2009).When one continues to use the substance, tolerance develops.

Tolerance refers to the need for an increased amount of the substance/ behaviour to achieve a previously similar desired effect. Tolerance develops when normal brain functions adapt to compensate for the disruption caused by the substance in both the behaviour and the bodily functions.

Chronic exposure to the substance produces neuronal adaptation that results not only in tolerance but in the requirement of the presence of the substance for normal function (Harris & Buck, 1990; Coombs & Howatt, 2005; Koob & Simon, 2009). As tolerance increase, absence of the substance may lead to craving.

Craving is the physiological need for the substance triggered by relevant brain activity. The body and the brain send intense signals during the absence of the substance triggering withdrawal symptoms. Withdrawal symptoms refer to a maladaptive behaviour change with physiological and cognitive effects that occur as a result of abrupt termination or substantial reduction of the substance in the body (Becker, 2008; Coombs & Howatt, 2005).

Habit refers to an automatic and compulsive, pattern of the behaviour that demonstrates poor self control and tends to continue despite negative feedback. This results from the deeply ingrained patterns in the memory of the nervous system (Coombs & Howatt, 2005). The brain’s normal circuits include the brain reward system that induces pleasurable feelings when stimulated.

To regain these rewarding feelings, the circuit encourages a repeat of the behaviours that stimulate pleasurable feelings that in turn encourages continued use of the desired substance (Coombs & Howatt, 2005).