When most people hear the word addiction, they picture someone whose life has visibly unravelled.
Yet addiction is often hidden in plain sight – affecting people in workplaces, schools, sporting clubs and family homes.
Addiction reaches across every age, income and background. Around one in three Australians in their 50s and 60s drink at risky levels , and many older adults rely on prescribed medications that, if taken incorrectly, can be harmful. Research suggests addiction affects a broad range of professionals – often in ways that go unrecognised for years.
We tend to use the term “addiction” loosely, saying we’re addicted to coffee, phones or a television series. But this means we often overlook the potential health impacts of addiction, and the barriers that may keep people from seeking treatment.
So what are still getting wrong about addiction? And what needs to change?
Addiction exists on a spectrum
Addiction describes a serious condition where a person finds it increasingly difficult to reduce or stop a certain behaviour, even if it causes harm to them or others.
About one in five Australians will develop a substance use disorder in their lifetime. Substance use disorder is a broader clinical term that encompasses the full spectrum of problems people can have with alcohol or other drugs, ranging from mild to severe.
Addiction sits at the severe end of that spectrum, characterised by powerful cravings , impaired control and continued use despite significant harm. Over time, the substance or behaviour takes up more space in a person’s life, affecting relationships, wellbeing and daily functioning .
Dependence is a distinct term that describes when a person becomes physically or psychologically reliant on a substance or behaviour.
Physical dependence refers to how the body adapts to repeated substance use. It is much more common than addiction. For example, someone taking opioids for pain or benzodiazepines for anxiety can become physically dependent on these medications. This means they may experience withdrawal symptoms – such as sweating, muscle aches and insomnia – if they suddenly stop taking them. This does not mean they have an addiction.
Psychological dependence describes when a person becomes increasingly reliant on a substance or behaviour as a way to cope with stress, manage emotions or get through everyday life.
Addiction may involve both physical and psychological dependence. However, a person who is dependent on a substance or behaviour isn’t necessarily addicted to it. It becomes an addiction only if a person keeps relying on it, even though they know it’s harmful.
Not just about drugs
When we talk about addiction, we tend to focus on alcohol, methamphetamine and opioids.
However, tobacco remains one of Australia’s leading preventable causes of disease and death. Gambling is known to inflict significant damage on people’s finances, relationships and mental health. And we’re only starting to unpack the long-term impacts of gaming and other compulsive behaviours, such as sex addiction and compulsive shopping .
What links these behaviours is not the substance itself. Rather, it’s the way they affect the brain – particularly its reward, motivation and decision-making systems. Over time, behaviours that initially provide pleasure or relief can become harder to control . And regular exposure to these behaviours can change the way the brain responds to rewards and stress.
This makes it much harder to reduce or stop these behaviours, even when someone is highly motivated to change . So for many people, addiction is less about chasing pleasure than avoiding distress.
Stigma still a barrier
The most damaging misconception about addiction is that it reflects a lack of willpower, weak character or poor moral choices.
Research consistently shows addiction is among the most stigmatised of all health conditions. This has a direct impact on how and when people access treatment.
On average, people with an alcohol use disorder take about 11 years to seek treatment after developing the condition. Research suggests people with other substance use disorders may take eight years , and those with mental health conditions closer to three .
But these figures don’t just represent a delay in treatment. Instead, they’re a measure of how long people live with a problem before they feel safe enough to ask for help.
Stigma also shapes how we respond to addiction on a system-wide level. Australian research shows negative attitudes towards addiction persist in health-care settings – for example, being refused pain relief or treated as less deserving of support. These attitudes can discourage people from seeking help or returning for care.
Changing the conversation
Words matter because they shape how we see people. When we define people by their addiction, it’s harder for them to seek help and easier for other people to judge them.
Addiction is not the result of a simple choice. Neither is it an inevitable consequence of gambling or using a specific type of drug. In reality, it’s a complex health condition shaped by various factors – such as past trauma, genetics and social isolation.
Importantly, addiction can be managed through treatment. Research suggests medications for alcohol use disorder are as effective as other evidence-based treatments – including those used to manage depression and high blood pressure.
And there is a wealth of evidence showing most people who develop a substance use disorder do eventually recover , with many doing so without ever receiving formal treatment . However, early support can prevent many of the long-term harms that accumulate over time.
Addiction is a health condition that deserves the same compassion and evidence-based care as any other. It’s time we recognised that. Only then will people feel safe to ask for help, and be confident they will receive the support they need.
If you or someone you know needs support, you can contact:
Lifeline on 13 11 14
Beyond Blue on 1300 22 4636
The National Alcohol and Other Drug Hotline on 1800 250 015
Gambling Help Online on 1800 858 858 or at gamblinghelponline.org.au
Counselling Online at counsellingonline.org.au
