Naples Integrated Recovery LLC gravitates toward a neurobiological and medical-model orientation to understand addiction, as this aids in reducing shame and stigma. Each individual case is complicated, with multiple underlying causative factors impacting very complicated, dynamic neural circuitry.

Addiction is a chronic, incurable medical condition centered in the mesolimbic dopamine reward pathway that is essential for our well-being. Addiction liability can begin with genetics that predispose certain individuals to seek behaviors that enhance the reward pathway. However, genetics only explain part of the variability among people.

Adverse childhood experiences, negative family interactions, societal pressures, and other factors interact with genetics, and can put an individual on a perilous path. The brain has multiple feedback loops for maintaining homeostasis, and chronic overstimulation of the mesolimbic pathway causes desensitization to dopamine, adverse rebound effects, and the need for more of the addictive agent to get the same effect as before, thereby creating a vicious cycle.

In some addictions, there are underlying psychological and psychiatric states that are lessened by self-medication. The addictive agent temporarily relieves symptoms, ranging from depression, anxiety, self-image, social inadequacy, sleep problems, PTSD, etc., but efficacy wanes due to tolerance. Dr. Nora Volkow summarized that addiction results from the repetition of voluntary behaviors until the landscape of the person with addiction becomes restricted to one of cues and triggers for drug use. This is why willpower alone is often not enough to stop someone from drinking or using substances.