( CNN ) -- Substance abuse is one of the most pervasive and costly problems in our country . Over 68 million American adults have some form of substance use disorder and about 25 million are addicted to one or more substances . Every year , millions of lives are lost because of it . What makes substance abuse hard to combat is the fact that addiction plays such a central role . Addiction is a nondiscriminating and devastating illness , affecting everyone from celebrities to teachers to soldiers to neighbors . Despite the prevalence of substance abuse , addiction remains widely misunderstood and misrepresented . However , major advances in scientific research have given us a much clearer picture of addiction -- what it is , what is is n't , and what causes it . Addiction is now known to be a chronic illness that affects the brain , behavior and health of people in progressive and lasting ways . More importantly , substance addiction is largely affected by genetic heritability . Dr. Sanjay Gupta : The truth about prescription medication addiction . Everyone has seen firsthand the friends or loved ones who were not equally affected by the same amount of alcohol , cigarette , marijuana or pills . These obvious differences between people have been attributed to `` character , '' `` upbringing '' or `` personal strength , '' but they 're actually the result of genetic heritability combined with environmental factors . Brain imaging has shown us that drugs and alcohol work powerfully on the dopamine system , the reward-driven learning center , by stimulating pleasure that can not be matched in normal human experience . This brain jolt results in a compelling desire in a person to repeat an experience , which then leads to signs of addiction : loss of control over use or the inability to temper use once started . If a person has untreated mental illness such as depression or anxiety , this effect can be greater . Once someone has become addicted to a substance , there are significant changes in brain functioning . Even after three to six months of sobriety , the brain is susceptible to relapses . For these reasons , punishments are rarely effective by themselves in reducing addiction . Most drug-related prison sentences , for example , result in relapse within months after release . Despite incarceration , the brain chemistry changes so that cravings do not completely disappear and the right environmental cues can trigger relapse . Family members of addicts know well the mystifying single-minded focus their loved ones show when they are in the throes of a compulsive cycle . Drug-seeking behavior becomes more extreme , interfering with work , education and family responsibilities . In short , users are no longer themselves , as their decision-making process has been short-circuited . So there is no `` cure '' for addiction . But the disease can be managed and recovery is possible . The most successful treatments are modeled after treatments for other chronic , noncurable , relapsing diseases such as diabetes , hypertension or asthma . Treatments for these diseases focus on helping patients comply with medications ( which reduce symptoms ) and adopting new health behaviors . Behavior therapy can help addicts by identifying their triggers and equipping them with coping skills for dealing with the overwhelming urges to use substance . FDA-approved medications can break the relapse cycle by helping addicts manage withdrawal symptoms and prevent relapse . For those addicted individuals with untreated mental illness , we should persuade them to go into treatment early on , because that may be contributing to their urges to use substance . It is critical to remember that addiction is a chronic illness and recovery is a lifelong process . The likelihood of sustained recovery is significantly improved after a year of continued abstinence . The chances of achieving this milestone are greater with the support of family and friends and a `` recovery network of peers '' such as Alcoholics Anonymous or other self-help organizations . Most of the public is unaware that relapse rates for all the substance use disorders are about the same as relapse rates for other chronic illnesses such as hypertension , asthma or diabetes , or that there are approximately 20 million individuals who are in stable , long-term ( a year or more ) recovery . These successes are not observable in part because those individuals wish to remain anonymous while they look and act exactly like the rest of us . Addiction is not hopeless , intractable or untreatable . Millions of people are in recovery from it . Follow CNN Opinion on Twitter . Join the conversation on Facebook . The opinions expressed in this commentary are solely those of Adam C. Brooks .
Substance abuse is a pervasive problem in America ; it is made worse by addiction . Adam Brooks : Addiction is now known to be a chronic illness that affects the brain . He says that for addicts , their decision-making processes are short-circuited . Brooks : There is no cure for addiction , but the disease can be managed .