What
Is Addiction? What Causes Addiction?
People with an addiction do not have control over what they are doing,
taking or using. Their addiction may reach a point at which it is harmful.
Addictions do not only include physical things we consume, such as drugs or
alcohol, but may include virtually anything, such abstract things as gambling
to seemingly harmless products, such as chocolate - in other words, addiction
may refer to a substance dependence (e.g. drug addiction) or behavioral
addiction (e.g. gambling addiction).
This article focuses mainly on addiction to physical substances.
In the past addiction used to refer just to psychoactive substances that cross the blood-brain barrier, temporarily altering the chemical balance of the brain; this would include alcohol, tobacco and some drugs. A considerable number of psychologists, other health care professionals and lay people now insist that psychological dependency, as may be the case with gambling, sex, internet, work, exercise, etc. should also be counted as addictions, because they can also lead to feelings of guilt, shame, hopelessness, despair, failure, rejection, anxiety and/or humiliation.
When a person is addicted to something they cannot control how they use it, and become dependent on it to cope with daily life.
This article focuses mainly on addiction to physical substances.
In the past addiction used to refer just to psychoactive substances that cross the blood-brain barrier, temporarily altering the chemical balance of the brain; this would include alcohol, tobacco and some drugs. A considerable number of psychologists, other health care professionals and lay people now insist that psychological dependency, as may be the case with gambling, sex, internet, work, exercise, etc. should also be counted as addictions, because they can also lead to feelings of guilt, shame, hopelessness, despair, failure, rejection, anxiety and/or humiliation.
When a person is addicted to something they cannot control how they use it, and become dependent on it to cope with daily life.
A habit may eventually develop
into an addiction
Many of us can use substances or become engaged in activities without any
significant problems. Some people, however, may experience damaging
psychological and/or physical effects when their habit becomes an addiction.
What is the difference between
a habit and an addiction?
- Addiction -
there is a psychological/physical component; the person is unable to
control the aspects of the addiction without help because of the mental or
physical conditions involved.
- Habit - it
is done by choice. The person with the habit can choose to stop, and will
subsequently stop successfully if they want to. The psychological/physical
component is not an issue as it is with an addiction.
Put simply - with a habit you are in control of your choices, with an addiction you are not in control of your choices.
Addiction to substances or activities can sometimes lead to serious problems at home, work, school and socially.
The causes of addiction vary considerably, and are not often fully understood. They are generally caused by a combination of physical, mental, circumstantial and emotional factors.
Addiction, often referred to as dependency often leads to tolerance - the addicted person needs larger and more regular amounts of whatever they are addicted to in order to receive the same effect. Often, the initial reward is no longer felt, and the addiction continues because withdrawal is so unpleasant.
According to Medilexicon's Medical Dictionary:
Addiction is Habitual psychological or physiologic
dependence on a substance or practice that is beyond voluntary control. Withdrawal
has many meanings, one of which is A psychological and/or physical syndrome
caused by the abrupt cessation of the use of a drug in an habituated person.
According to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association:
Substance dependence is When an individual
persists in use of alcohol or other drugs despite problems related to use of
the substance, substance dependence may be diagnosed. Compulsive and repetitive
use may result in tolerance to the effect of the drug and withdrawal symptoms
when use is reduced or stopped. This, along with Substance Abuse are considered
Substance Use Disorders..
Addiction may include prescription medications
Most people think of illegal
drugs when they hear the word “addiction”. However, prescription drug addiction is becoming a serious public health problem in
the USA and many other nations. Prescription
medication abuse was described as “an epidemic” by researchers from the
University of Nebraska Medical Center College of Medicine in a study they
reported on in November 2012.
The scientists explained that doctors today treat pain differently than they used to years ago. This change has led to an increase in prescription drug abuse.
In the USA in the 1990s - the decade of pain treatment - not only was there a change in medication, but also policy. Pain became the fifth vital sign doctors looked out for, along with respiratory rate, blood pressure, body temperature and pulse rate. Doctors’ offices today commonly have signs in their waiting rooms asking patients to rate their experience of physical pain from 1 to 10.
The scientists explained that doctors today treat pain differently than they used to years ago. This change has led to an increase in prescription drug abuse.
In the USA in the 1990s - the decade of pain treatment - not only was there a change in medication, but also policy. Pain became the fifth vital sign doctors looked out for, along with respiratory rate, blood pressure, body temperature and pulse rate. Doctors’ offices today commonly have signs in their waiting rooms asking patients to rate their experience of physical pain from 1 to 10.
What
Are The Signs And Symptoms Of Addiction?
A symptom is something the patient senses and describes, while a sign is
something other people, such as the doctor notice. For example, sleepiness may
be a symptom while dilated pupils may be a sign.
Substance dependence - when a
person is addicted to a substance, such as a drug, alcohol or nicotine, they
are not able to control the use of that substance. They continue taking it,
even though it may cause harm (the individual may or may not be aware of the
potential harm).
Substance dependence can cause powerful cravings. The addict may want to
give up (quit), but finds it extremely difficult to do so without help.
The signs and symptoms of substance dependence vary according to the
individual, the substance they are addicted to, their family history
(genetics), and personal circumstances.
- The person takes the substance and cannot stop - in many cases, such as nicotine, alcohol or
drug dependence, at least one serious attempt was made to give up, but
unsuccessfully.
- Withdrawal symptoms - when
body levels of that substance go below a certain level the patient has
physical and mood-related symptoms. There are cravings, bouts of
moodiness, bad temper, poor focus, a feeling of being depressed and empty,
frustration, anger, bitterness and resentment.
- There may suddenly be increased appetite.
Insomnia is a common symptom of withdrawal. In some cases the individual
may have constipation or diarrhea. With some substances, withdrawal can
trigger violence, trembling, seizures, hallucinations, and sweats.
- Addiction continues despite health problem
awareness - the individual
continues taking the substance regularly, even though they have developed
illnesses linked to it. For example, a smoker may continue smoking even
after a lung or heart condition develops.
- Social and/or recreational sacrifices - some activities are given up because of an
addiction to something. For example, an alcoholic may turn down an
invitation to go camping or spend a day out on a boat if no alcohol is
available, a smoker may decide not to meet up with friends in a smoke-free
pub or restaurant.
- Maintaining a good supply - people who are addicted to a substance will
always make sure they have a good supply of it, even if they do not have
much money. Sacrifices may be made in the house budget to make sure the
substance is as plentiful as possible.
- Taking risks (1) - in
some cases the addicted individual make take risks to make sure he/she can
obtain his/her substance, such as stealing or trading sex for money/drugs.
- Taking risks (2) -
while under the influence of some substances the addict may engage in
risky activities, such as driving fast.
- Dealing with problems - an
addicted person commonly feels they need their drug to deal with their
problems.
- Obsession - an
addicted person may spend more and more time and energy focusing on ways
of getting hold of their substance, and in some cases how to use it.
- Secrecy and solitude - in
many cases the addict may take their substance alone, and even in secret.
- Denial - a
significant number of people who are addicted to a substance are in
denial. They are not aware (or refuse to acknowledge) that they have a
problem.
- Excess consumption - in
some addictions, such as alcohol, some drugs and even nicotine, the
individual consumes it to excess. The consequence can be blackouts (cannot
remember chunks of time) or physical symptoms, such as a sore throat and
bad persistent cough (heavy smokers).
- Dropping hobbies and activities - as the addiction progresses the individual may
stop doing things he/she used to enjoy a lot. This may even be the case
with smokers who find they cannot physically cope with taking part in
their favorite sport.
- Having stashes - the
addicted individual may have small stocks of their substance hidden away
in different parts of the house or car; often in unlikely places.
- Taking an initial large dose - this is common with alcoholism. The individual
may gulp drinks down in order to get drunk and then feel good.
- Having problems with the law - this is more a characteristic of some drug and
alcohol addictions (not nicotine, for example). This may be either because
the substance impairs judgment and the individual takes risks they would
not take if they were sober, or in order to get hold of the substance they
break the law.
- Financial difficulties - if the substance is expensive the addicted
individual may sacrifice a lot to make sure its supply is secured. Even
cigarettes, which in some countries, such as the UK, parts of Europe and
the USA cost over $11 dollars for a packet of twenty - a 40-a-day smoker
in such an area will need to put aside $660 per month, nearly $8,000 per
year.
- Relationship problems -
these are more common in drug/alcohol addiction.
Some substance/alcohol abusers who are not technically addicted may also
suffer from or cause some of the descriptions mentioned above, but they do not
usually have the withdrawal symptoms of an addict or the same compulsion to
consume the substance.
What Are The Risk Factors
For Addiction?
A risk factor is something
which increases the likelihood of developing a condition or disease. For
example, obesity significantly raises the risk of developing diabetes type 2.
Therefore, obesity is a risk factor for diabetes type 2. Although anybody, regardless of age, sex or social status can potentially become addicted to some substances, there are certain factors which may increase the risk:
- Genetics (family history) - anybody who
has a close relative with an addiction problem has a higher risk of
eventually having one themselves. It may be argued that environmental and
circumstantial factors that close family members share are the prominent
causes.
- Alcoholics are six times more
likely than non-alcoholics to have blood relatives who are alcohol
dependent. Researchers from the Universidad de Granada, Spain, in a study revealed that "the lack of endorphin is hereditary,
and thus that there is a genetic predisposition to become addicted to
alcohol".
- Geneticists believe that the
reason some people try cigarettes and do not become smokers, while others
do so very quickly is probably linked to the type of genes we inherit from
our parents. Some people can smoke once in a while, throughout their
lives, and never seem to become addicted, while others are unable to stop
smoking without experiencing the unpleasant withdrawal symptoms. It is
most likely that the way the receptors on the surface of our brain nerve
cells respond to nicotine is influenced by our genes.
- Gender - a significantly higher
percentage of people addicted to a substance are male. According to the
Mayo Clinic, USA, males are twice as likely as females to have problems
with drugs.
- Having a mental
illness/condition - people with depression, ADHD (attention-deficit hyperactivity
disorder) and several other mental conditions/illnesses have a higher risk
of eventually becoming addicted to drugs, alcohol or nicotine.
- Peer pressure - trying to conform with other
members of a group and gain acceptance can encourage people to take up the
use of potentially addictive substances, and eventually become addicted to
them. Peer pressure is an especially strong factor for young people.
- Family behavior - young people who do not have
a strong attachment to their parents and siblings have a higher risk of
becoming addicted to something one day, compared to people with deep
family attachments.
- Loneliness - being alone and feeling
lonely can lead to the consumption of substances as a way of copying;
resulting in a higher risk of addiction.
- The nature of the
substance
- some substances, such as crack, heroin or cocaine can bring about
addiction more rapidly than others. For example, if a group of people were
to take crack every day for six months, and another identical group of
people were to drink alcohol every day for the same period, the number of
crack addicts at the end of the six months would be a lot higher than the
number of alcoholics. For some people trying a substance even once can be
enough to spark an addiction. Crack, also known as crack cocaine or rock,
is a freebase form of cocaine that can be smoked.
- Age when substance
was first consumed - studies of alcoholism have shown that people who start consuming
a drug earlier in life have a higher risk of eventually becoming addicted,
than those who started later. Many experts say this also applies to
nicotine and drugs.
- Stress - if a person’s stress levels
are high there is a greater chance a substance, such as alcohol may be used
in an attempt to blank out the upheaval. Some stress hormones are
linked to alcoholism.
- How the body
metabolizes (processes) the substance - in cases of alcohol, for example,
individuals who need a higher dose to achieve an effect have a higher risk
of eventually becoming addicted.
What Are The Causes Of
Addiction?
Doctors say there is a link
between the repeated use of an addictive substance and how the human brain
experiences pleasure - its use has a nice reward, leading to further and more
frequent use. The addictive substance, be it nicotine, alcohol or some drug
actually causes physical changes in some nerve cells in the brain. Another name
for a nerve cell is a neuron. Neurons release neurotransmitters into the
synapses (empty spaces) between nerve cells, which are received by receptors in
other neurons. What is a neurotransmitter - it is a chemical that a nerve cell releases, which thereby transmits an (electric) impulse from one nerve cell to another nerve cell, organ, muscle, or other tissue. Put simply, a neurotransmitter is a messenger of neurologic data from one cell to another cell.
Tolerance increases
After a while, the user of
the potentially addictive substance does not get the same pleasure and has to
increase the dose - his/her body’s tolerance to it increases.Eventually, the user no longer experiences pleasure from the substance and takes it simply to prevent withdrawal symptoms - taking the substance just makes them feel normal.
Experts say that when tolerance increases, the risk of addiction is much greater.
What
Are The Treatment Options For Addiction?
The first step for the addicted person is to acknowledge that there is a
substance dependency problem (addiction problem). The next step is to get help.
In most of the world there are several support groups and professional services
available.
Treatment options for addiction depend on several factors, including what
type of substance it is and how it affects the patients. Typically, treatment
includes a combination of inpatient and outpatient programs, counseling
(psychotherapy), self-help groups, pairing with individual sponsors, and
medication.
Treatment programs - these
typically focus on getting sober and preventing relapses. Individual, group
and/or family sessions may form part of the program. Depending on the level of
addiction, patient behaviors, and type of substance this may be in outpatient
or residential settings.
Psychotherapy - there may be
one-to-one (one-on-one) or family sessions with a specialist.
Help with coping with cravings, avoiding the substance, and dealing with
possible relapses are key to effective addiction programs. If the patient’s
family can become involved there is a better probability of positive outcomes.
Self-help groups - these may
help the patient meet other people with the same problem, which often boosts
motivation. Self-help groups can be a useful source of education and
information too. Examples include Alcoholics Anonymous and Narcotics Anonymous.
For those dependent on nicotine, ask your doctor or nurse for information on
local self-help groups.
Help with withdrawal symptoms – the main aim is usually to get the addictive substance out of the patient’s
body as quickly as possible. Sometimes the addict is given gradually reduced
dosages (tapering). In some cases a substitute substance is given. Depending on
what the person is addicted to, as well as some other factors, the doctor may
recommend treatment either as an outpatient or inpatient.
The doctor or addiction expert may recommend either an outpatient or
inpatient residential treatment center. Withdrawal treatment options vary and
depend mainly on what substance the individual is addicted to:
- Addiction to depressants - these may include dependence on barbiturates
or benzodiazepines. During withdrawal the patient may experience anxiety,
insomnia, sweating and restlessness. In rare cases there may be whole-body
tremors, seizures, hallucinations, hypertension (high blood pressure),
accelerated heart rate and fever. In severe cases there may be delirium,
which according to the Mayo Clinic, USA, could be life-threatening.
- Addiction to stimulants - these may include cocaine and other
amphetamines. During withdrawal the patient may experience tiredness,
depression, anxiety, moodiness, low enthusiasm, sleep disturbances, and
low concentration. Treatment focuses on providing support, unless the
depression is severe, in which case a medication may be prescribed.
- Addiciton to opioids –
Opioids are a class of drugs that are commonly prescribed for their
analgesic, or pain-killing, properties. They include substances such as
morphine, codeine, oxycodone, and methadone. Opioids may be more easily
recognized by drug names such as Kadian, Avinza, OxyContin, Percodan,
Darvon, Demerol, Vicodin, Percocet, and Lomotil. During withdrawal there
may be sweating, anxiety and stuffy nose – symptoms tend to be mild. In
rare cases there may be serious sleeping problems, tachycardia,
hypertension and diarrhea. The doctor may prescribe methadone, or
buprenorphine for cravings (alternative substances).
What Are The Possible
Complications Of Addiction?
Health - addiction to a substance, be it a
drug, narcotic or nicotine usually has health consequences. In the case of
drug/alcohol addiction there may be mental/emotional as well as physical health
problems. In the case of nicotine addiction the problems tend to be just with
physical health. Coma, unconsciousness or death - some drugs, taken in high doses or together with other substances may be extremely dangerous.
Some diseases - people who inject drugs have a risk of developing HIV/AIDS or hepatitis if they share needles. Some substances, including specific drugs or alcohol can lead towards more risky sexual behavior (unprotected sex), increasing the probability of developing sexually transmitted diseases.
Accidental injuries/death - people with a drug/alcohol addiction have a higher risk of falling over, or driving dangerously when under the influence.
Suicide - the risk of suicide is significantly higher for a person who is addicted to a drug/alcohol, compared with non-addicted individuals. This is not the case with nicotine dependence.
Relationship problems - social, family and marital relationships can be severely strained, leading to family breakups, etc.
Child neglect/abuse - the percentage of neglected or abused children who have one or both parents with an addiction problem is higher compared to those whose parents are healthy. These figures apply to some drugs and alcohol, not to just nicotine dependence.
Unemployment, poverty and homelessness - a significant number of drug/alcohol addicts find themselves without work or anywhere to live.
Problems with the law - if the substance is expensive, the addicted individual may resort to crime in order to secure his/her supply, making it more likely there will be problems with police, including imprisonmen
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