Addiction

A person with an addiction uses a substance, or engages in a behavior, for which the rewarding effects provide a compelling incentive to repeat the activity, despite detrimental consequences. Addiction may involve the use of substances such as alcohol, inhalants, opioids, cocaine, and nicotine, or behaviors such as gambling.

• The medical world currently views substance use disorders according to the class of drug that is used. As a result, it defines 10 distinct disorders. 
• • All of these disorders share the defining features of addiction: They directly and intensely involve the reward and reinforcement systems of the brain, causing an obsessive use that typically leads to the neglect of normal activities and negative consequences.
  • All substance use disorders share common symptoms. On the other hand, withdrawal symptoms differ from each. Withdrawal symptoms are not experienced in disorders with the use of hallucinogens and inhalants.

• Alcohol Use Disorder
  • Alcohol is a brain depressant and alcohol use disorder is common. Researchers found that women are more to the negative effects of alcohol. Studies also suggest that the disorder is commonly developed before the age of 40.
  • Alcohol Use Disorder is a pattern of unusual drinking that leads to significant distress. It can involve withdrawal symptoms, disruption of daily tasks, disagreement in relationships, and risky decisions that place oneself or others in harm’s way.

• Caffeine Intoxication: The consequence of very high doses of caffeine consumption, or caffeine intoxication is marked by symptoms including restlessness, nervousness, insomnia, flushed face, gastrointestinal disturbance, muscle twitching, rambling thoughts and speech, cardiac rhythm disturbances, periods of endless energy, and unintentional restlessness or involuntary movements of body parts known as psychomotor agitation.

• Cannabis Use Disorder: Cannabis use disorder is highest among 18-to 29-year-olds and prevalence of the disorder decreases with age.

• Phencyclidine and Other Hallucinogen Use Disorder: These substances alter perception. Phencyclidine is commonly called “angel dust” or PCP and produces feelings of separation of mind from body.

• Inhalant Use Disorder: Inhalant substances are volatile hydrocarbons—toxic gases that are released from glues, fuels, paints, and other volatile compounds and have psychoactive effects. The disorder occurs primarily among those ages 12 to 17.

• Opioid Use Disorder: Opioid drugs include the illicit drug heroin and prescription pain-relievers such as oxycodone, codeine, morphine, and fentanyl, among others. Prescribed opioids are the “overwhelming initial source” of addiction, according to the American Society of Addiction Medicine (ASAM).

• Sedative, Hypnotic, or Anxiolytic Use Disorder: Addiction to sleeping pills and anti-anxiety medications falls into this category. Like alcohol, these agents are brain depressants. Rates of the disorder are highest among 18-to-29-year-olds.

• Stimulant Use Disorder: Substances in this group include amphetamines; methylphenidate, best known as the prescription drug Ritalin; and cocaine. Stimulant drugs are commonly prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. 

• Tobacco Use Disorder: The nicotine in tobacco acts as a central nervous system stimulant. 

• Other (or Unknown) Substance Use Disorder: Substances ranging from antihistamines, betel nut, and cortisol to steroids may also have effects on the central nervous system that lead to compulsive use causing serious problems.

DISCLAIMER: This information is for educational purposes only and not to be used for self diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What are the primary symptoms/signs of addiction?

• Providing a simplistic explanation for addictive behavior is difficult. There is not just one cause: Although genetic or other biological factors can contribute to a person’s vulnerability to the condition, many social, psychological, and environmental factors also have a powerful influence on substance use.
• Some characteristics, such as a lack of ability to tolerate distress or other strong feelings, have been associated with addiction, but there is no one “addictive personality” type that clearly predicts whether a person will face problems with addiction.

• Recurrent use of a substance, or engagement with an activity, that leads to impairment or distress, is the core of addictive disorders. The clinical diagnosis of an addiction is based on the presence of at least two of a number of features:
  • The substance or activity is used in larger amounts or for a longer period of time than was intended
  • There is a desire to cut down on use or unsuccessful efforts to do so
  • A significant amount of time is spent on the pursuit of the substance or activity or the recovery from its use
  • There is a craving or strong desire to use the substance or engage in the activity
  • Use of the substance or activity disrupts obligations at work, school, or home
  • Use of the substance or activity continues despite the social or interpersonal problems it causes
  • Participation in important social, work, or recreational activities drops or stops
  • Use occurs in situations where it is physically risky
  • Use continues despite knowing it is causing or speeding up physical or psychological problems
  • Tolerance of the substance takes place. This is indicated either by the increase of the amount of substance to experience the desired effect. Or, due to the effect of the diminished effect of the same amount of substance
  • Withdrawal occurs, either as the presence of physiological withdrawal symptoms or the taking of a related substance to block them.

• The severity of the condition is evaluated by the number of symptoms present. The presence of two to three symptoms generally indicates a mild condition; four to five symptoms indicate a moderate disorder. When six or more symptoms are present, the condition is considered severe.

Please Note: This information is for educational purposes only and not to be used for self diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What factors can be contributing causes? 

• Research makes it clear: There is no way to predict who will develop compulsive substance use or gambling behavior.
• Addiction is a condition with many different aspects to it, arising from a combination of many elements—including, of course, exposure to an addictive substance. It is more accurate to think of risk factors for the development of substance abuse disorders, rather than direct causes. (There are also factors that protect individuals against addiction.)
• Biological factors
  • Genes. Estimates vary but scientists find that genetic factors contribute about half the risk for developing a substance use disorder. For example, a contributing factor to vulnerability is the variation in the genes that play a role in the organization/formation of brain receptors for the neurotransmitter – dopamine. Another factor appears to be the nature of the body’s hormonal response to stress. Research highlights a genetic component to alcoholism.
  • Physiological factors. Variations in liver enzymes that metabolize substances are known to influence one’s risk of alcohol use disorder.
  • Gender. Males are more likely to develop substance use disorder than females, although the said gender gap shrinks as females experience effects of intoxication at lower doses of alcohol.

• Psychological Factors
  • Personality factors. Both impulsivity and sensation seeking have been linked to substance use and gambling disorders. Impulsivity may be particularly related to the risk of relapse.
  • Trauma and abuse. Early exposure to significant adverse experiences can contribute to the development of substance use disorders by overwhelming an individual’s coping ability, perhaps by sensitizing brain pathways of alarm/distress, or by adding to the burden of stress.
  • Mental health factors. Conditions such as depression, anxiety, attention deficit disorder, and post-traumatic stress disorder (PTSD) increase the risk of addiction. Difficulties managing strong emotions are also linked to substance use.

• Environmental Factors
  • Family factors. Strong family bonds have been shown to act as protective factors against substance use disorder. Research indicates that marriage and taking on the child-raising responsibilities reduces the risk of addiction. Yet several functioning or circumstances of family could contribute to the risk. These include a sibling or parent with a disorder, lack of parental supervision or support and family disruptions such as divorce. Research reveals that abuse of any nature (sexual, physical or emotional), and poor quality and troubled parent-child relationships  contribute as risk factors.
  • Accessibility factors. Easy availability of alcohol or other substances in one’s home, at school or work, or in one’s community increases the risk of repeated use.
  • Peer group. As social animals, people are strongly influenced by their peers and, in wanting to be liked by them, may adopt many of their behaviors, particularly during adolescence. Positive social relationships, on the other hand, are known to strongly protect against substance use.
  • Employment status. Having a job, and developing the skills for employment, exerts pressure for stability and provides financial and psychological rewards that mitigate addiction risk.

What is the recommended treatment?

• Substance use is a treatable condition and complete remission is entirely possible. Recovery, however, is often a long-term process that may involve multiple attempts. Relapse is now regarded as part of the process, and effective treatment regimens address prevention and management of recurrent use.
• Since success tends not to occur all at once, any improvements are considered important signs of progress. Increasingly, programs are available to help those who recognize that they have a substance-use problem but are not ready to stop using the substance completely.
• Addiction impacts the many areas of an individual’s functioning such as the ability to tolerate frustration and establishing and maintaining a productive role in society. Therefore, a treatment is considered effective if the process focuses on the many dimensions of life including mental health, family roles and work skills.
• Treatment can include any of a number of components, which are often used in combination and are likely to change over the course of recovery:
  • Detoxification, conducted under medical supervision, may be needed but is only the first stage of treatment.
  • Medications that reduce or counter the use of illicit substances are suitable for some individuals, or medications may be used to target co-occurring disorders such as anxiety and depression.
  • Motivational Interviewing, is a short-term counselling process to help a person resolve feelings of doubt about treatment and find and hold onto incentives for change.
  • Cognitive Behavior Therapy (CBT) can help a person recognize and cope with situations that trigger the desire to use substances.
  • Group therapy and other peer-support programs use the direct experience of many to support individual recovery and prevent the recurrence of substance use.
  • Family therapy helps individuals repair any damage done to family relationships and to establish more supportive ones.
  • Life skills training, including employability skills, maybe part of an individual’s treatment plan.
  • Good treatment programs also feature the regular monitoring of individual progress.

• Treatment is available in a variety of settings, from a doctor’s office or outpatient clinic to a long-term residential facility. No one way will be right for everyone, and there is evidence that one’s commitment to change is more important than the type of treatment program he or she selects. Research suggests that any treatment that is considered will only be identified as an effective program if it includes the following features):
  • Patients undergo comprehensive medical and psychiatric screening
  • Treatment addresses individual needs, including co-occurring conditions, whether chronic pain, anxiety, or hepatitis
  • Families are involved in the treatment
  • There is continuity of care via active linkages to resources in each phase of recovery
  • The facility maintains a respectful environment
  • Treatment services are evidence-based and reflect best practices
  • Staff members are licensed and certified in the disciplines they practice
  • The program is accredited by a nationally recognized monitoring agency
  • Patient response to treatment is monitored and the program or facility offers outcome data reflecting treatment performance

• Treating alcoholism
  • In some cases, the first step in treating alcohol use disorder is detoxification—experiencing withdrawal in a safe setting with medical professionals. Following withdrawal, there are many paths to recovery.
  • Some people are able to stop drinking on their own. There are many organized programs that provide the support of peers, usually through frequent meetings. Alcoholics Anonymous is one such program; It offers a structured 12-step path toward recovery with a community of support from those who have dealt with similar challenges.
  • Cognitive behavioural therapy is another path, available in person or online. Non-abstinence-based recovery models—such as Moderation Management—advocate for reducing one’s alcohol consumption rather than abstaining completely.
  • The biggest barrier to therapy of any kind that patients may face is the shame and stigma associated with the condition; most programs address such concerns directly.

• A general practitioner (GP) or psychologist can usually diagnose the substance abuse disorder by asking questions about a person’s medical history and symptoms.
• The GP/psychologist will also inquire about a patient’s physical health to rule out other causes of addiction.
• The GP/psychologist will check the symptoms that the patient presents with against the standard criteria for the disorder before making a diagnosis.

• The prevalence of Alcohol Use Disorder among adult men is 12.4 per cent, which is significantly higher than for women (4.9%), although rates are rising among women as well.
• Cannabis use disorder is highest among 18-to 29-year-olds (4.8%).
• Relating to Tobacco Use Disorder, studies show that 68 per cent of adult smokers want to quit, and 50 per cent have made attempts to quit.
• About half of one’s predisposition to alcoholism can be attributed to genetic makeup.

If you are experiencing any of these signs, here are some activities you can do at home until you are able to consult a professional

• Exercise
• Engage in creative outlets such as writing, painting, or music
• Keep a gratitude journal
• Talk to a family member or friend about how you are feeling
• Practice Mindfulness
• Practice Yoga
• Engage in a well-balanced diet
• Maintain a good sleep schedule 
• Recognise what you can and can’t handle