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Understanding Addiction

addictionAddiction is a condition in which the body must have a drug to avoid physical and psychological withdrawal symptoms. Addiction’s first stage is dependence, during which the search for a drug dominates an individual’s life. An addict eventually develops tolerance, which forces the person to consume larger and larger doses of the drug to get the same effect. (APA, 2013)

Addiction is a complex condition, a chronic brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance, such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug when they know it will causes problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives.

People with a substance use disorder have disturbed thinking, behavior and body functions. Changes in the brain’s wiring are what cause people to have intense cravings for the drug and make it hard to stop using the drug. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory and behavior control.

People can develop an addiction to:

  • Alcohol
  • Marijuana
  • PCP, LSD and other hallucinogens
  • Inhalants, such as, paint thinners and glue
  • Opioid pain killers, such as codeine and oxycodone, heroin
  • Sedatives, hypnotics and anxiolytics (medicines for anxiety such as tranquilizers)
  • Cocaine, methamphetamine and other stimulants
  • Tobacco

These substances can cause harmful changes in how the brain functions. These changes can last long after the immediate effects of the drug — the intoxication. Intoxication is the intense pleasure, calm, increased senses or a high caused by the drug. Intoxication symptoms are different for each substance.

Over time people with substance use disorder build up a tolerance, meaning they need larger amounts to feel the effects.

According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:

  • to feel good – feeling of pleasure, “high”
  • to feel better – e.g., relieve stress
  • to do better – improve performance
  • curiosity and peer pressure

People with addictive disorders may be aware of their problem, but be unable to stop it even if they want to. The addiction may cause health problems as well as problems at work and with family members and friends. The misuse of drugs and alcohol is the leading cause of preventable illnesses and premature death.

Symptoms of substance use disorder are grouped into four categories:

  • Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
  • Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use
  • Risky use: substance is used in risky settings; continued use despite known problems
  • Drug effects: tolerance (need for larger amounts to get effect); withdrawal symptoms (different for each substance)

Many people experience both mental illness and addiction. The mental illness may be present before the addiction. Or the addiction may trigger or make a mental disorder worse.

Criteria for Addiction:

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V), identifies specific criteria to diagnose substance dependence. Substances are normally considered to be drugs of abuse such as alcohol, cocaine, and heroin.

A minimum of 3 out of 7 of the criteria listed below must be met for a person to be considered dependent or addicted, to a substance.  The criterion must be met within a given year.  

  1. Tolerance (more drug is needed for the same effect)
  2. Withdrawal
  3. Taking a larger amount of the substance or taking the substance for a longer period than was intended
  4.  Experiencing a persistent desire for the substance or an inability to reduce or      control its use
  5. A great deal of time is spent in activities necessary to obtain the substance
  6. Use of the substance interfering with important activities
  7.  Use of the substance continuing despite known adverse consequences.

When criterion 1 or 2 is met physiological dependence can be determined and diagnosed as such.

When criterion 1 and 2 are not met and one determines that number four, (experiencing a persistent desire for the substance or an inability to reduce or control its use), is present, then the dependency or addiction can be diagnosed as a psychological dependency.

Addictive behaviors represent confusing and complex patterns of human activity (Shaffer, 1996, 1997).   Shaffer identified these behaviors as drug and alcohol abuse, some eating disorders, compulsive or pathological gambling, excessive sexual behaviors, and other intemperate behavior patterns. These behaviors have defied explanation throughout history.

Psychological addictions are very serious issues that people struggle with and are just as serious and damaging as drug or alcohol related physical dependencies and addictions. Consider Psychological Addictions as the brain responding to the addiction, excessive eating, starvation, gambling, internet, and sexual addictions the same way the brain would respond to drugs and alcohol.

Simply put, regardless the habit, when the addict feeds the habit, the addiction will grow.

Adapted from: National Council on Alcoholism and Drug Dependence
American Psychiactric Association,https://www.psychiatry.org
American Psychological Association, https://www.APA.org
National Institute on Drug Abuse (NIDA) https://www.drugabuse.gov/
Narconon, http://www.narconon.org/drug-abuse/signs-symptoms-heroin-use.html

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