Addiction is a complex disease, often chronic in nature, which affects the functioning of the brain as well as the body. It also causes serious damage to families, relationships, schools, workplaces and neighborhoods. The most common symptoms of addiction are severe loss of control, continued use despite serious and destructive consequences, preoccupation with using, multiple failed attempts to quit, tolerance and withdrawal. The international disease of addiction can be effectively prevented, treated and managed by healthcare professionals in combination with family or peer support.
Individuals suffering from the disease of addiction do not have control over what they are doing, taking or using. 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 or behavioral addiction 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, depression, hopelessness, despair, failure, rejection, anxiety and/or humiliation.
Addictions and habits
With a habit you are in control of your choices, with an addiction you are not in control of your choices.
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. 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. The person suffering from the disease of addiction 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 and painful.
The disease of addiction may include prescription medications
Most people think of illegal drugs when they hear the word “addiction”. However, prescription drug addiction has become a very deadly and serious public health problem in the USA and many other nations. Unfortunately most doctors instead of treating the cause of the pain address the symptoms of pain, this trend has led to an increase in prescription drug abuse.
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. 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.
Signs and symptoms of substance addiction may include:
The person 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, all based upon the type of substance used.
There may suddenly be increased appetite or loss of 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.
Social and/or recreational sacrifices – some activities are given up because of an addiction to something.
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 – 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. while under the influence of some substances the addict may engage in risky activities.
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 or physical symptoms, such as a sore throat and bad persistent cough.
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.
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.
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.
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
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 empty spaces between nerve cells, which are received by receptors in other neurons.
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.
In many cases, it is a family member or very good friend who raises concern about the patient’s behavior , rather than the patient himself/herself doing so. The first port of call is usually a general practitioner, primary care physician or a family doctor.
Blood test – this may be ordered to determine whether the substance is still in the blood. It is not used to diagnose addiction.
DSM criteria for substance dependence – a patient diagnosed with substance dependence must meet criteria laid out in the DSM (Diagnostic and Statistical Manual of Mental Disorders), a manual published by the American Psychiatric Association.
The criteria for drug dependence that causes significant problems must include three of the following:
Tolerance – the substance has less effect on the patient because their body has developed tolerance. They need more and more of it to get the same pleasure.
There are physical/psychological withdrawal symptoms, or the patient takes the substance to avoid experiencing withdrawal, or the patient takes a similar substance to avoid experiencing withdrawal.
The patient frequently takes higher-than-intended doses of the substance.
The patient often tries to quit or cut down.
More and more time is spent getting hold of the substance, using it, or recovering from its effects.
The patient’s drug use causes him/her to give up social, occupational or recreational activities.
Even though patients know it causes psychological/physical problems, they continue taking it.
The first step for the addicted person is to acknowledge that there is a substance dependency or addiction problem. The next step is to get help. We at Ayeneh Foundation believe that those who are enjoying sobriety and are living in the world of recovery are the best guides and their life experiences are vital in giving validity to the fact that recovery is not just a dream but a fact.
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.
Addiction treatment programs
Addiction treatment programs 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.
Self-help groups 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 or tapering the dosages . 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.
Addiction 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.
The following are common complications caused by a substance addiction. An addiction may affect a person’s life in the following ways:
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 imprisonment.