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.
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.
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.
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.
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.
SIGNS & SYMPTOMS
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 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.
ADDITIONAL RISK FACTORS
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:
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.
COMPLICATIONS OF ADDICTION
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.
TREATMENT OF 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.
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.
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 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)
Author: Akwesi Osei
An avid reader and writer who has written articles for HypeNationGh, LoudsoundGh and akwesiosei.wordpress.com.
Currently the blogger and owner of The Health Bro