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What is Addiction?

The term 'addiction' is used to describe a devotion, attachment, dedication or inclination. Today though, 'addiction' describes a recurring compulsion to engage in an activity, despite harmful consequences to one's health, mental state or social life.

The term usually refers to drug or alcohol compulsions, but it is sometimes applied to problem gambling, impulse buying, compulsive shopping, compulsive overeating, etc. Many factors may cause addiction including genetic, biological/pharmacological and social factors, and this continues to be the source of much discussion and disagreement.

In the past, 'addiction' specifically referred to the use of a tolerance-inducing drug in sufficient quantity as to cause tolerance (the requirement that more of a given drug must be used to produce the same effect as time passes). At the same time, a non-medical definition of addiction has developed. This definition refers to individuals who continued to use a particular drug despite their own best interests. The medical community calls this the 'Disease Model' of addiction..

Obviously, terminology and definitions have become complicated in the field. Many health professionals continue to speak of addiction from a physiological standpoint. Psychiatrists, doctors and physicians refer to the disease state in terms of physical dependence as defined in the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV TR).

The medical community now makes a careful distinction between physical dependence (characterised by symptoms of withdrawal) and psychological dependence (or simply 'addiction'). Addiction is often now defined as 'uncontrolled, compulsive use'; if there is no harm being suffered by, or damage done to, the patient or another party, then medically it may be considered compulsive, but not necessarily 'addiction'. In practice, the two kinds of addiction are not always easy to distinguish. Addictions often have both physical and psychological components.

Therefore, a useful definition - and one referred to by many professionals - is that provided by the World Health Organisation (WHO):

Why do people keep using?

Addictive behaviours can be difficult to change. One of the most difficult aspects of abuse is that the initial effects tend to be positive. People may feel good, have more confidence and forget about problems. In contrast, the negative effects might not be obvious for some time.

Continued substance use, especially heavy use, causes changes in the body and brain. If people develop physical dependence and then stop using, they may experience distressing symptoms of withdrawal. Frequently the awareness of the severity of the problem is only made real to the individual when they first try to quit, and can’t. The changes to the brain brought about by long term use are long lasting. These changes are one of many reasons why people continue to crave substances and slip back into substance use long after they have stopped using.

Physical Dependence

Physical dependence on a substance is defined by the appearance of withdrawal symptoms when use of the substance is discontinued. Opiates (such as Heroin), benzodiazepines, barbiturates, alcohol and nicotine induce physical dependence.

The speed with which a person becomes addicted to a substance varies with the substance, the frequency of use, the method of use, the intensity of pleasure, and the individual's genetic and psychological susceptibility. Some people may exhibit alcoholic tendencies from the moment of first intoxication, while most people can drink socially without ever becoming addicted.

In the case of heroin (or other opiates) dependent people have different responses to even low doses of the drug, although this may be due to a variety of other factors, as opiate use heavily stimulates pleasure-inducing areas in the brain. Nonetheless, because of these variations, in addition to a variety of studies that have been undertaken, much of the medical community is satisfied that addiction is in part linked to a person's genetic makeup. That is, one's genetic makeup may regulate how susceptible a person is to a substance and how easily one may become psychologically attached to a pleasurable routine.

Psychological Dependence

Psychological dependence is a dependency of the mind, and leads to psychological withdrawal symptoms (such as cravings, irritability, insomnia, depression, anorexia etc). Addiction can in theory be derived from any rewarding behaviour and is believed to be strongly associated with particular areas of the brain’s reward system (as in the case of cocaine).

It is considered possible to be both psychologically and physically dependent at the same time. Some doctors make little distinction between the two types of addiction, since the result - drug or alcohol abuse - is essentially the same. However, the cause and characteristics of each of the two types of addiction is quite different, as is the type of treatment preferred.

Psychological dependence does not have to be limited only to substances. Even particular activities and behavioural patterns can be considered addictions if they become uncontrollable, for example gambling, Internet or computer usage, , sex or pornography, shopping/spending, eating, self harm, or work, etc..

How common is addiction?

Addiction affects many people. Those who have not experienced a substance use problem first-hand are likely to have a family member, friend or colleague who has. Although addiction affects men and women of all ages, rates are:

	2 to 3 times higher in men than women
	highest among people aged 15 to 24

Substance use problems can occur even with low levels of alcohol or other drug use, and in people who are not dependent. For example, estimates suggest that on average internationally more than 25 percent of men and nearly 9 percent of women who drink alcohol are "high-risk" drinkers. These are people whose drinking can be said to be hazardous and harmful to themselves or others, even though they may not be 'substance dependent.'

The stigma of addiction

Stigma is another reason why the rates of substance use problems may be higher than studies suggest. Stigma marks substance use problems as shameful and makes people want to hide their addiction.

Stigma also affects the families of people with addiction. It makes them hide the problem or pretend it isn't there at a time when families need support.

What can we do about stigma? One simple way you can help is to choose to talk about 'people with substance use problems' rather than about 'addicts,' 'alcoholics,' 'junkies,' 'stoners, or other labels.' Try this approach whether you are talking about another person or about yourself. When you do this, you put the person ahead of the problem. This helps to show that you know there is more to a person than a problem. You are also giving the person with an addiction the support and understanding it takes to recover.

What can you do

If you, or someone you care about, are suffering from addiction, be assured that you are not suffering alone. Reach out to someone you trust, and ask for help.

When you are ready, we are here to help you rebuild your life.

Contact us today

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