What is Addiction

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Addiction is a brain condition that drives compulsive use of a drug or engagement in behavior due to resultant rewarding effects that fuel more use of a substance or adherence to action despite clear harmful consequences. It is a chronic condition that affects the neurological functions of the brain, including the reward, incentive, and memory systems.

Common substances that leads to addiction include alcohol, cocaine, heroin, marijuana, inhalants (aerosol sprays, nitrites, gases and solvents) and nicotine. Also, prescription medications such as Demerol, Percocet, and amphetamines can cause addiction if misused.

Scientific evidence shows that behavioral additions can comprise sex, shopping, video game, gambling, internet, porn, love, tattoo, and food addictions, among others.

Humans usually engage in activities that are rewarding and fulfilling. The pleasurable effects resulting from a substance or behavior provide positive reinforcement that drives repeated behavior. Substance abuse disorders and behavioral addictions share the same characteristics regarding changes in the neural pathway of the reward system of the brain.

Research indicates that addictive behaviors portray common neurological and biological traits. They involve brain pathways that increase secretion of the ‘good-feeling’ neurotransmitter – dopamine. Continuous involvement in addictive behaviors leads to decreased dopaminergic functions. As a result, a person has to use more of a substance or engage in conduct several times to receive the same relaxing effects

An NCBI study shows that a decrease of  the frontal cortex  and the ventral tegmental area (VTA) due to addiction plays a crucial role in the neurobiological circuitry of the brain that exposes addicts to long-term susceptibility to relapse. Advances in molecular biology shows that behavioral addictions modify the frontal cortex so that the brain focusses on cues related to a particular substance or activity.

The good news is that all these neurobiological changes are reversible. Psychiatrists refer to the process of unlearning the use of a substance as rehabilitation. In Rehab centers, people exposed to behavioral, cognitive, evidence-based, and pharmacological therapies that enable them to unlearn the addictive behaviors.

In a 2017 research by the National Survey on Drug Use and Health (NSDUH),  19.7 million American adults  – aged 12 and older – were found to be struggling with one or more forms of substance abuse disorders. 8.5 million Americans suffer from both mental illness and addiction problems. There is a close relationship between neurological functions that connect mental health issues with substance abuse disorders.

A common feature between substance abuse disorders and behavioral addiction is loss of control and continued use despite knowledge of associated harmful consequences. In both conditions, more and more indulgence in addictive behavior is required to achieve a pleasurable feeling. With time, the urge to use a substance or engage in a particular behavior dominates one’s life.

Once a person becomes aware of addiction, he/she will rush to quit, but he won’t be able — feelings of helplessness and hopelessness sets in. Depression, anxiety, and stress looms. Work performance becomes to dwindle. Family relationships wobble, and withdrawal from social life becomes a necessity.

But there is hope. Research shows that addiction is curable. Different types of addiction require various forms of treatment. Sometimes, individuals undergo a natural recovery where they resume their normal functioning without undertaking any treatment. But in most cases, most people must seek treatment from rehabilitation centers, family therapists, support groups, peer networks, and clinicians.

The recovery journey can be full of hurdles, which include relapse, physical, and psychological withdrawal symptoms, as well as recurring urge to resume addictive behaviors. During the recovery process, neurological functions and synaptic density are gradually restored, allowing a person to lead an addiction-free life.

We can sum up the addiction cycle process in the picture below.

Debunking Addiction Myths

There exist several misconceptions about addiction that can hamper people from seeking treatment or increase guilt and depression. Here are some of the myths and facts about addiction

Myth: Addiction results from moral weakness and overindulgence in substances or behaviors frowned upon by the society

Fact: Addiction is a chronic brain condition that is caused by factors such as social influence, genetics, and personal behavior

Myth: People can stop addiction if they decide to

Fact: Addiction is caused by a series of neurobiological changes on dopaminergic functioning and frontal cortex that reduces one’s ability to quit a substance or activity

Myth: Most people relapse after abandoning addiction behaviors. A sign that treatments seldom work.

Fact: Structured rehab courses and the use of evidence-based treatment methods through detox, inpatient, outpatient, or residential therapies have high success rates.

Myth: Over-the-counter medications, drugs such as marijuana and behaviors such as gambling are not as addictive as people claim

Fact: Marijuana, alongside other opioids and practices such as gambling, are addictive as their use induce positive reinforcement.

Avoid myths that can lead you or your loved one astray and prevent you from finding treatment. Addiction needs to looked at like any other chronic disease. Typically, there is no quick fix. People trying to lose weight, try different exercises, subscribe to yoga classes, experiment on different diets, and even adopt new sleeping patterns until they can shed some few pounds. Like losing weight, eliminating addiction takes time, requires commitment, and may demand several rounds of treatment before a person resumes normal functioning. 

Signs and Symptoms of Addiction

Substance abuse has a wide range of physical, psychological, and social effects that dramatically reduces an individual’s quality of living. Most signs of addiction overlap and can differ from one person to another. As people continue to engage in addictive behaviors, they develop tolerance and eventually end up exhibiting signs and symptoms whenever they miss the addicting substance/behavior.

Physical Symptoms: 

• Irregular sleep patterns • Poor hygiene 
• Dilated pupils and red eyes
• Looking pale and undernourished 
• Change in eating habits
• Stammering 
• Weight loss 
• Withdrawal symptoms: sweats, cravings, diarrhea, seizures, constipation, and uncharacteristic behavior 

Behavioral Signs and Symptoms:

• Sacrificing social or individual well-being for an addicting substance/behavior 
• Sudden drop of hobbies and routines 
• Withdrawal from social life
• Denial of the addiction problem
• Uncharacteristic social behavior such as violence 
• Emergence of legal issues
• Financial difficulties. A person fails to meet financial obligations he previously handled without any issues 
• Missing important meetings/engagements
• Missing work/school
• Marital/relationship problems 
• Poor performance at work/school

Psychological Symptoms:

• Overdependence on addictive substance/behavior 
• Depression, anxiety, and stress
• Continuous use of substance despite apparent health issues 
• Defensiveness, blame, and guilt
• Irritability and mood swings 
• Paranoia 
• Poor judgment and memory problems
• Exacerbation of existing mental health issues
• Decreased self-esteem 

Different addictions exhibit different signs and symptoms, but most of them share the traits discussed above. The degree of each symptom depends on an individual’s biology and frequency of indulgence. Healthy persons always identify these symptoms and seek medication. However, an addicted individual will find an excuse to continue indulging in the addictive substance/behavior. 

Causes of Addiction 

Most psychologists, psychiatrists, and biologists agree that addiction is caused by a complex combination of factors, including social, behavioral, environmental, psychological, and spiritual factors.

Some people look addiction to the lenses of moral and spiritual façade. Others perceive it as a psychosocial issue, while others believe it results from dysfunctional thoughts.

Today, it is widely accepted in the U.S. that addiction is as ‘disease’ and a chronic condition that needs treatment like any other condition. Let’s discuss some of the known risk factors for addiction. 

Biological Factors

The National Institute on Drug Abuse (NIDA) defines addiction as a brain disorder caused by alteration of reward and pleasure neurons by an addictive substance/behavior. Drugs and actions create a decrease in dopaminergic activities increase tolerance.

Recent research shows that genomics might play a key role in addiction, especially when it comes to relapse and the vulnerability of falling into substance use disorders. Some hereditary psychological and physical traits make it easier for some people to develop an addiction than others.

Drugs and behaviors such as sex and gambling can change the cerebral cortex of the brain, impairing decision-making processes, and triggering compulsivity. Also, the makeup of the brain system that deals with rewards and emotions show that males are more likely than females to engage in addictive activities.

Addictive substances and behaviors give people positive reinforcement. It makes the amygdala of the brain to store cues that act as powerful motivators to using a substance even with the full knowledge of consequences. 

Psychological Factors

For some people, addiction kicks in after regular use of a substance or engagement in an inactivity for recreational purposes. Their peers influence others. Some want to experiment with various substances and behaviors. Regardless of how one starts to use drugs, psychologists argue that most addictions result from learned behaviors.

Also, people’s thoughts and beliefs can serve as an impetus to using a substance or engaging in an activity. For instance, people who grow up believing that alcohol reduces stress are likely to end up as alcoholics.

SAMHSA survey shows that 74% of young adults who begin using drugs or engaging in addictive behaviors in their teenage years are likely to develop addiction. Young people lack developmental maturity and may not understand the real-life consequences of addiction.

The presence of mental health disorders such as anxiety disorder, schizophrenia, and attention-deficit hyperactivity disorder (ADHD), predisposes people to addiction. Patients with mental health issues may lack the power to make objective decisions about their lives. 

Environmental Factors

People living in an environment that supports certain types of behavior are likely to associate with such acts.

Common environmental factors that cause addiction include:

• Family dynamics

Having a parent or sibling that has a substance use disorder can predispose one to substance abuse. Also, poor upbringing, coupled with a lack of parental supervision, can expose teenagers to early addiction. Family disruptions such as chronic stress or divorce can lead to substance abuse or engagement in addictive activities. Physical, sexual, or emotional abuse in the family can contribute to the use of drugs, which eventually leads to addiction.

• Peer Factors 

People spending time with individuals engaging in substance abuse are likely to fall as victims too. Poor social skills can hinder someone from talking out issues.

• Community Influence

If you live in a community with more bars than shops, the chances are that you are living among drug addicts. People living in Vegas are likely to become addicted to gambling because of the environment. Community drug use patterns can also expose people to addiction.

Besides these factors, legal and social policies such as taxes, penalties, school anti-drug policies, media influence, and low socioeconomic status can drive substance use orders. 

Treatment of Addiction 

Treating addiction is, and complete recovery is possible. It should be understood that the recovery process is a long-term process that takes months of combination of different treatment methods. Since relapse is a standard part of the recovery process, treatment programs usually address the prevention of recurrence.

Addiction treatments individualized since patients have different biological makeups, as discussed earlier. The recovery process is progressive, and the time one spends on rehab depends on many factors, including the severity of addiction, type of addiction, and type of treatment.

Addiction therapists usually monitor patients through the recovery journey, ensuring that they get sufficient support to prevent relapse. Support groups and family therapy sessions are used when reinstituting patients to society.

A combination of treatments is used to help patients navigate the road of recovery. Some therapies are useful during initial phases of treatment, while others are invaluable in preventing relapse. Hence, some treatments are dropped along the way as others are adopted.

Here are some of the standard and proven addiction treatments.

· Detoxification - It’s the process of removing toxins from a patient’s body. This phase is critical as it helps eliminate addicting substance from a person. Withdrawal symptoms accompany detox treatments. Medications such as naltrexone and nalmefene can be used to reduce the effects of anxiety, constipation, diarrhea, etc. that come with sudden withdrawal.

· Pharmacologic treatments - Addictions to opioids, inhalants, and other substances can easily be treated using certain medications. Also, preinitiation medicine is used to counter co-occurring conditions such as mental illness.

· Motivational Techniques - Motivational therapies are useful treatment methods for mild addiction. It involves counseling and exposing an individual to incentives that enable him to quit the addictive substance/behavior.

· Cognitive-Behavior Therapy - Cognitive-Behavior Therapy is an evidence-based long-term approach that focusses on rewiring a patient’s neural systems to prevent recurrence of the addiction problem. This technique concentrates on modifying addictive behaviors so that individuals can lead addiction-free lives.

· Peer support - Patients are allowed to share their stories about addiction and recovery, which gives hope for individuals that their situations are reversible. It serves to motivate patients and prevent the recurrence of substance use.

· Family therapy - Instituting a patient back to the community and family is a tough process. Family therapy allows recovering persons to mend broken family bonds and reconcile with other community members.

These treatments can be inpatient, outpatient, or residential treatment programs. The choice of program depends on a variety of factors.

Things to Consider When Choosing Addiction Treatment Program

· Patient’s situation 

· The success rates of a particular program

· Availability of aftercare services 

· Cost and access to emergency services

· Availability of specialized care 

· Treatment methods backed up by scientific evidence 

· Relevant state and federal agencies accredit treatment program 

· Staff and doctors are licensed and certified addiction therapists 

· Use of data to determine a patient’s progress and provision of varied treatments when others fail to work 

Substance Use Disorders

In the medical arena, substance use disorders are rated by classes assigned to various drugs. Have a look at drug classifications here. These disorders share key characteristics of addiction as they involve positive reinforcement that drives compulsive use of drugs or engage in the behavior despite known adverse consequences.

Substances pose varying levels of risk for developing addiction.

Alcohol Use Disorder

According to the CDC, alcohol use disorders causes 80,000 deaths every year. It’s the most common substance use disorder and affects males and females alike. Alcohol is a brain depressant that impairs an individual judgment ability. 

Caffeine Use Disorder

High consumption of caffeine can lead to intoxication characterized by restlessness, nervousness, agitation, insomnia, cardiac rhythm disturbances, and gastrointestinal disturbance.

Cannabis Use Disorder 

The prevalence of this disorder decreases with age, and it results from excessive use of cannabis/marijuana. Smoking marijuana leads to respiratory diseases. Long-term effects of using cannabis include hallucinations, impaired memory, mood swings, altered sense of time, and increased heart rate. 

Hallucinogen Use Disorder

SAMHSA 2014 report shows that about 246,000 Americans suffer from hallucinogen use disorder. Substances such as Phencyclidine are drugs that alter perception and give people feelings of hallucination. Often, users have feelings of mind-body separation.

Inhalant Use Disorder

The use of inhalants such as glue, paint, hydrocarbons, etc. that have psychoactive effects is prevalent among those below the age of age. Inhalant use disorders are not as common as other disorders. 

Tobacco/Nicotine Use Disorder

This disorder causes over 480,000 deaths every year in the U.S. Tobacco is increases vulnerability to lung cancer, heart disease, and respiratory diseases. Nicotine triggers adrenal glands to release adrenaline leading to increased blood pressure, breathing, and heart rates. 

Opioid Use Disorder

Deaths from opioid use disorders have been increasing due to drug overdoses. Opioids reduce pain and cause euphoria, nausea, confusion, and drowsiness. Heroin and most prescription drugs like fentanyl, morphine, and codeine are opioids.

Sedative Use Disorder

Tranquilizers and hypnotics such as Xanax®, Valium®, Lunesta®, and Ambien®, are some of the substances that people use to slow down brain activity. Sedatives are mostly prescription medicine used to treat anxiety and sleep disorders. Sedative use disorder is characterized by confusion, dizziness, poor concentration, slurred speech, memory problems, and slow breathing.

Stimulant Use Disorder

Stimulants such as cocaine methamphetamines and amphetamines cause euphoria, increased sense of well-being as well as perceived thoughts of power, knowledge, and strength. Stimulants have a high risk of dependence and addiction. 

Other Forms of Addictions

Addiction to behaviors such as gambling, sex, shopping, eating, and gaming also triggers the reward systems of the brain and is associated with positive reinforcement. Because of the instant rewarding effects, these behaviors can quickly morph from pastime to compulsive activities

Some of the characteristics that show that an individual is struggling with behavioral addiction include:

• Neglect of important life goals in pursuit of instant rewards from gambling, sex, gaming or other addictive behaviors 
• Difficulty in creating interpersonal relationships at work/school/home
• Retrenchment, bankruptcy, and homelessness 
• Lack of self-care
• Shame and guilt
• Denial and developing a penchant of lying

It is vital to note that these behavioral addictions work the same way as substance abuse disorders and are reversible.

If you or someone you know is struggling with any form of addiction, it is high time you seek treatment. You can choose any treatment options from the ones mentioned above or have one tailored by your doctor. The earlier you begin the recovery process, the better. It’s not late to get your life back together.

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