Addiction- Hardik

What is addiction?

Addiction is an inability to stop using a substance or engaging in a behavior even though it is causing psychological and physical harm.

The term addiction does not only refer to dependence on substances such as heroin or cocaine. Some addictions also involve an inability to stop partaking in activities such as gambling, eating, or working.

Addiction is a chronic condition that can also result from taking medications. In fact, the misuse of opioids — particularly illicitly made fentanyl — caused nearly 50,000 deaths in the United States in 2019 alone.

The American Society of Addiction Medicine defines addiction as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

Many people, but not all, start using a drug or first engage in an activity voluntarily. However, addiction can take over and reduce self-control.

Dependence Vs. Addiction

The difference between addiction and dependence can be difficult to understand. Some people have different definitions, use the words interchangeably or even abandon both terms altogether. Because of this lack of consistency, some ground rules can help differentiate between the two terms-

• When people use the term “dependence,” they are usually referring to a physical dependence on a substance. Dependence is characterized by the symptoms of tolerance and withdrawal. While it is possible to have a physical dependence without being addicted, addiction is usually right around the corner.

• Addiction is marked by a change in behavior caused by the biochemical changes in the brain after continued substance abuse. Substance use becomes the main priority of the addict, regardless of the harm they may cause to themselves or others. An addiction causes people to act irrationally when they don’t have the substance they are addicted to in their system.

• Addiction encompasses both a mental and physical reliance on a given substance.

Types of addiction

Chemical addiction-Chemical addiction refers to substances that can be addicting and is often what people think of when talking about addiction in general. This includes:-

Alcohol addiction-This is an addiction to any alcoholic beverage such as beer, wine, or hard liquor, resulting in alcohol use disorder (AUD). According to the National Institute on Alcohol Abuse and Alcoholism, AUD is an impaired ability to control or stop using alcohol despite adverse health, occupational, or social consequences.

Tobacco addiction-This is considered an addiction to any tobacco product—like cigarettes, cigars, and chewing tobacco—that contains nicotine, an addictive ingredient that increases the level of dopamine, a chemical in the brain that makes you feel good, and primes you for a reward, according to the National Institute on Drug Abuse.

Prescription drug addiction-This type of addiction encompasses the misuse of prescription drugs by taking a higher dose than prescribed, using someone else’s prescription, or taking a medication to feel high. Examples of commonly misused prescription drugs include opioids, stimulants like amphetamines, and central nervous system depressants like sedatives and tranquilizers.

Cocaine addiction-This type of addiction specifically involves the abuse of cocaine, which is an illegal stimulant drug. According to the NIDA, in 2014, 913,000 Americans met the criteria for having a cocaine addiction. It also noted that in 2011, 1 in 3 drug misuse-related emergency visits were due to cocaine.

Behavioral addiction-Behavioral addictions share some similarities to chemical addictions, but there’s still uncertainty in the medical community about whether or not engaging in a particular behavior can lead to a true addiction. That stems from a lack of current research into the various types of behavioral addictions, which is needed to first determine whether they are unique from other mental health disorders, and then establish criteria for an accurate diagnosis and recommendations for evidence-based treatments.

While further research is needed in this field, experts believe the following behaviors are or could be considered addictions and warrant further investigation:

Gambling addiction is characterized by a compulsion to bet on sports, play slot machines, buy lottery tickets, visit casinos, or participate in any other gambling behavior despite any negative consequences, according to the American Psychiatric Association.

Sex addiction features a need to engage in sexual acts regardless of the risks or negative consequences created by the activities. While not an official diagnostic term, many experts link it to compulsive sexual behavior disorder (CSBD), which is a recognized diagnosis. CSBD is the preferred term because there is debate within the mental health world about whether this behavior is categorized as an addiction or an impulse control disorder. Pornography addiction is also sometimes bucketed here.

• Video game addiction, also known as internet gaming disorder, is a relatively new disorder characterized by reduced control over gaming leading to adverse consequences in family, social, personal, or work life, according to the American Psychiatric Association.

• Internet addiction is also not an official diagnosis, but is used to describe excessive internet use and a compulsion to be online followed by adverse consequences like anxiety, irritability, and depression when not using it

• Shopping addiction, or compulsive shopping, involves compulsively buying items as a way to mask or get relief from negative feelings. While not a diagnosable disorder, it can have severe consequences like financial damage, increased stress, and increased anxiety.

• Plastic surgery addiction is an urge to change physical appearances by undergoing plastic surgery. While not a clinical diagnosis, it’s most likely a sign of body dysmorphic disorder (BDD), a condition that leads to persistent and obsessive thoughts about perceived flaws in your appearance.

• Food addiction refers to compulsively eating or binging on food to ease negative feelings and emotions. It’s not an official diagnosis, but it is closely related to binge eating disorder (BED).

• Exercise addiction describes an unhealthy relationship and obsession with participating in exercise and fitness activities to the point of being harmful both physiologically and psychologically.

What are the treatment options for chemical addiction?

There are a variety of treatments for chemical addiction, but finding the right one depends on many factors, including:

• The person’s unique personality, genetics, and medical history

• The drug of choice

• The amount and length of use of the drug

• A personal and family history

In severe cases, Dr. Lira de la Rosa says the person will need to check into a medical detox treatment facility and be monitored by medical staff while they withdraw from the chemical. The physical effects of withdrawal can be serious—including seizures and hallucinations—and depend on the type of substance and duration of use, so it’s important the person is monitored by a professional. After the person detoxes, the psychological aspects of addiction can be addressed, such as the mood changes associated with withdrawal and establishing new ways to handle urges.

In general, treating addiction from a psychological standpoint can include a variety of approaches, such as individual psychotherapy, group psychotherapy, and medication.

During the process, you may also need to address other parts of your life that have been neglected, including underlying medical conditions or mental health issues. Therapy may also help you to mend relationships that were impacted while using substances.

Dr. Lira de la Rosa also points out that some people may not be ready to live a life of sobriety. In these situations, he says harm reduction strategies can be used to help people cut back on substance use and have a healthier relationship with substances.

On another note, relapse is often a part of the recovery process. It doesn’t mean a person or their treatment has failed. It simply means their treatment plan needs to be adjusted or revisited.

Perhaps the most important part of recovery is that the person has to want to get better. “Sustained motivation is the cornerstone to treatment,” Dr. Mou says, but the onus is not only on the person in treatment. The treatment team also has a responsibility to help keep the person motivated in their recovery journey, he says.

What are the treatment options for behavioral addiction?

Treatment for behavioral addiction is typically centered around therapy, but can also include medication. “You may benefit from individual therapy to address triggers and withdrawal symptoms, as well as learning new ways to engage in healthier behavior,” Dr. Lira de la Rosa says.

Like chemical addiction, common treatments for a behavioral addiction include cognitive behavioral therapy and motivational interviewing. The goal is to change the patterns of thought and behavior and develop new coping skills.