Addiction

What is the difference between a habit and an addiction?

A habit can be defined as a behaviour pattern that results from the repetition of actions we enact to particular cues or situations. An example might be brushing your teeth or biting your nails. Due to their development through constant repetition, habits can often become automatic and appear in regularity. Some habits develop through performance enhancing activities and once these activities are no longer important or significant, the habit remains. Habits are not destructive by nature; however, some habits may develop into unhealthy addictions.

An addiction is a compulsive action or need, usually driven by the body’s reward system. A habit can also be driven by the body’s reward system, but the difference is in the intensity of the reward. In addiction, the brain becomes biologically accustom to the reward due its higher levels of intensity, creating a dependency; without it, the brain can develop withdrawal symptoms. Unlike habits, addictions are destructive by nature and can hinder a person’s physical and mental wellbeing, as well as social and occupational functioning.

What happens to the brain when on drugs?

Put simply, most recreational drugs work by increasing the levels of dopamine in one’s brain. Dopamine is associated with the brain’s reward system, and natural rewards such as winning an award stimulate dopamine, resulting in feelings of satisfaction or contentment. However, the high levels of dopamine or ‘unnatural reward’ caused by recreational drugs result in intense feelings of pleasure and euphoria. These excessively positive feelings reinforce the drug-taking behaviour, which can lead to addiction. However, experiencing abnormally high influxes of dopamine, over time, reduces dopamine’s impact on the reward system – making it abnormally low. Therefore, events that would once trigger a natural high no longer do, and ability to experience pleasure in sober, every-day life is reduced. Therefore an individual is likely to return to drugs to feel better, which only makes the problem worse – like is a vicious cycle.

Behavioural and substance addiction

An addiction occurs when an individual is dependent on something, such as an activity or a substance. Generally, addictions either concern one’s behaviour or substance-usage.

Behavioural addiction, also known as process addiction, involves repeatedly participating in a rewarding or thrill-seeking activity or behaviour that does not involve taking drugs, even if such behaviour leads to negative consequences. Examples of behavioural addictions include excessive involvement in gambling, eating food, exercising, risk-taking, video games, sexual activity, cosmetic surgery, watching pornography, the Internet, or shopping.

Substance addiction, also known as drug addiction, involves compulsively and repeatedly engaging in drug-taking or drug-seeking behaviour, regardless of the negative impacts on the community, one’s health, social, familial and work life. Examples of substances one may be addicted to are marijuana, depressants such as Xanax and Valium, Stimulants such as amphetamines (‘ecstasy’), cocaine and crystal meth (‘ice’), hallucinogens such as Lysergic acid diethylamide (LSD or ‘acid’), inhalants, and heroin.

Some addictions, particularly drug-addictions, can be physical meaning that if one were to cease drug-use they would experience adverse withdrawal symptoms such as sweating, nausea, vomiting, diarrhoea, or dangerous effects such as hallucinations, seizures, a stroke, or heart attack. However while physical factors may play a part in one’s drug addiction, most behavioural and drug addictions are psychologically based and used as a coping mechanism for emotional stress.

What are the consequences of a drug-addiction?

While at first taking drugs may seem ‘cool’ or ‘fun,’ chronic or excessive use can seriously negatively impact an individual and even lead to death. Other long-term problems include:

• Psychosis including paranoia, hallucinations and repetitive motor activity.
• Mood disturbances such as depression or anxiety.
• Changes in brain structure and function.
• Problems with one’s thinking, decision making, learning, and motor skills.
• Issues coping with stress.
• Increased distractibility.
• Memory loss.
• Dental, kidney, liver, heart and lung problems.
• Haemorrhaging
• Weight loss.
• Interpersonal, social, financial and work life issues.

What are the consequences of a behavioural addiction?

Most behavioural addictions are associated with general problems such as:

• Relationship and family issues
• Emotional distress such as anxiety and depression
• Suicidal thoughts
• Feelings of isolation
• Occupational and financial difficulties

Consequences more specific to the type of addiction are listed below:

• Gambling & shopping addiction – large debt, losing the family home, inability to pay bills and look after one’s family, legal problems, stealing, and an increased likelihood of your child becoming a gambling/ shopping addict.
• Cosmetic surgery addiction – permanent damage to muscle tissue and skin, excessive scarring and self-identity issues.
• Exercise addiction – reduced athletic performance, soreness and stiffness, injury, fatigue, problems concentrating and adrenal exhaustion.
• Food addiction – obesity, feeling ill, vomiting, fatigue, headache, sleep disorders, digestive disorders, heart disease, diabetes and other health problems.
• Computer, Internet & video-game addiction – fatigue, migraines, blurred or strained vision, poor hygiene, carpal tunnel syndrome, sleep disturbances, back problems and irregular eating patterns.
• Porn addiction – trouble forming and maintaining intimate romantic relationships, sexual dysfunction with real-world partners, physical injury and legal issues.  
• Sex addiction – pregnancy, contracting a sexually transmitted infection, human immunodeficiency virus (HIV), hepatitis b or c, and legal troubles.

What are causal influences on addiction? Why do some people who take drugs get addicted while others don’t?

There is no single cause of addiction; rather it is most likely caused by a combination of influencers including biological factors such as one’s gender or ethnicity, developmental factors such as the age in which one is exposed to drugs, and environmental influences such as one’s family, friends, stress-level, socioeconomic status and whether someone has been physically, sexually or emotionally abused.  Please see the following table for a list of risk and protective factors regarding addiction:

Personality type and addiction

It is usually believed that there is a stereotypical personality type that will develop an addiction, such as those individuals with antisocial personality or deviant traits; however, research suggests that is not always the case and that there are no definitive personality characteristics that are found in all addicts. What has been suggested to increase the risk of addiction is not the personality trait itself, but the extremity of the trait. Extreme personality traits such as high levels of impulsion and openness to experience are at a greater risk of developing addiction, but so too are those who have high levels inhibition and anxiety. What seems to be important is self-regulation of these extremities.

Signs & Symptoms of addiction

Addiction can have adverse effects on an individual’s wellbeing and functioning. The following table shows both behavioural and physical symptoms an individual with an addition might experience:

Treatment for addiction

Treatment for addiction is usually a dual process and involves addressing both the physiological and psychological factors driving the addiction.

The first process in the treatment of addiction is to address the physiological dependency. This involves either inpatient or outpatient care designed to help the individual develop abstinence and also help them to deal with the withdrawal symptoms. This processes is known as either detoxification or rehabilitation.

There are a number of inpatient treatments options, including:

• Therapeutic communities, which are an intensive social-psychological treatment option designed to help individuals modify destructive behaviours and learn a holistic way of life through community living. The duration of the treatment differs from program to program, but is usually estimated between 6-12 months.
• Shorter-term residential treatment, are the most common and are designed to help individuals in the detoxification process of their recovery through structured intensive therapy. The duration of short-term residential treatments vary but are usually between 28-30 days, with some programs offering 10-day treatments.
• Recovery housing, provide short-term accommodation for individuals who have recently completed other inpatient treatments.

In contrast to inpatient and residential treatment, outpatient treatment facilities work by allowing the individual to live in their home environment and attend daily programs. These programs are not recommended for those who need ongoing care to help deal with severe withdrawal symptoms.

The second process is to address the psychological and behavioural factors that not only initiated the addiction but are also a driving force behind its continuation; this is usually a longer process than the treatment of the physical addiction.

There are a number of different treatments available, this include, but is not limited to:

• Cognitive-behavioural therapy, or CBT, which is designed to help individuals recognise the cognitive processes that are driving their behaviour and addiction by helping them to anticipate problems and increase their self-control.
• Motivational interviewing, which is a therapeutic technique used to address an individual’s lack of motivation to change destructive behaviours.
• Self-help or support groups, which are designed to facilitate motivation in individuals by having then, share their experiences with other going through similar situations and by creating a safe and supportive atmosphere. These groups can also provide education information on addiction and other community opportunities.
• Contingency Management or Motivational Incentives, which is a therapy designed to change destructive behaviours by reinforcing positive behaviours, such as abstinence.
• Family-behavioural therapy, which utilises the family environment to encourage behavioural change, including destructive behaviours such as addiction.

Treatment of addiction and use of medication

Treatment of an addiction can be a very daunting process, especially when taking into consideration the physiological process of treatment and the potential withdrawal symptoms that accompany it. This in itself can be a strong deterrent for many people who are considering seeking help. An option that is available is prescription medication to help cope with the physiological withdrawal symptoms. Medications can also be prescribed to help individuals with relapse prevention. Though therapy or counselling should always be considered before or concurrently with medication.

Types of Addiction treated at Psylegal

Drug/Alcohol addiction

Some of the signs and symptoms of drug/alcohol addiction include:

• Needing to take more of the drugs/alcohol to feel an effect.
• Worry about when you will get your next “fix”.
• Taking drugs/drinking when you wake up in the morning.
• Hiding your habit from friends and family.
• You engage in risky behaviours such as drink driving, using dirty needles.
• Having more fights with your boss/partner/friends than ever before.
• Sweating or feeling nauseas when you don’t have the drug/alcohol.

Gambling addiction

Some of the signs of gambling addiction include:

• Hiding how often and how much you gamble.
• Continuing to gamble, even when you have run out of money.
• Friends and family are worried about your habit.
• Avoid work to gamble.
• Borrow money from friends and family that you can’t pay back etc. to gamble.

Pornography addiction

Some of the signs of pornography addiction include:

• Watching pornography is interfering with your sex life.
• Your partner is complaining of a lack of intimacy related to your pornography use.
• Feelings of distress or withdrawal when not viewing pornography.
• Pornography is used to escape negative moods or experience a “high”.
• You have caught, fired or reported for viewing pornography at your job or school.

Internet Addiction

Internet addiction is considered an impulse control disorder, much like an addiction to gambling or drugs.

Some of the signs of Internet addiction include:

• Day dreaming about previous online activity or the next time you can go online.
• Needing to use the Internet for longer to feel satisfied.
• Avoiding or neglecting real life friends for online friendship.
• Lying to family, friends and professionals about how much time you spend online.
• Being late to work or avoiding work responsibilities because you are online.
• Repeated and unsuccessful attempts to cut back on Internet use.
• Constant conflicts with parents/friends/partner about your current level of Internet usage.

How can Psylegal help you?

A psychologist’s primary role in dealing with addiction is to help identify the triggers and to prevent relapse from occurring. The steps to controlling addiction involve teaching necessary coping strategies to manage stress and alter negative thought patterns that fuel the addictive behaviours.

Give one of our addiction specialists a call today and find out more about our specialised programs for addiction and take control of your life. Call 1300 79 22 09.