Substance Abuse and Other Addictions

While not everyone agrees on what constitutes an addiction, in general it is recognized that an addiction can be to any substance (for example alcohol, amphetamines, cocaine, nicotine, opioids, sedatives, hallucinogens, inhalants, cannabis, phencyclidine, caffeine, and a wide variety of other substances), which, when ingested, cross the blood-brain barrier and alter the natural chemical behavior of the brain.  It is also accepted that addiction includes dependency on "things" as well as substances, such things as gambling, eating, sex and pornography.

In general, the term addiction, as defined by the DSM 1V-TR of the American Psychiatric Association (APA), describes a chronic pattern of behavior that continues despite the adverse consequences that result from engaging in the behavior. Many substances and behaviors that provide either pleasure or relief from pain pose a risk of addiction or dependency.

One way to differentiate the types of addiction is to consider two categories of dependence.  First is physical dependence, characterized by symptoms of withdrawal, and second is psychological dependence. Addictions often have both physical and psychological components.

Physical addiction and dependency on a substance is defined by the appearance of characteristic withdrawal symptoms when the drug is suddenly discontinued. Opiates, cocaine, barbiturates, hallucinogens, benzodiazepines, barbiturates, alcohol, nicotine, and a variety of more modern synthetic drugs are all well known for their ability to induce physical dependence and addiction.  While physical dependency can be a major factor in the psychology of addiction, the primary attribute of an addictive drug is its ability to induce euphoria while causing harm.

The speed with which a given individual becomes addicted varies with the type of addiction, the frequency of addictive behavior, and the individual himself or herself. Foe example, some alcoholics report they exhibited alcoholic tendencies from the moment of first intoxication, while most people can drink socially without ever becoming addicted. Because of this variation, some people hypothesize that physical dependency and addiction are in large part genetically moderated. Nicotine and caffeine are tow of the most addictive psychoactive substances.

Psychological addiction, as opposed to physiological addiction, is a person's need to use a drug or engage in a behavior out of desire for the effects it produces, rather than to relieve withdrawal symptoms. Instead of an actual physiological dependence on a drug, such as heroin, psychological addiction usually develops out of habits that relieve symptoms of loneliness, anxiety, depression, and feelings of worthlessness.  As the drug and/or behavior is indulged, it becomes associated with the release of pleasure and avoidance of pain, and a cycle is started that is similar to physiological addiction. This cycle is often very difficult to break.  It is quite common for an addict to express the desire to stop the behavior, but find that they are unable to stop the addictive behavior.

Psychological addiction can theoretically form for any rewarding behavior or as a habitual means to avoid undesired activity.  The most common of the psychological addictions include dependency on such things as gambling, eating, sex and pornography, Internet use, work, and shopping and spending money. It is possible to be both psychologically and physically addicted at the same time.

Alcohol addiction, the powerful craving for alcohol which often results in the compulsive consumption of alcohol, is one of the most widespread and costly addictions in our society.  The cause of this craving is heavily debated, but the most popular beliefs are that it is: (1) a chemical or nutritional imbalance; (2) a genetic predisposition; (3) a neurological effect caused by runaway learning mechanisms; or (4) an inability to curb one's own desire for enjoyment.

Psychological addiction is also involved in alcoholism since many alcoholics believe that they gain benefit from the use of the substance. They may believe that the alcohol improves their ability to socialize, helps them handle pressure, allows them to feel superior to others in that they can handle extreme intoxication, or that drinking allows them to fit into their peer group.  These effects all contribute to a person's impression of the beneficial effects of alcohol in his/her life, and may result in a denial of the negative effects. It is important to recognize that many of these benefits can be real, not imagined.  The person must be convinced of the net negative value of alcohol in their lives before any treatment can have meaningful lasting effects. An inability to stop drinking despite a clear understanding of alcohol's negative balance of effects on his or her life is a primary indicator that a person suffers from alcoholism.

Several explanations have been presented to explain addiction in general.  The moral explanation states that addictions are the result of human weakness, and are defects of character. The disease explanation holds that addiction is an illness, and comes about as a result of the impairment of healthy neurochemical or behavioral processes. The genetic approach states that there is a genetic predisposition to certain behaviors. The cultural approach recognizes that the influence of culture is a strong determinant of whether or not individuals fall prey to certain addictions. The blended model attempts to consider elements of all other models in developing a therapeutic approach to dependency. It holds that the mechanism of dependency is different for different individuals, and that each case must be considered on its own merits.

Therapists often classify addicts and their dependencies as either interested in changing or not interested in changing. Treatment for those not interested in changing is usually wasted time and effort.  Treatment for those interested in recognizing and changing involves planning for specific ways to avoid the addictive stimulus and therapeutic interventions intended to help the addict learn healthier ways to find satisfaction. An experienced therapist will frequently use therapeutic interviews in an effort to discover factors that led a person to embrace unhealthy sources of pleasure or relief from pain. The therapist will then tailor intervention approaches to the specific influences that affect the addict and his/her addictive behavior. 

Treatments for some addicts involve detoxification and hospitalization for withdrawal before other treatment efforts are undertaken.  Various forms of group therapy or individual psychotherapy can be used to deal with underlying psychological issues. Alcoholics Anonymous is the best-known example of a self-help group therapy approach. Other groups that provide similar treatment without AA's religious component include LifeRing Secular Recovery and Smart Recovery.  The use of medication has proven to be very effective in the treatment of some physical and psychological additions. Some treatment programs include nutritional therapy.

The more you understand about drug abuse, alcohol abuse, and substance abuse, the better you can cope with them and with related problems.  Reaching out for information and assistance can help you live a healthier and more fulfilling life. People who suffer from drug abuse, alcohol abuse, and substance abuse problems can get help from a mental health professional such as a psychologist, psychiatrist, or clinical social worker. For more information about drug abuse, alcohol, and substance abuse, please click on the linked websites listed below.

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I am available to help you or someone you know anywhere, anytime, and in any U.S. state, Canadian province or territory, or other country. However, if prefer to find a local psychologist, I suggest you contact your local psychological association listed below for assistance.

Alabama Psychological Association
(334) 262-8245
Montgomery, AL 36104

Alaska Psychological Association
(907) 344-8878
Anchorage, AK 99524-1292

Psychologists' Association of Alberta
(780) 424-0294
(780) 423-4048 (fax)
Edmonton, Alberta, CANADA T5J 3N6

Arkansas Psychological Association
(501) 614-6500
Scott, AR 72142

British Columbia Psychological Association
(604) 730-0501
Vancouver, BC, V6J 4S5

California Psychological Association
(916) 286-7979
Sacramento, CA 95834

Colorado Psychological Association
(303) 692-9303
Greenwood Village, CO 80111

Connecticut Psychological Association
(860) 586-7522
West Hartford, CT 06117-2507

Delaware Psychological Association
(302) 379-0528
Claymont, DE 19703

District of Columbia Psychological Association
(202) 336-5559
Washington, DC 20002-4241

Florida Psychological Association
(850) 656-2222
408 Office Plaza
Tallahassee, FL 32301-2757

Georgia Psychological Association
(404) 634-6272
Atlanta, GA 30345

Hawaii Psychological Association
(808)521-8995
Honolulu, HI 96813

Idaho Psychological Association
(208) 454-5594
Eagle, ID 83616

Illinois Psychological Association
(312) 372-7610
Chicago, Il 60601-2413

Indiana Psychological Association
(317) 257-7449
Indianapolis, IN 46220

Iowa Psychological Association
(712) 848-3595
Rolfe, IA 50581

Kansas Psychological Association
(785) 856-9572
Lawrence, KS 66046

Kentucky Psychological Association
(502) 894-0777
Louisville, KY 40207

Louisiana Psychological Association
(225) 766-0185
Baton Rouge, LA 70808

Maine Psychological Association
(207) 621-0732
Augusta, ME 04332

Manitoba Psychological Society Inc.
(204) 787-4563
Winnipeg, MB R3A 1R9

Maryland Psychological Association
(410) 992-4258
Columbia, MD 21044

Massachusetts Psychological Association
(781) 263-0080
Wellesley, MA 02481

Michigan Psychological Association
(517) 347-1885
Okemos, MI 48864

Minnesota Psychological Association
(651) 203-7249
St. Paul, Minnesota 55114-1067

Mississippi Psychological Association
(601) 372-7755
Jackson, MS 39236

Missouri Psychological Association
(573) 634-8852
Jefferson City, MO 65110-4900

Montana Psychological Association
(406) 252-2559
Billings, MT 59108

Nebraska Psychological Association
(402) 475-0709
Lincoln, NE 68508-3169

Nevada State Psychological Association
(702) 454-0050
Henderson, NV 89052

New Hampshire Psychological Association
(603) 225-9925
Concord, NH 03302-1205

New Jersey Psychological Association
(973) 243-9800
West Orange, NJ 07052

New Mexico Psychological Association
(505) 883-7376
Albuquerque, NM 87110

New York State Psychological Association
(518) 437-1040
Albany, NY 12203

North Carolina Psychological Association
(919) 872-1005
Raleigh, NC 27609-7353

North Dakota Psychological Association
(701) 223-9045
Bismark, ND 58507-7370

Association of Psychologists of Nova Scotia
(902)422-9183
Halifax, NS B3J 2A1

Ohio Psychological Association
(614) 224-0034
Columbus, OH 43215-1599

Oklahoma Psychological Association
(405) 879-0069
Oklahoma City, OK 73116-9111

Ontario Psychological Association
(416) 961-5552
Toronto, ON M4Y 2B7

Oregon Psychological Association
(503) 253-9155
Portland, OR 97216

Pennsylvania Psychological Association
(717) 232-3817
Harrisburg, PA 17102-1748

Ordre des Psychologues du Quebec
(514) 738-1881
Mont-Royal, QU H3P 3E5

Rhode Island Psychological Association
(401) 736-2900
Warwick, RI 02889

South Carolina Psychological Association
(843) 838-6050
Beaufort, SC 29901

South Dakota Psychological Association
(605) 336-0244
Sioux Falls, SD 57104-4537

Tennessee Psychological Association
(901) 372-9133
Memphis, TN 38168

Texas Psychological Association
(512) 280-4099
Austin, TX 78701

Utah Psychological Association
(801) 359-5646
Salt Lake City, UT 84117

Vermont Psychological Association
(802) 229-5447
Montpelier, VT 05601-1017

Virginia Psychological Association
(804) 643-7300
Richmond, VA 23219-2305

Washington State Psychological Association
(206) 547-4220
Seattle, WA 98103

West Virginia Psychological Association
(304) 345-5805
Charleston, WV 25358

Wisconsin Psychological Association
(608) 251-1450
Madison, WI 53703

Wyoming Psychological Association
(307) 745-3167
Laramie, WY 82073-1191