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 negative consequences that result from engaging in the behavior.
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. For 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 two 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 and drug addictions are very widespread 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 both drug addiction and alcoholism since many addicts believe that they gain benefit from the use of the substance. They may believe that the alcohol or other drug 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 the drug and 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 and drugs in their life before any treatment can have meaningful lasting effects.
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.
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