ADDICTION
Addiction is an incessant drive by person to pursue a particular activity.
The word is usually limited to drug and alcohol addictions but it is
occasionally used to describe other compulsive behavior, such as
overeating or gambling. Causative factors that have been put forward as
possible causes of addiction include social, pharmacological/biological
and genetic and social elements.
Many years ago, the term 'addiction' was used to define usage of a drug in
sufficient quantity so as to cause tolerance or a situation where by
larger and larger dosages were required to product the same effect. The
definition of addiction has changed over the years. The definition which
laypersons and the medical field have come to accept is that of addiction
as a disease. Pharmacologists refer to addiction as a physical dependence,
psychiatrists refer to addiction as dependence and other medical
professionals refer to the person who continues when it is not in his or
her best interest to use the addictive substance as addicts. The
Diagnostic and Statistical Manual of Mental Disorders are considering
changing the description from 'dependent' to 'addicted'.
Medical professionals narrowly define addiction as compulsive and
uncontrolled usage and draw a precise line between physical dependence
defined by withdrawal symptoms and psychological dependence (addiction).
Addiction is only diagnosed only if the person is causing harm to himself
or another, otherwise it is compulsion.
The outdated term 'physical addiction' is not recommended for use, because
of its associations. Using current pain control methodologies with opioids
physical dependence is very widespread. While opiates are absolutely
critical in the management of acute pain, the advantages of their use in
chronic pain treatment is not universally accepted.
While it is true that many would not function satisfactorily without the
use of opiates, it is also true that accidental deaths associated with the
use of opiates have increased sharply.
Medical doctors disagree on the definition of addiction. Its traditional
association has been with psychoactive substances including drugs, alcohol
and tobacco which can cross the brain-blood barrier and temporarily change
the natural chemical makeup of the brain. However, many psychological
experts and laypeople as well believe that the definition of addiction
should be expanded to include psychological addiction for such activites
and substances as shopping, work, porn, sex, food, and gambling which
don't cross the brain blood barrier. There is some movement to acknowledge
that peptides created in the brain by the hypothalamus are at least equal
to the effect of external chemicals during periods of addictive
activities.
PHYSICAL DEPENDENCY
When discontinuance of the substance or behavior results in the onset
of distinctivle withdrawal symptoms, the person is said to have a physical
dependence. Nicotine, alcohol, barbiturates, benzodiazepines and opioids
are all well known for their capacity to cause physical dependence, but
what is less well known as that most antidepressents, beta-blockers and
cortisone also cause physical dependence, but are not generally considered
to be addictive. Therefore, physical dependency can be considered to be a
major component in addiction and is typically a primary reason for
continuing in addiction, the beginning stages of using a substance known
to be addictive is its capability to provide pleasure. With ongoing usage,
the purpose of continuing becomes not a matter of providing pleasure, but
of avoiding anxiety which will occur if the substance is no longer
available. The exception to this is the use of nicotine where continuing
usage is pleasurable compared to the experience of not using nicotine.
This is true physical dependence upon the substance and underscores the
failure of 93% of cigarette smokers who try to quit each year and cannot
achieve their goal of abstinence.
Some substances such as many laxatives, nasal decongestants, and some
antidepressants including venlafaxine, sertraline, and paroxetine, cause
physiological tolerance or physical dependence, but not addiction.
Particularly in the case of antidepressants, but in many other
non-addictive drugs as well, a medical professional should be aware of
plans to disconue their use abruptly.
The length of time which is required to become addicted is dependent upon
the individual's psychological and genetic makeup,the level of pleasure
provided by the substance, the method of ingestion, frequency of usage,
and upon the substance itself.
Some people are able to drink socially and never become addicted, while
some alcoholics show signs of addiction almost from the first
intoxication. In the case of opiod dependence, there is a wide variance in
the responses to low dosages of the opioids. Most medical professionals
accept that the use of strong opiods regularly for even a brief period
will result in physical dependency. This result and others have convinced
many medical and scientific researchers that addiction is at least partly
tied to genetics.
PHYCHOLOGICAL DEPENDENCE
A psychological dependence is one of the mind and the withdrawal symptoms
experienced are also psychological. Examples are anorexia, depression,
irritability, insomnia and cravings. In theory, addiction can be obtained
from any activity which is rewarding. Addiction is understood to be
connected with the brain's dopaminergic reward system, such as is found in
addiction to amphetamines and cocaine. Another view of psychological
dependence is that it is a habit formed to avoid activity which is
undesirable. These habits or psychological addiction behaviors replace
positive stimilu which would be considered normal.
Psychological dependence is not restricted only to substances; both
behavioral characteristics and activities can be defined as addictive if
they harm the individual or others around them. Typical examples of
activities which may be considered psychologically addictive include work,
vandalism, self-harm, eating, pornography, sex, computer usage, internet
surfing, and gambling.
It is therefore possibly to be both physically dependent and
psychologically dependent. In fact, many medical health practitioners do
not place much distinction between the physical and psychological
addiction since both types of dependencies result in substance abuse.
However, the characteristics and underlying cause which leads to the two
different kinds of addiction are very dissimilar. The recommended
treatment for the two types of dependencies is also quite different. Only
a thorough study of the characteristics of the addictive behavior and the
person who exhibits it can determine the preferred course of treatment.
|
