Understanding Addiction

As human beings, we seem to look forward to opportunities to let go and not need to apply the restraint that everyday life requires. We tend to look forward to vacations, parties, and events where indulgence is not only permitted but encouraged. After the party is over and everything is cleaned or it is time to venture back home after being away - Everything migrates back into a form of order. There is an end to it. However, what happens when a person loses control of their behavior and can no longer apply restraint? When there is no end?

As a Licensed Counselor and Certified Addictions Specialist practicing in Chestnut Hill, Philadelphia and West Chester, PA with a specialty in addiction, including alcohol, drug, co-occurring disorders (dual diagnosis), I receive many calls from people who are struggling with a variety of addiction problems. Many people who have been struggling with chronic relapse for many years, as well as others experiencing negative fallout from their use, , but don’t quite understand why negative things are happening and are confused. They may suspect that they have a problem, because “bad things happen when they drink” or that other aspects of their lives are falling apart – Job loss, marital problems, financial issues, and or health concerns. Regardless of where someone is in relationship to an addiction problem, it is painful and destructive.

Addiction is an important problem to understand as it affects approximately 8.5% of the U.S. population. It is also vital to get help as promptly as possible as addiction does not get better on its own – it gets worse. Understanding the difference between problem vs. addictive behavior, identifying the types of addictions, as well as risk factors is helpful in approaching this multifaceted health issue.

Identifying addictive behavior is both a preventative measure as well as an intervention. Unidentified and untreated addictions can lead to a myriad of health concerns and high-risk behaviors which are life-threatening and often impact individuals, families and their communities.

On this note, April is Alcohol Awareness Month. Found and has been sponsored by the NCADD (National Council on Alcoholism and Drug Dependence) - http://www.ncadd.org/.

Problem vs. Addictive Behavior

Human beings are designed to survive. We are built to avoid conflict, conserve energy, avoid pain, and seek pleasure. We seek ways of feeling “better” to cope with stress related to unpleasant experiences; tending towards behaviors that feel soothing and eliminate discomfort.

These “maladaptive coping” behaviors, however, are short-term relief oriented “fixes” and are generally not helpful in the long-run. In fact, they often end up creating more problems, suffering and stress.

But when do these attempts to feel better cross the line and become problematic? Any time we repeat a behavior we make way to do it again at another time. Repetition leads to the development of habits, and over time, habits become part of our lifestyle. Lifestyle behaviors become part of our everyday lives and identity.

Lifestyle behaviors that are positive add structure, focus and meaning. For instance, our daily rituals of waking, washing, and eating.  We also have holidays and family gatherings, which could be pleasant and positive rituals. However, addictive ritual is very different.

Addiction is about dependency and causes a loss of behavioral control – the feeling of becoming powerless. Addiction can be as subtle as overeating or as intense as binging on alcohol, drugs, gambling or sex. Regardless of the kind of addiction, it is harmful to one’s health as well as the health of those around them. Addiction carries intensity – a deep craving, desire and urgency.

Two Types of Addictions

There are two main categories of addiction: 1. Substance Addiction, and 2. Process Addiction. 

We are most familiar with substance addiction, specifically with alcohol and drugs. Food, tobacco and caffeine are also included as mood altering substances.

Process addictions can present more subtly, but no less harmful. It is similar to compulsive behavior which is related to activities including: internet, sex, relationships, and shopping, gambling, self-mutilation.

Medications are readily available -- for pain, sleep, anxiety, or attention issues. We must be aware of the misuse and abuse of these substances:

•             Opiate pain medications such as Vicodin, OxyContin, Codeine, Morphine, and Hydrocodone.

•             Benzodiazepines , sedatives, hypnotics, including medications such as valium, Xanax, Adivan, Klonopin, Librium and Valium.

•             Psycho-stimulants such as Adderall, and Ritalin.

•             Over-the-counter (OTC) sleep aids & medications, such as; Sonata, Ambien (Benzodiazepine), and Lunesta.

These drugs are generally intended for shorter-term use or as needed and can easily be abused, resulting in increased tolerance leading to dependence. Without titration (weaning off) can result in withdrawal effects, including nausea, sweating, shaking and in some cases, seizures. Also, mixing these substances with other medications or with alcohol can intensify mood altering effects accelerating the addictive process and can lead to psychosocial, psychiatric and medical deterioration.

The increased use of technology lends itself to addictive behavior as immediate gratification needs are met through easy access to information. A click of a mouse can initiate a shopping spree or gambling run which can create havoc for a person’s finances.

Some of these addictive behaviors may come as a surprise to you. In thinking these addictions through, is there anything that stands out for you? Or do you notice any of these in someone else?

Risk Factors

Risk factors mark the increased probability of developing a specific disease or illness. For addiction, these risk factors include:

•             Genetics: Temperament, family history (addiction, medical, psychiatric disorders).

•             Social / Environmental: Exposure to and availability of substances, level of stress, isolation, adverse childhood experiences (including poverty), or loss.

•             Psychological / Emotional Problems: Depression, attention-deficit / hyperactivity disorder or post-traumatic stress disorder.

•             Medical Problems: Underlying neurological, endocrine-immune issues, fatigue, unresolved chronic pain, post-surgical complications, obesity, insomnia and other sleep problems, and depression.

A comprehensive evaluation includes each of these components as it relates to the client history and presenting addictive issue.

Treating an individual’s addiction generally involves working through multiple problems. Not identifying and not addressing the underlying issues opens the way for relapse as well as cross-addictions (the development of new addictive behaviors / replacements).  It is not unusual, for instance, that the recovering person turn to food or work upon abstinence. It is also not unusual that other co-addictions, those which coexist with the presenting addiction, such a sex, food and shopping not be identified upon evaluation.

Addictive behavior is an individual’s style of approaching life, and is a pattern that must be addressed to ensure long-term recovery.

How Prevalent is Addiction to Alcohol and Drugs?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) conducted the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), one of the largest surveys of its kind ever performed. It examined the prevalence of alcohol and other drug use and abuse in the United States. According to NESARC, 8.5 percent of adults in the United States met the criteria for an alcohol use disorder, whereas 2 percent met the criteria for a drug use disorder and 1.1 percent met the criteria for both.

Can You Abstain?

An essential part of Alcohol Awareness Month is the Alcohol-Free Weekend, which takes place on the first weekend (Friday, Saturday, and Sunday) of each April.  During this weekend, the NCADD invites all Americans to abstain from drinking alcohol.  Those who have trouble getting through this weekend without drinking are urged to get help.

If you or someone you know struggle with alcohol abuse or any other addiction call us today.

A helpful rehab listing for both inpatient and outpatient resources is  AllTreatment.com  - http://www.alltreatment.com/pa/philadelphia

Integrated Treatment Solutions provides addictions counseling and treatment that is integrative and holistically based. Through collaboration with our clients, we establish practical solutions in support of long-term recovery with the goal of extinguishing addictive behavior while increasing wellness.

We invite you to sign up for the monthly issue of Living Well News please on the Integrated Treatment solutions homepage www.myintegratedtx.com .