What is Addiction?


Addiction was historically a term used to describe a devotion, attachment, dedication and inclination. Nowadays however, the term addiction is used to describe a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to that individual’s health, mental state or social life. The term is often reserved for drug or alcohol addictions but it is sometimes applied to other compulsions, such as problem gambling, impulse buying or shopping, and compulsive overeating. Many factors are suggested as causes of addiction include genetic, biological/pharmacological and social factors and this continues to be the source of much discussion and disagreement.


In the past addiction was term that clearly referred to the use of a tolerance-inducing drug in sufficient quantity as to cause tolerance (the requirement that more of a given drug must be used to produce the same effect as time passes). With that definition, people can become addicted to various drugs quickly. At the same time, a non-medical definition of addiction developed. This definition referred to individuals who continued to use a particular drug despite their own best interest. This definition is now thought of as a disease state by the medical community.


Physical dependence, abuse of, and withdrawal from drugs and other substances is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR). Terminology and definitions have become complicated in the field. Many continue to speak of addiction from a physiological standpoint (some call this a physical dependence); psychiatrists refer to the disease state as dependence; most other physicians refer to the disease as addiction.


The medical community now makes a careful distinction between physical dependence (characterised by symptoms of withdrawal) and psychological dependence (or simply addiction). Addiction is often now defined as “uncontrolled, compulsive use”; if there is no harm being suffered by, or damage done to, the patient or another party, then medically it may be considered compulsive, but to the definition of some it is not categorised as “addiction”. In practice, the two kinds of addiction are not always easy to distinguish. Addictions often have both physical and psychological components.


A useful definition and one referred to by many professionals is that provided by the World Health Organisation (WHO).


Physical Dependence.


Physical dependence on a substance is defined by the appearance of withdrawal symptoms when use of the substance is discontinued. Opiates (such as Heroin), benzodiazepines, barbiturates, alcohol and nicotine induce physical dependence.


The speed with which a person becomes addicted to a substance varies with the substance, the frequency of use, the method of use, the intensity of pleasure, and the individual’s genetic and psychological susceptibility. Some people may exhibit alcoholic tendencies from the moment of first intoxication, while most people can drink socially without ever becoming addicted. Heroin (or other opiate) dependent people have different responses to even low doses of heroin, although this may be due to a variety of other factors, as heroin use heavily stimulates pleasure-inducing areas in the brain. Nonetheless, because of these variations, in addition to a variety of studies that have been undertaken, much of the medical community is satisfied that addiction is in part linked to a person’s genetic makeup. That is, one’s genetic makeup may regulate how susceptible a person is to a substance and how easily one may become psychologically attached to a pleasurable routine.


Psychological Dependence.


Psychological dependence is a dependency of the mind, and leads to psychological withdrawal symptoms (such as cravings, irritability, insomnia, depression, anorexia etc). Addiction can in theory be derived from any rewarding behavior, and is believed to be strongly associated with particular areas of the brain’s reward system (as in the case of cocaine).


It is considered possible to be both psychologically and physically dependent at the same time. Some doctors make little distinction between the two types of addiction, since the result, drug or alcohol abuse, is the same. However, the cause and characteristics of each of the two types of addiction is quite different, as is the type of treatment preferred.


Psychological dependence does not have to be limited only to substances; even particular activities and behavioural patterns can be considered addictions, if they become uncontrollable, for example gambling, Internet addiction, computer addiction, sexual addiction/pornography addiction, shopping/spending addiction, eating, self-harm, or work addiction.


Eating Disorders and Addiction.


Eating disorders are considered by many to be complicated pathological mental illnesses and thus are not the same as addictions described here. Eating disorders, which some argue are not addictions at all, are driven by a multitude of factors, most of which are highly different than the factors behind addictions.


It is, however, said by many that the same personality factors that place individuals at risk for substance abuse are often found in individuals with eating disorders. Often in those with eating disorders and substance abuse problems drugs or alcohol are used in attempts to avoid binge eating. Similarly, those with eating disorders may deny their problem or attempt to keep it a secret, much like addicts try to conceal their drug and alcohol usage. Similar to genetic components of addiction, there is a large genetic component to body type or image.


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