Alison Palmer, BSN

Addiction can strike in many different ways and probably touches our personal lives more than we think.  If that is true, it should give an indication of the importance of assessing these areas of our patient's lives beyond the casual parameters seen in general assessments.

Addiction is a disease process with a set pattern of symptoms, signs and progression, no matter what form it takes.  A particular act or substance disrupts the normal balance of communication within the brain, leading the individual to seek out the drug in order to create desired responses.  The brain's basic decision making ability may also be compromised.  Higher stress levels may drive a dependence on substances perceived as reducing stress.  Addictive behavior can exhibit either or both psychological tendencies and physical dependence.  Physical dependence tends to carry a greater sense of fear regarding the recovery process.  Regardless, any recovery can be a very daunting task.

Stigmas surrounding addiction stem from the fact that the addiction started with a personal choice that eventually took over the person's life.  The same choice will not produce the same consequences for every person, thus adding a perceived element of weakness of character.

The best way to look at addiction is to ask if continuing any behavior is causing problems in the patient's life and if they are having trouble stopping.  If the answer is yes, regardless of what this behavior is, they may be a candidate for recovery assistance. 

Addiction has many faces.  Almost 4 million people are combating drug addictions, most frequently with marijuana, cocaine or pain relievers.  Approximately 8% of the population is dependent upon or abuses alcohol.  71.5 million Americans use tobacco products especially within the 18 to 25 year-old bracket.  Even seemingly harmless drugs such as caffeine are addictive and will produce withdrawal symptoms in most of the population when stopped.

There are 16 million people suffering from compulsive sexual disorders, including pornography addiction. In such cases the individual becomes dependent on the chemicals produced during sexual pleasure.  A significant amount of these patients are female, with a history of childhood sexual abuse.

Eating disorders, such as anorexia, bulimia, and overeating affect approximately 4 million Americans and have a strong link to depression.

Within the United States, 2 million people gamble compulsively with no thought of consequences or control over their behavior.  Anywhere between 4 and 8 million additional people have significant gambling problems that border on addictions.  Their mood is also highly dependent on whether or not they are winning.

Exercise, Internet use and Gaming are impulse control disorders.  One in every 20 people is a compulsive shopper.  Contrary to popular beliefs, however, it affects men and women equally.  Many who are recovering from these addictions work for controlled moderation rather than the complete abstinence needed for other addictions.

Addiction is very much an individual disease and recovery process.  No single recovery method is going to be effective for all addictions.  But, there are some basic thoughts that can be applied as a starting point for recovery.

First, addiction never sleeps or takes a vacation, recovery choices shouldn't either.  Help needs to be in place and available 24 hours a day.  On that same note, most are never fully "cured" of an addiction.  The person gets progressively better, but the initial triggers and tendencies often remain.  Patients can not expect that the same stimulus will have a different effect "next time".

Step programs, such as Alcoholics Anonymous, can be very effective if used long term, but they are not the answer for everyone.  Patients shouldn't be pigeon holed into one method of treatment, ignoring other possibilities.  Addiction affects the whole person, and treatment from several different angles increases the chances of success.  Recovery takes full commitment.  It is also important to recognize the risk for secondary addictions.  While battling an addiction, substitute addictions may try to sneak in (i.e. - replacing smoking with overeating).

Research groups are actively working on vaccinations against addictive substances.  These are currently available for cocaine and nicotine.  The vaccines work to bind the chemicals before they can be absorbed and cause a physical and emotional response to block addictive properties.  The cocaine vaccine is being use to help previous addicts avoid relapse.

References:

Huttner, J. Disease of Addiction. Lake View Health Systems.  Sited in: Addiction Recovery Basics.  2008.

Lemonick, D. How We Get Addicted. Time Magazine.  July 05, 2007.

Marsden, J. Hope for a Vaccine. BBC Health.  May 2001.  Reviewed and updated November 2005.

Urell, B. Principles and Types of Addiction Treatment. Addiction Recovery Basics. 2008.

 

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