Definition of dependence
The term dependence in itself has no negative connotation. Just as the dependency of small children on their mothers, it is healthy and necessary. However, according to the definition of WHO, pathological dependence (addiction) is a disease: a psychological and in certain cases a physical condition characterized by a strong desire of compulsion to repeatedly and regularly take the substance, or repeat the compulsive action.
Psychological and physical addiction
- Psychical (psychological) addiction means insurmountable craving for alcohol, drugs or compulsive actions, while
- Physical addiction is reflected in withdrawal symptoms when the favoured substance is denied from the body.
Chemical and behavioural addictions
- Chemical addictions are caused by psychoactive substances: alcohol, cannabinoids (marijuana, hashish), sedatives (Xanax, Rivotril, Diazepam), cocaine (crack), amphetamines and methamphetamines (speed, ecstasy, pervitin), hallucinogens (magic mushrooms, mescaline, LSD), solvents (toluen, acetone), nicotine, caffeine, designer drugs (mephedrone, bio-grass, piperazines).
- Behavioural dependencies are caused by excessive, compulsive actions: gambling (slot machines, casinos), screen addiction (computer and video games, movies, series, Internet, pornography, smart phone), work addiction, sex addiction, shopping addiction, kleptomania, codependency.
Why does someone become addicted?
The question of why a person becomes addicted, and why another person does not, has stilled remained a focal point of investigation for science, as well. No exact cause may be pointed out, since addiction is formed as a result of several factors that are present concurrently:
- substance – materials (or compulsive actions) that have a psychotropic effect, and are capable of inducing addiction
- personality – factors associated with genetics and personality, making one person more vulnerable to addictions than others
- environment – family habits, peer relationships, consumer culture and the effects of the media reinforcing the emergence of addiction
- incentive – any motives causing a person to turn to drugs (or escape to compulsive actions): curiosity, boredom, peer pressure, feelings of emptiness, long-lasting frustration, escape from a situation that seems hopeless
How does addiction develop?
Psychotropic substances affect the neurotransmitters of the central nervous system (serotonin, dopamine, noradrenaline), and in this way activate neural pathways responsible for positive reinforcement. They penetrate the prefrontal cortex area, and end up in a sense of reward. If the body gets used to the “reward” effects of a substance, from which it is suddenly deprived of, withdrawal symptoms surface. This discomfort is then alleviated by another dose, which increases tolerance (against the substance) in the body. As a result of loss of control, addiction is formed, and addicts have only one goal: to obtain the substance (repeat the compulsive action).
Diagnostic criteria of addiction
According to the criteria included in Diagnostic and Statistical Manual, if 3 out of the following 6 criteria are present, addiction is diagnosed:
- Excessive craving for the substance (habit)
- Changes in behaviour caused by the substance
- Withdrawal symptoms when the usual amount of the substance is reduced, the use of the substance is stopped or suspended (physical and mental)
- Signs of tolerance (the effect of the substance is gradually reduced, the dose must be increased to achieve the same effect, mode of intake or frequency must be changed…)
- Decrease in former interests, change of the usual way of life
- Continuing the use of the substance despite the user is aware of the consequences of addiction
Recovery from addiction
Addiction is a complex problem that requires complex treatment. The most effective treatment is the therapeutic community. Both the problem and solution are best expressed by the bio-psycho-socio- spiritual model. Recovery covers the following areas:
- Health-related goal: Stop the deterioration of health, restore health and achieve total abstinence. No one can return to substance use later, as it induces loss of control again.
- Psychological goal: More than no drinking, no drug abuse or no games. The root of addiction lies deep underneath the surface; therefore, addicts need freedom, spiritual healing and a new life. With the help of self-awareness, addicts should be able to change their way of thinking, recognize risky situations and cope with them, too. Replacing the embedded bad practices by proper, sober routines that cause pleasure.
- Social goal: Responsible life, reintegration into society, restoration of degraded family relations, integration into a supportive community (I have abused, we recover!).
- Spiritual goal: Reconnecting with God. “We admitted we were powerless over addiction – that our lives had become unmanageable. Came to believe that a Power greater than ourselves could restore us to sanity. Made a decision to turn our will and our lives over to the care of God as we understood Him.” (Based on the twelve steps of Alcoholics Anonymous)