An Update on Defining Addiction in America

Dear Friends and Readers,

Over the years the term addiction has evolved into making a distinction between substance dependencies and behavioral addictions.
Before the 1980s, the so-called addictive personality was used to explain the development of addiction. The addictive personality was described as escapist, impulsive, dependent, devious, manipulative, and self-centered. Many doctors now believe that these character traits develop in addicts as a result of the addiction, rather than the traits being a cause of the addiction.

In addition to a preoccupation with using and acquiring the abused substance, the diagnosis of addiction is based on five criteria:
loss of willpower
harmful consequences
unmanageable lifestyle
tolerance or escalation of use
withdrawal symptoms upon quitting.

Today the term “Addiction” has been extended to include mood-altering behaviors or activities. Some researchers speak of two types of addictions: substance addictions (for example, alcoholism, drug abuse, and smoking); and process addictions (for example, gambling, spending, shopping, eating, and sexual activity). There is also a growing recognition that many addicts, such as polydrug abusers, are addicted to more than one substance or process. That dear friends would be me.

Oftentimes, people with addictions also may have mental illnesses compounding their addictions. Science and research has also found that both a propensity toward addiction and mental illnesses run generationally within families, suggesting a genetic component.  Understanding, the genetic predisposition to addiction has opened the realm of treatment for both substance dependencies and process or behavioral addictions.

With some substance dependencies treatments particularly for opiate and heroin addictions which oftentimes must include hospitalisation because the physical symptoms of withdrawl can be deadly.
However, research also has concluded that most people, 75% , recover from addictions without medical intervention. However, what was not considered was the length of time the person had been abusing drugs or alcohol. Research has found the longer the time of dependencies, the more difficult they are to treat.

This is partially due to the fact that using drugs repeatedly over time changes brain structure and function in fundamental and long-lasting ways. Addiction comes about through an array of changes in the brain and the strengthening of new memory connections. Evidence suggests that those long-lasting brain changes are responsible for the distortions of cognitive and emotional functioning that characterize addicts, particularly the compulsion to use drugs. Although the causes of addiction remain the subject of ongoing debate and research, many experts now consider addiction to be a brain disease: a condition caused by persistent changes in brain structure and function. However, having this brain disease does not absolve the addict of responsibility for his or her behavior, but it does explain why many addicts cannot stop using drugs by sheer force of will alone.

Scientists may have come closer to solving the brain’s specific involvement in addiction in 2004. Psychiatrists say they have found the craving center of the brain that triggers relapse in addicts. The anterior cingulated cortex in the frontal lobe of the brain is the area responsible for long-term craving in addicts. Knowing the area of the brain from which long-term cravings come may help scientists pinpoint therapies.But while physiology is important, social learning is even more important to understanding addiction.

Social learning is considered the most important single factor in addiction. It includes patterns of use in the addict’s family or subculture, peer pressure, and advertising or media influence.
If a person grows up in an environment where drug use is prevalent, that person may simply imitate or emulate the drug behavior. Similarly, inexpensive or readily available tobacco, alcohol, or drugs produce marked increases in rates of addiction.

Treatment requires both medical and social approaches. Substance addicts may need hospital treatment to manage withdrawal symptoms. Individual or group psychotherapy is often helpful, but only after substance use has stopped. Anti-addiction medications, such as methadone and naltrexone, are also commonly used. A new treatment option has been developed that allows family physicians to treat heroine addiction from their offices rather than sending patients to methadone clinics. The drug is called buprenorphine (Suboxone).
So, why should anyone care about drug addiction? After all, isn’t it a personal issue? Isn’t it really an urban issue? It doesn’t affect me. The truth is that substance abuse and addiction is expensive.
Addiction is one of the most costly public health problems in the United States. It is a progressive syndrome, which means that it increases in severity over time unless it is treated. Substance abuse is characterized by frequent relapse, or return to the abused substance. Substance abusers often make repeated attempts to quit before they are successful.
The economic cost of substance abuse in the United States exceeds $414 billion, with health care costs attributed to substance abuse estimated at more than $114 billion.
That’s billions of dollars that could be spent on building a better America.

Brianna S. Clark
The Addict Writes

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