What is Addiction?
Addiction is a complex brain disease which involves intense craving for something; could be anything perceived as pleasurable, such as shopping, gambling, or a substance(s). Addiction is a term that is used to describe continued and compulsive engagement in the behaviour that produces pleasure despite the consequences. In terms of problematic substance use, addiction is defined as a severe substance use disorder.
Substance use disorder is intense craving for a certain substance(s). This intense craving interferes with regular brain function and regular behaviour prior to addiction. Substance use disorder results in changes in the brain which are responsible for intense craving. The changes occur in brain regions responsible for decision-making, judgment, memory, and learning.
An individual with an addictive disorder may or may not be able to understand the consequences of their actions, but oftentimes they are unable to control the behaviour and intense craving without intervention.
Addiction is not a choice. Addiction is associated with changes to reward circuits in the brain. Our brains work on a reward system; behaviours that produce pleasure are reinforced and will be increased or continued. Brain function is also altered. The prefrontal cortex which is responsible for our decision-making has been shown to have reduced function in individuals with addictive disorders. An intense focus is placed on receiving the reward (pleasure) despite consequences. This can be supported by inability to control consumption regardless of consequences.
Signs of Addiction
Indicators of addiction (CAMH)
A – abstain -unable to refrain from consumption or participation
B – behaviour -little to no control over behaviour
C – craving -desire, hunger, craving, for substance or consumption
D – decrease -decrease in recognition of problems in behaviour and relationships E – emotional – distressing emotional response
4 C’s of Addiction: the 4 C’s of addiction are a way to describe addiction
- Control: loss of control of frequency or amount
- Consequences: use or engagement continues despite consequences
- Compulsion: urge to behave in a certain way; behaviours the individual feels MUST be performed
Symptoms of Addiction:
- Impaired control: craving to use, associated with desire or unsuccessful attempts to control use
- Social problems: difficulties in relationships, at work, and within self; decreased or ceased participation in hobbies, occupation, and social events
- Risky or dangerous use: use in harmful situations such as drinking and driving; continuing use of substance or engagement in behaviour despite knowing consequences
- Tolerance: adaptations in the brain result in a weaker response to substance(s), thus in order to
produce desired result a larger amount of substance must be consumed
- Withdrawal: discontinued use of substance may produce withdrawal symptoms, withdrawal
symptoms can be emotional and/or physical
Causes of Addiction
- A combination of genetic and environmental factors. Environmental factors such as childhood trauma, growing up with a parent who has had problematic substance use, and exposure to stress can impact likelihood of addiction. Inheritance of traits that make an individual more vulnerable to addiction is a genetic factor.
- Mental health and substance use disorder have a complex relationship; a mental health problem can cause substance use or vice versa. If both mental health problems and a substance use disorder is present at the same time, this is called a co-occurring disorder.
- The ability to cope; if coping mechanisms in response to a stressor are reliant on substance use then this increases the likelihood of substance use disorder or addiction to the substance(s).
- Some additional risk factors include (but aren’t limited to):
- Discrimination or oppression
- Social exclusion on basis of race, gender, ethnicity, or sexual orientation
There is no “treat all” method to treating addiction. A treatment is made to fit the individual and the severity of their addictive disorder. Factors like motivation to change and the level of support from family and friends can play a massive role in the methods of treatment chosen.
- Surrounding yourself with protective factors. Protective factors are positive role models, loved ones, motivating goals and passions, and taking part in meaningful activities such as volunteering.
- Self-help is a good method for some people with addictive disorders or substance use disorder to help themselves through methods such as self-help books or self-help groups. Self-help groups (also called mutual aid groups) are groups of people who provide support to people who desire to control their substance use disorder or addictive disorder. See the “Self-Help” section for additional information and resources.
- Harm Reduction can be a good method of intervention if the individual with the addictive disorder is not ready or willing to give up the addictive behaviour. Some examples include learning safe use of a substance, safe or supervised injection sites, and programs that ensure basic necessities (food, shelter, etc.) are fulfilled. See the “Harm Reduction” section for additional information and resources.
- Withdrawal management is management of the symptoms caused by withdrawal. This can be through a detox program or rehabilitation.
- Counselling can be in the form of individual, group, family, or couples therapy. Since addiction affects many areas of life counselling is a method of treatment that allows for aspects like an increase in awareness of how the addictive disorder impacts them. See the “Counselling” section for additional information and resources.
Medication can be used to control craving and provide relief from withdrawal symptoms. When used in conjunction with counselling or another method of treatment, this is further beneficial. See the “Psychiatry (medication)” section for additional information and resources.