If you or a loved one struggle with addiction, you are not alone. Around 21 million people in the United States are believed to suffer from alcohol or substance addictions, and gambling addiction alone impacts at least 2 million people. But what is addiction, and why does it happen?
Addiction is a treatable, chronic disease. Genetics, brain chemistry, environmental factors, and life experiences all play a role in the disease, and past trauma is often at the root of many addictions. For many who struggle with addiction, it can be helpful to know that risk factors and levels vary by person, but like any chronic condition, focusing on the cause and the symptoms in treatment offer the best chance for recovery.
Two Types of Addiction
There are two categories of addiction: substance disorders and behavioral or process disorders. While the way each addiction is acted out might vary, the results are the same: problems at school, work, or home, and the potential for significant health issues.
Substance addiction involves abusing alcohol, illegal or prescription drugs, and misusing common substances such as household cleaners to get high. Unlike behavioral addictions, substances create a physical need to use, which can lead to faster addiction. Nicotine is one of the most addictive substances, outranking methamphetamines, cocaine, and alcohol because of how quickly it creates that physical dependence. Heroin is still considered the most addictive substance because of how quickly the body and mind start to depend on it and the extreme detoxification effects it produces depression, hallucinations, physical pain, and nausea. This doesn’t mean quitting is impossible, rather than your support needs might be a bit more involved.
Examples of substance addictions:
- Alcohol – Beer, wine, liquor
- Antianxiety and Antidepressant Medications – Increasing dosage for faster effect, taking with alcohol to increase effect
- Dissociative Anesthetics – Ketamine, PCP, dextromethorphan
- Entactogens or Empathogens – MDMA, molly, ecstasy
- Nicotine – Cigarettes, cigars, e-cigarettes, some vapes
- Opiates – Heroin, Vicodin, OxyContin, morphine, fentanyl
- Psychedelics – LSD (Acid), mescaline, mushrooms
- Sedatives and Tranquilizers – Xanax, Valium, Klonopin, Ativan, benzodiazepines
Behavioral addiction is a compulsive behavior that disrupts your life in much the same way that drugs or alcohol can. They have the same impact as drug or alcohol addiction on personal relationships, finances, and overall health. Still, a key difference is that fully abstaining from some of these behaviors is impossible or not recommended. Eating, shopping, and working, for example, are necessities for most people.
Examples of behavioral additions:
- Intimacy disorder (sex addiction, porn addiction)
- Food addiction
- Online or computer gaming
- Work addiction
- Shopping or compulsive spending
Signs and Symptoms of Addiction
The most recognizable addiction symptoms involve using substances or behaving compulsively, even if you experience harmful consequences as a result. In plain language, drinking when you know that you won’t be able to stop or gambling with more money than you can afford because it makes you feel better in the short term.
Common signs of addiction:
- Looking for reasons to use
- Sleeplessness or memory loss
- Increased secrecy
- Blaming other people or things for their problems
- Increased depression and anxiety
- A hard time identifying feelings or telling them apart from physical sensations
- More severe stress reactions
- Needing more to get the same effect
- Spending money on substances or related activities even when they can’t afford it
- Doing things they wouldn’t normally do, like stealing
- Engaging in risky behaviors while under the influence
Often, people with addictions are aware that the substances or behaviors they wrestle with cause them problems; the nature of addiction is such that simply wanting to stop is not enough.
Five Stages of Addiction
There are five stages that a person with addiction typically experiences, beginning with experimentation or first use and resulting in dependency and addiction.
- Experimentation or First Use: Trying a substance or engaging in potentially addictive behavior is the first step towards addiction. Again, this does not mean that you will develop an addiction immediately. However, some substances like nicotine, cocaine, and opiates cause faster physical dependency than others.
- Social or Regular Use: As someone starts to use substances more frequently or starts to engage in behaviors like internet gaming or shopping, a pattern will develop. What may begin as a once a week or weekend only activity will become more frequent, and signs of addiction will be more noticeable.
- Problem: When people use more frequently, their behavior becomes more dangerous, like driving while drunk or high. At this point, your personal relationships may begin to suffer, along with school or work performance.
- Dependency: At this point, a person’s tolerance for substances or behaviors have developed, and they can no longer regulate their use. With drugs and alcohol, physical and mental cravings are more intense, and going without can bring on withdrawal symptoms. These symptoms may include muscle cramps, vomiting, or fevers. Both substance and behavioral addiction cravings can create feelings of irritability, impatience, and anger
- Addiction: As these phases progress, it leads to a substantial loss in a person’s life: relationships, work, and school are notably impacted because they can no longer function without the addictive substance or behavior. For some people, this is known as hitting rock bottom, but you don’t have to wait for a catastrophic event to occur in order to get help.
Available Treatment Options
Addiction can make it feel like there are no options for relief, and stigma, or shame, around addiction can make it even more difficult to find or ask for help, but you don’t have to be ashamed: you are worthy of recovery. With treatment and support, hope and healing are within reach.
- Therapy, Counseling, and Outpatient Treatment – Treatment that addresses all areas of your life, rather than focusing solely on changing behaviors, is usually the most successful. Working with a therapist, counselor, or addiction specialist is the best way to determine an ideal treatment plan for you. Your path may include residential treatment, individual or group therapy, or a combination of approaches that fit your needs and goals. Treatments counselors use for addiction include Cognitive Behavioral Therapy (CBT), Person-Centered Therapy, Dialectical Behavioral Therapy (DBT), Solution-Focused Therapy, and Rational-Emotive-Behavior Therapy (REBT). Counseling for addiction aims to reduce the problematic behaviors in a person’s life by behavioral changes, changing thoughts, or addressing the root cause.
- Medication and Medical Interventions – In some cases, treating addictions with medication is ideal. This approach might be best if there are underlying mental disorders. A combination of medication and therapy can help eliminate unhealthy coping behaviors such as substance use. Some medicines help control drug cravings or help with withdrawal symptoms. More involved medical services may best manage withdrawal symptoms during detox and can include hospital admission for care and observation for more severe symptoms. If there are other health complications from using substances, receiving additional medical attention may be necessary and beneficial.
- Inpatient Treatment Programs – Inpatient treatment for addiction may be needed for those who have not seen success with other treatment types or who need more comprehensive care as they journey towards recovery. There are various centers, some through local hospitals and organizations, and private, offering multiple options. Both short- and long-term residential programs are available, and it is essential to continue therapeutic and other support work after completing a residential program.
- Self-help Programs – Self-help and support groups, including 12-step programs such as Alcoholics Anonymous or Narcotics Anonymous can be useful in addiction treatment. These work best when combined with therapy and for ongoing maintenance of the addiction.
- Trauma Healing and Support – Because trauma is the cause of many addictions, treating the underlying trauma and emotions is essential to recovery. Psychotherapy is the most common method for addressing trauma, and advanced techniques such as Eye Movement Desensitization and Reprocessing (EMDR) may help you process and heal from the trauma. EMDR targets traumatic material and helps to process it in a focused manner.
Whatever methods of treatment and support work best, remember that you are worth the effort, and you can recover.
If you’re struggling with addiction and looking for help, you are not alone on this journey. Recovery from addiction is possible and within reach; choosing a path forward might seem overwhelming, but we are here to help you determine your next steps.