Addiction

Having an addiction means regularly engaging in a behavior that is hard to control, and that results in negative outcomes. Many people think of substance use when hearing the word addiction. Indeed, addiction can develop from regular use of illegal substances (e.g., amphetamines, cocaine, heroin), prescription medications (e.g., xanax, opioids, painkillers), and legal substances (e.g., alcohol, marijuana (dependent on State), and tobacco). Other behaviors that are hard to stop, despite negative outcomes, might also result in an addiction, including compulsive gambling, shopping, or video gaming, and sex addiction, to name a few.

Here are some common signs that suggest the presence of an addiction:

- The substance use/behavior interferes with important obligations, such as work, school and relationships.

- It is difficult to change or stop the use/behavior, despite negative outcomes.

- There is a desire to cut back or stop the use/behavior, but it is difficult to do so. Using more/engaging in the activity for longer than intended is another sign of addiction.

- Experiencing strong urges to use or engage in the behavior makes it difficult to fully engage in other daily activities. Or, a lot of time is spent in pursuit of the substance/activity, at the expense of engaging in other important life activities.

- Continued use/behavior despite it being damaging. For example, ongoing alcohol use despite one or more DUIs, or continued compulsive video gaming despite failing to complete school work.

- The substance or behavior is no longer enjoyable, and instead has become a source of distress.

- Finally, tolerance and withdrawal are signs of an addiction. Tolerance is defined as needing more of the substance, or needing to engage in the behavior more often, in order to feel the same effects as you once did. Withdrawal is suffering from physical and/or psychological symptoms when stopping the substance use or the behavior.

There is no one cause of an addiction. Addictions arise from a combination of biological, psychological and environmental factors. One is at greater risk for developing a substance addiction if there is a family history of addiction. Though there is no clear “addictive” personality, the traits of impulsivity and sensation seeking are associated with addiction. Also, early childhood trauma can place one at risk for developing an addiction, as can the challenges of managing strong emotions and mental health issues such as depression, bipolar disorder, anxiety, and ADHD. The quality of parent-child relationships and of peer groups can also influence an addiction.

Though relapse is common, addictions are treatable and recovery is possible. There are numerous resources that are helpful in addiction treatment, and no one way will be right for everyone. Often, more than one resource is incorporated into a recovery plan, and different resources may be best at different stages of recovery. Common treatment approaches include:

- Peer-based groups: These group programs provide a community of support from others who are suffering from similar addictions, for example, Alcoholics Anonymous (AA), Gamblers Anonymous (GA), and Sex Addicts Anonymous (SAA). In addition, support groups are available for those affected by a loved ones’ addictive behavior, such as Al-Anon (for loved ones of alcohol addicts) and S-Anon (for loved ones of sex addicts).

- Inpatient rehabilitation programs and intensive day treatment programs provide multidisciplinary daily support for those suffering from an addiction. Treatment typically includes working with both medical and mental health providers, and in both group and individual formats.

- For many, individual therapy is used alone and/or in conjunction with other recovery programs. Treatment approaches that are a good fit for addiction recovery include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Motivational Interviewing. Determining if there are co-occurring mental health issues is important as one begins recovery. When looking for a mental health professional, it is important to ask about experience in working with addiction. Some therapists are also Credentialed Alcoholism and Substance Abuse Counselors (CASAC).

- For greatest likelihood of success, it is valuable for one’s family to be engaged in the treatment and recovery process.

Relapse, or falling back into use/behavior after a period of abstinence, is the rule rather than the exception. Given this normal path of recovery, treatment typically includes resources that focus on relapse prevention. Even if one is not ready to entirely quit use/behavior, therapists can, through Motivational Interviewing, help you identify whether a problem exists and evaluate your desire to make changes.