Addiction: A Help Guide

Addiction can be understood as a dependency on something. This can be physiological and/or psychological. In the case of an addiction, the individual will have no control over their choices associated with the addiction. The individual will experience withdrawal symptoms when the addictive process is stopped. The addictive property can be perceived by the individual as the most important part of one’s life.

When looking at the symptoms of addiction, many people consider their behaviour to be a craving, dependence or bad habit. However, a habit is when someone has control over use and behaviour whereas an addicted individual has limited or no control. Every addiction can be associated with a range of signs and symptoms, both physical and psychological. Some of the most common include:

Physical

• Sweating, racing heart, palpitations or tremors
• Muscle tension or difficulty breathing
• Nausea, vomiting or diarrhoea
  

Psychological

• Feelings of craving or feeling out of control
• Anxiety or panic attacks
• Depression, guilt or shame
• Risk-taking
• Sleep disturbances or insomnia
• Obsessive-compulsive traits
• Irritability or paranoia

Other indicators that the individual is suffering from an addiction include deteriorating relationships, poor work performance/absenteeism and escalating financial problems.

Many people assume that we can only become addicted to substances that exert a physical effect on the body, such as alcohol or drugs. However, an addiction can develop from a huge range of activities that for most people are pleasurable and allow us a temporary escape from the pressures of modern day living.  There are important physiological explanations as to why and how an addiction can develop.

Our brain responds in particular ways to reinforce behaviours which are associated with our survival. Our brain has a ‘reward and encouragement system’ that responds by releasing particular neurotransmitters such as dopamine. When we are eating for example, or having sexual intercourse, our brain tells us that this is a significant experience which relates to our survival. We experience a high level of arousal and pleasure. We remember such significant experiences and the associated feelings. We then apply this memory to future choices of behaviour as a survival tool.

Some drugs when taken can imitate a similar brain activity response to that of survival behaviours. Some drugs release neurotransmitters including dopamine to produce feelings of a similar positive nature. Some individuals will then wish to experience the feelings gained from the drug again. This urge for repetition is how an addiction can begin.

It is unlikely that anyone choses to have an addiction. It is important to address why an individual chooses to take a harmful substance in the first place to then become addicted.

In understanding addiction, it is very important to explore the effects of certain substances and explore why an individual may want to feel a certain way.

Strong links have been found with victims of trauma and substance addiction such as alcohol. One reason for this is the ‘numbing’ effect that some drugs can have. Someone wishing to forget, suppress or block out memories and emotions may use substances to help do so.

This process can be explained to be a coping mechanism. Those with a range of mental health problems such as depression, anxiety disorders, and post traumatic stress disorder may ‘turn to’ substances in effect to try and cope with the symptoms. Those who are highly stressed are also more likely to use substances in this way. Research shows that individuals with little or no social support are also more likely to develop an addiction.

Exposure to substances or certain behaviours has also been highlighted as a contributor to addiction. For example those with parents or social groups with addictions may be more likely to become addicted themselves. It has also been found that early life exposure is more likely to lead to addiction.

There have been some genetic links found with addiction. Research has shown that variation within a number of different genes can contribute to an individual's overall susceptibility to addiction.

Sadly, the addiction industry is a large and powerful one. Many organisations and individuals take advantage out of the process of addiction and are making a lot of money from it. Many addictive substances and behaviours are readily available and seem all the more appealing by marketing and advertising. These influential tools arguably lead to the enhancement of addiction.

Individuals are susceptible to become addicted to a large number of substances and behaviours. Some argue that people can become addicted to almost anything.

There are some substances that are highly addictive in nature. Opiates such as heroin, codeine, and morphine fall under this category. This is because their structure is very similar to a natural neurotransmitter (endorphin). However the reaction of opiates is much more powerful than any natural stimulus, creating an overwhelming state of euphoria.

Some of the most prevalent addictions are suggested to be influenced somewhat by society. Some addictions are more sociably accepted and manageable than that of a drug such as heroin. Issues of availability and legality also serve to raise certain addictions such as tobacco and alcohol.

Cigarettes are highly addictive and create differences in our brain chemistry. As well as the release of dopamine, tobacco is also responsible for releasing further neurotransmitters (such as glutamate) which reinforce the habit even more so. Alcohol also imitates certain neurotransmitters.

Some substances do not imitate existing neurotransmitters, instead they influence the balance of natural neurotransmitters. Substances such as methamphetamine and amphetamine (cocaine, crystal meth, ecstasy, bath salts) interrupt the absorption of important excitatory chemicals such as dopamine and norepinephrine. The brain produces extremely high concentrations of these chemicals. The way the brain copes with this differs for each substance, yet all are highly addictive.  

Some research suggests behavioural addictions are becoming more prevalent such as gambling, eating, sex, internet, pornography, work and exercise. Gambling can be highly addictive as it affects brain chemistry in the same way as certain drugs. It is not simply the winning that can lead to addiction; it is the ‘near misses’ that can too. For example getting 2 out of 3 symbols on a slot machine is an ‘almost reward’. When almost getting a reward, our brain can strongly anticipate getting a reward for the future. This can be the reason why we repetitively try to win.

It can be seen that our brain chemistry strongly relates with any addiction. Our individual differences and environment (i.e. genetics, experiences, location, socio-economic status, and social circle) will also affect the likeliness of addiction. Some people may be more likely to become addicted to cigarettes whereas others may become addicted to heroin, and others will have no addiction at all. 

It can be assumed that people who suffer with addiction have a lack of will power, self respect or principles. This falsified belief is unhelpful to people who suffer with addiction. As discussed, addiction is a complex issue and overcoming it can be extremely difficult. An empathetic and considerate approach can be a better way to understand the problems that face addicted individuals. 

One risk if left untreated is the worsening of symptoms and the development of mental health problems. Addiction can lead to significant impairment in occupation, interpersonal relationships and everyday functioning. Individuals suffering with symptoms should seek help and should not delay treatment.

If you suffer from a substance addiction and do not seek help, you may become more tolerant to its effects. This means that you may take more and more of the substance in order to have the same feeling as you once did. This can also lead to addiction to other, more powerful and more harmful substances.

Addiction affects parts of your brain that are critical to decision making, learning, memory, behaviour control and judgement. This can lead to devastating consequences and exacerbate the addiction.

Many substances have terrible consequences, sometimes life threatening.

If left untreated, addiction can be a spiral of rejection, desperation, anxiety, humiliation, relationship problems, absenteeism from work and bankruptcy. 

A main reason why addiction can be so difficult to combat is the existence of withdrawal symptoms. When an addiction comes to a stop, the brain does not experience the usual repetition of positive neurotransmitter release that the addiction provides. Therefore the brain sends out signals which tell you to relapse back to the addictive pattern. 

Withdrawal symptoms will differ for each addiction and individual yet some of the most common and general include lack of concentration, cravings, insomnia, headaches, loss/ gain of appetite, heart palpitations, physical weakness, muscle aches, chills/ sweating, depression, anxiety, resentment, bitterness, anger and digestive problems.

It is important to note that withdrawal symptoms do not last for very long and can soon fade away following the beating of an addiction. Over time, brain chemicals will become balanced and will find a way of functioning despite the withdrawal. In some cases, it is important to slowly reduce addictive substances rather than suddenly stop so that the brain can process these changes effectively. If you are concerned about this, speak to a healthcare professional.

There are high success rates in treatment for addiction in current times. Research, experiments, and clinical practice have led to the development of many evidence based treatments.

There are many positive outcomes of overcoming addiction. In many cases this can be life-saving. Other significant benefits include improved health, fitness and well-being, financial benefits, improvement in relationships and occupation, and the feeling of gaining control over one’s life and body.

A life without addiction is wanted by so many and with the motivation and right support it is possible for anyone to change.

The National Institute for Health and Clinical Excellence (NICE) was set up in 1999 to reduce variation in the availability and quality of NHS treatments and care - the so called ‘postcode lottery’.

NICE quality standards are a set of specific, concise statements that act as markers of high quality, cost effective patient care, covering the treatment and prevention of different diseases and conditions.

NICE provides information related to addiction. There are guidelines that are based on issues such as psychosocial interventions, drug misuse, alcohol dependence, and needle and syringe programmes.

Click here to read some publications from NICE relating to addiction.

Much research suggests that the best approach to treatment is almost always psychology based. Some medication can ease symptoms or replace a substance with a less harmful one, however some suggest they often do not alleviate the problem, therefore are not an effective treatment exclusively.

Because addiction can often have an impact on families and carers, interventions may be more effective when collaborated with families/ carers.

Treatment should holistically consider the individual’s causes of addiction, risks, social issues, relapse prevention, mental health needs, and any other related areas to one’s well-being.

There are many evidence based treatments available.

Psychotherapy and counselling can address the causal factors of the addiction. Exploration as to why and how the addiction has developed can be a useful tool to go on and overcome your addiction. Psychotherapy can help the individual deal with feelings of helplessness and other symptoms of addiction.

There are many specialised treatment programmes depending on the substance or behaviour. Recognisable examples include Alcoholics Anonymous and Gambling Anonymous. Approaches vary and may include gentle reduction in a substance or behaviour whilst some approaches involve complete abstinence.

Cognitive Behavioural therapy (CBT) explores your thoughts, feelings and behaviour around addiction. Practical ways of effectively dealing with the dependency and withdrawal symptoms are developed.

When you feel ready there are many ways in which you can seek help, support and advice.

Understand that sacrifices will have to be made for the alleviation of your addiction. For example, removing yourself from certain social situations and changing your lifestyle. However, there are so many positive gains from removing yourself from the world of addiction. Common benefits include:

• Improved health, fitness and well-being
• Financial benefits
• Improvement in relationships
• Gaining control over your life and body

It is important to acknowledge that recovery from addiction can be a long process which involves setbacks. Relapse can be common but it doesn’t mean that you or the treatment has failed. Trying to stop your addiction is a huge step to have taken already. Keep on trying and do not give up.

It may be worthwhile reading a self-help book. There are many out there:

• Alcoholics Anonymous-The Big Book 1976
• Over the influence: The harm reduction for managing drugs and alcohol. Patt Denning, 2003.
• The sex addiction workbook: Proven strategies to help you regain control of your life. Tamare Penix Sbraga, 2004
• Change Your Gambling, Change Your Life,  Howard Shaffer PhD, Ryan Martin, PhD, and John Kleschinsky, MPH, with Liz Neporent, 2011.
  

Some self-help websites include:

• The NHS help page on addiction:
• The MIND help page, providing further support:

Some useful telephone numbers include:

• NHS Direct- 0845 4647
• Turning point- 020 7481 7600

There are now many counselling and therapeutic services and organisations available. There are many trained professionals who will be able to support you such as Counsellors, Psychotherapists, Psychologists and Psychiatrists. Here are details of available services:

The NHS - seeing your GP and asking for a referral to see a specialist.

Charities - (such as MIND, Rethink, Young Minds and the Mental health foundation) some may provide support groups, therapy and advice in your local or near-by area. See their websites for further details.

Counselling and psychotherapy clinics and services - Search through online directories or contact your council for organisations that offer can therapeutic help. (Harley Therapy is one example of a clinic)

When seeing a healthcare professional you may be involved in an initial assessment. This will include being asked some questions to identify the issues, causes and problems. Try to be honest and open in your answers. The person asking the questions just wants to understand and help.