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What is Addiction?
Addiction is a compulsion to repeat a behaviour regardless of its consequences. A person who is addicted is sometimes called an addict. There is a lack of consensus as to what may properly be termed “addiction.” Some within the medical community maintain a rigid definition of addiction and contend that the term is only applicable to a process of escalating drug or alcohol use as a result of repeated exposure. However, addiction is often applied to compulsive behaviors other than drug use, such as overeating or gambling. In all cases, the term addiction describes a chronic pattern of behaviour that continues despite the direct or indirect adverse consequences that result from engaging in the behavior. It is quite common for an addict to express the desire to stop the behaviour, but find himself or herself unable to cease.
Addiction is often characterized by a craving for more of the drug or behavior, increased physiological tolerance to exposure, and withdrawal symptoms in the absence of the stimulus. Many drugs and behaviours that provide either pleasure or relief from pain pose a risk of addiction or dependency.
Terminology and Usage
The medical community now makes a careful theoretical distinction between physical dependence (characterized by symptoms of withdrawal) and psychological addiction (or simply addiction). Addiction is now narrowly defined as "uncontrolled, compulsive use despite harm"; if there is no harm being suffered by, or damage done to, the patient or another party, then clinically it may be considered compulsive, but within this narrow definition it is not categorized as "addiction". In practice, however, the two kinds of addiction are not always easy to distinguish. Addictions often have both physical and psychological components.
There is also a lesser known situation called pseudo-addiction, where a patient will exhibit drug-seeking behaviour reminiscent of psychological addiction, however in this case, the patients tend to have genuine pain or other symptoms that have been undertreated. Unlike true psychological addiction, however, these behaviours tend to stop as soon as their pain is adequately treated. The term "dry drunk" is sometimes attached to patterns of behavior that persist after an object of dependence and/or misuse has been removed from daily living routines. This type of behaviour is fairly common in early recovery for those recovering from substance misuse.
The obsolete term physical addiction is deprecated, because of its connotations. In modern pain management with opioids: physical dependence is nearly universal but addiction is rare. Some of the highly addictive drugs (hard drugs), such as cocaine, induce relatively little physical dependence.
Not all doctors do agree on what addiction or dependency is*, particularly because traditionally, addiction has been defined as being possible only to a psychoactive substance (for example alcohol, tobacco, or drugs), which is ingested, crosses the blood-brain barrier, and alters the natural chemical behaviour of the brain temporarily. Many people, both psychology professionals and laypersons, now feel that there should be accommodation made to include psychological dependency on such things as gambling, food, sex, pornography, computers, work, and shopping / spending. However, these are things or tasks which, when used or performed, cannot cross the blood-brain barrier and hence, do not fit into the traditional view of addiction. Symptoms mimicking withdrawal may occur with abatement of such behaviours; however, it is said by those who adhere to a traditionalist view that these withdrawal-like symptoms are not strictly reflective of an addiction, but rather of a behavioural disorder. In spite of traditionalist protests and warnings that overextension of definitions may cause the wrong treatment to be used (thus failing the person with the behavioural problem), popular media, and some members of the field, do represent the aforementioned behavioural examples as addictions.
* the Diagnostic Statistical Manual (DSM IVR) specifically spells out criteria to define abuse and dependence conditions.
Source: Wikipedia: Addictions
Understanding Drug Abuse and Addiction
Many people view drug abuse and addiction as strictly a social problem. Parents, teens, older adults, and other members of the community tend to characterize people who take drugs as morally weak or as having criminal tendencies. They believe that drug abusers and addicts should be able to stop taking drugs if they are willing to change their behavior.
These myths have not only stereotyped those with drug-related problems, but also their families, their communities, and the health care professionals who work with them. Drug abuse and addiction comprise a public health problem that affects many people and has wide-ranging social consequences. It is NIDA's goal to help the public replace its myths and long-held mistaken beliefs about drug abuse and addiction with scientific evidence that addiction is a chronic, relapsing, and treatable disease.
Addiction does begin with drug abuse when an individual makes a conscious choice to use drugs, but addiction is not just "a lot of drug use." Recent scientific research provides overwhelming evidence that not only do drugs interfere with normal brain functioning creating powerful feelings of pleasure, but they also have long-term effects on brain metabolism and activity. At some point, changes occur in the brain that can turn drug abuse into addiction, a chronic, relapsing illness. Those addicted to drugs suffer from a compulsive drug craving and usage and cannot quit by themselves. Treatment is necessary to end this compulsive behavior.
A variety of approaches are used in treatment programs to help patients deal with these cravings and possibly avoid drug relapse. NIDA research shows that addiction is clearly treatable. Through treatment that is tailored to individual needs, patients can learn to control their condition and live relatively normal lives.
Treatment can have a profound effect not only on drug abusers, but on society as a whole by significantly improving social and psychological functioning, decreasing related criminality and violence, and reducing the spread of AIDS. It can also dramatically reduce the costs to society of drug abuse.
Understanding drug abuse also helps in understanding how to prevent use in the first place. Results from NIDA-funded prevention research have shown that comprehensive prevention programs that involve the family, schools, communities, and the media are effective in reducing drug abuse. It is necessary to keep sending the message that it is better to not start at all than to enter rehabilitation if addiction occurs.
A tremendous opportunity exists to effectively change the ways in which the public understands drug abuse and addiction because of the wealth of scientific data NIDA has amassed. Overcoming misconceptions and replacing ideology with scientific knowledge is the best hope for bridging the "great disconnect" - the gap between the public perception of drug abuse and addiction and the scientific facts.
Source: National Institute on Drug Abuse
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