What is Addiction?
6 Min Video on Understanding Addiction
An addiction is a relationship with drugs or alcohol in which you use more than you would like to use, and you continue to use despite negative consequences.
People use drugs or alcohol to escape, relax, or to reward themselves. But over time, drugs and alcohol make you believe that you can’t cope without them, or that you can’t enjoy life without using. The greatest damage is to your self-esteem.
What is the Medical Definition of Addiction?
An addiction must meet at least 3 of the following criteria. This is based on the criteria of the American Psychiatric Association (DSM-IV) and World Health Organization (ICD-10).(1)
1. Tolerance. Do you use more alcohol or drugs over time?
2. Withdrawal. Have you experienced physical or emotional withdrawal when you have stopped using? Have you experienced anxiety, irritability, shakes, sweats, nausea, or vomiting? Emotional withdrawal is just as significant as physical withdrawal.
3. Limited control. Do you sometimes drink or use drugs more than you would like? Do you sometimes drink to get drunk? Does one drink lead to more drinks sometimes? Do you ever regret how much you used the day before?
4. Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?
5. Neglected or postponed activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?
6. Significant time or energy spent. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?
7. Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?
How Common is Drug or Alcohol Addiction?
Approximately 10% of any population is addicted to drugs or alcohol. Addiction is more common than diabetes, which occurs in approximately 7% of the population.
Addiction crosses all socio-economic boundaries. 10% of teachers, 10% of plumbers, and 10% of CEOs have an addiction.
The terms alcohol addiction, alcoholism, and alcohol dependence are all equivalent. The same is true for the terms drug addiction and drug dependence. (Reference: www.AddictionsAndRecovery.org.)
How Does Addiction Feel?
An addictive substance feels good because it stimulates the pleasure center of the brain through neurotransmitters such as dopamine and GABA. If you have a genetic predisposition, addictive substances don’t just feel good. They feel so good that you will want to chase after them.
This is where addiction comes in. If you have a genetic predisposition, addictive substances feel so good that you are willing to suffer negative consequences in order to get more and to continue to feel the high.
Addictive substances feel different inside an addict’s brain than they do to a non-addict. This is why the two sides have difficulty understanding each other. In someone who is not addicted, drugs and alcohol only produce a mild high. Therefore a non-addict cannot understand why the addict would go to such lengths, when it is clearly destroying their life.
Denial is a big part of addiction. Because addictive substances feel good, an addict will initially deny that they have a problem. In the long-run addiction isolates you from the people and activities and that mean the most to you.
The Cost of Addiction
The dollars and cents cost of addiction is mind boggling. At least twice as many people die from alcoholism in the US every year as die from motor vehicle accidents.(2)
Alcohol intoxication is associated with 40-50% of traffic fatalities, 25-35% of nonfatal motor vehicle injuries, and 64% of fires. Alcohol is present in nearly 50% of homicides, either in the victim or the perpetrator.(3)
Alcohol intoxication is involved in 31% of fatal injuries, and 23% of completed suicides.(4)
One study found that 86 % of homicide offenders, 37 % of assault offenders, and 57 % of men and 27 % of women involved in marital violence were drinking at the time of their offense.(5)
The Consequences of Addiction
People only stop using drugs and alcohol when they have suffered enough negative consequences. When you've suffered enough pain and enough regret you are ready to stop.
You are ready to stop when the two sides of addiction collide. On the one hand, addiction feels so good that you want to use more. On the other hand, addiction leads to negative consequences. After a while, something has got to give.
You don't have to hit rock bottom. The purpose of websites like this is to show you the potential negative consequences of addiction so that you will be ready to quit before you've lost everything. You can imagine what it would be like to hit rock bottom. And that can help motivate you.
The most important consequences of addiction are social, emotional, and psychological. People usually think of the physical and economic consequences of addiction. "I don't have a serious addiction because my health is fine, and I haven't lost my job." But those are very late stage consequences.
As far as work is concerned that's usually the last thing to suffer. You need your work in order to pay your bills, so that you can continue your addiction. When your work begins to suffer, you've slipped from being a functioning addict to a non-functioning addict.
The damage addiction does to your relationships and self-esteem is far deeper and takes longer to repair. You've hurt friends and family. You've disappointed yourself. You've traded important things in your life so that you could make more time to use. You've lived a double life. You've seen the hurt in your family's eyes, and the disappointment in your children's faces. Those are the consequences that can motivate you to begin recovery.
1) DSM stands for The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. ICD stands for The International Classification of Disease, published by the World Health Organization.
2) Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L., Actual causes of death in the United States, 2000. JAMA, 2004. 291(10): p. 1238-45.
3) Lowenfels, A. B., & Miller, T. T., Alcohol and trauma. Ann Emerg Med, 1984. 13(11): p. 1056-60.
4) Smith, G. S., Branas, C. C., & Miller, T. R., Fatal nontraffic injuries involving alcohol: A metaanalysis. Ann Emerg Med, 1999. 33(6): p. 659-68.
5) Roizen, J., Epidemiological issues in alcohol-related violence. Recent Dev Alcohol, 1997. 13: p. 7-40.