Addiction

The Cycle of Addiction

Sources:http://www.getcured.com/addict.htmVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield. 1999. New Harbinger Publications, Inc.Gambling and Gaming Addiction in Adolescence by Mark Griffiths. 2002. BPS Blackwell Publishing, Ltd.Comments and additions by Gao Laoshi

What is Addiction?

When the word “Addiction” is mentioned, most people think of alcohol, drugs or smoking.

What is Addiction?

But “Addictions” can be related to a vast number of behaviors as well as substances:– Internet/video games– Eating problems (bulimia, compulsive eating,

compulsive dieting, etc.)– Gambling– Exercise – Watching movies/TV– Shopping– Sex– Work/studying– Etc.

What is Addiction?

One good definition of addiction (Marlatt et al. 1988. P. 224 cited by Griffiths) is:

“….a repetitive habit pattern that increases the risk of disease and/or associated personal social problems

Addictive behaviors are often experienced subjectively as ‘loss of control’ – the behavior contrives to occur despite volitional attempts to abstain or moderate use.

These habit patterns are typically characterized by immediate gratification (short term reward), often coupled with delayed deleterious effects (long term costs).

Attempts to change an addictive behavior (via treatment or self initiation) are typically marked with high relapse rates.”

What is Addiction?

Powerlessness and unmanageability are two common effects of a prolonged addiction.

Often people report being “out of control” of their behavior, almost as if the addiction takes precedent over their better judgment.

What is Addiction?

Addiction, both substance and behavioral, produce the same type of

» tolerance and »withdrawal

as other addictions.

What is Addiction?

Tolerance and Withdrawal can only be noticed from within.

Thus, a simpler definition of addiction provided by David Greenfield is:– Addiction involves a behavior or substance on

which

you are dependent and that is painfully difficult to stop. – Abuse (preceding actual addiction) may simple be a

repeated pattern of use without tolerance or pain

(withdrawal) as a result of trying to stop.

What is Addiction?

Tolerance: over time the addictive substance or behavior becomes

less and less effective in being able to produce the original pleasurable sensation or relief from unpleasant feelings.

the “need” for the addictive substance or behavior increases to produce the same effect.

What is Addiction?

Withdrawal:

It is very difficult to end an addiction. Doing so means having to tolerate some discomfort and pain.

Most of us don’t like to experience pain; we like PLEASURE.

What is Addiction? (Greenfield)

The Paradox of Addiction is that the initial pleasure (or relief from pain/unpleasant feelings) is gradually replaced by an endless cycle of discomfort, guilt and shame…relieved only by continuing the addictive behavior or substance….which causes more pain and discomfort.

It is this unrelenting cycle that is the most difficult part of ending an addiction.

What is Addiction?

Withdrawal:

Occurs when the substance or behavior is reduced or stopped and results in two or more of symptoms that vary according to the specific addiction.

Examples of typical ones:• Insomnia• Nervousness/restlessness• Irritation• Anxiety

What is Addiction? (Greenfield)

Addiction is usually serious before it is recognized as a problem because of DENIAL.

Denial is a psychological defense mechanism that enables someone to continue to do something that has obvious negative consequences.

Three Characteristics of Addiction (Greenfield)

There are many characteristics, but these are primary ones associated with all addictions:

• Loss of control: The user cannot predict what will happen when he uses the substance. One day he may be able to stop after one drink, or after one line of cocaine; the next day he may not be able to control his use at all.

• Compulsive preoccupation: The addict spends a great deal of time thinking about the substance.

• Continued use despite negative consequences: If drinking or drug use causes problems but one continues to do it, one is tempting addiction or is already addicted. The person has lost voluntary control of the use of that substance.

Definition of TermsVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

Real-time living: living in your reality; it is using the Internet (and other technologies) in a way that doesn’t overwhelm or consume your life

The Dark Side of the InternetVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

People can become addicted to the use of the Internet.

There’s the risk of social isolation and withdrawal, possible increase in depression, family separation, marital problems, reduced job/school performance (it’s hard to do your job/study if you’re spending four hours a day surfing the Internet!).

Internet: Pros and ConsVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

It’s quick and easy to access

It’s relatively inexpensive.

It’s available anytime, day and night.

You can buy or download things not available elsewhere

Sometimes you wait forever to download information.

The Internet can still be a nightmare to navigate, even with the new and improved search engines.

The increasing user traffic can slow the electronic highway to a virtual parking lot.

There is plenty of annoying electronic junk mail (Spam).

Internet: Pros and ConsVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

You can shop for things and invest from the comfort of your home.

It’s intellectually stimulating. It can change your mood

and make you feel good. You can an communicate

with friends, family and for business.

Some people can become addicted.

There is not currently adequate protection for children who are online.

When you are online, you are not doing other important things

It can negatively affect marriages and relationships.

The Nature of AddictionVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

The two most common effects of addiction are:

• Powerlessness and• Unmanageability.

The same addictive phenomenon of “tolerance” that occurs with drug and alcohol addiction also occurs in Internet addiction.

ToleranceVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

“The psychological dependence that occurs when someone becomes habituate (tolerant) to a behavior or substance is very powerful.”

Many people, for whom the Internet use has become unmanageable, report that the Internet has taken a central and dysfunctional position in their lives.

What kinds of behaviors are potentially addictive?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

– Work– Sex– Gambling– Food– Exercise– Shopping– Television– Computers– The Internet– Drugs– Alcohol

Why is Internet use soooo addictive? Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N.

Greenfield, Ph.D. 1999. New Harbinger Publications.

Everyone likes to experience pleasurable things and to avoid unpleasant ones.

Normal life can seem very uninteresting and boring compared with the excitement that is produced by an addiction.

Many addictions begin as an escape from boredom. Addiction starts out to be the “solution” for a problem

(like boredom or some other negative feeling/thought such as emotional pain), and eventually becomes, itself, a much bigger problem that the original one.

DenialVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

“What problem? I don’t have a problem!”

Denial is a psychological defense mechanism that makes it possible to “not see” that a problem (addiction) is clearly a big problem in one’s life.

Denial is present (to a greater or lesser extent) in all addictions.

What makes the Internet so attractive?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

The Virtual World of the Internet is like nothing else. Why?– It is stimulating (produces a “high”).

– 24 hour-a-day accessibility

– It is intense! (It creates a sense of power, exhilaration and intensity. It provides instant and anonymous intimacy.)

– Time disappears (dissociation).

– Anonymity (You can be anyone you create. 35-50% of Internet users are lying about themselves!)

What makes the Internet so attractive?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

The Virtual World of the Internet is like nothing else. Why?– Dis-inhibition (Social norms can be ignored without negative

consequences.)

– Instant Intimacy with no accountability.

– Ease of access/comfort of access

– Infinite (never ending: “incomplete Gestalts”)

– Interactive (You can be both participant and observer.)

– Hypnotic (some preliminary evidence show that staring at a monitor can induce a form of hypnotic trance.)

Are YOU addicted?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

Do you find yourself spending all your time alone with your computer?

Has your life begun to become unmanageable because of your Internet use?

Do you feel powerless to stop or cut down your use?

Are YOU addicted?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger Publications.

Use the following questions to evaluate whether or not you are experiencing an addiction.– Does a substance or behavior elicit a clear change

in your mood? And is that substance or behavior later sought and utilized to achieve its mood-altering effects?

– Does ingesting the substance or performing the behavior interfere with your life in any way, shape or form? That is, does it have a negative impact on your work, school, family, friends, relationships, etc.?

What is Internet Addiction? David Greenfield. P. 55)

The Seven Critical Signs of Internet Addiction:1. You spend many hours online, often neglecting or in place of other crucial areas in your life (the more hours spent online, the more likely it is that you’ll be addicted).


The Seven Critical Signs of Internet Addiction:2. Your friends and loved ones think you have a problem with your Internet use (the more people who think you have a problem, the greater the chance that you’re addicted).


The Seven Critical Signs of Internet Addiction:3. Your age matters – the younger you are, the greater the likelihood you’ll be addicted (you are more likely to be addicted if you’re in your twenties).


The Seven Critical Signs of Internet Addiction:4. You’ve had serious negative consequences from your Internet use. (Missing class, low grades from lack of studying, etc.)


The Seven Critical Signs of Internet Addiction:5. You perceive your Internet experience as intensely intimate.


The Seven Critical Signs of Internet Addiction:6. You keep the amount of time you sepnd online a secret.


The Seven Critical Signs of Internet Addiction:7. You CAN’T WAIT to get on the computer or Internet on a regular, even daily, basis.

If all 7 criteria are true of you, there’s a very high likelihood that you are Internet addicted or at least seriously abusing the Internet.


There are 12 Warning Signs that you may be too involved with the Internet. If you can answer yes to between three and five of them, then it would be a very good idea to take a look at the time and energy you are spending online.

If you answer positively to six or more, you may have a more serious problem.


There are 12 Warning Signs that you may be too involved with the Internet. If you can answer yes to between three and five of them, then it would be a very good idea to take a look at the time and energy you are spending online. (Greenfield p.57)

If you answer positively to six or more, you may have a more serious problem.

What is Internet Addiction? (Griffiths pp. 3-4)

What is the established criteria for all addictions?Salience: the particular activity becomes the most important activity in someone’s life and dominates that person’s thinking (preoccupations and cognitive distortions), feelings (cravings) and behavior (deterioration of socialized behavior). For instance, even if not actually engaged in the behavior, the person will be thinking about the next time he or she will be.


What is the established criteria for all addictions?Mood modification: subjective experiences produced by doing/using the addictive behavior/substance: e.g., a coping strategy that produces a “buzz” or “high” or else a tranquillizing feeling of “escape” or “numbing”.

People use the same activity or substance to achieve different effects at different times.


What is the established criteria for all addictions?Tolerance

Withdrawal

Conflict in interpersonal relationships

Relapse

Who Is at Risk of Becoming Addicted? (Nearly) Everyone With the “right” circumstances and painful

life experiences, nearly anyone could become addicted to a substance or a behavior.Many people struggle with an addiction…many with several.

Since many addictions are known only to the individual, they are not apparent to other people.

What is Alcohol Addiction?

ALCOHOL/DRUGS/SUBSTANCES: Once it was thought that a person was a drug addict or

alcoholic only if he needed the drug daily, or if he went through withdrawal symptoms (vomiting, seizures, cramps, death) when he abruptly stopped using the substance. It was thought that alcoholics and drug addicts were unemployed, poor, and from the inner city.

These are misconceptions. Many drug addicts do not use drugs or alcohol daily and do not experience physical withdrawal when they stop using. The majority of addicted people are employed and appear to be functioning normally.

http://www.getcured.com/addict.htm

Another former misconception dealt with the differences between physical and psychological addiction.

Physical addiction was thought to be the determining factor in addiction, and little attention was paid to psychological addiction.

It is now known that all addictions are characterized by physical and psychological changes.

Addiction is far more than physical or psychological dependency: it is a primary disease.

Why doesn’t he/she just stop?!http://www.getcured.com/addict.htm

A nonuser or casual alcohol/drug user may have difficulty understanding why addicts don't just stop.

Use and abuse of psychoactive (mood-altering) drugs seem to be voluntary; addiction seems to be characterized by involuntary, compulsive use.

In most cases, drug addicts don't stop because they are addicted. They cannot stop on their own.

What Causes Addiction?http://www.getcured.com/addict.htm

There has been controversy over the cause

of addiction. Historically, it was thought that addiction was caused by lack of willpower, by poverty, moral weakness, mental illness, genetics, family socialization, anti-social personalities, and societal problems.

Some scientists believe drug addiction is a disease, although the evidence to support this theory is weak.

What Causes Addiction?http://www.getcured.com/addict.htm

The Drug: Some drugs are more

addictive than others. This is due to the pharmacology of the substance, and how it affects the mood of the user.

What Causes Addiction? http://www.getcured.com/addict.htm

The Addict: – People who have low self-concepts, who feel bad about

themselves, have a higher rate of addiction. – People with low self-concepts use psychoactive substances

either to enhance or create pleasure in their lives, or to decrease the constant emotional pain they live with.

– The better a person feels about himself, the less likely he will be to use or abuse psychoactive substances.

– A society that has easy access to drugs, that has a population that is "addiction-prone" due to genetics or emotional pain, and that has pro-use or unclear norms, is a society prone to addiction.

What Causes Addiction? http://www.getcured.com/addict.htm

The Environment: In our biochemical society, we hear mixed messages about the use of psychoactive drugs. Some, such as alcohol and tobacco, are accepted, while use of hard drugs is condemned. Some drug use is glamorized in the media. All of this makes it easier for people to accept drug use as "normal".

The Cycle of Addiction How it Happens http://www.getcured.com/addict.htm

No one wants to be a drug addict or alcoholic, but this doesn't stop people from getting addicted.

The most commonly asked question is simply - how? How could my son, daughter, father, sister, or brother become a liar, a thief, someone who cannot be trusted? How could this happen? And why won't they stop?

Drug Addiction At Its Rootshttp://www.getcured.com/addict.htm The first thing you must

understand about addiction is that mind-altering drugs are basically painkillers. For drugs to be attractive to a person, there must first be some underlying unhappiness, sense of hopelessness, or physical pain.

The Cycle of Addiction http://www.getcured.com/addict.htm

Drug addiction follows a cycle like this:

A person has some problem, sense of unhappiness or hopelessness, or physical discomfort. It could be a teenager experiencing his first romantic rejection, or a grandmother with arthritis, or it could be a man in his prime, wondering why he keeps failing on the job. Or it could be someone at any age in between.

What is the underlying dynamic to addiction?

People who turn to drugs to relieve their emotional pain are most often people who have not learned how to “sit with” (tolerate) their painful feelings (anger, sadness, loss, fear, embarrassment, etc).

Emotional maturity is about learning to “sit with” one’s feelings…and in doing so, putting “time” between “impulse and action”

The “time” allows one to choose how to deal with one’s negative emotions in a constructive way.

The Cycle of Addiction http://www.

getcured.com/addict.htm

This person drinks or

tries drugs. The alcohol or drugs APPEAR to solve his problem. He feels better. Because he now SEEMS better able to deal with life, the drugs become valuable to him.

The Cycle of Addiction http://www.


The person gradually increases his usage of his drug of choice. He is then trapped. Whatever problem he was initially trying to solve by using drugs or alcohol fades from memory. At this point, all he can think about is getting and using drugs. He loses the ability to control his usage and disregards the horrible consequences of his

addiction.

The Cycle of Addictionhttp://www.getcured.com/addict.htm

The addict will now

attempt to withhold the fact of his drug use from friends and family members. He will begin to suffer the effects of his own dishonesty and guilt. He may become withdrawn and difficult to reason with. He may behave strangely.

The Cycle of Addictionhttp://www.getcured.com/addict.htm The more he drinks and

uses drugs, the more guilty he will feel, and the more depressed he will become. He will sacrifice his personal integrity, possibly lying and stealing to finance his drinking or drug habit. His relationships with friends and family and his job performance will go drastically downhill.

Addiction and Tolerance http://www.getcured.com/addict.htm

The drugs and alcohol are now the most important thing in his life. He has thrown away his job, his life-savings, his dreams and ambitions, all in an effort to maintain the painkilling and emotion killing effects he once obtained from the drugs. But ironically, his ability to get "high" from the alcohol or drugs gradually decreases as his body adapts to the presence of foreign chemicals. He must take more and more, and he now has to have them to be able to function at all.

Addiction and Tolerancehttp://www.getcured.com/addict.htm

As he continues to drink or use drugs, his body continues to adapt to the presence of the drugs. This is when the newly created addict begins to experience drug cravings. He will experience an overwhelming obsession with getting and using his drugs, and will do anything to avoid the pain of withdrawing from them.

Addiction and Tolerancehttp://www.getcured.com/addict.htm

He has crossed an invisible and intangible line. He is now a drug addict or alcoholic.

Progression of Addictionhttp://www.getcured.com/addict.htm Whether he wants to

stop or not, he is now trapped. By now, the drugs he abuses will have changed him both physically and mentally.

Personality Changes http://www.getcured.com/addict.htm

Long-term addiction can cause one's personality to change. This is called the Biochemical Personality. Some of the characteristics are:

Mood swings Unreliable. Unable to finish

projects. Unexpressed resentment and

secret hatreds. Dishonesty. Lies to family,

friends, employers. Withdraws from those who

love him. Isolates self. May appear chronically

depressed. May begin stealing from

family and friends. (Drug/ alcohol addiction)

Personality Changes http://www.getcured.com/addict.htm

Addicts cannot stop using drugs for two reasons. These are:

Cravings caused by drug residues which remain in the body.

The Biochemical Personality caused by drugs and the lifestyle of

the addict.

Bio-Chemical Aspects of Addiction and Drug Cravinghttp://www.getcured.com/addict.htm

When a person continuously drinks or uses drugs, his body becomes supersaturated with metabolites (the chemicals the body converts the drugs or alcohol into). These metabolites, although removed rapidly from most bodily tissues, may become trapped in the fatty tissues and remain there for years.

Bio-Chemical Aspects of Addiction and Drug Cravinghttp://www.


Presence of these metabolites in the blood, even in microscopic amounts, cause the brain to react as if the addict were withdrawing from the drug.

Receptor sites in brain cells that have adapted to large amounts of the drug metabolite are now forced to deal with having only a small amount of the drug metabolite available.

The brain "requests" the addict to give it more of the drug. This is called drug craving. The only way to end this is to take more drugs or drink more, and the cycle begins all over again.

Facts about Drinking (Source: Internet)

It causes more deaths than any other drug (about 200,000 per year).

It is responsible for 70% of drownings and chokings. It is involved in 50% of all “freak accidents.” It causes some 27,000 deaths a year by liver disease 30% of all suicides are alcohol related 20% of all airplane car crashes are alcohol related. 50% of all murders are drunk when they kill. 50% of all fire deaths are alcohol related.


It causes about a third of all traffic deaths. (It would be higher, if blood tests were given to the dead, too.)

Statistics based on US Govt. reports It leads to drug addiction (18 million in the USA

= 8.5% of the population). It is involved in both spouse and child abuse. It contributes to mental and physical diseases. 45% of the homeless are alcoholics. It causes 500,000 injuries per year.


1 in 10 social drinkers will become addicts. (Would you get on an airplane if there was a 10% chance it would crash?)

Alcohol is the number three health problem (in the US).

Alcohol results in ½ million hospital admissions. Alcohol impairs the function of vital organs. Alcohol causes liver diseases. It contributes to heart attacks. It increases the chances of cancer 3-6 times. It is the number three cause of birth defects. It can cause insanity.

Facts about Smoking(based on US Brands) (Source:

Internet: http://www.realtruth.org/articles/0201ttas.html?gclid=CLzA5tPp7IQCFQNjDgodmGnHmQ and http://www.rgj.com/news/printstory.php?id=106481 )

Clinical data studies tend to confirm the relationship between heavy and prolonged tobacco smoking and incidence of lung cancer (this was known in 1953).”

• “Tobacco companies put ammonia in cigarettes which makes your brain absorb more nicotine than it normally would” (www.thetruth.com).

• “[Other] additives are used to make cigarettes that provide high levels of ‘free' nicotine which increases the addictive ‘kick' of the nicotine.)”



Research has proven that teens become more quickly addicted to cigarettes (within four weeks of their first cigarette) than do adults.

It takes about two years for the average adult smoker to become fully addicted.

It also takes less time for teens to experience withdrawal symptoms when trying to quit (usually within hours of their last cigarette).



Tobacco companies know that nicotine changes your brain so, eventually, your brain can't function normally without it” (Brain/nicotine: Tobacco: Biology and Politics, Stanton A. Glantz, Ph.D., 1992).

• “According to a…report issued by the Office of the Surgeon General, 400,000 adults die every year from smoking-related illnesses, making smoking the number one cause of preventable disease and death in the nation” (www.sciencefriday.com).”



“Many smokers think that ‘light' cigarettes are safer than regular cigarettes, and that by smoking ‘light' cigarettes they will inhale fewer cancer-causing chemicals, or less nicotine.

B.C.'s [British Columbia Ministry of Health] new smoking tests have shown how wrong this belief can be.

The reports filed by the tobacco companies show that light cigarettes are likely to deliver as many (or more) poisons or toxins to smokers as regular cigarettes” (Nov. 1998).



“In addition to tobacco, which contains nicotine…599 ingredients have been identified in tobacco industry documents as being added to tobacco in the manufacturing of cigarettes by the five major American cigarette manufacturing companies.

While some of these chemicals, such as sugars, vanilla extract, prune juice, and vinegar, are generally recognized as safe when used in food products, all produce numerous additional chemical compounds when burned. None, probably, is more deadly than nicotine.” (www.drugs.indiana.edu).

Health & Medicine

Addiction