When we hear the word "addiction", many images come to our mind. We see the falling down drunk. We see a woman who sells her body in exchange for a "fix." We remember a permanently disabled teen in a wheelchair because of a drunk-driving accident. We read about a famous entertainer who died, and another whose sensational sex scandals are splashed across the tabloids. Most of us know a friend or family member, whose lives are affected by addiction. We all know that addiction is a serious problem. But behind that widely held agreement are many disagreements and questions. How big are addiction problems exactly? How does addiction differ from experimentation, misbehavior, and bad habits? What causes addiction? How does one overcome it? How successful is addiction treatment? How should society respond to individuals with addiction? What should governments do about addiction? Is addiction mostly a modern problem? Is the addiction problem getting worse?
Includes both substances (drugs and alcohol) and activities (such as sex and gambling).
Leads to substantial harm.
Is repeated involvement despite substantial harm.
Continues because it was, or is, pleasurable and/or valuable.
Substance addiction includes any substances that are taken into the body, which may include street drugs, nicotine, and some prescription medications when used improperly.
An activity or process addiction includes activities such as gambling, sex, the internet, pornography, and shopping.
As someone's addiction gets worse, that person feels "out-of-control" or "powerless" over their own behavior and despite their best intentions to remain in control, there are repeated episodes with more negative consequences.
Using data reported for 2010 by the U.S. Substance Abuse and Mental Health Services Administration shows that:
51.8% of the U.S. population aged 12 or older, or 131.3 million people, are current drinkers of alcohol.
Nearly one quarter (23.1%) of the U.S. population, or 58.6 million people, aged 12 or older participated in binge drinking during past 30 days, which includes having five or more drinks at least 1 day in the 30 days prior to the survey.
6.7% of the U.S. population aged 12 or older, or 16.9 million people reported heavy drinking, which is binge drinking on at least 5 days in the past 30 days.
40.6% of young adults in the U.S. (age18 to 25) participated in binge drinking and the rate of heavy drinking was 13.6%.
12.0% of persons aged 12 or older drove under the influence of alcohol at least once in the past year. 8.9% of the U.S. population, or 22.1 million people, aged 12 or older would meet the diagnostic criteria for a drug or alcohol use disorder (substance use disorder).
23.1 million people aged 12 or older needed treatment for an alcohol or substance use disorder and of these, only 2.6 million people received treatment at a specialized addiction facility.
There are many costs to addictive behavior and identifying those that you are currently experiencing can help you recognize whether the costs are beginning to cause substantial harm and may signal an addiction being present. In addition to your own evaluation, try to imagine how others might rate your behavior on this list.
Emotional costs of addiction: living with daily feelings of fear, anger, sadness, shame, guilt, paranoia, loss of pleasure, boredom, emotional instability, self-loathing (disgust with oneself), loneliness, isolation, and feelings worthlessness.
Social costs of addiction: disruption or damage to important relationships; decreased ability or interest in forming meaningful connections with others; and limiting one's social sphere to other unhealthy, addicted persons.
Physical and health costs of addiction: poor general health; poor personal hygiene; lowered energy and endurance; diminished enjoyment of sex or sexual dysfunction; poor sleep; and damaging the health of an unborn child (with certain types of substance use).
Intellectual costs of addiction: loss of creative pursuits; decreased ability to solve problems; and poor memory.
Work and productivity costs of addiction: decreased productivity in all aspects of life; missing important deadlines and failing to meet obligations; impaired ability to safely operate tools and equipment (including driving); and lost time due to accidents arising from being impaired (e.g., falling and breaking a leg).
Financial costs of addiction: money spent on the addiction itself; money spent dealing with the consequences of addiction (healthcare costs, legal costs, etc.).
Legal costs of addiction: direct legal costs due to involvement with an illegal drug or activity (e.g. selling drugs, child pornography); indirect legal costs because of what someone did while engaging in their addiction (DUI, bar fights, domestic violence, divorce); or did not do (failing to care for children properly).
Lost time due to addiction: sacrificing time spent in meaningful, life enriching activities in order to engage in addictive behaviors.
Diminished personal integrity due to addiction: as addicted people gradually lose their moral compass, they begin to disrespect the rights and needs other people. They even mistreat the people that matter to them most. This begins by failing to meet certain responsibilities, commitments, or obligations and evolves into more obvious forms of disrespect and mistreatment as addiction progresses, such as flat-out lying and deception; stealing from loved ones; and threatening these same people if their demands are not met.
While we do not yet know how various influences combine to form an addiction, we do know there are two basic types.
One type of influence is biological forces, such a person's genetics.
The second type is environmental influences, which includes people's life experiences, interpersonal relationships, and culture.
There are many different explanations, or models, of addiction. One of these, the Bio-Psych-Social-Spiritual (BPSS) Model of addiction recognizes these different aspects of addiction are inter-related.
Addiction is unlike many medical diseases where we can point to a certain germ or defect that caused the disease.
Models of addiction have very practical applications and understanding the causes of addiction, can lead to effective treatments.
The BPPS model of addiction accepts there are multiple causes and multiple solutions to addiction. In practice, it is possible to combine models or elements of models and these mergers regularly occur.
The Bio-Psycho-Social-Spiritual (BPSS) model of addiction says that there are 4 inter-related issues that lead to an addiction.
The biological portion of the BPSS Model considers addiction a brain disease with biological, chemical, and genetic roots.
We now know that certain activities, in addition to drugs or alcohol, can also be addictive (eating, sex, gambling). Addiction is a problem of brain functioning and our genetics greatly determine this. We become addicted to the chemicals our brain releases, not the substance or activity that causes this release.
The psychological portion of the model views addiction as a learned behavior, a problem of faulty thinking, or of developmental delay. Other psychological disorders can also contribute directly or indirectly to the development of an addiction.
The social portion of the model looks at multiple factors including the sociological forces that cause entire groups of people to be more vulnerable to addiction, the type and severity of sanctions that the society places on those that engage in addictive behavior, and the family and support system that a person has around them.
Adding "Spirituality" to the Bio-Psycho-Social model assists some people to move beyond the physical aspects of their addiction. It is clear that the violation of deeply held beliefs and values is a significant consequence of addiction and restoring these beliefs and values becomes an important component of recovery.
What are the diagnostic criteria for Substance Use Disorders (Addiction)?
The DSM-5 has established a group of Substance-Related Disorders including Alcohol, Cannabis or marijuana, Hallucinogens, Inhalants, Opioid such as heroin, Vicodin, and oxycontin, Sedatives/Hypnotics or Anxiolytics, Stimulants including cocaine and methamphetamine, and Tobacco.
Regardless of the particular substance, the diagnosis of a substance use disorder is based upon a pathological set of behaviors related to the use of that substance that fall into four main categories including impaired control, social impairment, risky use, and tolerance and withdrawal.
Impaired control includes 1) Using for longer periods of time than intended, or using larger amounts than intended; 2) Wanting to reduce use, yet being unable to do so; 3) Spending excessive time getting/using/recovering from the drug use; or 4) Cravings that are so intense it is difficult to think about anything else.
Social impairment may occur when people continue to use despite problems with work, school or family/social obligations, despite having interpersonal problems because of the substance use and important and meaningful social and recreational activities may be given up or reduced because of substance use.
Addiction may be indicated when someone repeatedly uses substances in physically dangerous situations and other risky situation. For instance, using alcohol or other drugs while operating machinery or driving a car, or continuing to use even though they are aware it is causing or worsening physical and psychological problems, such as the person who continues to smoke cigarettes despite having a respiratory disorder such as asthma.
Tolerance occurs when people need to increase the amount of a substance to achieve the same desired effect.
Withdrawal is the body's response to the abrupt stopping of a drug, once the body has developed a tolerance to it. These very unpleasant and sometimes fatal symptoms are specific to each drug.
Alcohol Use Disorder - Alcohol is the most widely used (and overused) drug in the United States. For more information
Cannabis-Related Disorder - the more commonly used word for cannabis is marijuana. Other names are pot, hash, weed, Buddha grass, dope, ganga, herb, and reefer. Marijuana is the most commonly used illegal substance. For more information
Hallucinogen-Related Disorder - Hallucinogens include a wide variety of substances, including LSD (also called acid), morning glory seeds, mescaline, mushrooms, and ecstasy. These substances create a high and have effects that cause visual and auditory perceptual distortions. For more information
Inhalant Use Disorder - Inhalants refer to a wide variety of household products, such as glue, gasoline, paint thinners, cleaners, and various aerosols, which contain hydrocarbons that produce vapors. Intoxication occurs by inhaling these vapors, through a process known commonly as huffing. For more information
Opioid-Related Disorder - The most common opioids are opium, morphine, heroin, codeine, methadone, oxycodone, and Vicodin. For more information
Sedative, Hypnotic, or Anxiolytic Use Disorder - This class of drugs include sedatives, such as Valium, Librium, Ativan, Klonopin, Rohypnol, Barbiturates, such as Amytal, Nembutal, Seconal, Phenobarbital, and other antianxiety and sleeping medications. For more information
Stimulant/Amphetamine Use Disorder - The most commonly known drug in this class is methamphetamine or "crystal meth" (also known as crank). For more information
Tobacco-Related Disorder - Cigarettes are by far the most commonly used tobacco product. For more information
Gambling Addiction - Gambling addiction occurs when an individual continues to gamble despite negative consequences. For more information
Sexual Addiction and Pornography Addiction - Sexual activity, like alcohol, drugs, and gambling, increases levels of dopamine in the brain, which is the primary neurotransmitter in the brain's reward system. For more information
Internet Gaming Addiction - The DSM-5 does not currently recognize Internet gaming disorder as an official diagnosis, but has proposed it for future consideration and further study. For more information
Biological approaches to addiction treatment attempt to correct or modify the presumed underlying faulty brain chemistry. Medications can make recovery efforts more comfortable, and make addiction less rewarding. For more information
Psychological approaches to addiction recovery aim to increase a person's motivation for change by helping them to accurately determine the costs and benefits of their addiction. For more information
There is the social support approach to addictions recovery, which capitalizes upon the benefits of social support through groups that meet to discuss their hopes, disappointments, successes, and failures. For more information
How can I develop a personal action plan for addiction recovery?
Prepare for a personal marathon (not a sprint) - You don't need to be perfect, or re-set the clock every time you slip.
Determine whether you just need to work on an addiction problem, or whether you also need to address other life problems.
Make a beginning plan with a few small and easily accomplished steps, not a huge master plan.
Keep records - Find something truly meaningful that supports recovery and count it or measure it.
Expect that the transition period is usually the most difficult and that it will end.
Remain focused on the reasons you are making this change.
Remember the three fundamental facts about craving - they are time-limited, will not harm you and cannot force you to use.
Get private (anonymous) input if you need it.
Devote your time and attention to the two great pleasures of life: love and meaningful work (in that order).
Involve some other trustworthy people in your project.
Check out a few therapists, and/or check out a few support groups.
Keep at it and Re-cycle through these actions.
Be creative and approach your addiction problems from a fresh perspective.
Among Rich Nations, U.S. Has Highest Rate of Fatal Drug ODs
It's a ranking that no country would want to have: A new study shows America has taken the lead in drug overdose deaths, with rates almost four times higher than in 17 other wealthy nations. More...
How Heavy Drinking Might Boost Your Appetite for Alcohol
Binge and heavy drinking may trigger DNA changes that make your booze cravings worse, a new study says. More...
Opioid Addicts Are Overdosing on Diarrhea Drug
A popular anti-diarrheal drug is fast becoming another dangerous byproduct of the opioid crisis, as more addicts take huge quantities of it to ease withdrawal symptoms or get dangerously high. More...
Many Addiction Centers Lack Anti-Opioid Meds: Study
Although the U.S. opioid epidemic dates back more than a decade, only 6 percent of treatment centers in 2016 offered the three medications approved to treat opioid addiction, new research reveals. More...
Are Some Opioid Abusers Using Their Pets to Get the Drugs?
Veterinarians are prescribing large quantities of opioids to pets, raising concern that some people might be using Fido or Snuggles to feed their addiction. More...
1-800-662-HELP: Too Few Opioid Users Aware of Lifesaving Helpline
Millions of Americans are living with drug addiction, but a free, national hotline that offers help is underused because most don't know about it, new research finds. More...
At Risk for an Opioid OD? There's an App for That
University of Washington researchers have developed an app that can detect when a person's breathing dangerously slows or stops. More...
After Opioid OD, Most Patients Can Leave Hospital in an Hour
People who overdose on opioids can often be saved quickly with a dose of naloxone, but it hasn't been clear how long someone should be kept in the hospital after being revived. More...
Advice for Battling Opioid Addiction
As the United States continues to struggle with its unprecedented opioid crisis, an expert says all Americans need to take action to prevent addiction and help those in need. More...
U.S. Opioid Addiction Crisis Is Top Health Story of 2018
The scourge of opioid addiction and related deaths cut through American society again in 2018, capturing headlines and making it the year's top health story. More...
Opioid OD Deaths Soaring Among Native Americans
As the epidemic of opioid addiction rips through the United States, one group is being hit especially hard: Native Americans. More...
Today's More Potent Pot Means Higher Odds for Dependence: Study
Pot's increasing potency could make it more likely that toking will interfere with users' lives, a new study argues. More...
U.S. OD Death Rate Worst Among Wealthier Nations
With the rate of drug overdose deaths more than doubling since the turn of the century, the United States now leads the world in these preventable tragedies. More...
Breaking the Smoking-Drinking Connection
Smoking and drinking often go hand-in-hand, stimulating pleasure centers in the brain. But there's even more to this unhealthy relationship than meets the eye. More...
Fentanyl-Laced Crack Cocaine a Deadly New Threat
entanyl, a powerful and dangerous synthetic opioid, is now showing up in crack cocaine and causing life-threatening overdoses. More...
Workers' Comp Often a Gateway to Opioid Abuse: Study
Many injured workers turn to opioid painkillers for relief, and nearly 30 percent may still be taking them three months after their injury -- increasing the odds of addiction, a new study suggests. More...
Firsthand 9/11 Exposure Fueling Alcohol- and Drug-Related Deaths: Study
People directly exposed to the World Trade Center terrorist attacks appear at increased risk of drug- and alcohol-related death, a new study finds. More...
Is Pot Addictive? Study Shows Withdrawal Symptoms Can Occur
But a new study shows that some heavy users will experience withdrawal symptoms while coming down from their high. More...
A Couple's Tough Trek Back From Opioid Addiction
In 2016, almost 174 Americans died each day due to drug overdoses -- and roughly two-thirds of those deaths were caused by opioid drugs. The statistics are startling and make the problem seem hopeless. But is it? More...
Sleepy Teens More Prone to Drug Use, Suicide Attempts
High school students who get too little sleep are more likely than others to use drugs, drink alcohol or attempt suicide, U.S. researchers warn. More...
Genes May Control How Tough It Is to Stop Drinking
When they give up booze, some alcoholics have more severe withdrawal symptoms than others. This discrepancy may come down to genetics, researchers say. More...
New Treatment Approved for Opioid Dependence
Cassipa (buprenorphine and naloxone), a film designed to be placed under the tongue, has been approved to treat opioid dependence, the agency said in a news release. More...
Alcohol Helps Kill 2.8 Million People Globally Each Year
Alcohol contributes to 2.8 million deaths a year worldwide, and there is no safe level of alcohol consumption, researchers say. More...
Resetting E-Prescriptions for Opioids Helps Curb Use: Study
In electronic medical-record systems, prescriptions have a default number of pills. It's been suggested that reducing this number may help curb the use of addictive opioids, such as OxyContin. More...
Treatment for Opioid Abuse Grows, but Many on Medicaid Don't Receive It
Approval of the drug buprenorphine led to a rise in the number of Medicaid patients getting medication to treat opioid addiction. But the rates were lower among poor, black and Hispanic patients, a new study says. More...
Risky Prescribing Boosts Opioid Death Risk
When opioid pain medications, such as OxyContin, are prescribed in a risky manner, that increases a patient's chances of death. More...
Native American Teens at Higher Risk for Substance Abuse
Native American teens are at greater risk of alcohol and drug abuse than other American teens, a new study finds. More...
Pot Still a Drug of Choice for Many U.S. Adults
Fewer American teens may be smoking pot, but the same can't be said for older adults, a new study finds. More...
Parkinson's Meds Tied to Higher Rate of Gambling, Sex Addiction Than Thought
Medications that restore normal movement in patients with Parkinson's disease can unlock their inner demons more often than thought, a new study finds. More...
FDA Approves Non-Opioid Medication to Treat Opioid Withdrawal
The U.S. Food and Drug Administration on Wednesday approved the non-opioid drug Lucemyra to help adults cope with symptoms of opioid withdrawal. More...
Hit Hard by Opioid Crisis, Appalachian States Expand Clean-Needle Programs
Clean-needle programs are exactly what's needed, experts say, with Appalachia now an epicenter of the opioid addiction crisis ravaging the United States. More...
Programs That Monitor Opioid Painkillers May Drive Some to Heroin
Prescription drug monitoring programs are touted as a way to reduce overdoses from opioid painkillers, but they might have the unintended effect of increasing heroin overdose deaths, researchers say. More...
Racial Divide Narrows in Opioid Prescribing in U.S.
Black Americans are no longer less likely than whites to be prescribed opioid painkillers -- but that means their risk of addiction to the narcotics has increased, researchers say. More...
Fentanyl Now Drives Drug Overdose Deaths in U.S.
Overdose deaths involving dangerous synthetic opioids like fentanyl have skyrocketed in recent years, surpassing deaths from prescription painkillers, a new U.S. study reveals. More...
Questions Surround Concept of Internet Gaming Disorder
The concept of internet gaming disorder and the pathways leading to it are unclear, according to a review published online April 6 in Developmental Medicine & Child Neurology. More...
When Does Online Gaming Become an Addiction?
For most, playing online video games is largely a harmless hobby. But a new review finds that some fall prey to what experts call "internet gaming disorder." More...
An injectable sensor that could provide ongoing monitoring of the alcohol intake of people receiving addiction treatment is in development. More...
Education, Depression, Pain Associated With Opioid Misuse
In adults age 50 or older, higher education, illicit drug use, depression, and pain interference with normal work are significantly associated with opioid misuse, according to a study published recently in Nursing Outlook. More...
Addicts Should Be Trained to Give OD Antidote, Study Finds
Frequent opioid users may be the best candidates for training to reverse overdoses in other users, researchers say. More...
Fentanyl Fuels Latest Spike in Opioid OD Deaths
Drug overdose deaths continue to pile up in the United States, driven largely by the opioid epidemic and the emergence of dangerously potent synthetic opioids like fentanyl, a new government report shows. More...
U.S. Opioid ODs Cluster in Centers of Poverty
Poverty may be fueling America's opioid crisis, a new study suggests. More...
Substance Use Mortality Varies Widely Across U.S. Counties
Across U.S. counties there is considerable variation in mortality due to alcohol use disorders, drug use disorders, self-harm, and interpersonal violence, according to a study published in the March 13 issue of the Journal of the American Medical Association. More...
Opioid ODs Outpacing Other 'Deaths of Despair'
Though fewer Americans are dying from alcohol abuse, suicide and murder, opioid overdose deaths have risen dramatically in recent decades, a new report finds. More...
Text Message-Based Intervention Helps With Sobriety Maintenance
Mobile alcohol interventions may help liver transplant candidates with alcoholic liver disease maintain sobriety, according to a study published online March 2 in Alcoholism: Clinical & Experimental Research. More...
ER Visits for Opioid Overdoses Soaring: CDC
America's opioid epidemic is escalating at breakneck speed, with tens of thousands of overdose victims spilling into the nation's emergency rooms seeking lifesaving treatment, a new government report shows. More...