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Addiction can take many forms such as sex, gambling, drugs, alcohol, maybe even Internet Porn sites. Whatever it is, the social stigma related to this addiction can be as problematic as the addiction itself. This paper was created in an effort to provide the layperson a better understanding of addiction. In this paper we will discuss the definition of addiction according to medical experts, causes of addiction, social ramifications, and interventions.

 

The most accepted definition of addiction is someone who cannot control his or her urge to participate in the activities they are addicted to. In other words, it is out of their control. The American Psychiatric Association (APA) and the World Health Organization (WHO) base a medical definition of addiction on a set of criteria.

 

“An addiction is any behavior that meets at least three of the seven criteria during the same 12-month period.

 

1. Tolerance. Has your use of drugs or alcohol increased over time?

2. Withdrawal. When you stop using, do you experience at least one of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting?

3. Difficulty controlling your use. Do you sometimes use more or for a longer time than you'd like? Do you drink to get drunk?

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. Significant time or emotional energy spent. Do you spend a significant amount of time or thought obtaining, using, concealing, planning, or recovering from your use?

6. Put off or neglected activities. Have you given up or reduced social, recreational, work, or household activities because of your use?

7. Desire to cut down. Have you repeatedly thought about cutting down or controlling your use, or have you made unsuccessful attempts to cut down or control your use?” (Addictions and Recovery.org, 2008)

 

Now that we have a working “medical definition” of addiction, what are some of the causes? Is it hereditary, environmental, or developmental, or could it be a combination of all three?

 

Heredity

 

There is a long-held belief that a genetic predisposition to addiction exists. If Mom, Dad, Aunt Sally, or Uncle Bob has problems with addiction, these genes are passed on to little Johnny. In effect perpetuating the vicious cycle of addiction. Heredity may be just a part of the puzzle however. “The genes that people are born with––in combination with environmental influences––account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental disorders may influence risk for drug abuse and addiction” (NIDA, 2008)

 

Environment

 

Environment is another factor to consider when dealing with addiction and addictive behaviors. It would seem that addiction is also part of learned behavior along with genetics. “Environmental risk factors are characteristics in a person's surroundings that increase their likelihood of becoming addicted to drugs. A person may have many environments, or domains, of influence such as the community, family, school and friends. Their risk of addiction can develop in any of these domains” (Genetic Science Learning Center, 2008).

 

Development

 

Developmental stages also play a role in addiction as adolescents and pre-teens experiment with legally available drugs such as tobacco and alcohol. This gives rise to the “Gateway Theory” in that the more experimentation involved, the more likely an addiction will occur. “One of the most robust findings in adolescent drug use over the past 30 years has been that almost all adolescents who have tried cocaine and heroin first used alcohol, tobacco and cannabis, and the more regularly adolescents use cannabis, and the earlier the age at which they begin, the more likely they are to use other illicit drugs” (Kandel, 2006)

 

There is, according to medical experts in the field, a chemical imbalance in the addicted person's brain. The addict seeks to decrease this imbalance with illicit drugs in an effort to help them feel better or "normal". They are in effect self-medicating.

 

Another widely held position on chemical dependency is that the drugs themselves cause changes in the brain over long-term use. Because of these changes, the addict seeks the drug to level the imbalance. "Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person's self control and ability to make sound decisions, and at the same time send intense impulses to take drugs (NIDA, 2008)

 

The impact on social interactions of the addict is extreme. They may lose interest in family functions, personal hygiene, have problems on the job, and a variety of other situations that lead to a “downward spiral” and eventual rock bottom. Although family and friends are concerned for the individual, they may lack resources to effectively help the addict deal with their situation. Should they intervene on the addict’s behalf or let him or her deal with it on their own. This raises the question of voluntary intervention or mandated intervention.

 

Intervention

 

At some point in the addict’s illness, the need for treatment will arise. It may be a result of personal enlightenment, natural consequences, or a judicial mandate. Whatever the case may be, it all boils down to which school of thought is prevalent at the time and applied. However, the question remains as to which is more effective, voluntary treatment, or mandatory treatment via the judicial system?

 

This is a good question and to that end, many high schools have implemented a mandated treatment program for students committing infractions with illicit drugs. The outcomes are favorable although those that are required to receive treatment are initially resistant. In the same light, some prison systems require criminals to undergo substance abuse treatment as part of their sentencing requirements.

 

These mandates may be all well and good, but how effective are they? Will a person who is facing jail time be more apt to fully participate in a treatment program knowing that the alternative is prison? In a 2006 study published in “Journal of Addictive Diseases” adolescents who committed crimes were sent to mandatory chemical abuse treatment centers. These same youths were then followed for 18 months after treatment through administrative records for evidence of relapse and recidivism. The results were promising. “Clients who completed treatment, compared to those who did not, had significantly lower risks of each outcome, while those with treatment episodes longer than 90 days had lower risks of readmission and felony convictions” (Luchansky, He, Longhi, Krupski, & Stark, 2006) It would appear that even mandatory substance abuse treatment is effective to some extent.

 

To recap, addiction is a complex illness that manifests itself in behaviors beyond a person’s control. There exists a genetic predisposition for addiction that is compounded by environmental and developmental variables. An addiction is a chemical imbalance in the brain that, left unchecked, grows to affect social interactions and impaired judgment. This in turn leads to a downward spiral and lands the addict at the very bottom of the social ladder. Interventions, either voluntary or involuntary can be successful. The key to success for the addict is ongoing support and a commitment to stay clean and sober.

 

References:

 

Addictions and recovery.org, (2008) The medical definition of addiction. Retrieved

 

December 1, 2008,

 

Genetic Science Learning Center (2008, December 1) Environmental Risk Factors for

 

Addiction. Learn.Genetics. Retrieved December 1, 2008, from http://learn.genetics.utah.edu/content/addiction/factors/environment.html

 

Kandel, D. (2006) Testing the Gateway Hypothesis; Addiction 101, (4), (pps. 470-476)

 

Retrieved December 1, 2008, from Ebscohost database.

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