Causes and Symptoms (Magill’s Medical Guide, Sixth Edition)
Addiction is a disorder that can affect any animal and may result from the use of a variety of psychoactive substances. Typically, addiction involves psychological or physiological dependence, or both.
Tolerance involves pharmacokinetics, pharmacodynamics, and environmental or behavioral conditioning. Pharmacokinetics refers to the way in which a biological system, such as a human body, processes a drug. Substances are subject to adsorption into the bloodstream, distribution to different organs (such as the brain and liver), metabolization by these organs, and then elimination. Over time, the processes of distribution and metabolism may change, such that the body eliminates the substance more efficiently. Thus, the substance has less opportunity to affect the system than it did initially, reducing any desired effects. As a result, dose increases are needed to achieve the initial or desired effect.
Pharmacodynamics refer to changes in the body as a result of a pharmacologic agent being present. Tissue within the body responds differently to the substance at the primary sites of action. For example, changes in sensitivity may occur at specific sites within the brain, with direct or indirect impact on the primary action site. Direct changes at the primary sites of action denote tissue sensitivity. An example might be an increase in the number of receptors in the brain for that particular substance. Indirect changes...
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Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
Because of the potential combination of psychological and physiological addiction processes, dependence is a type of disorder that often demands both psychological and pharmacological treatments. Typically, interventions focus on decreasing or stopping the substance use and reestablishing normal psychological, social, occupational, and physical functioning in the addicted individual. Though the length and type of treatments may vary with the particular addictive drug and the duration of the addiction problem, similar principles are involved in the treatment of all addictions. Similar strategies are used for problems of abuse. Because abuse is limited to problems that are more social in nature, however, pharmacological treatments often are not used for abuse problems alone.
Psychological treatments focus primarily on extinguishing psychological dependence, as well as on facilitating more effective functioning by the addicted individual in other areas of life. Attempts to change the behavior and thinking of the addicted individual usually involve some combination of individual, group, or family therapy. Adjunctive training in new occupational skills and healthier lifestyle habits is also common.
In general, treatment focuses on understanding how the addictive behavior developed, how it was maintained, and how it can be removed from the person’s daily life. Assessments of the situations in which the drug was used,...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
The use of substances to alter the mind or bodily experiences is a practice that has been a part of human cultures for centuries. Time and again, even through legislated acts such as Prohibition, drug and alcohol use have persisted. The continued use of drugs for recreational and medicinal practices seems virtually inevitable, and it is unlikely that substance abuse and dependence will disappear from the world’s societies. Consequently, an understanding of substance use, how it leads to addiction, ways to minimize the development of addiction problems, and strategies for improving addiction treatments will be critical.
At different times in history, addiction has been viewed as strictly a moral, medical, spiritual, or behavioral problem. As the science of understanding and treating addiction has progressed, the variety of ways in which these aspects of addiction combine has been noted. Modern treatments and theories no longer view addiction from one strict point of view, but instead recognize the heterogeneity of paths leading to addiction. Such an approach has been helpful not only in treating addiction but also in preventing it. Efforts to curb the biological, social, and environmental forces contributing to addiction have become increasingly important.
Addiction remains a disorder with no completely effective treatment. Of individuals seeking treatment across all addictive disorders, fewer than 20...
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. 4th ed. Arlington, Va.: Author, 2000. This manual provides detailed descriptions of the behaviors and types of symptoms used to describe and diagnose different addictive disorders. It is written by mental health professionals from psychiatric, psychological, and social work backgrounds.
Block, Jerald J. “Issues for DSM-V: Internet Addiction.” American Journal of Psychiatry 165 (March, 2008): 306-307. Results of a case study that concludes that “Internet addiction appears to be a common disorder that merits inclusion” in updated editions of the Diagnostic and Statistical Manual of Mental Disorders.
Brickman, Philip, et al. “Models of Helping and Coping.” American Psychologist 37 (April, 1982): 368-384. This article describes a four-model perspective on helping and coping with problems related to addiction. A classic in the addiction field, providing a good review of historical factors influencing different treatment models.
Dupont, Robert L. The Selfish Brain: Learning from Addiction. Center City, Minn.: Hazelton, 2000. Discusses the commonalities across different types of addiction in an easy-to-understand manner.
Julien, Robert M. A Primer of Drug Action: A Concise, Nontechnical Guide to the Actions, Uses, and Side Effects of...
(The entire section is 389 words.)
Addiction (Encyclopedia of Medicine)
Addiction is a dependence on a behavior or sub-stance that a person is powerless to stop. The term has been partially replaced by the word dependence for substance abuse. Addiction has been extended, however, to include mood-altering behaviors or activities. Some researchers speak of two types of addictions: substance addictions (for example, alcoholism, drug abuse, and smoking); and process addictions (for example, gambling, spending, shopping, eating, and sexual activity). There is a growing recognition that many addicts, such as polydrug abusers, are addicted to more than one sub-stance or process.
Addiction is one of the most costly public health problems in the United States. It is a progressive syndrome, which means that it increases in severity over time unless it is treated. Substance abuse is characterized by frequent relapse, or return to the abused substance. Substance abusers often make repeated attempts to quit before they are successful.
In 1995 the economic cost of substance abuse in the United States exceeded $414 billion, with health care costs attributed to substance abuse estimated at more than $114 billion.
By eighth grade, 52% of adolescents have consumed alcohol, 41% have smoked tobacco, and 20% have smoked marijuana....
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Addiction (Encyclopedia of Mental Disorders)
Most definitions refer to addiction as the compulsive need to use a habit-forming substance, or an irresistible urge to engage in a behavior. Two other important defining features of addiction are tolerance, the increasing need for more of the substance to obtain the same effect, and withdrawal, the unpleasant symptoms that arise when an addict is prevented from using the chosen substance.
The term addiction has come to refer to a wide and complex range of behaviors. While addiction most commonly refers to compulsive use of substances, including alcohol, prescription and illegal drugs, cigarettes, and food, it is also used to describe excessive indulgence in activities such as work, exercise, shopping, sex, the Internet, and gambling.
Causes and symptoms
Some experts describe the range of behaviors designated as addictive in terms of five interrelated concepts: patterns, habits, compulsions, impulse control disorders, and physical addiction. There is ongoing controversy as to whether addictions constitute true physical disease in the same sense that...
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Addiction (Encyclopedia of Science)
Addictions can be physical (of the body), psychological (of the mind), or both. In fact, almost any behavior can be termed an addiction if it becomes the primary focus of a person's life, and especially if it results in harmful effects to one's physical health and well-being. The term addiction is most commonly associated with a person's compulsive and habitual desire to consume a chemical substance, such as alcohol or other drugs. The addict's life is eventually dominated by the craving. It is estimated that up to 25 percent of the American population displays some form of addictive behavior.
Alcohol. Alcohol is a central nervous system depressant that reduces inhibitions and anxiety. As the body becomes accustomed to a particular quantity of alcohol, more and more alcohol is needed to alter the drinker's mental state in the desired way. Eventually, the liver (an organ that plays a key role in digestion, filtration of the blood, and the storage of nutrients) can become damaged by constant exposure to alcohol and its metabolites (by-products of alcohol's breakdown). A damaged liver loses its ability to detoxify the blood, which can result in permanent mental changes, organ failure, and death.
The opiates: opium, morphine, and heroin. Opiates (also called narcotics) are addictive drugs derived from opium, a drug...
(The entire section is 1768 words.)
Addiction (Encyclopedia of Children's Health)
Addiction is a physical or mental dependence on a behavior or substance that a person feels powerless to stop.
Addiction is one of the most costly public health problems in the United States. It is a progressive syndrome, which means that it increases in severity over time unless it is treated. The term has been partially replaced by the word "dependence" for substance abuse. Addiction has been extended, however, to include mood-altering behaviors or activities. Some researchers speak of two types of addictions: substance addictions (for example, alcoholism, drug abuse, and smoking); and process addictions (for example, gambling, spending, shopping, eating, and sexual activity). There was as of 2004 a growing recognition that many addicts are addicted to more than one substance or process. Substance abuse is characterized by frequent relapse or return to the abused substance. Substance abusers often make repeated attempts to quit before they are successful.
The National Survey on Drug Use and Health (NSDUH) is conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services. Among the findings of the 2003 study are...
(The entire section is 2506 words.)
Addiction (International Dictionary of Psychoanalysis)
The Latin addictus refers to a person who is bound and dependent as a result of unpaid debts. Metaphorically, this term came to be used for any behavior that results from a heavy dependence on something, such as a drug. A number of common substances or those that can be freely purchased can be used as drugs or become addictive substances: medication, alcoholic beverages, glue, and so on. Psychoanalytically, the power of a particular addiction depends both on the unconscious fantasies that underlie the subject's ingestion, and the substance's actual chemical effect.
Sigmund Freud refers to addiction in an early paper on "Hypnosis" (1891d, p. 106), and in a letter to Wilhelm Fliess of December 22, 1897, he refers to masturbation as the "primary addiction" (1950a, p. 272; 1985c, p. 287). Karl Abraham (1908/1927) studied alcohol addiction. Sándor Radó (1933) associated addiction with a regression to childhood. Otto Fenichel (1945) developed the concept of addiction as a regression to infantile stages, and his descriptions of alcohol as a means of diluting the superego are especially interesting. Herbert Rosenfeld (1965) referred to the manic-depressive signs that underlie addiction, and connected addiction to pathological narcissism of the Self. Donald Winnicott (1951/1953) associated addiction with a pathology of the transitional. Winnicott's transitional object, a creation/discovery of the subject, opens up an intermediary zone of experience, which then expands into play and cultural life, while the transitional object is disinvested and loses its meaning. In addiction, this process of opening up and development is held back, and the transitional object continues to carry out its original function (counter-acting depressive anxiety), in the form of a continuing disavowal. The transitional object is concretized, is "fetishized," and becomes susceptible to replacement by a drug as an object that can be manipulated by the omnipotent subject, enabling him to deny the separation and the resulting depression.
A number of authors who have studied compulsive behavior have included a dependence on alcohol or another substance into their inquiry. Dostoyevsky, in The Brothers Karamazov, provides a clear description of the motivations that underlie addictive behavior, such as sexual dependency and pathological games.
Addiction to a substance is sometimes replaced with another form of dependence, for example, addictions to food, to sex with prostitutes, to gambling, to spree-buying, to physical exercise, to web surfing, or to playing video games (whereby the internal world is projected onto the characters who fight, kill, love, or hate on screen). There is also the addiction to pseudo-religious cults, which serves as a substitute for a dependence on and subjugation to drugs. It is important to note that the other can also become an addictive object (McDougall, 1982), serving as a drug might, to fill holes in the subject's identity.
See also: Alcoholism; Alienation; Cocaine and psychoanalysis; Dependence; Dipsomania; Freud: Living and Dying; Passion.
Abraham, Karl. (1927). The psychological relations between sexuality and alcoholism. In Selected papers on psychoanalysis, London: Hogarth Press. (Original work published 1908)
Freud, Sigmund. (1891d). Hypnosis. SE, 1: 103-114.
. (1897a). Infantile cerebral paralysis. (Lester A. Russin, Trans.). Coral Gables, FL: University of Miami Press, 1968.
. (1950a [1887-1902]). Extracts from the Fliess papers. SE, 1: 173-280.
. (1985c [1887-1904]). The complete letters of Sigmund Freud to Wilhelm Fliess, 1887-1904 (Jeffrey M. Masson Ed. and Trans.). Cambridge, MA, London: Belknap/Harvard University Press.
Fenichel, Otto. (1945). The psychoanalytic theory of neurosis. New York: W.W. Norton.
McDougall, Joyce. (1982). The narcissistic economy and its relation to primitive sexuality. Contemporary Psychoanalysis, 18, 373-396.
Radó, Sándor. (1933). The psychoanalysis of pharmacothymia. Psychoanalytic Quarterly. 2, 1-23.
Rosenfeld, Herbert. (1965). Psychotic states: A psychoanalytic approach. London: Hogarth Press.
Winnicott, Donald W. (1953). Transitional objects and transitional phenomena, a study of the first not-me possession. Collected papers, through paediatrics to psycho-analysis (pp. 229-242). (Reprinted from International Journal of Psycho-Analysis, 34 (1951), 89-97.)
Addiction (Encyclopedia of Drugs, Alcohol, and Addictive Behavior)
(formerly the British Journal of Addictions) is the oldest specialist journal in its field, originating in 1884 as the Proceedings for the Society for the Study and Cure of Inebriety. The bound volumes provide a unique perspective on the historical development of clinical practice, policy debates, and the emergence of a scientific tradition. Addiction is today among the most international of journals focusing on addiction. In addition to publishing refereed research reports, editorial policy has been directed at establishing it as a leading forum for informed debatepecially commissioned "commentary" series contribute to this purpose. The prestigious Addiction Book Prize is awarded annually. In furtherance of its role as an international medium of scientific exchange, the journal, which has its head office in Britain, in 1993 established regional offices in the United States and Australia.