Addiction has become an increasingly large problem in the United States over the past few decades. Jails have become overcrowded with those who are caught selling and using addictive substances. It has become the social norm for celebrities to be in and out of addiction rehabilitation centers every other week, and activities such as gambling and overeating have been labeled, along with substances such as alcohol and cocaine, as potentially addictive.
A. Physical Addiction
B. Psychological Addiction
III. Medical Debates
IV. Debate over the Causes of Addiction
V. Effects within the Family
VI. Family and Recovery
Once a narrowly defined term, addiction, or dependence, has been expanded to describe behaviors or activities that one wouldn’t normally think of as being addictive. Among the more recent uses of the term are food addicts, sex addicts, and Internet addicts. With this expanding definition has come a heightened desire to uncover the causes behind addiction, whether it is to a traditional addictive drug or to a certain behavior. While the use of certain substances and certain activities often become addictions, not everyone who engages in these activities or consumes these substances becomes addicted to them, further complicating the issue. As a result, addiction counselors believe that there are certain reasons why one person becomes addicted more easily than another. Personality and biological factors are among some of the proposed reasons. Research into the topic has produced many debates over the subject of dependency and addiction, including conflicts over the cause and treatment of addiction and whether the term should apply to behavioral issues as well as to mood-altering substances.
Addiction has begun to play a large role in family life in the United States. Conceptions of harmonious family life suggest that serious problems such as addiction exist only in other people’s families. As a consequence of this view, many families fail to recognize, deal with, and recover from a problem in their midst. The development, maintenance, and treatment of substance abuse are intimately connected with families. Families that have an addicted individual undergo a large assortment of effects, ranging from children lacking a parent due to addiction, to parents struggling to help their child to overcome an addiction, to divorce of marital partners when the lack of communication inherent with addiction leads to a breakdown of the marriage. Regardless of the stance one takes on the origin of addiction, it is important to remember that all addictions can be managed, and overcoming addiction is often achieved with the help of loved ones. Th us, family plays a central role in the recovery process.
Addiction is a recurring compulsion or need by an individual to engage in some particular activity or to consume some specific substance. The activity or substance becomes the sole focus in an addicted individual’s life. He or she begins to lose interest in other activities, loses focus on goals that were once important, and will begin to abandon normal behavior in order to gain access to the addictive activity. As the need for the activity or substance grows, the individual will do anything for the substance. In extreme cases, the addict even breaks laws in order to continue engaging in the activity or substance. Family is often the target of the illegal activity and may pay stiff penalties in personal and financial security as an addiction (particularly to illicit drugs) escalates.
When the term addiction was first coined, it clearly referred to the use of a tolerance-inducing drug. This definition recognizes that humans can become quickly addicted to various drugs. The modern understanding of chemical transmission in the brain, and how substances can lead to addiction, began in the mid-1800s in France. From this initial research by Claude Bernard, scientists began to discover how the body responds to drugs.
Addictions develop because the substance or activity produces a pleasure response in the individual, who then wants to receive more of the pleasure. For example, if an individual ingests a substance such as crack cocaine, he or she will feel a euphoric high feeling. As the drug enters the brain, it triggers the body’s natural pleasure sensor to release endorphins, which results in a pleasurable sensation. The individual wants to continue to feel this euphoric high, but, as the addiction builds, the individual’s tolerance to the substance grows. Over time, greater dosages of the drug must be used to produce an identical effect.
Over the years, however, as a medical model of behavior gained prominence, addiction began to be defined as a disease. This is in reference to the physiological changes that occur when one becomes addicted to a substance. The influence of both the medical and the psychological communities has been crucial in the area of addiction research. Two types of addiction—physical dependence and psychological dependence—have been identified through their combined efforts.
Physical addiction is determined by the appearance of withdrawal symptoms when the substance is suddenly discontinued. Withdrawal refers to the symptoms that appear when a drug that is regularly used for a long time is suddenly discontinued or decreased in dosage. The symptoms of withdrawal are often the opposite of the drug’s direct effect. Sudden withdrawal from addictive drugs can be harmful or even fatal, so the drug should not be discontinued without a doctor’s supervision and approval. Part of the rehabilitation process is to wean the addict off of the drugs in a safer and less traumatic manner.
Alcohol, nicotine, and antidepressants are examples of substances that, when abused, can produce physical addiction. The speed at which an individual develops an addiction depends on the substance, the frequency of use, the intensity of the pleasure that the drug induces, the means of ingestion, and the individual person.
Psychological addiction is the dependency of the mind and leads to psychological withdrawal symptoms such as cravings, insomnia, depression, and irritability. Psychological addiction is believed to be strongly associated with the brain’s reward system. It is possible to be both psychologically and physically dependent at the same time. Some doctors make little distinction between the two types of addiction, because they both result in substance abuse. The cause and characteristics of the two types of addiction are quite different, as are the types of treatment. Psychological dependence does not have to be limited only to substances; activities and behavioral patterns can be considered addictions within this type of dependency. The popularity of Internet usage, video games, pornography, and social networking services such as Facebook and Twitter have all been characterized in this manner.
Not all doctors agree on what constitutes addiction. Traditionally, addiction has been defined as only possible when a substance is ingested that temporarily alters the natural chemical behavior of the brain to produce the euphoric high associated with these drugs. However, over time, people have begun to feel that there should be an alteration of the definition of addiction to include psychological dependency on such things as gambling, food, sex, pornography, computers, work, exercise, cutting, shopping, and so forth. These activities do not alter the natural chemical behavior of the brain when they are performed; thus, they do not fit into the traditional views of addiction, despite their impacts on social interactions and family life.
Those who support the contemporary view of addiction show that symptoms mimicking withdrawal occur when the individual stops the addictive behavior, even if it is not a physiologically acting substance. Those who support the traditional view purport that these withdrawal-like symptoms are not strictly reflective of an addiction, but rather of a behavioral disorder. Proponents of the traditional view say that the overuse of the term may cause the wrong treatment to be used, thus failing the person with the behavioral problem.
The contemporary view of dependency and addiction acknowledges the possibility that individuals who are addicted to a certain activity feel a sense of euphoria, much like the euphoria received from addictive substances. For example, when a person who is addicted to shopping is satisfying his or her craving by engaging in the behavior, chemicals that produce a feel-good effect, called endorphins, are produced and released within the brain, enforcing the person’s positive associations with the behavior. Additionally, there could be negative, real-life consequences to participation in the activity, including isolation from family and friends, increased debt, and so forth.
Debate over the Causes of Addiction
The causes of addiction have been debated for years within the scientific community. One school of thought believes that addiction is a disease that cannot be controlled by the individual. This theory states that addiction is an inherited disease, and an individual with the inherited trait of the disease is permanently ill with the addiction located at a genetic level. Even those with long periods of overcoming the addiction will always contain the disease. This viewpoint states that if one’s parent was addicted to something, whether a substance or an activity, he or she is predisposed to also develop the addiction. Even if the person avoids the substance or activity, he or she still technically has an addiction to it. The idea that “alcoholism runs in families” has a long tradition in the substance abuse field. Studies that compare alcoholism rates of natural and adopted children indicate that the adopted children of alcoholics have significantly lower rates of alcoholism than do their biologically related progeny. Additionally, a family history of alcoholism has been linked to a younger initial age of alcohol consumption.
Another school of thought argues that addiction is a dual problem caused by both a physical and a mental dependency on chemicals along with a preexisting mental disorder. This theory says that addiction is not caused by one factor alone but instead by many factors combined. Addiction is caused not just by the fact that a person’s family member had the disease of addiction, but because the person’s family member had the disease of addiction in addition to being emotionally unstable and prone to finding quick ways to happiness. Clearly, when a parent is “absent” due to his or her use of mood-altering substances, the socialization of the children is affected.
The social learning model suggests that the pattern of addiction is learned by watching or modeling the behavior of others. In families where addictive behaviors and substance abuse occur, children see role models of how to participate in addictive activities. This occurs even when parents attempt to hide their addictive behaviors. The fact that persons tend to share addictions over time through the process of assortative mating provides support for the idea that two persons with similar tendencies toward addictive behaviors will likely become partnered. There is scientific research to support all concepts of the causes of addiction. No one theory has emerged as having greater veracity in explaining and predicting dependency.
Effects within the Family
Addiction is the number one disease in the United States, with one in three families having at least one addicted member. With the problem of addiction so widespread, the effects on the family have become an important subject. Addiction affects the family in many ways. An addicted individual puts stress on the rest of the family. There is often a stigma of shame associated with addiction; this shame burdens the family and makes it harder for the family to seek help for the individual because of the fear of ridicule from the outside world. There is a substantial fear of discovery, and many families may hide the addiction for years without seeking the medical attention needed to help the addicted person. A significant loss of self-esteem in the addicted individual is noticed and may cause the addiction to get worse and the addicted individual to further deteriorate.
Many families that have an individual who has the disease of addiction are overcome by denial. They try to deny that there is a problem to everyone they know, including themselves. This act of denial will often lead to exaggerated feelings and may result in explosive behavior to which the family can become emotionally exhausted. One of the most concerning aspects of addiction in the family is that most illicit drug users are fairly young, of childbearing age (18 to 35 years), and thus are exposing children to addictive substances, behaviors, and outcomes.
Addiction may sometimes produce physical effects. Domestic violence—whether physical, emotional, or sexual—is increased in families that have an addicted member, particularly someone with alcoholism. Domestic violence can occur in well-educated families as well as families with less professional backgrounds. It is predicted that members of families where abuse due to addiction takes place are more likely to require medical care. Additionally, children of substance abusers who experienced physical or sexual abuse are more likely to experience psychiatric symptoms and marital instability than those persons in whose family there was not addictive behavior.
Typically, families experiencing substance abuse witness the allocation of the addict’s role to others in the family. Often this “absent parent” cedes his or her responsibilities to a child. The child then must assume duties that are inappropriate to his or her age, even having to raise himself or herself because the parents were unavailable to nurture the child. As one can imagine, this leads to strained relationships, even as the child reaches adulthood. Resentment for a lost childhood is not uncommon.
Families with an individual who is an addict often withdraw from their community, are distrustful of others, and have severe financial difficulties. The fear of exposure and subsequent stigma may force the withdrawal. If the addict is engaging in illegal activities, it is possible that he or she will be caught and sentenced to jail. Indeed, 80 percent of women inmates are mothers, and the vast majority have children under the age of 18. If the individual has no one to care for the children during the incarceration, the children might be left alone, placed in foster care, or put into state-run child care facilities.
Another issue that families with an addict must face is the fact that children could be born to an addict and be drug dependent themselves. In these cases, the infants must go through detoxification and often have a low birth weight or other lingering physical and behavioral manifestations of the addiction. If the mothers remain addicted, they may have tremendous difficulty meeting the care needs of their child. One of the factors most associated with an increase in infants addicted to substances is the wide availability and low cost of crack cocaine.
Family and Recovery
The family often plays a large role in the recovery process for the family member who is an addict. Because denial is the primary barrier to effective treatment for addiction, the addict must admit that there is a problem. It is usually the family members who help the addict admit the addiction and realize that it is something that must be overcome. Wives routinely encourage husbands to seek treatment for alcoholism, for example. Today, most recovery programs involve the family members in counseling and behavior modification, suggesting that fewer relapses occur when family support networks are readily available.
In order for an addict to successfully overcome an addiction, he or she must have the support of his or her family. It is very important to find a treatment center or a recovery program that is a good fit for the person. Programs are available that can be easily adjusted to better suit the person undergoing the treatment. Online programs as well as weekly meetings with other recovering addicts are useful methods. There are also live-in treatment centers that take a drastic approach to help the person recover, though they may be avoided due to the stigma of their hospital-like approach.
Addiction is only one of many subjects relating to the importance of one’s family in the world today. The debate over what specifically constitutes an addiction, its precise causes, and which disease metaphor is the most appropriate will likely continue for some time. The focus of these debates should transition into how to prevent addiction and to diminish the damaging effects that it has on the family. We live in a society where it is the social norm to associate addiction with a negative stigma. Ideally, we would live in a society where those with an addiction were embraced so that the recovery process could happen immediately with no shame or blame given to the family of the addict. When we reach this point, family members will be better able to relate to one another and will be more emotionally stable.
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