Addiction is a mystery for many

RBC I Ask 10 Americans what addiction is and you are likely to get 10 different answers. Some will insist addiction is a weakness of people who won’t take responsibility for their behavior. If addicts want to self-destruct, let them. They choose to abuse.Other explanations will range from heredity to the “disease” model which views addiction as progressive, irreversible and the only treatment is total avoidance of the substance or behavior. In this model, one is forever “in recovery” from the addiction.Most experts view addiction from a bio-psycho-social model, which incorporates biological, psychological, cognitive, social and environmental variables. For example, we could say that a person’s alcohol addiction is due to a combination of factors: perhaps one or both parents were alcoholic; maybe the person has a mental health problem that they are self-medicating with alcohol; the alcohol use is reinforced by a temporary feeling of relief from stressors; and their environment normalizes the use of alcohol.This helps to explain the causes of addiction but what exactly is an addiction? A common definition is the compulsive and continued use of a substance or participation in a behavior, exhibiting little if any control over the behavior. Often there are associated negative consequences. Over time, increasing amounts of the substance or behavior are required to achieve the same “high,” and withdrawal symptoms may occur when the substance or behavior is stopped. This is the phenomenon of tolerance and withdrawal, the two criteria the American Psychiatric Association uses to distinguish between abuse and dependence. When referring to addiction, we tend to think of alcohol, drugs, smoking or caffeine but people can also be addicted to gambling, eating, sex, even exercise.For many addicted people, negative consequences are enough to make them change their behavior. For many others, treatment is vital to their recovery. The most common treatments include outpatient therapy, medications or 12-step groups. Inpatient, or residential, treatment is now only considered as a last resort after numerous attempts at outpatient treatment have not worked. This is due to the expense, lack of availability and the time commitment required.No single treatment is appropriate for all individuals, and effective treatment addresses the multiple needs of the individual, not just the addiction. Recovery from an addiction can be a long-term process and may require multiple “episodes” of treatment. However, it is possible for people to resume a high level of functioning, managing their lives in a healthy way. If you have questions about addiction, please contact a mental health or substance abuse professional, who will be glad to answer your questions and if necessary, can help you get started on the path to recovery.By Michael Toothaker and Gina Toothaker