What does it mean?
Around 64% of people in the UK know someone who has an addiction, yet around 2/3 of those people know very little about it. It’s hard to support friends and loved ones when we don’t know what it is.
Someone I had the pleasure of working with and supporting a while ago had started to use alcohol and drugs at the tender age of 14, in the belief it would help him escape his adverse childhood experiences. This is such a common belief. Another common belief, again mostly with young people, is the hope of “fitting in” if they drink or take drugs. Once someone becomes addicted to the substance or the behaviour, it becomes so ‘addictive’ it can be harder to get to the bottom of why they started the ‘dependence’ in the first place. This is usually because shame, guilt and ill health can kick in.
It's not just young people who find themselves in this position. More recently I’ve worked with people who’ve retired, some from high powered jobs that have kept them busy and away from their families for more hours than enough, and who find it overwhelming being at home. They find relationships with family and their partners to be strained and struggle to find a new sense of purpose. This has led them to drink to, “take off the edge”, or develop eating disorders as a way of “coping”.
I’ve also worked with women who struggle with the return to work after childbirth… some who simply miss their children and others who feel excluded at work for many and varied reasons. They’ve started by having a glass of wine every night to “wind down” and then one glass turns to two each night and before they know it one bottle turns to two… This is often when the shame kicks in and so too the addiction cycle.
There’re lots of reasons why people become addicted, and the numbers are rising. A particular concern is the number of work-related accidents instigated by workers under the influence of substances like alcohol, opiates and heroin. In fact, research shows that 60% of poor performance in the workplace and 40% of accidents in the workplace are related to substance use/abuse.
So, what is it… Well, an addiction may be described as:
A physical and psychological dependence on a substance, e.g., alcohol or drugs, or a behaviour, e.g., eating disorder or unhealthy compulsive behaviours, and feeling unable to function properly without it. If the dependence is on a substance, this becomes an extremely important, or the most important factor in the person’s life and they may go to great lengths to get it. There are physical and psychological effects of withdrawal and the addict is unable to overcome the addiction without help. Psychological dependency on gambling, sex, internet and work are also considered addictions by many psychologists and health care professionals.
What are the causes of addiction?
The causes of addiction are not fully understood and usually involve a combination of physical, mental, emotional and circumstantial factors. Scientists also believe there’s a link between the repeated use of an addictive substance (e.g. alcohol, drugs) and how the brain experiences pleasure. Our brains are wired to ensure we repeat life-sustaining activities, such as sex and eating, by associating those activities with pleasure or reward – this is known as the brain’s reward system, which releases dopamine creating the feeling of pleasure. Most addictive substances enter the brain very quickly and cause the nerve cells to release abnormally large amounts of dopamine, which produces the euphoric effect. This ‘flooding’ can be up to 10 times higher than that of normal rewards and can last much longer, so that normal rewards pale into significance. The result of this is twofold:
The effect of such powerful reward is a strong motivator to take the substance again and again
Tolerance – when a substance is repeatedly taken, the brain adjusts to the overwhelming surges in dopamine by producing less dopamine and as a result, dopamine levels become abnormally low causing feelings of lifelessness and depression. Therefore, more of the substance is needed, just to try and bring the dopamine function back to normal and feel any enjoyment for anything. Furthermore, greater and more regular quantities of the substance are needed in order to achieve the same euphoria as previously - eventually the person no longer experiences pleasure from the substance and takes it just to avoid withdrawal symptoms.
Who might be affected? The truth is anyone at any time.
There are certain factors that increase the likelihood/risk of addiction, including:
· Having a mental illness/condition, including stress, depression and PTSD
· Peer pressure
· The nature of the substance and the age when substance was first consumed
· How the body metabolises the substance
· Avoidant coping style
Working with a trained professional, a person with addiction can be supported safely through the appropriate stages of change to help alter and develop positive behaviour. It’s a difficult journey, made easier with understanding and support from others, especially loved ones. It can be challenging in the first year of change (e.g. sobriety), but also liberating with the addition of improved mental health.
Let’s use this week of Addiction Awareness effectively to remove stigma and help those struggling to get the help they need and deserve. Addiction is not a choice and is a serious mental health condition. The people I've worked with told me the extreme shame and guilt they carried made it all the harder to accept and seek help. If you, or someone you know, is suffering there is professional help available, and recovery is possible.
Sandra C Thompson