The addiction

definition

Addiction, or as it is called in the technical jargon, the “harmful use and dependence on psychoactive substances”, is a huge problem that does not adhere to social classes or educational standards, but affects all social classes.

Almost everyone knows someone who “refills up to the point of pupil stop” every weekend. Almost every fifth adult in Germany also smokes, although by now most of them should know what the consequences are or can be (see also Mental Disorders / Drug Psychosis).

Substances that are addictive affect both the body and our psyche. Usually they ensure that you briefly come into a state that is experienced as more beautiful, calmer or more relaxed than without the substances. The only problem here is that people can get used to such conditions and want to experience them as often as possible. You become dependent. An addiction is denied.

Here you can read more about the consequences of drugs such as cannabis, ecstasy or amphetamines.

Epidemiology

How many people ultimately meet the criteria for addiction can only be estimated. Since it is unfortunately typically part of the disorder that there is a tendency to understate or deny consumption, one tries to use various known statistics (e.g. accident statistics or arrests for doge possession).

The most common addiction disease is the Tobacco addiction. Statistics go by at least 10 million addicts out.

The second most common addiction disease in Germany is the Alcohol addiction / alcoholism. About 2.5 million certainly suffer from this disease.
However, there are also estimates that, taking into account the so-called "Dark figure ", from one Frequency of 10-15% so 8 to 12 million Sick can be assumed.

About 1.5 million people in our country suffer from one Drug addiction (Painkillers, sedatives, sleeping pills, etc.)

With regard to the so-called illegal drugs (heroin, cocaine etc,) the numbers vary between 90,000 - 160,000 Suffer.

Apart from the drug dependency are clearly found in the group of the sick more men than women. The typical Starting age for tobacco and alcohol lies between that 16 and 18 years of age.

Classification of addiction

Substance addiction

Substance-related addiction describes the dependence on certain substances. Those affected have an extremely strong desire to consume this substance over and over again and, depending on which substance is used, lose control of their lives.

The alcohol addiction

Alcohol addiction is a common phenomenon. Those affected consume larger amounts of alcoholic beverages every day.
This has negative effects on the cardiovascular system. Organ damage can also occur. The liver in particular is often affected. Over time, the person affected can also experience a change in character.
Therapy should come from several areas. Psychotherapeutic care is an important basis here.

Read more on the subject here Alcohol addiction.

The nicotine addiction

Another common addiction is nicotine addiction. Nicotine stimulates the body's own reward system and makes you feel good. Over time, a dependency arises.
However, nicotine is very harmful to our bodies. In particular, the heart, the lungs and the stomach are damaged. Symptoms such as high blood pressure and shortness of breath occur, but stomach ulcers can also develop. In addition, the risk of cancer increases sharply.
There are various tips and tricks on how to successfully quit smoking.

Find out more about the topic here Nicotine.

The cannabis addiction

The consumption of cannabis (so-called "grass") has increased significantly in recent years. It has a relaxing, euphoric effect. Regular consumption leads to psychological and physical dependence.
Cannabis has negative effects on cognitive performance, such as memory. In addition, psychoses and hallucinations can be triggered.
Depending on the severity of the addiction, outpatient or inpatient treatment may be necessary.

Learn more about: What are the consequences of cannabis?

Memory Problems and / Due to Drugs - Causes & Therapy

Addiction to hard drugs

Hard drugs are substances such as heroin and coke. These have a euphoric effect on the mood and quickly lead to dependence.

Cocaine has negative effects on the cardiovascular system and can lead to hallucinations. Pure heroin, on the other hand, hardly damages the organs. However, this drug leads to social isolation, as those affected are very fixated on consumption.
Therapy should take place on several levels, including psychotherapeutic measures.

Addiction to medication

The drug addiction describes the strong desire for certain drugs. Mostly these are painkillers and sleeping pills. Those affected are mostly older women.
Drug addiction is a widespread phenomenon that is often not properly recognized. When stopping the medication, typical withdrawal symptoms such as restlessness, irritability, nausea and the psychological desire for the medication arise.

Those affected should first contact their family doctor or seek psychotherapeutic treatment.

Read more on the topic: Drug addiction

Non-substance addiction

The anorexia

Anorexia (also Anorexia nervosa) describes an Esstrom that mostly affects young women. Affected people try to eat as little as possible in order to lose as much weight as possible. This can even lead to life-threatening conditions, as the organs are no longer adequately supplied with nutrients.
Other symptoms that can result from anorexia are, for example, circulatory disorders, hormonal disorders and depression.

Treatment for anorexia should be inpatient. In addition, psychotherapeutic treatment should be given to treat individual conflicts that cause this eating disorder.

Find out more about the topic here Anorexia.

The bulimia

Bulimia is also an eating disorder with the aim of weight loss. In contrast to anorexia, those affected eat a lot in a short period of time. However, since these food cravings are associated with weight gain, self-induced vomiting is often provoked.
Symptoms of bulimia include circulatory disorders, electrolyte disorders, anemia, heartburn, and depression.
The therapy should also be carried out as an inpatient here. In addition, psychotherapeutic measures should be taken.

Read more on the subject here Bulimia.

The media addiction

Media addiction describes the excessive use of media, such as the Internet, the television or even the cell phone.
Those affected chat for hours on the Internet or play online. Others sit in front of the television all day. Social contacts are increasingly neglected.

For these reasons, those affected should receive psychotherapeutic treatment.

The gambling addiction

This addiction describes a loss of control when gambling.
Those affected invest more and more money and try to compensate for losses. You get into a vicious circle and often get into debt. Social contacts are also neglected.
There are hardly any physical symptoms. Only irritability, nervousness, sleep problems and depressive moods can be observed.

Therapy should be carried out through psychotherapeutic measures. There are also self-help groups that can be turned to.

The job addiction

Workaholism describes people who are dependent on their work and need it for their personal well-being.
Those affected work an above-average amount and are very perfectionist. Social contacts are neglected for reasons of time. Symptoms such as depression and anxiety can also develop over time.

Those affected should receive psychotherapeutic care in order to identify the cause of work addiction and to treat it successfully.

The shopping addiction

Buying addiction describes the compulsion to buy clothes or objects that are not needed at all. Often these are young women trying to improve their self-esteem and gain recognition.
As a result of this compulsion, those affected spend money in an uncontrolled manner and get into debt. As a result, there is a guilty conscience, anxiety and depression.

In Germany, shopping addiction is not recognized as an independent disease. Those affected are recommended to use behavior therapy or join self-help groups.

Classification of addiction according to ICD-10

In order to be able to diagnose an addiction disorder, at least 3 of the following criteria must be met:

1. Tolerance develops. Tolerance means that a patient always needs more substance over time in order to feel the same positive effect.
   Example: An alcoholic who drank about half a bottle of schnapps at the beginning of his illness in order to induce a state of pleasant intoxication will probably need a whole bottle after a few weeks to feel the same as at the beginning of the illness.
2. Physical withdrawal symptoms. This means that if the substance is not taken, the typical physical symptoms appear, which indicate that the body needs its "poison". Typically, you will see increased sweating, physical restlessness, tremors and insomnia.
3. Substance use with the aim of reducing withdrawal symptoms. This means that in the advanced stage of the disease it can no longer only be about intoxication, but rather that it is often necessary to consume substances in order to get into a "neutral" state at all.
4. Decreased ability to control the beginning, the end and the amount of consumption. Usually you ingest a substance to achieve a certain effect and then stop using it. You drink a certain amount and then you stop. The addiction disorder makes the patient "unstable" or "unstable". You lose control over the start, end and amount of consumption. This is operated as an unlimited matter of course and therefore no longer pursues a real, limited purpose. One takes e.g. before drinking just a single glass of wine with dinner and then drinking a whole bottle.
5. Strong desire to consume certain substances. This mechanism is also known as "craving". This denotes a desire that is so strong that it overlays any good intentions or threatening negative consequences. This type of craving is not associated with withdrawal symptoms.
   Example: An alcohol-dependent patient once mentioned this desire to me: It feels like wandering through the desert for three days and then finding an oasis. No matter how many warning signs there can be. You will drink!
6. Restricted behavior pattern when dealing with psychoreactive substances. This means that e.g. the alcohol or cannabis loses its original purpose in the context of addiction. In the past, they were perhaps seen as a mood-enhancer or simply as part of a successful weekend and socializing. Later, however, they are only used to no longer perceive reality or simply because it has become a habit. It's about being "on top" because life is so hard to bear.
7. Progressive neglect of other amusements or interests. This means that addiction, similar to cancer, grows into the patient's life and determines more and more areas of life.

Example: addiction and neglect

A man who initially only drank at home after work and slowly slipped into addiction is fired for being drunk at work. As a result, anger and sadness lead to a significant increase in alcohol consumption. More and more often he is found drunk at home by friends who actually want to stand by him. In addition, the friends withdraw more and more and since the man is ashamed, he also neglects more and more external contacts. Ultimately, his wife can no longer stand it and leaves him, so that the man gets into complete "social isolation".

8. Persistent substance use despite clear physical and psychological consequences. This point in particular makes the diabolical nature of the addiction disease clear. Most patients know very well what is happening to them. They notice the changes in and in their bodies. They also notice the changes in thought and nature. Addicts do not want these changes, nor do they wish to die. Nevertheless, it is not possible for them to stop.

diagnosis

Addiction is a serious and serious condition. For this reason, the diagnosis should by no means be given lightly. In order to get a professional picture, the diagnosing person must know different areas.
What symptoms does the patient present to him and what symptoms develop in the course of treatment.

Example: alcohol addiction

Some patients who regularly consume large amounts of alcohol do not experience withdrawal symptoms. On the other hand, others who drink significantly less often have symptoms. However, if a patient states that he only drinks 2 bottles of beer with dinner and shows very pronounced withdrawal symptoms, a significantly larger amount can be assumed.

What can the practitioner learn from a diagnostic interview?
On the one hand, it is about getting to know the addiction habits and on the other hand, hearing the patient's story (e.g. what led to the disorder, what keeps the disorder going and what consequences the disorder has had on the patient's life, etc.).

• 1. There are various questionnaires that are typically used in clinical diagnostics. Some examples (of alcohol) are:
  2. MALT - Munich alcoholism test in which a self-assessment clearly distinguishes between alcoholics and non-alcoholics.
  • TAI - Trier Alcoholism Inventory. A self-assessment is used to determine whether there is an alcohol-dependent experience and behavior.
  • BDA - Basel Drugs and Alcohol Questionnaire. This is also a self-assessment questionnaire in which e.g. the severity of both of the above Substance groups are requested

Consequences of addiction

With the mostly unavoidable negative consequences of addiction, one has to distinguish between the physical-psychological and the social consequences.

Almost all organs can be physically affected. The alcohol / alcoholism e.g. leads directly or indirectly to:

• Liver damage or destruction
• Inflammation of the pancreas (pancreatitis)
• Brain damage
• Stomach discomfort or ulcer
• to nerve damage
• to high blood pressure (arterial hypertension)
• increased risk of stroke (apoplexy)
• Varicose veins (varicosis) in the esophagus
• increased risk of cancer
• Etc.

In the case of illegal drugs, infectious diseases (hepatitis, AIDS, etc.) are also increasing.

Drug-dependent patients often also experience a so-called “paradoxical” (ie the opposite) effect. For example, excessive consumption of headache tablets inevitably leads to new headaches. Sleep pill abuse leads to insomnia.

Psychologically, changes can arise, especially depressive states and social loneliness, as direct or indirect consequences. Especially with the addiction to cannabis, especially in adolescents, it has been shown that there can be significant disturbances in the development of one's own emotionality and social development. There is also evidence that cannabis can increase the likelihood of an outbreak of psychosis or schizophrenia, if there is a corresponding predisposition. Cannabis also increases anxiety and panic disorder. The initially calming effect leads to frequent use of cannabis (quasi as an attempt at self-medication), which in the course of anxiety patients leads to a “rebound” effect. This leads to an increased and frequent occurrence of the symptoms that are actually suppressed.

Alcohol / alcoholism e.g. leads in the long term to permanent breakdown processes in the brain, to word finding disorders, to memory loss, disinhibition, loss of logical, planned thinking, etc.
Read more about this under Memory loss.

2 insertions by the author on the supposedly "harmless" cannabis:

1. During my time in the psychiatric hospital, we always treated at least half a dozen 20-year-olds who suffered their first episode of schizophrenia while consuming cannabis. Cannabis is probably not responsible for making someone sick in general, but it is fatal for someone who has the potential to develop schizophrenia. So it can be said that the disease might not have broken out without drug use.
2. In my experience, if someone has had psychosis or even schizophrenia and then consumes cannabis, the probability of a relapse into the disease is between 80-100%, regardless of whether the patient is taking medication or not! This poison is therefore anything but harmless!

What do the secondary diseases mean for the addict?

It means that the sick person has a significantly higher risk of dying than the "normal population". With alcohol the probability is 4x higher, with medication about 2x higher and with hard drugs about 20x higher than with non-addicts.

Smokers are approximately 13 times more likely to develop lung cancer.

The social consequences of an addiction disorder are typically family disputes and the loss of friends and interests.

In principle, dependencies also lead to a significant decline in physical and mental performance, which of course extends to professional activities in the medium term, which can then result in the loss of one's job.

Since addictions / addictions usually cost a lot of money, it can lead to criminal offenses and convictions either in the context of drug-related crime, but also in the context of intoxication.

Dependence / addiction can also lead to a significant reduction in roadworthiness, so that it is not uncommon for a driver to be lost

Read more on the topic: Consequences of drugs

Causes of addiction

1. Every addiction / addiction begins with what is known as “trying”. When certain external and internal factors of a person come together, trying can turn into repeated consumption, i.e. abuse. An ultimate transition between abuse and addiction is fluid.
   Internal factors that favor the development of an addiction:
   The person lacks general skills in dealing with stress, self-doubt, and communicating their own desires and worries.
   There are difficulties with regard to the consumption of a substance to withstand the so-called peer pressure. ("Come on, you Lusche, we can still do one ...")
   There is no critical discussion regarding the short-term and long-term effects of the substance or regarding legality and illegality. ("Forbidden apples are the sweetest ...")
   External factors that favor the development of an addiction:
   The substance is easy to obtain.
   Interesting experiences are made when taking the substance
   Before the next intake, there is the expectation of even more interesting experiences.
   The immediate reference group (friends, club) has a very positive relationship with the substance.
   The reference group can have a manipulative effect on the individual because of its importance in the life of the individual
2. A learning theory hypothesis on the development of abuse and addiction (using the example of alcohol):
   Ingesting certain amounts of alcohol usually does two things at the same time. On the one hand, you experience a state of relaxation and looseness. This is referred to as a positive reinforcement effect ("When I drink, I feel better!"). At the same time, alcohol consumption often leads to the forgetting of bad and unwanted thoughts and emotions. There is an end to negative states (negative reinforcement). So if a person is permanently in such negative states due to his job, his partnership or other life circumstances, he will possibly often use the instrument that can end these states.
   It is now the case that people learn consciously and unconsciously. An individual who consciously uses alcohol to "escape" from certain defined states will at the same time unconsciously learn that stress can basically be successfully combated with alcohol. This can ultimately have the consequence that new stress, which has nothing to do with the initial situation, can be understood as a stimulus to use alcohol, thus laying the foundation for addiction.
3. Physical withdrawal syndromes:
   Another contributing factor to the development of an addiction is the likelihood that a substance will trigger withdrawal symptoms. There are very big differences here. "Crack" (a drug related to heroin) e.g. will trigger severe physical withdrawal symptoms after just one or two ingestion. Since these withdrawal symptoms can make the user very sick, there is of course the need to end this condition as soon as possible. If the drug is taken again, the withdrawal symptoms end immediately, so that a "negative" reinforcement occurs again (the uncomfortable state / pain ceases).
   The probability of how quickly withdrawal symptoms develop with other substances differs from substance to substance and also depends on the physical conditions of the consumer. Cannabis usually does not cause any physical symptoms.
4. Genetics:
   It has long been known that it is often the children of addicts (especially alcohol) who later become dependent on them. Today it is assumed that there is actually a genetic component for this, and that dependence is (at least in part) hereditary. On the one hand, there were studies with twin pairs, but also with children of alcoholic parents who gave up their children for adoption, which the o.g. Theory underlined.
   Nevertheless, the genes are certainly not to be blamed alone.