A non-addict can understand addiction
Dependence and addiction are an obsessive need and dependency on a certain substance, a distinction being made between psychological and physical dependence.
- psychological addiction
overwhelming and irresistible desire to take a certain substance again
- physical addiction
is characterized by an increase in dose and the occurrence of withdrawal symptoms
Numerous different "drugs" are addictive, with alcohol addiction ranking first in our latitudes. This is followed by psychotropic drugs such as barbiturates, opiates (heroin, methadone, opium), cocaine, cannabis / marijuana, hallucinogens (e.g. LSD), amphetamines (e.g. speed), organic solvents (sniffing) and modern designer drugs (e.g. ecstasy).
The pleasant effects such as euphoria, happiness, reduction of inhibitions, increased performance and hallucinations are followed by side effects such as vegetative symptoms, e.g. sleep disorders, organ damage and infections (e.g. HIV and hepatitis), symptoms of intoxication and social slippage.
Today, dependency is one of the greatest social and health problems of our time. On the one hand, reduced work performance, accidents, etc. result in high direct and indirect costs, on the other hand, dependency also has serious consequences in the social environment. Around half of all crimes are committed under the influence of alcohol; The families of those affected also suffer from the consequences of addiction.
Depending on the type of substance, a distinction is made between alcohol, medication and drug addiction.
Basics & causes
Dependent behavior is characterized by a vicious circle: the consumption of alcohol, drugs or medication appears to improve an unsatisfactory and unbearable situation. If the effect of the substance diminishes, however, it literally leads to a "disillusionment" because the person has to realize that their situation has not really changed. Often it seems even more unbearable, so that the person now "needs" the substance to escape the situation.
The interaction of various factors is assumed for the emergence and development of a dependency.
- The drug
Whether a dependency develops depends on, among other things. on certain characteristics of the substance. On the one hand, it is crucial how readily available a particular substance is. The fact that alcohol addicts make up the majority of addicts may be due, at least in part, to the fact that alcohol is very easy to obtain. As the discussion about the legalization of so-called "soft" drugs shows, on the other hand, the "attraction of the forbidden" seems to be particularly great when a substance is difficult to obtain. In addition, the effect of the respective substance plays an important role. For example, alcohol consumption leads to disinhibition and relieves fears. In the case of drug addiction, the analgesic or calming effect is in the foreground, at least at the beginning. Another influential characteristic of the substance is its addictive potential, that is, how easily it leads to psychological or physical dependence. However, the potential for dependency should not be regarded as a fixed value. Although some substances lead to dependency more quickly than others, other factors, such as the personality of the user, play a decisive role. The tolerance for the respective substance also varies from person to person.
- The individual
On the part of the individual, the following factors are related to addiction:
Self-insecurity and complexities, enjoyment of the forbidden and risk, boredom, susceptibility to influence, suppression of problems, increased performance, contact disorders and the urge to gain recognition. In combination with the effects of the drug, these factors lead to the fact that addiction is practically learned. Using the example of alcohol consumption, this means, for example: A rather insecure and fearful person experiences that under the influence of alcohol they are much more relaxed and come into contact with others more easily. She learns that alcohol is an (apparent) help and solution to problems. It could also be shown that people who have difficulty dealing with frustrations and who have not developed appropriate strategies to deal with conflicts have an increased risk of addiction. Genetic factors also seem to be involved, e.g. the identical twin of an addict is often also dependent. With regard to drug addiction, there is a presumption that there is some kind of "reward system" in the brain; the memories associated with the first drug use seem to be a trigger for the next drug use.
- Situation and social environment
The environment influences the development of addiction at various levels. In our society, for example, alcohol consumption is not only tolerated, it is almost part of everyday life. In certain groups (e.g. clubs) there are fixed drinking rituals, abstinence is laughed at, and drinkability is praised. In other circles, cocaine, for example, is considered chic. Ideological factors also play a role.
On family level Children often learn from their parents about the inappropriate consumption of alcohol. They experience that alcohol is part of their leisure time and is also used to solve problems, and they often adopt this behavior later. Often it is children from families with dysfunctional relationships who become dependent. The influence of peers is also great.
Drug abuse is often based on physical complaints and psychosomatic disorders (e.g. fear, restlessness, depression). These complaints often arise from working and living conditions such as time pressure, emotional stress and isolation, which lead to conflicts and tensions. Medication of one's own choosing or medication prescribed by a doctor is then taken against the symptoms, but these do not help against the actual causes of the symptoms.
So it is a combination of different risk factors that make addiction likely to develop. This also becomes clear when one considers why certain professions, such as B. Pilots are considered to be at risk professions for addiction. On the one hand, the availability of alcohol in this area, e.g. in duty-free, is very high. In addition, the job is associated with great responsibility and tension. In addition, the family situation is problematic due to the frequent separations. When staying in a foreign city, social contacts are usually limited to meetings with colleagues in hotel bars and pubs.
Dependence manifests itself through diverse physical and mental disorders. On the psychological side, loss of interest, mood swings, indifference, anxious restlessness, tension, etc. can often be observed. Physical symptoms include: Sweating, nausea, weight loss, insomnia, neurological failures. Typical symptoms are symptoms of intoxication up to coma and withdrawal syndrome, often with seizures. There are characteristic behaviors such as glossing over, denying and concealing tendencies. Dependency also often has social implications, such as crime or career decline. The risk of suicide is high for addicts.
Depending on the substance, a distinction is made between the following sub-types:
- Morphine / opiate type
These include opium, heroin, methadone, and some powerful pain relievers. This substance class has the highest potential for dependency among drugs; psychological as well as physical dependence arises with rapid increase in dose. In the case of abuse, euphoria, remoteness and mood swings dominate the picture. Coma and difficulty breathing appear as signs of poisoning. Typical withdrawal symptoms are restlessness, runny nose, goose bumps, muscle pain, stomach cramps and insomnia. These symptoms start about 6-12 hours after the last dose and peak after 24-48 hours. They subside within 10 days.
- Barbiturate / alcohol type
These substances include sleeping pills (barbiturates), sedatives, and alcohol. There is a considerable potential for addiction to barbiturates, and they are also used relatively often in suicide attempts. After ingestion, calmness, mood swings, memory lapses, euphoria and also depressive moods set in. Weakness, nausea, and nightmares develop after stopping. If the drug is suddenly stopped after long-term use of high doses, it can lead to confusion with anxious restlessness and seizures.
With the alcohol addicts you can different types of dependencies distinguish. The most significant forms are the addict and habitual drinker. In the addicted drinker, psychological and later physical dependence develops. The dose increases and there is a loss of control over alcohol consumption, but the ability to abstinence is temporary (mostly due to external pressure). The habit drinker is physically dependent and incapable of abstinence. It is characterized by low-noise alcohol consumption throughout the day and tries to keep the alcohol level constant in order to avoid withdrawal symptoms. Mental symptoms the alcohol addiction are often depressive mood, feelings of guilt, decreased performance. Thinking revolves around alcohol, more and more people are drinking secretly and already in the morning. Acute symptoms of intoxication range from a heightened sense of achievement, euphoria and slower reactions to changes in muscle movement and visual disturbances to the possibility of turning into a depressive mood and transition to a narcotic state. Delirium occurs as a withdrawal symptom, which is characterized by insomnia, fear, restlessness, visual hallucination, tremors. However, it can also lead to death from cardiovascular failure. Severe nerve and brain damage are possible as sequelae of alcoholism.
- Cocaine type
The most common are cocaine and crack. There is a strong psychological but not a physical dependence. The acute cocaine effect manifests itself in a "kick" with a euphoric feeling of happiness, reduction of inhibitions and reduced hunger, thirst and sleep feeling. The subsequent intoxication stage, in which hallucinations come to the fore, is followed by a depressive stage with anxiety and depression. The desire to take it again sets in to end this negative state. Chronic cocaine consumption often leads to impotence / erectile dysfunction, palpitations, increased hallucinations and paranoia. Withdrawal sets in a depressed mood. The consequences of crack consumption can be very serious, e.g. irreparable cardiovascular damage occurs, which can lead to death.
- Cannabis / marijuana type
A psychological, but not a physical, dependency develops with only a slight tendency to increase the dose. There is no characteristic withdrawal syndrome. Cannabis consumption can lead to euphoria, memory disorders, hallucinations, sensitive hearing, restlessness and a racing heart. Acute fear reactions occur relatively frequently, and there can also be after-intoxication without taking the drug. Chronic cannabis use can result in apathy and passivity.
- Amphetamine type
These synthetically produced, stimulating substances are taken to increase drive and performance (doping) and as an appetite suppressant. This also includes the fully synthetic drug ecstasy, which is produced in a laboratory. A psychological, but not a physical, dependency arises. There is no typical withdrawal syndrome. Psychological symptoms are restlessness, disinhibition, euphoria, and the feeling of being followed can also occur. Physical effects are appetite suppression and an increase in blood pressure.
- Hallucinogen type
There is strong psychological dependence here with a tendency to rapidly increase the dose, but no physical dependence develops. The substances are partly synthetic, partly vegetable (mushrooms, cacti) of origin. The state of intoxication is characterized by intensification of feelings, visual hallucinations as well as changes in body feeling and space-time experience. Acute fear reactions and after-intoxication are also relatively common. Physical symptoms include increases in heart rate and blood pressure, and possibly nausea.
- Sniffing addiction (organic solvents)
Here, a state of intoxication is induced by inhaling glue, solvents or paints. There is psychological, but not physical, dependence. After a brief state of excitement with irritation of the upper respiratory tract, a dream state with clouding of consciousness occurs. In addition to euphoria, acute intoxication leads to disorientation and visual hallucinations. The physical consequences are cardiac arrhythmias, nerve damage, liver and kidney damage and damage to the airways.
This designation means a multiple dependency. Many drug addicts also consume alcohol and medication as substitutes for withdrawal symptoms. This makes the withdrawal treatment much more difficult.
Relatives are not only co-affected, but they are often themselves dependent in coexistence with addicts.
If one speaks of addiction or drug addiction in public, the addicts are usually the focus of the discussion. It is mostly overlooked that for the relatives their life is also associated with a lot of suffering and problems. This seems all the more curious if you look at the corresponding numbers. Here it is above all the alcoholics who often involve their families in their addiction over the years.
In most cases, it is the women and their children who want to cover up an addiction in their husbands. Instead of taking consistent steps to move the addict to a possible reaction away from the addiction, they carry the situation with them - out of feelings of guilt, shame towards the neighbors, fears of a changed, perhaps lonely future.
Another peculiarity of this problematic situation is the codependence of many relatives. The partner's addiction becomes the only purpose in life. Your own feelings are completely in the background. One of the characteristics of this codependency is that couples often separate according to the way out of the addiction. Relatives of addicts need as well psychological care like the addicts themselves.
General treatment goals are the maturation and stabilization of the personality and the rehabilitation and reintegration of the addict. Decisive elements are the motivation of the addict and measures to prevent relapses.
The treatment is divided into:
- Contact and motivation phase
This is where addicts get their first contact with aid measures, whereby their own motivation is important. Often, basic diagnostic investigations take place here. Affected people are informed about the consequences of addiction and ways out of the addiction are conveyed and offered.
- Detox phase (physical withdrawal)
Inpatient / outpatient detoxification can be used, but this depends on the type of addictive substance, the expected withdrawal symptoms and the social environment. In addition, intensive treatment of the accompanying mental illnesses and psychological treatment takes place in this phase.
- Weaning treatment
Here the psychological treatment, with models from family therapy, behavior therapy as well as self-confidence training, relaxation training is used.
- Follow-up and rehabilitation phase and relapse prevention
This is where it is decided whether weaning was successful and whether it can be permanent. Psychological support can provide help. This involvement is very important. It is precisely at this stage of weaning that the person affected must not be left alone. Relapse prevention is an important part of the aftercare phase. Preventive measures against relapse include self-confidence training and personality strengthening and measures to avoid contact with addictive substances. In addition, techniques should be taught to endure critical situations without having to resort to addictive substances.
This phase model should have an orientational character. Aid measures and therapy should always be based on the motives and the individual circumstances. Nobody can be successfully treated against their will.
- Individual psychological treatment
- Psychological group treatment
- Couple and family conversations
- Relaxation training (muscle relaxation according to Jacobsen)
Questions about "Dependency & Addiction"?
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