Addiction refers to a wide spectrum of complex behaviors that range from patterns of behavior to physical addiction.
The spectrum of behaviors designated as addictive may be described with five interrelated concepts:
People who engage in any of the wide-ranging activities that can be considered addictive tend to have certain attitudes and types of behaviors in common. An addiction is generally associated with relieving anxiety or blocking out other types of uncomfortable feelings. To a greater or lesser extent, people engaged in addictive behavior tend to plan their lives around it, and in extreme cases they will do almost anything to obtain the substance or engage in the behavior. Characteristics of people with addictions include the following:
Alcohol is a frequently abused psychoactive substance. When blood alcohol level reaches 0.1%, individuals are considered to be intoxicated. Judgment and other rational processes are impaired, as well as motor coordination, speech, and vision. Alcohol abuse typically progresses through a series of stages from social drinking to chronic alcoholism, which is also known as alcohol dependence. Danger signs that indicate the probable onset of a drinking problem include the frequent desire to drink, increased alcohol consumption, memory lapses, and morning drinking. Among the most acute reactions to alcohol are four conditions referred to as alcoholic psychosis: alcohol idiosyncratic intoxication (an acute reaction in persons with an abnormally low tolerance for alcohol); alcohol withdrawal delirium (delirium tremens); hallucinations; and Korsakoff's psychosis (an irreversible brain disorder involving severe memory loss).
As of 2013, alcohol abuse and dependence (alcohol use disorders or AUDs) affected 16.6 million American adults (about 7% of the adult population), but only 1.3 million adults received treatment at a specialized facility in that year, according to the 2013 National Survey on Drug Use and Health. Alcoholism is almost twice as common among American men as American women: 10.8 million men (9.4% of adult U.S. males) versus 5.8 million women (4.7% of adult U.S. females).
Alcoholism also affects youths. According to the 2013 National Survey on Drug Use and Health, nearly 700,000 adolescents between 12 and 17 years old (2.8% of this age group) had an AUD. AUDs were more common among female adolescents: 385,000 girls (3.2%) versus 311,000 boys (2.5%).
Other psychoactive substances frequently associated with abuse and dependence are:
While drug abuse and dependence can occur at any age, they are most frequent in adolescence and early adulthood. According to the 2013 National Survey on Drug Use and Health, more than 9% of the U.S. population aged 12 or older had used an illicit drug (including marijuana, cocaine, heroin, various hallucinogens and inhalants, and non-prescribed prescription psychotherapeutics, such as tranquilizers or sedatives) during the month prior to the survey. These numbers, as well as those from 2010 and 2012, are higher than those seen in 2002–2009 and in 2011, which ranged from 7.9% to 8.7%.
There are various causes of substance abuse. Some people are at high risk for dependence due to genetic or physiological factors. Researchers have found the sons of alcoholics to be twice as prone to alcoholism as other people. Nonetheless, the majority of people with alcoholic parents do not become alcoholics themselves, so other factors influence addition. These include psychosocial factors, such as personality dynamics and a variety of environmental stressors (e.g., occupational or marital problems).
Variations in the incidence of alcoholism exist among different ethnic groups, which suggests that social learning plays a role in addiction. Parental modeling of the use of alcohol and other drugs, as well as peer pressure, can be particularly influential on children and adolescents.
Not all addictive behavior involves the use of drugs or alcohol. One such potentially life-threatening type of behavior is compulsive overeating associated with obesity. While obesity is viewed as a physiological condition in some cases, it is commonly linked to a long-standing pattern of overeating and an addictive relationship to food that generally is linked to personality factors in combination with learned responses. Another type of non-drug-related addictive behavior is compulsive gambling. While about half of all persons participate in one or more types of gambling at some point during their lives, compulsive gamblers engage in this activity to the extent that it disrupts their lives psychologically and financially.
The first step in the recovery process is for individuals to admit that they have a problem and seek help. Biological intervention may be necessary, including medication to treat withdrawal symptoms and potential malnutrition. Many kinds of psychological intervention are available and are offered in forms ranging from counseling to inpatient programs. Among the most effective are group therapy; environmental intervention, which deals with negative factors in an addict's social environment; behavior therapy, including aversive conditioning (associating a disagreeable stimulus with the addictive behavior or the addictive substance, such as drugs that induce nausea when the addict imbibes); and 12-step programs based on the approach pioneered by Alcoholics Anonymous (Alcoholics Anonymous’ 12-step program has a religious component).
See also Food addiction .
Kuhar, Michael. The Addicted Brain: Why We Abuse Drugs, Alcohol, and Nicotine. Upper Saddle River, NJ: Pearson Education, 2011.
Kuhn, Cynthia, Scott Swartzwelder, and Wilkie Wilson. Buzzed: The Straight Facts About the Most Used and Abused Drugs from Alcohol to Ecstasy, 4th ed. New York: Norton, 2014.
Maisto, Stephen A., Mark Galizio, and Gerard J. Connors. Drug Use & Abuse, 7th ed. Stamford, CT: Cengage Learning, 2015.
Alcoholics Anonymous. “A.A. Fact File.” http://www.aa.org/assets/en_US/m-24_aafactfile.pdf (accessed August 25, 2015).
Mayo Clinic. “Alcohol Use Disorder.” http://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/basics/definition/con-20020866 (accessed August 25, 2015).
Mayo Clinic. “Drug Addiction.” http://www.mayoclinic.org/diseases-conditions/drug-addiction/basics/definition/con-20020970 (accessed August 25, 2015).
MedlinePlus. “Alcoholism and Alcohol Abuse.” https://www.nlm.nih.gov/medlineplus/alcoholismandalcoholabuse.html (accessed August 25, 2015).
MedlinePlus. “Drug Abuse.” https://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v:project=medlineplus&v:sources=medlineplus-bundle&query= Drug+abuse (accessed August 25, 2015).
National Institute on Drug Abuse. “Drug Facts: Understanding Drug Abuse and Addiction.” http://www.drugabuse.gov/publications/drugfacts/understandingdrug-abuse-addiction (accessed August 25, 2015).
National Institute on Drug Abuse. “Want to Know More? Some FAQs about Marijuana.” http://www.drugabuse.gov/publications/marijuana-facts-parents-need-toknow/want-to-know-more-some-faqs-about-marijuana (accessed August 25, 2015).
National Survey on Drug Use and Health. “Underage Drinking Declined Between 2002 and 2013.” The CBHSQ Report. http://www.samhsa.gov/data/sites/default/files/report_1978/Spotlight-1978.pdf (accessed August 25, 2015).
Alcoholics Anonymous General Services Office, PO Box 459, New York, NY, 10163, (212) 870-3400, http://www.aa.org.
American Addiction Centers, 115 E. Park Dr., 2nd Fl., Brentwood, TN, 37027, (888) 300-3332, http://americanaddictioncenters.org.
National Institute on Alcohol Abuse and Alcoholism, PO Box 10686, Rockville, MD, 20849-0686, (888) 696-4222, http://www.niaaa.nih.gov .
National Institute on Drug Abuse, 6001 Executive Blvd., Rm. 5213, MSC 9561, Bethesda, MD, 20892-9561, (301) 443-1124, http://www.drugabuse.gov .