Addiction/Addictive Personality

Addiction refers to a wide spectrum of complex behaviors that range from patterns of behavior to physical addiction.




Drug addicted homeless man preparing heroin





Drug addicted homeless man preparing heroin
(© Logan Fuller Photography/Alamy)

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).

RAT PARK STUDIES




Experimental psychologist B. Frederic Skinner at Harvard University training brown rat in Skinner Box to press lever and be rewarded with food, January 1964.





Experimental psychologist B. Frederic Skinner at Harvard University training brown rat in Skinner Box to press lever and be rewarded with food, January 1964.
(© Nina Leen/ Getty Images)

The Rat Park study was an experiment conducted by Canadian psychologist Bruce K. Alexander to study the nature of drug addiction. The debate surrounding drug addiction continues, however the Rat Park experiment provided interesting data regarding the effects of isolation versus social life on addictive behaviors and tendencies.

As an experimental psychologist in the 1960s and 1970s, Alexander worked with rats living in so-called Skinner boxes being used in behavioral experiments popularized by the work of B.F. Skinner. He observed that the rats in these boxes got no exercise, could not see nor touch one another, and that their only visual stimulation was seeing the researchers who fed and cleaned them. They were often subjected to punishments such as electric shocks and starvation. Alexander believed that this treatment was analogous to psychological torture and solitary confinement in humans, so naturally the results of experiments on these rats would not give a complete, natural, or contextual picture of normal rat behavior.

In the 1960s, similar behavioral studies were performed on rats in order to test theories about drug addiction in humans. Researchers soughtto create the effects of craving, tolerance, and withdrawal. Rats in Skinner boxes were given access to drugs by pressing a lever. These rats would generally consume large amounts of heroin, morphine, amphetamines, cocaine, and other drugs, sometimes even administering the drugs to the point of death. Researchers deduced from this that drugs were irresistibly addicting not only to rats but to humans as well. However Alexander believed that the results said more about the effects of confinement and restraint than the effects of addiction.

He believed the problem of drug addiction to be less a chemical and more of a cultural phenomenon. He thought it unsurprising that a creature in solitary confinement would continually take advantage of the opportunity for mind-numbing drugs. Applying this to humans who become addicted to drugs he wrote, “People do not have to be put into cages to become addicted–but is there a sense in which people who become addicted actually feel ‘caged’?” Alexander also emphasized the importance of race, class, and other more nuanced aspects of culture, rather than a purely biological basis when it comes to understanding drug addiction.

In order to test his ideas, Alexander and colleagues designed a large area for the rats to live in, filling it with cedar shavings, tin cans for hiding, exercise wheels, and platforms for climbing. They called it “Rat Park.” Both male and female rats were put into the park, and soon reproduced copiously. The rats in Rat Park were referred to as “social males” and “social females.”

Alexander and colleagues then ran a series of studies to test drug consumption in the rats of Rat Park, as compared to those in Skinner boxes (whom they referred to as “caged males” and “caged females” ). In all of the experiments they found that the caged rats consumed a great deal more of the drug solution than the social rats–up to 16 times more.

They wrote up their findings in a paper entitled “The effect of housing and gender on morphine self-administration in rats,” however the major science journals, Science and Nature, rejected the reportand it did not receive wide attention in the field of addiction research. It was published in the smaller journal Psychopharmacology in 1978.

The Rat Park experiment would be very difficult or impossible to replicate in humans without treating the subjects inhumanely or unethically. Alexander and colleagues attempted such an experiment with humans in a simulated prison situation, but of course could not give the subjects drugs, rather interviewing them and asking hypothetical questions. They found the results to be inconclusive.

The debate surrounding the mechanism and cause of drug addiction continues, but the Rat Park studies raise important questions regarding the relationship between addiction and environment, culture, and quality of life.

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.

KEY TERMS

Alcohol idiosyncratic intoxication—
A type of alcohol psychosis, an acute reaction in persons with an abnormally low tolerance for alcohol.
Alcohol withdrawal delirium—
Also known as delirium tremens or “the shakes,” a psychotic condition characterized by uncontrolled shaking, anxiety, disorientation, and sometimes hallucinations.
Codependency—
A dysfunctional relationship between two or more people in which one person supports, facilitates, or allows another's unproductive or unhealthy behavior or activities, such as drug or alcohol addition.
Compulsions—
Behaviors that originate for the purpose of relieving anxiety.
Environmental intervention—
In addiction therapy, intervention that focuses on negative factors in an addict's social environment.
Impulse-control disorders—
Disorders, such as overeating, that constitute a specific type of compulsive behavior that provides short-term gratification but is harmful in the long run.
Korsakoff's psychosis—
A type of alcohol psychosis, an irreversible brain disorder involving severe memory loss.
Physical addiction—
Addiction thatinvolves dependence on a habit-forming substance characterized by tolerance and well-defined physiological withdrawal symptoms.

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 .

Resources

BOOKS

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.

WEBSITES

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).

ORGANIZATIONS

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 .