Questions That This Paper Raises
What is the most efficient way of reducing the social costs of alcohol and drug use: through policy aiming at reducing alcohol and drug use, or through policy targeting the indirect consequences, such as violence, accidents and social marginalization?
What is the relative contribution of gateway drugs, social risk factors and genetic risk in producing addiction?
How does the concept of addiction influence practice in the fields of prevention and treatment?
What is the worldwide influence of drug policy on human rights, democracy, and the living conditions of people, especially the poor?
Can harm reduction policy be integrated with ambitious treatment programmes?
Similarities And Differences Between Dsm
The criteria are summarized in . DSM-IV has more optional criteria for both dependence and abuse than ICD-10. In the DSM-IV, 3 of 7 criteria are needed, whereas in the ICD-10, 3 of 5 criteria are needed, including the obligatory criterion of use or desire to use. Therefore, the DSM-IV diagnosis is less restrictive, resulting in higher prevalences for DSM vs. ICD in studies where both set of criteria have been applied to the same populations . The milder abuse/harmful use diagnoses have no overlapping criteria, and are clearly not the same thing. Therefore, agreement between the two dependence diagnoses is generally better than between the harmful use and abuse diagnoses .
The Requirements Of A Successful Theory Of Addiction
A successful addiction model must synthesize pharmacological, experiential, cultural, situational, and personality components in a fluid and seamless description of addictive motivation. It must account for why a drug is more addictive in one society than another, addictive for one individual and not another, and addictive for the same individual at one time and not another . The model must make sense out of the essentially similar behavior that takes place with all compulsive involvements. In addition, the model must adequately describe the cycle of increasing yet dysfunctional reliance on an involvement until the involvement overwhelms other reinforcements available to the individual.
Finally, in assaying these already formidable tasks, a satisfactory model must be faithful to lived human experience. Psychodynamic theories of addiction are strongest in their rich explorations of the internal, experiential space of their subject matter. Likewise, disease theorieswhile seriously misrepresenting the nature and constancy of addictive behavior and feelingsare based on actual human experiences that must be explained. This last requirement may seem the most difficult of all. One may wonder whether models built on social-psychological and experiential dynamics make any sense when confronted with the behavior of laboratory animals or newly born infants.
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Alcoholism Short & Long
Short- and long-term physical effects associated with alcohol addiction can include:10
- Heart problems like cardiomyopathy , arrhythmias , high blood pressure, and stroke.
- Liver disease, including steatosis , alcoholic hepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.
- Pancreatic problems like pancreatitis, an acutely painful inflammatory condition that can progress to a chronic disease. Pancreatitis can affect a range of pancreatic functions, including the normal release of digestive enzymes.
- Certain types of cancer, including head and neck cancer, esophageal cancer, liver cancer, breast cancer, and colorectal cancer.
- A weakened immune system, which can increase your risk of infection and contraction of diseases like pneumonia and tuberculosis.
Potential short- and long-term psychological and cognitive effects associated with alcoholism include:10, 11
- Cognitive problems, such as memory loss or problems thinking clearly.
- Blackouts .
- Serious brain damage and disorders like WernickeKorsakoff Syndrome, which leads to confusion, impaired optic nerve function, profound movement deficits, and problems with memory recall and consolidation.
- Mood disorders, like major depressive disorder or bipolar disorder.
- Anxiety disorders, especially panic disorder and social phobia.
The short- and long-term social impact of alcoholism can include:2, 13
- Bluish skin color.
Risk Factors For Excessive Alcohol Use And Alcoholism
There are both short-term and long-term health risks for excessive alcohol use and alcoholism.
Short-Term Health Risks
Excessive alcohol use has immediate effects that can be dangerous and harmful to the user. They are most often the result of binge drinking.
Short-term side effects and symptoms of alcohol abuse include:
- Injuries, including vehicle crashes, falls, drownings, and burns
- Violence, including homicide, sexual assault, partner violence, and suicide
- Alcohol poisoning
- Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can potentially lead to unintended pregnancy or sexually transmitted diseases
- Miscarriage, stillbirth, or fetal alcohol spectrum disorders in pregnant women
- Memory loss or blackouts
- A hangover
Long-Term Health Risks
With time, excessive drinking can lead to the development of chronic diseases and other serious health issues.
Long-term side effects and symptoms of alcohol abuse include:
- High blood pressure
- Mental health disorders, including depression and anxiety
- Learning and memory issues, including dementia and poor school and work performance
- Social issues, including lost productivity, family problems, and unemployment
What is the definition of being an alcoholic?
An alcoholic is a person who has a psychological and physical dependence on alcohol. Alcoholism is a severe mental disorder. It often prevents those experiencing it from stopping drinking, despite potential or actual negative causes.
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Other Signs Of Sex Addiction
Because its not a formal diagnosis, signs of sex addiction are not established.
On the other hand, not everyone living with compulsive sexual behavior will experience the exact same symptoms or with the same intensity. In fact, signs can take many forms depending on the unique circumstances of your case.
Some potential signs of compulsive sexual behavior include persistent and uncontrollable activities like:
- watching pornography
- engaging in sexual activities that put your safety at risk
- neglecting other aspects of your life to prioritize sexual activities
For example, you may have intense urges to watch pornography all the time. You may skip work or school to stay home to watch porn.
You might even lock yourself in the office bathroom to watch it on your phone. This, in turn, can lead to problems with your productivity and professional relationships.
You may be aware of this problem and it may cause you an intense deal of distress. Despite this, you find yourself unable to stop watching porn.
This might be a sign of a compulsive sexual behavior or out of control sexual behavior.
That said, you may enjoy watching porn frequently, but you know when to stop, and you do it at will whenever you need to attend to other businesses.
In this case, watching porn is likely not a sign of sex addiction. Youre able to stop yourself from doing it when needed, and the activity is not a cause of distress in your life.
When To Contact A Doctor
Anyone using substances, even socially, should discuss them with a doctor to ensure safe use and monitor for signs or symptoms of addiction.
However, a person with addiction may not be ready or willing to seek professional medical help, regardless of the negative impacts it is having on their health and wellness.
If a person experiences a substance overdose, those around them should seek emergency medical assistance immediately. A person who has recovered from an overdose may want to seek professional help to treat their addiction.
When a person is ready and wants help with their addiction, they may wish to contact a medical professional to discuss options for treatment. These options include rehab, therapy, detox, and medication.
Medicinal advances and progress in diagnosis have helped the medical community develop various ways to manage and resolve addiction.
Some methods include:
- medical devices to treat withdrawal
- treating related psychological factors, such as depression
- ongoing care to reduce the risk of relapse
Addiction treatment is highly personalized and often requires the support of the individuals community or family.
Treatment can take a long time and may be complicated. Addiction is a chronic condition with a range of psychological and physical effects. Each substance or behavior may require different management techniques.
A person with addiction can find many organizations that may help them. A person can also call a hotline for help with their addiction.
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Addictions Vs Substance Use Disorders
The term addiction is used to describe compulsive drug-seeking behaviors that continue in spite of negative outcomes, but it is important to note that addiction is not considered an official diagnosis in the DSM-5.
Rather than using the term “addiction,” the DSM-5 classifies substance use disorders. While the diagnostic criteria vary for each type, the DSM-5 describes these disorders as a problematic pattern of use of intoxicating substances that leads to significant impairment and distress. These symptoms can result in impaired control, social impairment, risky use, and tolerance/withdrawal.
While these conditions might be informally referred to as addictions, your doctor will officially diagnose you with some form of substance use disorder or one of the two behavioral addiction disorders that are officially recognized by the American Psychiatric Association .
Who Should Not Drink Alcohol
For most people, having an occasional alcoholic drink doesnt usually cause any harm. However, in specific situations and among certain groups, alcohol should be avoided. These include:
- Pregnant and breastfeeding women: Theres no safe level of alcohol use for lactating women and those who are pregnant. Alcohol use during pregnancy increases the danger of miscarriage, congenital disabilities, and cognitive and developmental issues.
- People with medical conditions: This group may also need to watch their drinking or abstain from it completely. Alcohol may worsen pre-existing health issues, including liver disease, diabetes, and kidney disease.
- People taking over-the-counter and prescription medications: Alcohol can also negatively interact with certain medications. These medicines can include antidepressants, antibiotics, and opioids.
- People under 21 years of age: Underage drinking is also associated with adverse consequences. This is especially true when associated with heavy and binge drinking. Current and recovering alcoholics should also abstain from drinking. They should avoid their triggers for alcohol abuse.
- People who plan to drive, operate machinery, or participate in activities that require alertness and coordination.
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The 5th Edition Of The Diagnostic And Statistical Manual
As compared to DSM-IV, the DSM-5s chapter on addictions was changed from Substance-Related Disorders to Substance-Related and Addictive Disorders to reflect developing understandings regarding addictions. The DSM-5 specifically lists nine types of substance addictions within this category . These disorders are presented in separate sections, but they are not fully distinct because all drugs taken in excess activate the brains reward circuitry, and their co-occurrence is common.
In summary, DSM-5 concluded that of existing disorders, only gambling had enough in common with substance addictions to justify its inclusion with those other disorders. In addition, other disorders that have garnered much research attention around the world problematic Internet use, compulsive sexual behavior were deemed to have insufficient evidence for their inclusion as a disorder regardless of category.
If You Think You Might Have An Addiction
It is common, if not normal, to go through a stage of engaging in substance use or an addictive behavior without believing you are addicted. This is so common, in fact, that it has a name, the pre-contemplation stage.
If you are starting to think you might have an addiction, you have probably moved into the contemplation stage. This is a great time to find out more about the substance or behavior that you have been engaging in and to reflect honestly on whether you are experiencing any signs or symptoms of addiction.
Many people then decide to make changes. For some people, this is easy and manageable. For many others, quitting can lead to unpleasant withdrawal symptoms, even with behaviors, and can open up uncomfortable feelings that were being soothed or suppressed by the addictive behavior.
If this happens, or if you have been drinking or using drugs, such as opioidsillicit or prescribed, other prescription medications, stimulants, cocaine, or methyou should seek medical help immediately.
Stopping some drugs then relapsing can heighten your risk of overdose, mental health problems, or other life-threatening medical complications, and should be done under medical supervision.
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The Other Side Of The Addiction Concept
Putting a theme on the agenda is not the same as successfully resolving the problem. The addiction concept can be used for other purposes than simple awareness raising. For instance, patients may use the addiction concept to distance their own use of a substance from others use, and therefore in fact make light of their use.
Symptoms Of Drug Addiction
People who have developed an addiction to drugs or alcohol tend to be affected by tolerance to the substance. Tolerance occurs when a person is no longer affected by the same amount of a drug and needs to take more of it to feel the same effects. Tolerance is one of the major signs of addiction, as is physical dependence. Other signs include:
- When a person feels that he or she needs to use the drug on a regular basis, whether daily or several times throughout the day
- Experiencing strong urges to use a drug
- Maintaining a steady supply of the drug
- Falling short in school or work responsibilities due to substance abuse
- Engaging in risky behavior to obtain the drug
- Wanting to stop using the drug, but being unable to successfully quit
- Undergoing withdrawal when a person tries to quit
When trying to recognize drug addiction symptoms in those around you, behavioral changes may be the biggest clue. For example, people who are newly affected by drug addiction may begin falling behind in school or work performance, or may no longer have interest in activities they used to love.
They may also no longer pay much attention to their appearance, or may neglect their health. People with developing addictions may also become secretive in an effort to hide their addictions, especially if they are not ready to face their disorder yet.
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What Is Sex Addiction
If you have difficulty breaking free of intrusive and repetitive sexual urges and thoughts, you might be living with what some people refer to as sex addiction.
Compulsive sexual behavior disorder or hypersexuality is commonly referred to as sex addiction. However, sex addiction as a condition is not formally accepted by all members of the medical community.
Though a diagnosis of sex addiction does not formally exist, compulsive sexual behavior can result in significant emotional pain and other devastating consequences.
Many people may ask, Is sex addiction a real thing?
In reality, compulsive sexual behavior goes beyond desire, and its a challenging reality for many people who live with it.
In fact, approximately 3% to 6% of the general population experiences symptoms of compulsive sexual behavior.
CSBD involves a variety of complex and intense unwanted sexual behaviors and fantasies that, at times, may become harmful to you and others.
The condition can be managed, though. It might require seeking the help of a health professional and committing to long-term treatment.
How Is Sex Addiction Diagnosed
Compulsive sexual behavior, hypersexuality, and out of control sexual behavior can all be diagnosed by a psychiatrist or a psychologist, among other mental health professionals.
To reach a diagnosis, these professionals will talk with you about your personal and medical history, your concerns and challenges, and some of your behaviors and thoughts.
They will then compare the information gathered to the criteria set by diagnostic manuals or literature.
Obtaining a sex addiction diagnosis isnt always a straightforward process. Youll have to be willing to honestly share your sexual fantasies, urges, and behaviors with a mental health professional.
This level of candid conversation might be challenging for some people. To address this challenge, tests have been developed to ease you through the process.
The Sexual Addiction Screening Test might be one of the most common tools. Developed by Patrick Carnes, PhD, noted addiction recovery therapist, the 25-item, self-reported questionnaire helps assess your behaviors and thoughts.
The test has been modified and updated to reflect modern internet influences, such as pornography use.
Your health team might also want to rule out other conditions that may lead to hypersexuality.
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Theories Of Addiction A Detailed Analysis
In many cases, addiction theorists have now progressed beyond stereotyped disease conceptions of alcoholism or the idea that narcotics are inherently addictive to anyone who uses them.
The two major areas of addiction theorythose concerning alcohol and narcoticshave had a chance to merge, along with theorizing about overeating, smoking, and even running and interpersonal addictions.
Yet this new theoretical synthesis is less than meets the eye: It mainly recycles discredited notions while including piecemeal modifications that make the theories marginally more realistic in their descriptions of addictive behavior.
These theories are described and evaluated in this section as they apply to all kinds of addictions. They are organized into sections on genetic theories , metabolic theories , conditioning theories , and adaptation theories .
While most addiction theorizing has been too unidimensional and mechanistic to begin to account for addictive behavior, adaptation theories have typically had a different limitation.
They do often correctly focus on the way in which the addicts experience of a drugs effects fits into the persons psychological and environmental ecology. In this way drugs are seen as a way to cope, however dysfunctionally, with personal and social needs and changing situational demands. Yet these adaptation models, while pointing in the right direction, fail because they do not directly explain the pharmacological role the substance plays in addiction.
Can Addiction Be Treated Successfully
Yes. Addiction is a treatable, chronic disorder that can be managed successfully. Research shows that combining behavioral therapy with medications, if available, is the best way to ensure success for most patients. The combination of medications and behavioral interventions to treat a substance use disorder is known as medication-assisted treatment. Treatment approaches must be tailored to address each patients drug use patterns and drug-related medical, psychiatric, environmental, and social problems.
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