Addictive Disorders and Dependence

By: Maria Trimarchi

Addictions and dependency problems don't stop with alcohol and illicit drugs.
Addictions and dependency problems don't stop with alcohol and illicit drugs.
Joe Raedle/Getty Images

Substance abuse, dependency and other addictive behaviors affect the lives of millions of Americans. According to the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Survey on Drug Use and Health: National Findings, an estimated 22.3 million Americans ages 12 and older suffered from a substance abuse problem in 2007 -- 15.5 million of whom abused alcohol alone, while 3.7 million abused other illicit drugs.

Addictions and dependency problems don't stop with alcohol and illicit drugs, though. Seventeen million Americans, for example, are estimated to be compulsive shoppers. Types of addictive and related disorders, including behavioral addictions, may involve:

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  • Sex
  • Gambling
  • Shopping
  • Work
  • Overeating
  • Exercise
  • Internet use
  • Drug use
  • Alcohol use

Addiction and dependency are different illnesses and manifest in different ways.

According to the American Society of Addiction Medicine, the American Pain Society and the American Academy of Pain Medicine, development of addiction or addictive disorder is caused by a combination of exposure to a substance or activity that gives us pleasure and a genetic vulnerability that controls our drive to have more. Addiction is rooted in our genetics, our psychological development, social maturation and environmental factors that lead to excessive and prolonged usage, tolerance (and the need for more) and withdrawal (including anger, tension and depression) despite negative consequences of the behavior. For example, a compulsive gambler feels an overwhelming urge to gamble, is thinking about gambling when not engaging in it, may lie about how much time and money is spent on gambling, feels guilty about the time and money spent gambling but does not (and cannot) quit.

Dependence, specifically physical dependence, happens when a person becomes tolerant to a substance or has symptoms of withdrawal when he or she suddenly ceases taking that substance -- be it an illicit drug or a prescribed medication. Addiction by comparison does not always include physical dependence.

Learn about the signs and symptoms of addiction on the next page.

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Signs, Symptoms and Therapies

Signs & Symptoms

An individual may have an addictive disorder if there are signs of:

  • Chronic, daily use of a substance, such as alcohol, or compulsion to act on a behavior, such as shopping or exercise
  • Excessive spending
  • Neglect of daily responsibilities
  • Deterioration of relationships
  • Loss of control
  • Failed attempts to stop abusing a substance or engaging in the recurrent behavior
  • Withdrawal symptoms (including sweating, trembling, raised blood pressure)

Signs of physical dependency may include:

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  • Tolerance of dosage and the increased desire for more
  • Withdrawal symptoms upon suddenly stopping a medication or drug

For more information, visit Mental Health America's factsheet about substance abuse:

http://www.mentalhealthamerica.net/go/substance-abuse

Therapies

Treatment plans for addictive disorders and substance abuse are tailored to an individual's needs and the intensity of the impulse.

Therapies may include:

  • One-on-one psychotherapy, including behavioral therapy
  • Family therapy
  • Group therapy including 12-step recovery programs
  • Drug therapy
  • Diet and nutritional modifications
  • Relaxation techniques, such as meditation, guided imagery or yoga
  • Detox, in-patient or out-patient hospitalization

Additionally, a study published in the Journal of Neuroscience finds that targeting dopamine (a feel-good chemical) production in the brain -- specifically decreasing it -- may help treat addiction.

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