It is possible to develop a wide variety of addictions, for example alcohol, drugs, gambling, computer games, or food. This article aims to look at the underlying causes of addiction, and how clinicians and researchers understand the phenomenon. Not least, there are tips on treating addiction.

Photo: by Brooklyn Bob of Unsplash


This is something that emerges in a guest post from psychologist Kristian Fjellskaalsnes from Lian & Fjell Psychologist services.

 

Treatment of addiction

Why is it that very few people who receive pain-relieving treatment with morphine, an opiate of high medical quality and closely related heroin, get substance abuse problems after discharge? Everyone over the age of 18 in the country has almost free access to alcohol - why do not all become alcoholics? This article aims to look at the underlying causes of addiction, and how clinicians and researchers understand the phenomenon.

 

  1. Why do some people become addicted? 

  2. What can one become addicted to?

  3. Signs that one is addicted

  4. Test yourself: Are you addicted?

  5. Our treatment of addiction 

 

1. Why do some people become addicted?

Addiction has traditionally been understood very simplistically: Physiological and psychological dependence occurs after repeating an action or taking a substance enough times. The subsequent fear in society of the dangers of for example drugs, gambling and computer games have been a natural consequence. Modern research and understanding of addiction, on the other hand, has nuanced this picture considerably, and made it clear that addiction is far more complex than previously thought.

Previously, addiction has only been seen from a biological / medical perspective, which was based on old traditional studies of rats, where it was seen that rats in cages chose water with morphine for the dead, rather than ordinary water. In the 70s and 80s, this study was challenged by the psychologist Bruce Alexander, through the "Rat park" experiment. Here it became clear that social and psychological factors also played a significant role in the development of addiction.

Among other things, Alexander studied what would happen if the rats were not isolated in a small cage, but were given a large park with many other rats to be with, with the opportunity to participate in a number of rewarding activities. In short, he found that the rats in "Rat Park" largely preferred regular water over water with morphine. The rats isolated in the small cage drank 19 times as much morphine water as the rats in Rat Park.

 

Video explaining addiction 

Source: YouTube, Johann Hari ("everything you think you know about addiction is wrong")

 

If the social and psychological aspects have such a large influence on the addictive behavior of a small mammal, how extensive are they then in humans?

The simple answer is: very much! When we humans are not feeling well psychologically or socially, we tend to be able to resort to a range of coping strategies to deal with it, including intoxication. Taking a drug can effectively alleviate loneliness, anxiety or depression, at least "here and now". The problem is that these are often short-term strategies that have the potential to create even greater problems in the long run.

The research is clear that for example people who have been exposed to difficult relational and emotional events have a significantly increased chance of developing addition problems such as with alcohol, cannabis, heroin and cocaine. On the other hand, depressed, introverted and anxious individuals have an increased chance of becoming addicted to computer games / gaming. Stress is clearly associated with food addiction and overweight / obesity and so on.

 

2. What can you become addicted to?

In our brain, we have an area called the "nucleus accumbens" - which is best known as the reward center. When we do something pleasurable such as having sex, eating tasty food or finishing a workout, amounts of dopamine are secreted in this area, which makes us feel good. Both animals and humans are driven to repeat what gives us pleasureable feelings. The relevant neurons in the nucleus accumbens are highly activated when we take stimulants such as amphetamines and cocaine, when we win money, or by a range of other things that are typically pleasurable for humans.

In addition, many with underlying difficulties will be able to experience secondary effects of intoxication or other addictive activities.

When intoxication or activities are used as a coping strategy through their anxiety and emotion-regulating qualities, the risk of developing a psychological addiction increases.

For example, someone struggling with anxiety will often have a particular effect of anti-anxiety drugs, and may be at risk for alcohol and / or pill addiction. One with chronic pain will experience particular effect and subsequent dependence on opiates. A person with autistic traits and / or social anxiety may be particularly fond of gaming / computer games, where he can regulate social stimuli according to his own preferences. 

In summary, this means that the variety of activities and drugs one can become addicted to is very wide.

Here is an excerpt of what people have historically become addicted to, and what we at Lian & Fjell can work with:

 

  1. Psychoactive / drugs 

    • Cocaine
    • Amphetamine
    • Alcohol
    • Cannabis
    • Caffeine
    • Nicotine
    • Opiates
    • Benzodiazepines
    • Sleeping pills
    • Solvents
  2. Gambling addiction

    • Casino / online casino
    • Card games / poker
    • Odds, betting
  3. Gambling addiction / gaming addiction (recently recognized as a diagnosis in ICD-11)

    • Console
    • Computer
    • Mobile
  4. Food addiction

 

Some may also become addicted in close relationships. This is more of a psychosocial phenomenon versus addiction in the medical sense. One can be "hooked" on one's partner, and be so connected to this person that one loses oneself. For example, you may be convinced that you won't manage anything on your own, and may struggle with low self-esteem and a lot of self-criticism. This can be especially unhealthy in verbally and physically violent relationships.

 

3. Signs that one is addicted

According to the ICD-10 diagnostic manual, dependence should only be set if three of the following criteria are met:

 

  1. Strong desire, or feeling of compulsion, to ingest the substance.

  2. Problems controlling the intake of the substance when it comes to both starting the intake, ending the intake or limiting the amount ingested.

  3. Physiological withdrawal condition that occurs if the use of the substance ceases or decreases, or manifests itself with characteristic withdrawal syndrome for the substance in question, or through the use of the same or related substance to relieve or avoid withdrawal symptoms.

  4. Development of tolerance, so that larger doses are needed to give the same effect as before.

  5. Increasing indifference to other joys and interests. Increasing time spent acquiring the substance, using it, or getting in shape after using it.

  6. The behavior and use continue even if there are obvious signs of harmful consequences.

 

4. Treatment of addiction

Many people who struggle with addiction are used to having negative thoughts about themselves or feeling guilty and ashamed. Many expect to be judged or criticized by others. Threatening with punishment does not seem to help someone who is struggling - on the contrary.

Therefore, it is especially important when going to treatment that you find a therapist you feel safe with and are accepted by, and where you agree on goals and the way to achieve these goals. At Lian & Fjell Psykologtjenester, we are used to considering the use of drugs or other addictions as a coping strategy for something else that is difficult.

Substance abuse is considered by us to be secondary to the underlying difficulties in life, and an essential part of treating addiction is treating these difficulties.

Therefore, no course of treatment looks exactly the same. All individuals have a unique history, and their own reasons why they have become addicted. Therefore, it is important for the psychologists in Lian & Fjell that your treatment plan is sewn together only for you.

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Written by

ove heradstveit

Ove Heradstveit

Psychologist, specialist in clinical community psychology. PhD.
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