Medicine woke up to the reality and the existence of addiction sometime in the 19th century, when it became clear that there was a downside to injecting patients with copious amounts of morphine, and the downside was not just the potential of an overdose.
The history of opium, alcohol, and hallucinogens is long and extremely detailed. We discovered beer and liquor as far back as the days of ancient Egypt, and even further back in the days of ancient China (about 9,000 years ago). However, it was not until the 19th century that we began to scientifically question drunkenness, and research the topic from a perspective of Western empirical science. In that time, physicians discovered that getting patients hooked on alcohol and morphine meant that they would develop a tolerance, and eventually go into withdrawal without more drugs.
Addiction went from being a physiological phenomenon to being a psychological phenomenon, and to the masses, it remained a matter of moral failure, synonymized with sin. Even today addiction carries with it the guilt and stigma of being an addict in a society where drug use is considered a sign of failure, of desperation, and of a broken will. It is not a medical issue as much as it is an issue of character to many, and therein lies a huge problem.
Yet even if we address addiction from a medical point of view, looking simply at the physical aspects of addiction – the effects of tolerance and withdrawal that we recorded so long ago – would not be enough to truly encapsulate what addiction is. In the debate between physical and emotional, the answer is that addiction is a bit of both and that every patient comes with a different answer.
Defining Addiction
Addiction is a condition wherein someone suffers from the compulsive habit of needing to take a certain substance – it is not just a question of wanting drugs, but a question of actively relying on them. Addiction, then, is when someone cannot help themselves with their substance use.
Coffee is not quite addictive in the same way that alcohol, cigarettes, and prescription opioids are. While tolerance and withdrawal exist in the use of caffeine, the symptoms are mild and most people can cycle off caffeine without too much issue.
Nicotine, on the other hand, is one of the hardest addictions to break – and alcohol withdrawal is so dangerous that it can actually kill. Opioid deaths have become a national epidemic due to how easy it is to an overdose after building up a tolerance to initial dosages, and the same goes for stimulants like meth and cocaine. Furthermore, addiction can be better explained as not just one or the other, but a combination of both physical and psychological symptoms that manifest differently, and for different reasons, having much to do with the multitude of factors proven to determine the risk of addiction.
The Physical Aspects of Addiction
Addiction is hallmarked by the symptoms of tolerance and withdrawal – yet how they function is what makes them most interesting. In the example of opioids, overloading of the opioid receptors in the brain can cause an adverse effect where the brain requires increasingly larger amounts of opium in order to feel pleasure. Euphoria goes from being a natural emotion, brought about by everyday activities and joys like sports, food, or sex, to becoming something only possible through drugs.
When the steady flow of opioids stops, withdrawal kicks in – the body goes through a violent sequence of symptoms because the drug use has heavily interfered with receptors in the brain that handle physical regulation. A withdrawal after heavy abuse of opioids does not just create a state of apathy but a state of agony.
Alcohol withdrawals are even worse. Unlike opioids, which are dangerous due to their effects on the respiratory system, alcohol is a poison and can kill in high enough dosages. Improperly detoxing from alcohol can kill as well.
The Emotional Aspects of Addiction
Addiction is more than a physical experience – it is an emotional one, as well. The psychological effects of addiction unfold typically as one is stuck either looking towards drugs as an answer to problems (such as depression or pain), or when drugs help develop and make a problem mature.
While physical dependence is one thing, emotional dependence is also commonly heard of. This is when someone struggles to get off drugs. Instead of requiring a drug to silence the pain of withdrawal, someone suffering from an emotional or psychological addiction may require their drug as a way to silence the anxiety and total emptiness in their mind.
Psychological Treatments for Addiction
Some medications do actually help people struggling with emotional addiction – anti-depressants, for one, may help tackle the root cause of the issue – but for the most part, the most common and most effective treatment for the psychological effects of addiction is therapy. Therapies come in all forms, including CBT, DBT, and family behavioral therapy, all of which tackle the way in which a patient sees the world.
There are also a few unique approaches to dealing with the many emotional issues in addiction. One includes sober living, a community therapy approach where post-rehab living among other sober individuals helps teach a person how to cope with life without drugs, looking for work and maintaining productivity while living among people who walk the talk and inspire sobriety.
Addiction can be overwhelming in the beginning because of the sheer amounts of stress one is confronted with after months, or even years of drug abuse, as well as the effects of post-acute withdrawal. Therapies that help soften the blow can provide a long-term benefit in preventing relapses.
It is the Systemic Approach that Matters Most
Let us face it – if this post conveys any message, it is that addiction is complicated and involves a lot of working, moving parts. If the risk factors alone are any indication, addiction may occur due to trauma, genetics, depression, circumstance, the crowd you hang out with, or just one mistake leading down a slippery slope of bad decisions at the wrong time.
Just as addiction can develop in a number of different ways, treating it requires an understanding that it is never easy, and there is never one answer that fits all situations. Instead, a good rule of thumb is that it is important to try different methods to see what works best, from group therapy to one-on-one sessions, to self-help and more.