Addiction has many forms. There exists drug and alcohol addiction, sex addiction, spending or shopping addiction, gambling addiction, and co-dependency to name a few. The World Health Organization defines addiction as "a pathological relationship with mood altering substance or experience that has life damaging consequences." The empirical working definition of what constitutes a substance addiction was suitably described by the director of NIDA, Alan I. Leshner, MD. "Drug addiction is a brain disease that develops over time as a result of the initially voluntary behavior of using drugs." The same definition can be altered to fit other addictions such as alcoholism, sex addiction, gambling addiction, etc.
Addiction can be physiological, psychological or both and is identified by indicator characteristics that will point to the existence of the condition. At the outset, the beginning of the addiction is with the substance being taken voluntarily. Once the drug (this definition includes ingestible alcohol - ETOH) is taken in, there is an initial sensation of pleasure; a change of feeling, mood, and/or emotion providing an "immediate gratification". When the addiction develops there begins to be continued usage despite negative consequences. Consequences can include but are not limited to legal ramifications, family discord, financial concerns, social difficulties, health distress, and difficulty in housing and job problems.
Physical addiction entails a tolerance that leads to increased usage and physical craving. Removal of the usage causes physical withdrawal: increased heart rate nausea, vomiting, diarrhea, and cramps. The process of addiction creates physiological changes in brain function by essentially "re-wiring" the pleasure centers of the mind. An obsession is created requiring great amounts of time and energy resulting in behavioral problems. Impulse control and the ability to self-regulate are diminished, and using behavior is practiced in an attempt to "manage" a life that has become "unmanageable". Other symptoms that indicate the presence of addiction are denial that usage is causing negative consequences, isolation, and feelings of shame and guilt. Addicts become trapped in their behaviors-it is very difficult to stop without a plan and support.
Becoming addicted starts with an initial pleasurable feeling and continued usage over time changes occur in brain physiology that regulates mood, memory, perception and ones emotions. These changes happen in the reward centers of the brain that are normally activated when a person does something that would bring a natural reward. Over time the addict loses the ability to maintain substantial control over their intake and chemical usage becomes a habit that is difficult to break. Once addicted, brain structure and function is altered and oftentimes this alteration is evident long after substance use is ceased.
Breaking free of addiction is a serious undertaking. Physical withdrawal has many dangers including seizures and even death. The long term psychological ramifications necessitate ongoing management through the use of recovery tools. These tools need to be applied everyday in everyday life and are best learned in a structured drug rehab or alcohol rehab treatment center.
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