In any given year, 1 in 5 Canadians experience either a mental health illness or an addiction. How big of a problem is addiction in Canada? Consider these stats: 36% of Canadians report “high frequency alcohol consumption”; 1 in 10 adults who have ever used cannabis will develop an addiction to it; and 82,000 Canadians report using opioids for non-medical purposes. The cost of addiction to Canadian taxpayers is about $22.8 billion every year.
WHAT IS ADDICTION?
Addiction is considered a form of poor adaptive memory. The process of addiction begins with a substance or behavior that directly and intensely activates the brain’s “reward circuits”. This type of experience produces strong conditioned associations where some individuals become drawn into repetition of the experience – focusing on the immediate pleasure, despite negative long-term consequences.
“Addiction can be defined as a state of physiological or psychological dependence on a drug or behavior liable to have a damaging effect; a great interest in something to which a lot of time is devoted; or to devote oneself habitually and compulsively”. For someone experiencing a drug addiction, the individual’s drug of choice is neither random nor accidental. Drugs are chosen because an individual discovers a specific pharmacological reaction that aids in alleviating emotional discomfort or suffering.
Substance use is initially adaptive. Addiction-prone individuals often turn to substances or addictive behaviors as a way to cope with inner difficulties such as stress, negative emotions or emotional pain, lack of assertiveness, social anxiety or other uncomfortable or difficult emotions. Certain substances rapidly reduce these negative emotions and enhance functioning, and thus become extremely attractive and powerful reinforcers.
Not all “addicts” are addicted to substances. Common addictions involve alcohol, street drugs, prescription drugs, inhalants, nicotine, caffeine, food, gambling, sex, shopping, work, religion, meditation, pornography, and internet use.
WHY DO PEOPLE ENGAGE IN ADDICTIVE BEHAVIORS?
People engage in addictive behaviors for various reasons. Addictions can be part of a pattern of avoiding present reality, an attempt to control an experience, or related to alleviating physical or emotional pain. As addictions progress, the individual gets further and further away from actual experiences, meaningful relationships, and the underlying truth.
Achievement has become the cornerstone of modern society and the desire to achieve is often implicated in addictive behaviors. For most of us, the pursuit of achievement is healthy and leads to a sense of happiness, accomplishment and fulfillment. For others, this pursuit may be frustrating and come with feelings of pain and fear. “High achievers”, those who have experienced a significant degree of acclaim in their field of expertise, often find themselves in high-stress environments, which can make them vulnerable to addictive behaviours. In some cases, high achievement comes at a cost. Some triggers of susceptibility include misrepresentation of one’s success; falsification of wealth or work performance; or changes in status, income or level of responsibility. These experiences play a role in exposing one’s insecurities and disrupt one’s sense of self and safety.
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ADDICTION AND THE HUMAN BRAIN
Addictive behaviors have a powerful effect on the brain. Addictive behaviors involve and affect the frontal cortex (the thinking part of the brain); and the limbic system (consisting of the amygdala, neocortex and thalamus) – changing neural activity leading to abnormal messages. Addictive type behaviors and drugs erode the area of the brain associated with self-control and impede one’s ability to make sound judgements and decisions, while producing intense impulses to engage in addictive behaviors. These areas of the brain also impact symptoms of anxiety and depression and other mental health issues - which reinforce continued use/abuse. As it relates to drugs, continued abuse can increase tolerance resulting in the need for higher doses to produce a similar effect – again reinforcing the addiction and compulsive use. With drug addictions, there is often an instant and euphoric feeling that lasts longer than those produced by natural, healthy “brain reward circuits”. This creates a powerful incentive, which strongly motivates people to continue using.
The use of any psychoactive substance often prompts the desire for other substances, reducing the ability to avoid temptation. This learned “reflex” is extremely durable and can affect a person even after many years of abstaining from the substance.
Early warning signs of addictive behaviours can include:
• Family history of addiction
• Being particularly drawn to a substance or potentially damaging activity and seeking out situations where the substance or activity is present
• Episodes of “binging” or loss of control with little to no feelings of remorse
Signs of addiction include:
• An activity or substance takes precedence over the other important things or responsibilities in one’s life, causing a disruption in everyday life
• Recurring engagement in the substance or activity for longer periods of time than originally planned
• Experiencing anxiety or uncomfortable feelings when one cannot engage in the activity or substance use
SUPPORTING SOMEONE WITH AN ADDICTION ISSUE
Is there someone in your life struggling with an addiction? Here are some ways you can support:
• Match interventions to the user’s stage of readiness for change
• Roll with resistance
• Avoid arguments
• Try to become comfortable with ambivalence
• Offer choices and support
• Try to negotiate, don’t pontificate
• Be supportive - support self-determined change
• Be willing to compromise
• Gently correct misinformation and distortions
ADDICTION TREATMENT AND RECOVERY
Addiction treatment and recovery can be a long and tedious process with setbacks. There are various treatment options available for all types of addictions, as well as resources for family and friends. Whatever the chosen treatment option, it is crucial the choice is geared towards the user’s willingness to get treatment. Common addiction treatment options include; detox, rehabilitation, individual and/or group therapy, removing drugs from one’s system, and counseling focused around developing awareness and coping skills. Successful recovery often includes psychotherapy; Cognitive Behavioral Therapy (CBT), pharmacotherapy (when needed), and mindful practice.
It is important to note that because of the significant brainaltering effects of addiction, it is often difficult to assess the impact of a particular substance on an individual until use of that substance has stopped for several weeks or months.
For those suffering with addictions, feeling accepted is an integral part of the treatment process. With a commitment to treatment, the relationship between the user and the treatment provider is very important. Successful relationships of this nature are unconditional, non-judgmental, kind, and supportive.
Treatment delivered by a skilled healthcare practitioner helps remove some of the barriers that often deter addicts from seeking professional help. A skilled treatment provider can do the following:
• Enhance an individual’s motivation for change
• Facilitate the development of achievable goals
• Improve motivation for self-help and self-care
• Aid an individual in developing self-harm reduction strategies
• Support sustainable abstinence-focused strategies
• Enhance strategies for relapse-prevention
• Provide ongoing recovery-focused psychotherapy
HELPFUL TIPS FOR THOSE STRUGGLING WITH ADDICTION
In addition to professional support, treatment and rehabilitation, the following are some tips for individuals struggling with addictions:
• Plan free time carefully to avoid boredom
• Identify, avoid and manage both internal and external triggers
• Develop strategies to safely manage cravings and urges
• Identify, anticipate and avoid high risk situations
• Develop a support network to aid in recovery
• Be patient with yourself, every day is a new day
Addiction is a complex issue that affects men and women of all races, ethnicities, religions, and socioeconomic backgrounds. No one engages in substance use with the intent of becoming an addict. Addiction typically begins with the belief that one will not become an addict, “that won’t happen to me, I’m in control”.
Early intervention may prevent the development of more severe and difficult-to-treat cases of addiction. Early addiction treatment and counseling can significantly reduce the risk of future health problems and injuries, work-related issues, and problematic relationships.
Know someone who is suffering with an addiction or who exhibits addictive behaviours? It is important the individual experiencing the addiction remain encouraged and supported. A support network that is compassionate, empathetic, caring, and patient is the most effective.
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