AddictionAuthor / Source: Wikipedia Category: Addiction |
The term “addiction” is used in many contexts to describe an obsession, compulsion, or excessive physical dependence or psychological dependence, such as: drug addiction, video game addiction, crime, alcoholism, compulsive overeating, problem gambling, computer addiction, pornography addiction, etc.
In medical terminology, an addiction is a state in which the body relies on a substance for normal functioning and develops physical dependence, as in drug addiction. When the drug or substance on which someone is dependent is suddenly removed, it will cause withdrawal, a characteristic set of signs and symptoms. Addiction is generally associated with increased drug tolerance. In physiological terms, addiction is not necessarily associated with substance abuse since this form of addiction can result from using medication as prescribed by a doctor.
However, common usage of the term addiction has spread to include psychological dependence. In this context, the term is used in drug addiction and substance abuse problems, but also refers to behaviors that are not generally recognized by the medical community as problems of addiction, such as compulsive overeating.
The term addiction is also sometimes applied to compulsions that are not substance-related, such as problem gambling and computer addiction. In these kinds of common usages, the term addiction is used to describe a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to the individual’s health, mental state or social life.
History of addiction models
The term “addiction” appeared as far back as at least 1599, when Shakespeare used it in the first scene of Henry V; however it wasn’t until 1906, in reference to opium, that it began to be used regularly. There is also an isolated usage, recorded from 1779, referring to tobacco. The first use of the adjective ‘addict’ (with the meaning of ‘delivered, devoted’) was in 1529 and comes from the Latin addictus, pp. of addicere (‘deliver, yield, devote,’ from ad-, ‘to’ + dicere, ‘say, declare’).
Prior to the latter half of the 20th Century, addiction was primarily a pharmacological term that referred to the process of developing drug tolerance so that more of a drug was required, more frequently, for the same effect to occur. However, with the founding of Alcoholics Anonymous in 1935, the allergy concept eventually morphed into the disease-model of addiction was proposed, based on the work of Dr. William Duncan Silkworth, and began to gather support in the professional community, amongst medical and social services workers, and amongst addicts themselves. The disease-model concept led to a definition of addiction based on the continued use of alcohol or drugs despite negative consequences for the user. This latter definition is now thought of as a disease state by the medical community. Morse and Flavin summarise the disease-model definition of addiction commonly utilized by treatment centers and substance abuse counselors:
Addiction is a primary, progressive, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and can sometimes be fatal. It is characterized by impaired control over use of the substance, preoccupation with the substance, use of the substance despite adverse consequences, and distortions in thinking.
In the latter half of the 20th Century, the twelve-step program began to be applied to a wide range of problem behaviours, many never previously identified as addictions. For example, during this process the establishment of Overeaters Anonymous in 1960 led to the identification of an associated concept of food addiction and the establishment of Sex and Love Addicts Anonymous in 1977 led to the identification of the concept of sexual addiction. However, although these terms are widely used in the recovery movement, and by commentators on that movement, neither of them are widely accepted by members of the professional communities working in the fields of addiction.
In the 21st Century, attempts have been made to model addiction using the tools of economics, for instance, by calculating the elasticity of addictive goods and determining to what extent present income and consumption has on future consumption. In general, most modern economists identify 3 models of addiction when analyzing patterns for policy research. These are:
- Myopic/Naive: This model essentially stipulates that addicts are characterized by near-sighted behavior and are wholly incapable of ascertaining the potential implications of their behavior. Therefore, under this model, demand for whatever the addict is addicted to would be totally inelastic, implying that the addict is unable to even slightly reduce consumption regardless of cost.
- Rational time-consistent: Under this model, the addict is assumed to be perfectly aware of future consequences of their behavior and is assumed to have fully considered all benefits and costs of their actions. Under this model, the elasticity of demand would be very high (at or nearing 1), implying that the addict will almost certainly change their behavior in response to price, since a high price may outweigh potential benefits.
- Time-inconsistent (as well as imperfectly rational): Under this model, the addict is assumed to be capable of some level of analysis of the benefits and costs of their behavior, but may not be able to act on the conclusions of this analysis due to physical dependencies and/or insufficient “willpower”. The essence of this model is an attempt to classify typical behavior by which most addicts wish they could quit, indicating rationality and proper benefit/cost analysis, but are still unable to. Under this model, there is a moderate level of elasticity indicating some but not perfect responsiveness to price.
Definition
Not all doctors agree on the exact nature of addiction or dependency however the biopsychosocial model is generally accepted in scientific fields as the most comprehensive theorem for addiction. Historically, addiction has been defined with regard solely to psychoactive substances (for example alcohol, tobacco and other drugs) which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain. However, “studies on phenomenology, family history, and response to treatment suggest that intermittent explosive disorder, kleptomania, pathological gambling, pyromania, and trichotillomania may be related to mood disorders, alcohol and psychoactive substance abuse, and anxiety disorders (especially obsessive-compulsive disorder).” However, such disorders are classified by the American Psychological Association as impulse control disorders and therefore not as addictions.
Many people, both psychology professionals and laypersons, now feel that there should be accommodation made to include psychological dependency on such things as gambling, food, sex, pornography, computers, work, exercise, spiritual obsession (as opposed to religious devotion), cutting and shopping so these behaviors count as ‘addictions’ as well and cause guilt, shame, fear, hopelessness, failure, rejection, anxiety, or humiliation symptoms associated with, among other medical conditions, depression and epilepsy. Although, the above mentioned are things or tasks which, when used or performed, do not fit into the traditional view of addiction and may be better defined as an obsessive-compulsive disorder, withdrawal symptoms may occur with abatement of such behaviors. It is said by those who adhere to a traditionalist view that these withdrawal-like symptoms are not strictly reflective of an addiction, but rather of a behavioral disorder. However, understanding of neural science, the brain, the nervous system, human behavior, and affective disorders has revealed “the impact of molecular biology in the mechanisms underlying developmental processes and in the pathogenesis of disease”. The use of thyroid hormones as an effective adjunct treatment for affective disorders has been studied over the past three decades and has been confirmed repeatedly. Modern research into addiction is generally focused on Dopaminergic pathways. There is great and sometimes heated debate around the definition of addiction with parties falling into two main camps the Disease model of addiction and the behaviorists, explanations of various models can be found in the article on Drug rehabilitation.
Article Reference: http://en.wikipedia.org/wiki/Addictions
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