What is an addiction?

Defining addiction is not a simple task though we all have a sense of what it is. In this posting most of the examples are coming from alcohol addiction. The clinical definition, commonly used, is based on the International Classification of Disease (ICD-10) (World Health Organisation, 1992). This pertains to alcohol, but is also appropriate for other substances that induce physical or psychological dependence. A diagnosis of dependence (ie addiction) requires the presence of three or more of the following:

1. a strong desire or sense of compulsion to take alcohol
2. impaired capacity to control alcohol taking behaviour
3. a physiological withdrawal state (eg tremor, nausea, rapid pulse rate when alcohol intake is abruptly stopped)
4. evidence of tolerance to the effects of alcohol (ie the need to increase the amount consumed to gain the same effects)
5. preoccupation with alcohol use (to the detriment of alternative pleasures or interests)
6. persistent alcohol use despite clear evidence of harmful consequences

Those who are addicted often speak of it being hell, like a prison but paradoxically also like a love affair. Addicts are sufferers but only seek treatment when they realise the nightmare that they have been in. When asked why they took drugs addicts often spoke of the enjoyment frequently describing heroin as “magic”. For some in a life where there appears to be no hope, no future; the offer of something that will bring great pleasure has a predictable, though not inevitable, outcome. The same applies to the question of relapse. For addicts it will only be tolerable to come off if one retains the idea that one can go back. Addicts will always love it, and feel that if they want they can go back to it.

The reasons that addicts get into the positions that they do are complex but it is clear that often the substance that leads to addiction provides a relief from pain or deep seated need of one sort or another. To use a parallel example: research with those who survive serious attempts at suicide has shown that they do not wish to die but they do want the pain to go away. They know that their death will be hurtful to those around but see that pain as less than the pain or distress with which they are faced. Addiction often provides a route out of pain or satisfies a deep seated need.

Credits

The p[icture of the bottles was taken by Chris_J.

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