ADDICTION IN COUNSELLING
Addiction — The state of being enslaved to a habit of practice or to something that is psychologically or physically habit-forming, such as narcotics, to such an extent that to stop causes severe trauma.
Drugs are simply chemicals that make changes in the body chemistry or internal makeup.
Drug misuse refers to using drugs for purposes or conditions for which they are not suited or for appropriate purposes with improper doses.
Drug abuse is a pattern of harmful use of a substance or habitual activity for the purpose of altering one’s mood. People abuse drugs to forget or not feel painful feelings such as loneliness, anxiety, depression, anger, grief.
Tolerance is a phenomenon that occurs when a substance is used repeatedly and the same dose of the substance begins to have less effect. This is the reason a person who is addicted to a drug must increase amount of drug intake to have the desired effects.
Leads to overdose in relapse from recovery – body does not need the amount for it no longer has built up tolerance. A person relapses, using the amount of drug at height of addiction.
Physical Dependence means that the body has adapted to the presence of the chemical and withdrawal syndrome appears as drug level in system drops – when the person stops taking the drug. Withdrawal syndrome varies from one class of drugs to another.
Psychological Dependence (also called behavioral dependence) is defined by observable behavior, such as frequency using a drug or by the amount of time or effort an individual spends obtaining the drug.
Models of Addiction
Disease Model – Explains that there is a legitimate and verifiable difference between those who are addicted and those who are not. Addiction is viewed as a progressive disease, making people incapable of not using their drug of choice once they start. The drawback of this model is that by claiming it is an incurable disease, addicts are more likely to avoid responsibility for change. “I can’t change; I have a disease.”
Genetic Model – Focuses on differences in genetic and physiological processes to explain addiction. Family, twin, and adoption studies suggest that 40 to 60% of an individual’s risk for alcoholism is genetic. However, this does not mean individuals with certain genes will necessarily become addicted to a particular drug, for it is a matter of susceptibility or genetic predisposition. For example, in some people with certain genes, it is harder to quit once they start than for others.While there are genetic factors, not everyone from an alcoholic family will develop an addiction.
Choice or Moral Model– States that the individual person and his/her choices are the primary cause of an addiction problem. The model is based on the idea that each individual has free choice and is responsible for their behaviors. Alcohol and drug consumption are viewed as choices. Scriptures teach that each person has a moral responsibility to God, as Hebrews 4:13 says, “Nothing in all creation is hidden from God’s sight. Everything is uncovered and laid bare before the eyes of him to whom we must give account.” However, under the choice model of addiction, addicts are often labeled as weak, with poor willpower or other moral failings. This kind of contempt is destructive and not helpful for their recovery.
Biological Model – Focuses on unique biological conditions, such as abnormal drug metabolism and brain sensitivity to explain addiction. It is known that highly addictive drugs such as stimulants can spur the dopamine pathway in the brain, resulting in a feeling of being high. This causes the body to produce less dopamine. Studies with brain-scanning technology show the difference in brain structure activity between brains that have been influenced by drugs and healthy brains. However, these studies tend to show some of the physiological consequences produced by drug usage and not necessarily the causes of dependence. Science has failed to prove a true biological cause.
Personality Model – Considers addiction as rooted in an abnormality of personality, which may be characterized by poor impulse control, a lowered self-esteem, poor coping skills, egocentricity, and manipulative traits. There are frequent correlations between drug abuse and antisocial personality and juvenile delinquency. However, this does not fully explain whether abnormality of personality causes addiction.
Coping/Social Learning Model – considers one’s development as playing an important role in addictive behaviors. People with addiction problems are seen as emotionally wounded. Many have experienced severe trauma in childhood. For example, the research on sex addicts has shown that 81 percent have been sexually abused, and 97percent emotionally abused. Addiction is considered as a coping mechanism to alleviate pain.
Sociocultural Model – Points to the role of society, environmental factors, and subcultures in shaping an individual’s addiction. In essence, addiction is viewed as a learned behavior from others. For example, alcohol consumption is powerfully influenced by the availability of alcohol and social interactions. The level of availability to illicit drugs may vary depending on the family environment, socioeconomic status, peer pressure, educational or prevention programs, legal regulations, and so on. Social support and accountability are essential for recovery from addiction.Social environment is environmental, but everyone has a choice to take or not to take the drug when offered.
Spiritual Model – Views addiction as stemming from a lack of spirituality, a lack of faith-based values, and disconnection from God, who is seen as the source of light, truth, love and wellness. This model suggests that recovery from addiction requires a restored relationship with God. The Word of God does not imply that alcohol (wine) in and of itself is evil. In fact, alcohol consumption was part of everyday customs and prevailing biblical cultures and was also used for various celebrations as well as medicinal purposes. Yet the Bible is clear that drunkenness is sinful (Gal. 5:21). The scriptures also acknowledge that battles between the desires of the flesh and the Spirit’s desires (Gal. 5). We are not to gratify the sinful desires of the heart but to live by the Spirit (Rom. 6:12, 8:5; Gal. 5:16).
If choice were never part of the equation and the process were purely biological, genetic or disease-based, then it would be questionable as to whether anyone could move towards sobriety and recovery; yet the fact remains that thousands of individuals do become sober.
Some will say there is no shame in addiction because it is a disease; however, there is shame in addiction; but there is not shame to be in recovery. Recovery is the strength and courage to ask for help.
Most common is addiction is a bio-psycho-social-spiritual phenomenon, having a many causations and contributing factors.
Effects of Addiction
Compulsion: 3 Elements
Reinforcement – Occurs when the addictive substance or behavior is first engaged. The effect of the substance or the feeling it produces (such as pleasure, stimulus or pain relief) reinforces the user.
Craving—means that your brain sends intense signals that the drug is needed.
Habit – Continual use; becoming part of your lifestyle.
Loss of Control – Addict senses the addiction is out of their control; typically cannot predict or determine when or how much of the drug will be consumed.
Negative Consequences – The addict continues to use despite all the painful consequences to himself/herself and others. Including poor physical helath,s, interpersonal relationship difficulties, poor job or school performance, financial problems, falling into habitual sin and separation from God.
Tolerance – When the substance is used continually, the body begins to tolerate the drug’s or behavior’s pharmacological effects. The Body needs an increased amount of the chemical or behavior to produce the same effects.
Withdrawal – Unpleasant effects when drug use stops. Symptoms are substance and amount dependent; can be life threatening; may require careful medical attention (detoxification) as in the case of alcohol.