My Understanding
What causes addiction?
Obvivously, if people didn't drink alcohol, use drugs, gamble or indulge in other potentially destructive behaviours they wouldn't become addicted.
But, why is it that there are some people who can indulge without becoming addicted? Is it in their genes, their background or family history.
Dependence exists in many different ways and to a variety of degrees of intensity. We cannot view addiction or dependence in absolute terms as there are some people who use substances on a fairly regular basis and over a prolonged period and experience few, if any, problems as a result.
For some of us though the capacity to control how often and how much we use seems to wear down quickly and a more powerful attachment or preoccupation with drinking the alcohol develops.
I would be totally surprised if anyone set out deliberately to become addicted to alcohol.
Alcohol addiction usually takes time to develop what normally happens is your consumption progresses through several stages.
Initiation - your first drink, this may or may not give you pleasure (like your first cgarette is never pleasurable!). This first tatse may be to experiment to see what alcoholic drinks taste like or just to succumb to peer pressure !
Following Initiation - you may go on to have another alcoholic drink, then begin to drink on celebratory occasions and then on a regular basis. The amount that you drink may also begin to increase. With alcohol the body usually becomes tolerant over a longer period of time – usually months to years. This means you will increase the amount drunk to achieve the desired effect you require.
Addiction does not stop at drugs and alcohol. People can become attached to gambling, chocolate, computer games - even using the internet. These addictive behaviours are similar to those in which drugs or alcohol are used in that there is a lack of control over the behaviour.
How does alcohol addiction start?
People drink alcohol because of the physical effects. It has a marked effect on the body and mind. If there were no effect, people would be less likely to try it again. No one sets out to become addicted. Some substances and certain behaviours change the way we feel. If they make us feel better, relax us, make us feel powerful, excite us, let us escape and so on, we tend to go back to them.
Dependence
What makes some people more susceptible is perhaps a genetic predisposition. This theory, with some evidence to support it, makes sense especially since addiction crosses all social levels, although this is still not totally proven.
Risk factors
There are certain jobs, situations, lifestyles or relationships that may increase your risk factors.
If your job or home life is stressful and you feel unable to change it, you may turn to substances like alcohol to relieve that stress, significant life events such as birth, marriage, bereavement, divorce, bullying at work or college, lack of money, infidelity etc may contribute.
There are cultural and social factors that put people at greater risk. You are less likely to become alcohol dependent if you grow up in a country where alcohol consumption is unacceptable rather than where it's a normal part of everyday life, but if alcohol is taboo you are more likely to want to try it, the forbidden fruit as it were. Growing up in a family or group where there's alcohol or drug abuse increases the risk, you may also find this is true for people who suffer childhood abuse and neglect.
Dependence Assessment
Below is an example of the kind of questions doctors use to assess whether someone has a substance-related problem and their level of dependency, these questions are just the starting point for a more thorough and detailed assessment.
Substance dependence
Below is an example of the kind of questions doctors use to assess whether someone has a substance-related problem and their level of dependency, these questions are just the starting point for a more thorough and detailed assessment.
Assessment
These questions concern the last 12 months.
Each question is answered 'yes' (1) or 'no' (0). The questions can be used for any substance though.
- Did you find you needed more alcohol to get the desired effect or that the same amount has had less of an effect?
- Did you feel sick or unwell when the effects of alcohol wore off or did you take more of it or a similar drug to relieve or avoid feeling unwell?
- Did you use alcohol in larger amounts or for a longer period of time than you intended?
- Would you say that you've had a persistent or strong desire to drink alcohol?
- Did you spend a large amount of time obtaining/using or recovering from the effects of alcohol?
- Did you reduce or give up work, recreational or social activities as a result of your alcohol use?
- Did you continue to use alcohol despite having physical or psychological problems with it?
Results
If you answer 'yes' to three or more to the 7 questions then you are likely to be dependent on the substance assessed. It's also important to find out whether there are signs of physiological dependence (this means you have answered 'yes' to question 1 or 2).
*Adapted from the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.
Treatment ? and the Options
The best way of ensuring that someone gets the treatment that is right for them is through assessment.
When you contact a community-based service (in the UK) the staff will talk through the situation with you to see what the best course of action to take is.
Counselling can be very effective, and may involve approximately 8 - 12 sessions, more may be given if you need it.
It involves helping you to look at all aspects of your problem, and then helping you to build strategies for overcoming the feelings of wanting to drink alcohol. The therapist-client relationship is important for successful treatment, therefore if you have a bad relationship you should try and change counsellors for someone you have a good rapport with.
Counselling may be given as outpatient or inpatient treatment.
More than 1,000 children under 15 in
The strong sense of compulsion to light up, particularly in situations where this is not allowed, such as in an aeroplane or a lift (elevator) will be recognised by anyone who has ever smoked cigarettes.
These aspects of addiction have a physiological basis related to how the substance acts on the brain and a psychological aspect relating to the reasons for taking the substance (such as smoking to improve concentration or alcohol to relax).
Residential or inpatient treatment
The aftercare and support aspect should be looked into because a person with alcohol consumption problems may find it more difficult to not drink when back in the ‘real world’ where alcohol is advertised frequently on the television, on bill boards and freely available in shops and supermarkets.
Residential rehabilitation programmes may be quite different in the way that they operate, but most of them share some of the following basic features:
- A ban on alcohol in a controlled or semi-controlled therapeutic environment.
- Communal living with other alcohol users in recovery.
- Emphasis on shared responsibility by peers and group counselling.
- Counselling and support aimed at preventing relapse.
- Individual support.
- Promotion of education, training and vocational experience.
- Improved skills for activities of daily living.
- Housing advocacy and resettlement work.
- Aftercare and support
References:
MY PERSONAL THOUGHTS ON ADDICTION
I personally feel that there may be differences in addiction, like physical or emotional addiction to substances or emotions surrounding an object. I clung to alcohol as a way out of coping with reality, not having a drink for over 7 months has made me realise that the reality is still the same and the pain wasn't really any less for me when I was drinking too much.
The problem was I had gotten myself into a routine, I couldn't cope if there was no alcohol in the house...why?
It had become so ingrained in my psyche that I needed that drink, the routine of buying it, taking it home, the anticipation of the first taste (I never tasted anything after that, just drank it as fast as I could without savouring the taste), the effect on me that it had, all these things were entrenched in me.
Once I had broken this habit, this routine, I was fine but breaking it was the hardest....I needed to find a good habit to replace the old one... but one where I wouldn't be a slave to it. I think I am slowly changing my habits and it does take time, I gave up smoking once for 10 years and started again, only to give up again after 2 years and haven't smoked now for over 3 years.
It looks like I need my crutches, many of us do, but finding the right one that does not harm us is the answer, not looking at the bottom of an empty drinks bottle, or the empty syringe, the empty pocket devoid of gambling money nor empty pill bottle...
How am I managing to live without the alcohol now then?
The answer to that is that I have broken the habit, but that is not to say that if I have another sip I wouldn't be back into that habit like wild fire !
I have no other answer except that one day I just decided 'No more'. I knew I was killing my body, my mind and most importantly my family.
I only had this in mind when I eventually had the will (and God's help) to stop.
Someone posted a questionnaire on another site (mywayout.org) that tests for addiction, allergic reaction etc to alcohol.
I have reprinted it below, please try it for yourself:
"The Difference in Drinkers''
''Your body holds the key to understanding the effect alcohol has on you. If you have the ability to drink large amounts of alcohol, you have good reason to suspect that you might be predisposed to alcoholism. But, capacity is only part of the story.
Alcohol affects brain and body processes in different ways in different people. In this chapter, you'll learn whether or not you are alcoholic and, if so, what kind of alcoholic you are.
The following quiz helps illustrate three different body chemistries that underlie vulnerability to alcoholism (and one type that may lead to a mistaken diagnosis of alcoholism).
A new biotype might be identified in the future, but, in all likelihood, if you have a problem with alcohol, you fall into one of the four groups. If there are alcoholics on both sides of your family, you may find that you fit into two categories. If so, the one that predominates, even slightly, is the one to work with as you embark on this program.
The first step will be to test yourself to determine whether or not you are an alcoholic and, if so, what kind you are. Once you know your chemical traits, you can choose the right course to restore your health.
Establishing your underlying physical vulnerability has another major advantage. It takes all the shame out of being alcoholic. There is no reason to be embarrassed about the hand your genes have dealt you.
Establishing Your Biotype
The biotype survey below will help you identify your alcohol biotype. You may find that more than one statement applies. Print out this questionnaire and circle any that are true for you today.
Biotype Survey
A. Physiologic Response
1. Alcohol quickly makes me light-headed, spacey, and unco-ordinated. It has always affected me this way.
2. Even a little alcohol makes me sick. This has always been true.
3. When drinking, I have lots of energy and perform better.
4. At first, alcohol exhilarates me; then I may lose control and drink until drunk.
5. In the past, alcohol always gave me a lift, now it just takes away my shakiness and makes me feel normal.
6. After only a few drinks, I usually feel sedated by alcohol.
7. I can overcome my depression by drinking alcohol, but afterward the depression seems worse.
8. (Women only) I need and use more alcohol premenstrually.
9. Usually, I can't feel the effect of my first one or two drinks.
10. Now alcohol lifts my depression temporarily. In my earlier drinking years, I did not suffer from depression.
B. First Experience
1. I remember the first time I drank alcohol; I liked the feeling it gave me.
2. My first drinking experience was not good; I reacted badly to alcohol.
3. I can't remember my first drinking experience.
4. From my first taste, alcohol has had no appeal for me.
C. Hangovers
1. All my drinking years I have usually felt miserable the morning after heavy alcohol use.
2. I rarely have hangovers.
3. I frequently suffer from depression after a night of heavy drinking.
4. 1 never got hangovers in my early years of heavy drinking, but now I do.
5. I don't get hangovers from my habitual light drinking.
6. I do get uncomfortable even with very little alcohol. This has always been true.
D. Patterns
1. I drink six or more eight-ounce glasses of beer a day or the equivalent in wine (six four-ounce glasses) or hard liquor (six drinks, each containing one and one-half ounces of alcohol) and do not get hangovers.
2. I usually can't predict or control how much alcohol I will drink at one time.
3. I may go for days, weeks, or months without alcohol, but when I drink I tend to binge for several days. This has been my usual pattern since I began drinking.
4. I rarely want more than two or three drinks at one time.
5. I do not drink because I dislike the way even a little alcohol affects me.
6. I often experience an urge to drink at the end of the workday following job-related exposure to fumes from gasoline, printer's ink, house paint, hydrocarbons, or formaldehyde.
7. 1 recognize that I can regularly drink a lot, need little sleep, have a strong sex drive, and tend to be a compulsive type-A personality.
8. (Women only) I drink quite moderately except before my period when my need for alcohol seems to increase.
9. I have never been a heavy drinker, but I notice if I haven't eaten, I can get drunk on one or two drinks.
10. I drink daily (or frequently) to avoid depression.
E. Heredity
1. No one on either side of my family has regularly consumed large amounts of alcohol.
2. I have a close maternal and/or paternal relative who drinks (or formerly drank) alcohol in large amounts.
3. I am of Scandinavian, Celtic, Welsh, or Scottish ancestry and have drinking relatives who suffer from depression.
4. I am adopted and do not know my biological parentage.
5. My family may or may not be teetotalers, but my biological origins are predominantly northern European or Native American.
6. My family is from a southern Mediterranean country.
7. A close relative is a heavy drinker, but even one or two drinks makes me spacey.
8. I am of Oriental descent. My relatives and I become flushed, dizzy and nauseated from very little alcohol.
F. Personality Effects
1. My personality and behaviour often change markedly when I drink. This effect has been my response to alcohol since I began drinking.
2. My personality and behaviour now change markedly when I drink. This was not true in my earlier years of drinking.
3. I mellow out and grow sleepy on a few drinks.
4. I feel revved up and can often party all night when I'm drinking with few or no signs of intoxication.
5. I sometimes get into fights when drinking a lot. This has been true almost from the time I began drinking.
6. I use alcohol to control anxiety whenever possible.
7. I can count on alcohol to lift my lifelong depression temporarily.
8. My behaviour sometimes gets bizarre when I drink.
9. I dislike drinking alcohol because it physically upsets me; it does not alter my personality.
10. I feel a quick sense of well-being from my first drink or two but can't handle more than that without feeling spacey and light-headed.
G. Tolerance
1. I have always had a high tolerance for alcohol and can drink large amounts without problems.
2. I have been able to increase my tolerance for alcohol markedly over time, handling it super-normally with minimal hangovers.
3. I have no ability to handle a lot of alcohol.
4. My tolerance for alcohol has gone down recently. It was much higher for many years.
5. I am inconsistent in how much alcohol I can handle. Often I cannot predict or control how much I will drink.
Your responses in four or five of the seven categories should be consistent within a particular alcohol biotype.
If you are over forty and have been drinking heavily for several decades, you may have circled many allergic/addicted responses as well as II ADH/THIQ answers. This would indicate that your drinking has damaged your immune system, your body's defense against disease.
However, you are predominantly a II ADH/THIQ alcoholic.
In rare cases, a person will be a combination of biotypes if there are different kinds of alcoholics on each side of his or her family.
Scoring
A. Physiologic response
Nonalcoholic chemistry, A6
Nonalcoholic (alcohol-intolerant) chemistry, A2
Nonalcoholic hypoglycemic chemistry, A1, A8
II ADH/THIQ alcoholic chemistry, A3, A5, A9, A10
Allergic/addicted alcoholic chemistry, A4
Omega-6 EFA deficient alcoholic chemistry, A7
B. First experience
Nonalcoholic chemistry, B3
Nonalcoholic (alcohol-intolerant) chemistry, B2, B4
Nonalcoholic hypoglycemic chemistry, B3
II ADH/THIQ alcoholic chemistry, B1
Allergic/addicted alcoholic chemistry, B2
Omega-6 EFA deficient alcoholic chemistry, B1
C. Hangovers
Nonalcoholic chemistry ,C5
Nonalcoholic (alcohol-intolerant) chemistry , C6
Nonalcoholic hypoglycemic chemistry , C6
II ADH/THIQ alcoholic chemistry , C2, C4
Allergic/addicted alcoholic chemistry , C1,C3
Omega-6 EFA deficient alcoholic chemistry, C3
D. Patterns
Nonalcoholic chemistry, D4
Nonalcoholic (alcohol-intolerant) chemistry, D5
Nonalcoholic hypoglycemic chemistry, D8, D9
II ADH/THIQ alcoholic chemistry, D1, D7
Allergic/addicted alcoholic chemistry, D2, D3, D6
Omega-6 EFA deficient alcoholic chemistry, D10
E. Heredity
Nonalcoholic chemistry , E1, E6, E8
Nonalcoholic (alcohol-intolerant) chemistry, E8
Nonalcoholic hypoglycemic chemistry , E1 E7
Alcoholic chemistry (possible to probable) , E2, E5
Omega-6 EFA deficient (possible, probable) , E2, E3
Unidentifiable chemistry, E4, E5
F. Personality effects
Nonalcoholic chemistry, F3
Nonalcoholic hypoglycemic chemistry, F3, F10
II ADH/THIQ alcoholic chemistry , F2, F4, F6
Allergic/addicted alcoholic chemistry, F1, F5, F6, F8
omega-6 EFA deficient alcoholic chemistry, F7
G. Tolerance
Nonalcoholic chemistry , G3
Nonalcoholic (alcohol-intolerant) chemistry , G3
Nonalcoholic hypoglycemic chemistry , G3
II ADH/THIQ or Omega-6 EFA deficient , G1, G2, G4
Allergic/addicted alcoholic chemistry, G5
The Characteristics of Your Biotype
1. Nonalcoholic Chemistry (Normal Drinker)
A6 With a few (one to four) drinks, alcohol has a sedating effect on you.
B3 You probably have no outstanding memory of your first alcoholic drink or your reaction to it.
C5 Your alcohol use is usually light; hangovers are rare.
D4 Typically, two to four drinks are enough for you.
E1 Usually, no one on either side of your family drinks or has frequently drunk large amounts of alcohol.
E6 Some of your biological relatives come from southern Mediterranean areas of Europe.
F3 Getting sedated by alcohol is the typical response of a non-alcoholic.
G3 Your ability to "keep up with the boys" when drinking at parties is poor. You would consider it punishment to have to drink twelve beers or a pint of vodka daily and simply couldn't do it, no matter what your personality or character. You are blessed with the chemistry of a non-alcoholic drinker
2. Non-alcoholic (Alcohol-Intolerant) Chemistry
A2 Drinking even a little alcohol tends to make you dizzy or nauseated or causes flushing or other negative reactions.
B2 Your first drinking experience made you sick.
B4 Because of alcohol's negative effects on you, it has never had any appeal.
C6 Even a little alcohol may give you lingering effects the next day.
D5 Because you dislike the way even a little alcohol affects you, you don't drink.
E8 Your family may be of Oriental extraction and you may possess only one alcohol dehydrogenase enzyme in your liver.
F3 Getting sedated by alcohol is the typical response of a nonalcoholic.
F9 Alcohol offers you no rewarding highs; it only upsets you physically.
G3 You learned quickly that you are alcohol intolerant and you avoid drinking.
3. Non-alcoholic Hypoglycemic Chemistry (May Mistakenly Be Labeled Alcoholic)
A1 A little alcohol tends to make you light-headed, spacey, and unco-ordinated.
A8 If you are a female hypoglycemic you often want and use more alcohol pre-menstrually; your altered hormonal levels depress glucose metabolism, resulting in severe sugar cravings. Alcohol can temporarily correct this by supplying your brain with glucose, its vital fuel.
B3 Your first drinking experience probably does not stand out in your memory.
C6 You usually get a hangover from moderate drinking because alcohol triggers an outpouring of insulin, which creates mild to severe insulin shock and symptoms of fatigue, confusion, depression and irritability.
D8 If you are a woman, you may drink more alcohol premenstrually.
D9 The effects of one or two drinks on your empty stomach are dramatic. You almost certainly feel a quick lift followed shortly thereafter by light-headedness, confusion grogginess, clumsiness, and weakness.
E1 Quite possibly, no one in your family is a heavy drinker. Or...
E7 A close relative may be alcoholic, but even a few drinks make you spacey. In certain alcoholic families, one or two children may inherit the tendency to abnormal glucose metabolism (hypoglycemia) but be spared the high tolerance for alcohol that can lead to alcoholism.
F3 You may be the type of hypoglycemic who tends to become light-headed and sleepy rather quickly as a result of drinking alcohol.
F10 You usually feel a quick sense of well-being from a drink or two.
G3 You never could handle much alcohol. You don't need much to raise blood-sugar levels; a drink or two gives you the temporary lift you seek.
4. II ADH/THIQ Alcoholic Chemistry
A3 Alcohol gives you energy and improves your performance. or...
A5 It used to do this, but now it just stops the shakes and restores you to normal.
A9 You need several drinks to get the feeling you seek.
A10 Alcohol is stimulating the production of endorphins; gradually, this will inhibit natural production of these opiates. Depression can develop as natural endorphins become less available; drinking temporarily relieves your depression.
E1 Your first drinking experiences were pleasant; alcohol didn't make you sick.
C2, C4 Alcohol causes few adverse effects; your hangovers were rare in the heyday of your drinking, but years or even decades later liver damage changed the picture.
D1 You can handle a lot of alcohol. For many years you did not ordinarily have hangovers or experience other alcohol-related consequences.
D7 Besides your ability to handle a lot of alcohol well, you tend to be a Type A personality compulsive with a strong sex drive; you require very little sleep to function efficiently.
E2 A close relative has shown a pattern of high alcohol tolerance.
E5 Your ancestors are predominantly northern European or Native American.
F2 After years of handling a lot of alcohol super normally, you are finally showing signs of the damage alcohol is doing to your brain and nervous system.
F4 Alcohol serves to rev up rather than sedate you; you can party for long periods with few or no signs of intoxication.
F6 Alcohol helps you handle situations that make you anxious.
G1 You had a high tolerance for alcohol even as a teenager. Or...
G2 Your tolerance increased markedly with continual use of alcohol. Or...
G4 Your high tolerance of yester-year has declined after a long drinking career.
5. Allergic/Addicted Alcoholic Chemistry
A4 Alcohol will exhilarate you at first, but you often lose control and may drink until drunk.
B2 You probably can remember getting sick after your first drinking experience. At the time, your body was able to tell you how it felt about alcohol. With repeated use, your body was forced to adapt and accommodate alcohol. The result is the altered response of allergy/addiction.
C1 You usually have serious after effects the morning following heavy drinking because of the toxicity of alcohol to your allergic body.
C3 Depression usually follows a night of heavy drinking.
D2 You often can't predict or control how much you will drink at one time because alcohol quickly alters your brain's ability to make choices.
D3 You may go without alcohol for days, weeks, or even months, but when you drink, you tend to binge, sometimes for several days.
D6 Daily exposure to such chemicals as gasoline, formaldehyde, printer's ink, and hydrocarbons can easily intoxicate your sensitive brain and set off cravings for alcohol. If you work around these chemicals you may notice an overwhelming urge to drink immediately after work.
E2 Typically, you have a close relative with a similar drinking pattern. Or...
E5 Your relatives are all teetotalers for good reason. Chances are you are of predominantly northern Europe or Native American background.
Fl Your personality and behavior are often dramatically affected by alcohol because your brain and nervous system are easy disrupted by alcohol's toxicity.
F5 When drinking, you often engage in arguments and bar fights with anyone, even total strangers.
F6 Alcohol tends to mediate your high levels of anxiety and is your preferred way to deal with stress.
F8 The physical changes alcohol triggers in your allergic brain can result in irrational or bizarre behaviour; contrary to appearances, you have little control over these actions once you are locked into this altered brain state.
G5 You often can't control how much you drink.
6. Omega-6 EFA (Essential Fatty Acid) Deficient Chemistry
A7 You know you can temporarily relieve depression by drinking alcohol.
B1 Your first drinking experience produced immediate relief from long-standing depression.
C3 Your depression returns after you stop drinking.
D10 You drink daily (or frequently) to prevent depression from returning.
E2 You have relatives who are alcoholics and/or depressed; there may have been some suicides in your family.
E3 Your ancestry is predominantly Scandinavian, Irish, Welsh, or Scottish.
F7 You have come to depend on alcohol for relief from depression present since childhood.
G1 Your tolerance for alcohol probably has increased over the years. Or...
G4 Your tolerance may be much reduced after years of drinking which has caused liver damage.''
What's Next?
''If you clearly fall into an alcoholic category, you now have the opportunity to rewrite your future. You may decide to keep drinking even though your alcohol biotype indicates that you are headed for disaster. I hope not. You are vulnerable to alcohol and will become addicted in the future if you aren't already. The physical addiction cannot be managed into social drinking.
Since alcoholism is progressive, your drinking habits won't improve; they won't even stay the same. They will get worse. Your physical need for alcohol will gradually speak so loud that no act of will can overcome it. Life will become an unending quest for the normalizing lift alcohol provides, even though it will be destroying your health and sanity.''
''Please remember that most alcoholics today do not recover. They die prematurely from alcohol-induced diseases. "
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