Addiction is an inability to stop using a substance (such as alcohol or illegal drugs) or engaging in a behaviour (such as gambling or excessive exercise) despite negative consequences. The addicted person does not have control over their behaviour, which can lead to serious harm to the tangata and others.
Addiction is a complicated condition that affects people of all ages, backgrounds and ethnicities. It’s not fully understood what causes some people to be more prone to addiction than others. Usually, several factors contribute to the condition.
Substance addiction
The tangata may be addicted to one or more of the following substances:
- alcohol
- illegal drugs
- prescription drugs
- tobacco
- caffeine
- inhalants such as aerosol sprays
Not everyone who takes these substances has an addiction. The continuum of use of a substance describes the levels of use.
Behavioural addiction
The tangata may be addicted to one or more of the following:
- gambling
- work
- exercise
- eating certain foods or too much food
- viewing social media or other websites
- video gaming
- using smartphones
- shopping
- sex/pornography
- getting plastic surgery
Very little study has been done on behavioural addiction, though gambling addiction has been considered a socially destructive behaviour for many years.
Like substance addiction, behavioural addiction affects the reward centre of the brain, and the impact on the addict and their whānau can be very similar.
Addiction disorders
Addiction disorders include:
- gambling disorder
- alcohol use disorder
- cannabis use disorder
- stimulant use disorder
- opioid use disorder
- tobacco use disorder
- polysubstance use disorder
Common addictive substances
The website of the New Zealand Drug Foundation – Te Puna Whakaiti Pāmamae Kai Whakapiri describes the main addictive substances.
Activity
Click on the link to access the Drugs A-Z web page. Click on the link for each addictive substance and read the information. Then, complete the activity that follows.
Gambling disorders
For many New Zealanders, buying a Lotto ticket, playing the occasional pokies game or having a day out at the races is harmless entertainment. However, for some people, gambling becomes addictive. A gambling addiction can cause harm, including:
- financial harm
- relationship problems
- problems with work or study
- mental health issues such as anxiety and depression
- negatively impacting friends and whānau; every gambler affects between 5 and 10 other people
Ref: Healthify: Gambling overview.
Harmful gambling disproportionately impacts the following:
- Māori
- Pacific people
- Asian communities
- young people
- individuals with limited incomes
Ref: Ministry of Health: Gambling harm
Signs that gambling might be causing harm
You may notice signs that indicate someone you know has a problem with gambling.
Activity
Click on the link to access Safer Gambling Aotearoa’s Noticed some warning signs?
Watch the short video clips where Nan discusses the signs of gambling problems.
Watch: Inside the brain of a gambling addict (3:24 minutes)
Watch the following video that demonstrates, using an MRI, how a gambler’s brain changes while gambling. Complete the reflection activity that follows.
Reflection
Did the MRI results shown in the previous video surprise you? In what way?
Explore
In this course, the only behavioural addiction we have considered is gambling, which is known to cause a lot of harm in New Zealand. However, you might end up treating tangata who have addictions to other behaviours. All behavioural addictions carry similar risks to the tangata and their whānau.
In the following activity you will research two other behavioural addictions.
Drugs
Drugs are chemicals that affect the body and brain. Different drugs can have different effects. Some effects of drugs include health issues that are long-lasting or permanent. Effects of drug addiction may include:
- increased strain on the liver puts the person at risk of significant liver damage or liver failure
- increased strain on the heart
- lung disease
- sleep problems
- increased risk of accidents
- seizures, stroke, mental confusion and brain damage
- problems with memory, attention and decision-making
- overdose – where a dangerous amount or a dangerous mixture of drugs is taken. This can lead to serious ill effects or death
Physical addiction
Physical addiction to a substance can occur when repeated use of a drug changes the way the brain feels pleasure. The addicting drug causes physical changes to some nerve cells (neurons) in the brain. Neurons use chemicals called neurotransmitters to communicate. These changes can remain long after a person stops using the drug.
Eventually, drugs can change how the brain works and interfere with a person’s ability to make choices, leading to intense cravings and compulsive drug use.
Withdrawal
When people stop using a drug they are addicted to, they are likely to suffer withdrawal. This is because the body is used to and may even depend on the drug. When the drug is no longer taken, side effects can occur. Side effects will vary depending on the substance and the duration and severity of the addiction but can include:
- tremors
- nausea
- headaches, body pain
- sweating
- confusion
- insomnia
- anxiety, agitation, irritability
- extreme cravings for the substance
Watch: How Addiction Affects The Brain (2:28 minutes)
Addiction is not due to weakness or a lack of willpower. Instead, it’s a chronic disease involving changes in the brain. Watch this video to learn more, then answer the questions that follow.
Personal impact on the addict
Addiction can lead to multiple behavioural problems, both in the short and long term, including impaired judgement, aggressiveness, impulsiveness and loss of self-control. This can have flow-on effects that impact all parts of the addict’s life.
- The need to fund a drug or gambling addiction may cause the addict to spend all of their money. They may also take out loans to fund their habit.
- Lack of concentration and other negative behaviours can lead to job loss, exacerbating financial problems.
- Financial worries, aggression and lack of control can result in relationship breakdowns.
- The addict may be driven to criminal behaviour to fund their habit.
Personal impact on whānau
Not only can addiction harm the addict, but it can negatively impact their whānau. Addiction can lead to conflict between whānau members. Family members can become stressed or anxious when dealing with the addicted person, which can negatively affect their own health. Any financial problems relating to the addiction may also impact whānau.
Activity
Addiction can be treated successfully. However, every addiction type and every addicted person faces different challenges. A wide range of approaches and models can be applied to treating addiction. These treatments are ideally combined with positive lifestyle changes.
Addiction treatment approaches
Approaches to addiction treatment include:
- Inpatient treatment: Provides intensive support, often including withdrawal management, in a controlled hospital or clinic setting.
- Intensive community treatment: Offers dedicated and comprehensive care within the community, focusing on addiction recovery.
- Community treatment: Provides outpatient support for individuals dealing with addiction while allowing them to continue living at home.
- Residential treatment programmes: Offers a structured and supportive environment for individuals to address addiction, typically in a live-in facility.
- Evening treatment programmes: Provides addiction support during evening hours, accommodating work and daily commitments.
- Therapeutic communities: Emphasise peer support and mutual aid within a residential setting to promote recovery.
- Special treatment settings: Tailored addiction treatment within correctional facilities to address the unique needs of incarcerated individuals.
- Harm reduction: Focuses on minimising the negative consequences of substance use and promoting safer practices.
- Counselling: Offers one-on-one or group therapy sessions to address addiction-related issues and provide emotional support.
- CBT: Cognitive behavioural therapy can be used to change an individual's thoughts and beliefs about their addiction and thereby help curb addictive behaviour.
Models of addiction treatment
Models of addiction treatment include:
- The Wheel of Change model (Prochaska and DiClemente, 1982)
- Brief Intervention (Babor, T. F., & Higgins-Biddle, J. C., 2001)
- any Twelve-Step Programme
- motivational interviewing
- recovery-oriented systems of care
- 5 Step Method Family Intervention (Copello, Orford, Templeton and Velleman, 2010)
Share
Select one of these addiction treatment models listed. Use the internet to conduct research and write a summary.
Post the summary on the 5.4.3 Addiction treatment models forum thread.
Medications
Sometimes, medications are used to treat substance addiction.
Medication to help with withdrawal
When a person stops taking a drug, they can suffer withdrawal. If unpleasant side effects are not addressed, the tangata may be tempted to take the addictive substance. The following medication types may be used to address some of the side effects:
- benzodiazepines (tranquilisers)
- anti-nausea medications
- pain killers
- sedatives
Opioid substitution treatment (OST)
If a person is addicted to opioids, it can be impossible to stop taking them. With OST, the patient is prescribed a less harmful opioid such as methadone, buprenorphine and naloxone. The substitute opioid helps with cravings and withdrawal symptoms and allows the tangata to take steps to address their addiction. The amount of substitute opioids prescribed is reduced over time with the ultimate aim of coming off all opioids.
Ref: Healthinfo, Treating alcohol or drug addiction.
Nicotine replacement therapy (NRT)
People often find it very hard to give up cigarette smoking. In many cases, this is because they are physically addicted to nicotine. NRT is a medication that supplies a small amount of nicotine, which reduces cravings and some of the effects of withdrawal. The medication is delivered in various forms, including skin patches and chewing gum.
Ref: Healthify, Nicotine replacement therapy.
Recovery support
There are five major areas that support recovery and support wellness while undergoing addiction treatment.
Activity
Watch: addiction and self-trust (9:54 minutes)
Watch the video about addiction and trust and answer the reflection questions that follow.
Reflection
- The video discusses the idea of delay discounting. Can you think of an example where you have valued immediate rewards over future rewards?
- Does the idea of addicts trusting themselves rather than trusting medical professionals or a higher power resonate with you? Why or why not?
