DRUG ADDICTION

Drug addiction has been defined in various ways in the recent past, and there are still many definitions in the professional and lay literature that partially overlap. Modern medicine understands addiction as a chronic brain disease, while some psychologists consider it an uncontrollable habit. Some people and organizations even try to avoid the term “addiction” altogether because of its derogatory and defamatory connotations.

Neurobiological research helps to explain many ambiguities regarding addictions. It has been found out that in natural situations, dopamine (a chemical or hormone associated with pleasant feelings and conditions) is released when a rewarding experience is new, better than expected or unexpected. Such release of dopamine helps the individual to remember the signals announcing the reward. Thus, when the dopamine system is over-excited as a result of drug use, attempts to repeat these effects may prevail over other important targeted activities. Activities that previously brought pleasure to the user are not attractive anymore. On the contrary, drug use brings pleasure and desire to use it repeatedly.

From a medical point of view, a person is diagnosed with drug addiction if he or she feels a strong desire to use the drug, has problems in having control under drug use in terms of quantity, but also frequency (how often he or she takes it), has mental and physical problems after as he or she does not take the drug, he/she uses more and more drugs (tolerance increases) to achieve the original effects of lower doses, neglects other pleasures and interests, and continues to take drugs despite clear evidence of obviously harmful consequences. A person is diagnosed with an addiction if he or she has three of these six symptoms in the last year. Drug addiction is diagnosed only by a psychiatrist or an addictologist. Since not all of these symptoms may be present in a drug addict (e.g. drug tolerance may not be developed), there is no completely accurate characteristic of a drug addict. However, we can say that a drug addict is strongly motivated (consciously or unconsciously) towards such behavior that has no purpose in terms of survival, while this motivation is strengthened by repeated practice (drug use) and therewith associated behavior has a significant potential to harm oneself or his/her closest family and friends.

Where is the line between drug users and drug addicts?

Drug users are often incorrectly automatically labeled as addicts. In fact, out of the total number of drug users, drug use causes major problems for a maximum of about 10% of users, and even with a smaller percentage it is possible to make a diagnosis – drug addict. The American psychiatrist N. Zinberg dealt with the issue of controlled and continuous drug use and came up with a theory based on research, which points out that not every drug use or regular usage leads directly to addiction and that every person can be at different stages of drug use.

The degree of risk of addiction on the continuum of use increases from left to right. It is not a rule that people always or exclusively move in this direction along this continuum – i.e. in the direction of gradually increasing their dose and frequency until they end up with drug addiction.

Each point can represent the beginning, the middle and the end in drug use. It is not a rule that the user has to go through all the points. For example, a person may start experimenting e.g. with marijuana, the experiment converts into regular use, then regular use with problems, and finally the person decides to abstain due to the problems associated with marijuana use.

Within the continuum of use, each of us can constantly move on these imaginary points. There is also a misunderstanding that the person who is on the far right of the continuum of use is referred to as a drug user. Among the common drug users, we also include the already mentioned experimental adolescents, occasional celebrants, but also those who use it daily, albeit in small quantities.

Zinberg’s theory suggests that most experimenters will not become regular drug users. Secondly, many people may remain occasional users of legal or illegal drugs with certain problems related to their use. And thirdly, most drug users (including those diagnosed with addiction) have had use under some type of control, at least a long period of drug use.

Why do people use drugs?

In general, people take drugs for several reasons (these can be psychological, biological, and existential):

– to feel good: Drugs can produce intense feelings of pleasure. This initial euphoria is followed by other conditions that differ from the type of drug used. For example, in case of stimulants (e.g. cocaine), high feelings is followed by feelings of strength, self-confidence and increased energy. Conversely, euphoria caused by opiates (e.g. heroin) is followed by feelings of relaxation and satisfaction.

– to feel better: Some people suffering from social anxiety, stress and depression start using drugs to feel less anxious. We can also include the need to avoid pain or find peace, to relieve from physical and mental pain – this includes pain from boredom, dissatisfaction, a feeling of difference from others or low self-esteem.

– to do things better: Some people feel the need to improve their attention at school or at work or to improve their skills in sports. Therefore, they may start or continue taking drugs such as stimulants (amphetamines, cocaine, etc.).

– need for transcendence: Substances with a psychedelic effect (especially hallucinogens and cannabinoids) can induce a state of experience of fusion and / or self-transcendence, unity with oneself and with others, with God, etc.

– curiosity and social pressure: Teenagers and adolescents are a particularly risky group, as peer pressure can be very strong. Teenagers are more likely than adults to be behave risky and audaciously in order to engage attention of their friends and show their independence from their parents and social norms.

Why do some people become addicted and some not?

The likelihood of developing addiction varies from person to person, and no single factor determines whether a person becomes addicted to drugs. In general, the more risk factors a person has, the greater the chance that drug use will lead to addiction. On the other hand, protective factors reduce this risk. Risk and protective factors can be of biogenetic, social, ethnic, anthropological and psychological origin. In the area of family relationships, a disturbed mother-child relationship has traditionally been assumed; based on recent research, attention has also begun to focus on the father-child relationship.

Risk factors

– genetic predisposition

– stress, high impulsivity, depression, anxiety, eating disorders

– personality disorders and other mental disorders

– physical, sexual or emotional abuse in childhood or other trauma

– lack of parental supervision (emotional coldness, distance, indifference)

– excessive parental care and protection

– poor communication between parents and adolescents

– addiction of another family member (usually a parent), their criminal activity

– drug experimentation

– availability of drugs in schools

– social poverty

Protective factors:

– good self-control

– supervision and support of parents

– positive relationships

What other factors increase the risk of addiction?

Early use. Although drug use at any age can lead to addiction, research shows that the sooner a person starts taking drugs, the higher the probability that is will lead to serious problems. This are due to the harmful effects that drugs have on the developing brain.

Method of use. Smoking or injecting drugs increases their addictive potential. In this way, drugs enter the brain within seconds, producing a strong rush of pleasure. However, this intense feeling can disappear within minutes. Researchers believe that this marked contrast leads some people to repeated drug use in an effort to capture a fleeting pleasant state.

Sources

CASAColumbia (2012). Addiction medicine: Closing the gap between science and practice. New York : The National Center on Addiction and Substance Abuse at Columbia university.

Heretik, A., sr., Heretik, A., jr. (2016). Klinická psychológia. Nové Zámky : Psychoprof. ISBN 978-80-8932-224-4

Hupková I., Liberčanová K. (2012). Drogové závislosti a ich prevencia. Trnava : Pedagogická fakulta Trnavskej Univerzity. ISBN 978-80-8082-563-8

Köpetz, C. E., Lejuez, C. W., Wiers, R. W., & Kruglanski, A. W. (2013). Motivation and Self-Regulation in Addiction: A Call for Convergence. Perspectives on psychological science : a journal of the Association for Psychological Science, 8(1), 3–24. doi:10.1177/1745691612457575

NIDA. (2018). Drugs, Brains, and Behavior: The Science of Addiction. Dostupné na: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction (20. 12. 2019)