Addictions these days are not limited to smoking, drinking, and gambling.
Instead, the tag of addict includes a variety of actions including excessive indicators of shopping, text messaging, overworking, or even over-exercising.
“All addictions start with the experimental stage,” says Pam Slater, MS, licensed professional counselor at Hickory Trail Hospital in Dallas, Texas. “Usually consequences follow, but if the pay off from the engagement is greater than the perceived emotional or physical pain, the participant continues despite any negative consequences.”
Even as the “soft” addictions teeter on the brink of acceptance, society definitely takes a harder look at addictions such as heroin, and amphetamines, all definitely still a prominent problem in society, but consider too the legally prescribed drugs. In this era of “instant pleasure’ nicotine and alcohol, two drugs believed by Dr. David Sack, CEO of Promises Treatment Centers in Los Angeles and Malibu, to be the most abused substances today. Both are widely accepted, as is the rampant use of prescription medication.
In addition, while each generation always finds simple ways of getting alcohol and cigarettes, unfortunately, the ease with which people obtain pharmaceutical drugs is now creating an even more dangerous addiction for all age groups.
“The biggest change in addiction in the United States is the rise of prescription opiate abuse,” says Sack. “Changes in the way doctors treat pain problems make prescription narcotic drugs far more available and this leads to greater experimentation with this class of drugs.”
Another factor is the recent increase in the internet sales of narcotics
According to Slater, the most abused prescription drugs are hydrocodone and oxycontin. “These opiates have now far surpassed the formerly popular cocaine of the 90s, as well as surpassed crystal meth of this decade,” she says. “There is an estimated 20.4 million Americans reportedly abusing these prescription drugs, but the true number is probably higher due to underreporting.”
Suellen Fagin-Allen, JD, licensed mental health counselor in Orlando, Fla. does raise that number even higher, “It’s estimated by government sources that over 41 million Americans suffer from addiction to either just alcohol, or alcohol in combination with other drugs. A significant percentage of these individuals have other co-occurring mental health issues. Based on my work in the addiction’s field over nine years, I would say it’s about 50 percent. I would also say that nicotine is right up there with alcohol, with research indicating that nicotine is the cause for one in every five deaths in the U.S. today.”
How does an addictive nature develop?
“There is considerable data to suggest that the personality trait of impulsivity carries with it an increased risk for substance use disorders,” Sack explains.
Robert Weiss, licensed clinical social worker, CSAT-S and the Founding Director of the Sexual Recovery Institute in Los Angeles, Calif., adds that in his work with sexual addiction, he finds that addictive personalities tend to be more narcissistic, self-involved, self-protective, easily wounded, and needy, but hide it.
Fagin-Allen also believes that people with symptoms of depression have a statistically higher likelihood to abuse alcohol or pain relievers, noting that about 40 percent of patients treated for alcohol abuse or dependence also show symptoms of depression.
“Antisocial personality disorder highly correlates to substance abuse disorders, although it is not clear which precedes which, because the statistics show that persons with substance abuse disorders are more likely to commit crimes or engage in other antisocial behavior, be less satisfied with their lives, and be more isolated and depressed than those who do not,” she adds.
So, with the mounting number of possible addictions, how do we treat addicts?
“Though the medical model works to safely detox patients,” Slater says. “The most effective treatments involve long term residential rehabs, which utilize cognitive behavioral therapies, family and recreation therapy, and confrontive behavior modification therapies.”
Slater adds that the focus of current research is on developing medications that block drug induced euphoria. “For example, Weill Cornell Medical College is developing a ‘cocaine vaccine’ which would block the rush of cocaine.”
Sack says, “The approach to addiction has dramatically changed with the availability of medications that work with psychotherapeutic approaches to reduce relapse and decrease use. These include long acting injected medications that decrease craving and block the ability to get high.”
Weiss also notes the use of virtual reality therapy, which he says is gaining momentum. “As an example, virtual reality therapy enables the addict to go into a virtual bar, see the bar’s patrons, smell the familiar bar smells, see the alcohol present, and enable them to learn to lower their reactivity to all of those triggers through the virtual reality component.”
A technique of the future, perhaps, but Sack says, “People who become addicted often respond differently to drugs than their peers.” Even more eye opening is the fact that 90 percent of all people with drug and alcohol problems never seek treatment.
Fagin-Allen believes that some alternative methods in treatment might also be the answer, but she says common treatments today still emphasize a bio-psycho-social approach that deals with the physical process of addiction, the individual, and the person’s functioning in the environment.
She points out that alternative therapies include mindfulness-based practices, such as energy medicine, and eastern medicine like meditation, acupuncture, and Qi Gong. Another option is the Emotional Freedom Technique, which combines tapping on acupressure points located in various parts of the body while reciting positive affirmations. Fagin-Allen says there is a growing body of evidence that these practices do reduce cravings by helping the patient to learn how to fight the cravings, which is at the heart of recovery from addiction.
“The first step is to recognize that there is a problem,” Sack concludes. “For many this only occurs when their family, work, or legal system forces the issue. There are many approaches, both inpatient and outpatient, that can be effective and which approach to take depends on the severity of the drug use, and the number of other psychiatric and medical problems the individual faces.”
Sources:
Pam Slater MS, LPC – Hickory Trail Hospital in Dallas, TX
Suellen Fagin-Allen, JD, LMHC – Orlando, FL
Dr. David Sack, CEO of Promises Treatment Centers in Los
Angeles and Malibu, CA
Robert Weiss, founder and director of Sexual Recovery
Institute (SRI) – Los Angeles, CA