“Addictions” in the context of mental health may refer to smoking, alcoholism or substance use disorders. In the larger sense “addictive behaviors” may also refer to problems such as compulsive buying, gambling, certain eating disorders such as binge eating, sexual addictions just to name a few. Usually there is a compulsive habit pattern wherein the individual seeks a state of immediate gratification. This is typically followed not only by negative consequences such as physical discomfort or disease, social disapproval, decreased self-esteem, but also terrible financial and possibly legal problems. This article will refer mainly to Alcohol and Substance Use Disorders. These disorders have been described as the “equal opportunity destroyers”-affecting every community, geographical location and socioeconomic class.
In the most recent Diagnostic and Statistical Manual of Mental Disorders, one sees two levels of severity defined, namely “Abuse” and “Dependence”.
“Substance Abuse” is defined by a maladaptive pattern of substance use leading to serious impairment or distress, due to one (or more) of the following, occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or
home
2. Recurrent substance abuse in situations in which it is physically hazardous (e.g., during driving)
3. Recurrent substance-related legal problems
4. Continued use despite having persistent or recurrent social or interpersonal problems caused or
exacerbated by the effects of the substance
“Substance Dependence” is defined by a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
1. Tolerance, a need to take more drugs or alcohol to achieve the intoxicated state.
2. Withdrawal symptoms characteristic of the substance- depending on the type of substance, withdrawal can include( but is not limited to: shaking, cravings for the substance, impaired social interactions, and impaired judgment.
3. The substance is often taken in larger amounts or over a longer period than was intended
4. Persistent or unsuccessful desire to cut down or control substance use
5. A great deal of time is spent in trying to obtain the substance
6. Important social, occupational, or recreational activities are given up or reduced because of substance use
7. The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance
One could apply these criteria either to alcohol or to any illicit drug. Some of the biggest challenges before one seeks help is the awareness and acceptance that one may have a problem. One could ask their primary care provider or a psychiatrist to guide them on ways to get help. Thousands of people who suffer from addictions find help in mutual-help 12 step programs such as Alcoholics Anonymous or Narcotics Anonymous. One could find a treatment center at www.findtreatment.samhsa.gov or at www.maryland-adaa.org/index.html. Families could empower themselves through educating themselves and learning to be supportive and yet not enabling.