Psychological Problems - Addiction

Addiction is a psychological problem where people feel that they need to do something regularly to avoid negative feelings.

The International  Classification of Diseases version 10, where addiction is known as a ‘dependence disorder’ focuses on drugs. 

People with addiction often have symptoms of withdrawal if they can’t do what they are addicted to.

This makes the person feel bad or guilty that they have to take this thing again to feel normal.

To be diagnosed with this, you have to have these symptoms at the same time for at least 1 month in total.

Symptoms of dependence disorder 

  • Feeling like you have to take the substance 
  • Stopping is very difficult
  • Withdrawal symptoms : shaking, sweating
  • Tolerance to the substance, so they have to increase it each time they use it
  • Ignoring evidence that substance is harmful
  • Replacing fun activities with time spent using substance

How does addiction affect individuals and society?

  • By doing the thing they’re addicted to, they may ignore their family and the things they regularly did like going to work. They also spend money for food on addiction. Their quality of life and health is affected because they cannot invest in themselves.
  • Impact on the workplace. Company has to cover the workload of the individual.
  • Cost of health care. Substance misuse costs the NHS £488 million including treatment for diseases as a result of addiction (lung cancer) and rehab programmes.
  • Addiction may cause you to turn to criminal behaviour. There’s emotional and physical costs for victims but also costs to investigate the crime.

Genetic explanation of addiction

  • Carmelli et al (1992) found that monozygotic twins have higher chances of addiction if the other was too. 
  • Goodwin et al found that adopted children who had at least one biological parent with alcohol addiction were highly likely to show signs of alcohol addiction. 
  • The DDR2 gene has been shown to be related to developing addiction. Many addictions are linked to a variation of this gene (A1). This gene affects the way the brain reacts to pleasurable activities.

Strengths and weaknesses of the genetic explanation of addiction

Strengths Weaknesses 
Lots of scientific evidence to support it.Twin studies and adoption studies act as a control for possible factors that could explain addiction. Reliable. Reductionist. Fails to take into account social factors.E.g. Many twins in Carmelli et als study would have shared the same home environment which may be a factor.
It would explain why people are more prone to addiction. This helps us understand those in treatment because they can’t help the way they behave.Research has not been able to find a single gene that explains where addiction comes from.This makes it hard to pinpoint what is causing addiction.
Learning theory 
Classical conditioning Behaviour learned through associations. People may associate a substance with a positive feeling, so they want to do it again.
Operant conditioning Behaviours are repeated when they lead to a positive consequence.If the thing they are addicted to makes them feel good, it reinforces the behaviour and makes them want to do it again.A person might also continue their addiction in order to fight the withdrawal symptoms.
Social learning theory Behaviour is learned as a result of observing other people, role models. 

Strengths and weaknesses of learning theory

Strengths Weaknesses 
By assuming that addictions are the result of learning, we can unlearn them.Ignores the role of biological factors. 
Classical conditioning helps us to explain why previous addicts sometimes relapse.Conditioning theories do not explain why lots of people try drugs, alcohol.By learning from associations, everyone can get addiction too.
Operant conditioning takes into account biological factors. Taking the drugs makes the pathways in our brains reward us internally.

CBT treatment of addiction 

  • It aims to help people understand the triggers for their addictive behaviours and then learn how to control and manage these behaviours.
Functional analysis 
Looking closely at the addict’s behaviour and working out what makes them turn to their addiction. By understanding the source of addiction we can learn to avoid the behaviour. 
Skills training 
The patients learn skills that they can use to avoid engaging in addictive behaviour. How to cope with cravingsAssertiveness training – useful when people are often encouraging them to participate in the thing they’re addicted toImproving motivation – helps them commit to therapy

Strengths and weaknesses of using CBT to treat addiction

StrengthsWeaknesses 
It aims to give the patient control to stop their own addictive behaviour. This builds skills and motivations to stay away from the behaviour in the future.Addict has to be motivated to change their behaviour.Addict might find it difficult to stop.It will only work if the patient is willing.
Supported by research evidence Young’s (2007) study found that CBT was effective for treating people with internet addiction in the short term and 6 months after treatment.It can provide long term treatment.
Some research suggested that even though addicts can learn better coping skills it does not always reduce problem behaviour.

Drug therapy as a treatment for addiction

  • Patients with drug addictions often benefit from taking a form of medication to help them cope with the effects of detoxification. 
  • When stopping many substances, there are negative side effects.
Withdrawal When the person stops the thing they are addicted to, they face physical symptoms of withdrawalE.g. sweating, shaking, headache, lack of appetite, irritability This makes the process of detoxification difficultDrugs can be given to reduce these symptoms and chance of relapse
Reducing cravings Many patients crave substance when they stop using itThis can be because their nervous system has become used to the effects of the substanceMedication can be given to help control these symptoms
Treating other underlying mental health problemsSome patients have other mental health problems such as depression or anxietyThese drugs reduce symptoms of problems that could cause relapse

Behavioural addiction 

  • Naltrexone can help to lessen these cravings and help to stop (gambling) addicts from relapsing when they stop gambling. 
  • Antidepressants such as SSRIs can be used for behavioural addiction, these increase the amount of serotonin available in the brain.  These seem to help the patient control the urge to participate in the behaviour. 

Strengths and weaknesses of drug therapy

Strengths Weaknesses 
Research evidence to support it. Suck won kim et al (2001) presented evidence that 75% of gambling addicts who had naltrexone improved in symptoms. This was compared to gambling patients with a placebo drug (24%)Evidence supporting it is very mixed.John Krystal (2001) found that there was no significant difference in relapse rates over a 12 month period between alcoholic patients taking naltrexone and those with a placebo. 
They may help the patient access other types of therapy that could help control their addiction in the long term by dealing with short term symptoms associated with stopping their addiction.Some argue that giving medication to patients who are already addicted to something, especially if their medication is another substance, could make their problems worse in the long term because they may become dependent on the medication.When they stop taking the medication, their chance of relapse could increase when faced with withdrawal symptoms. 

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