Addiction is a state in which the body relies on a substance for normal functioning. Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative When this substance is removed, it can cause withdrawal. It was first used in 1906, in reference to opium (there is an isolated instance from 1779, with ref. Opium is a Narcotic formed from the Latex (ie sap released by lacerating (or "scoring" the immature seed pods of opium poppies ( Year 1779 ( MDCCLXXIX) was a Common year starting on Friday (link will display the full calendar of the Gregorian calendar (or a Common to tobacco). The first use of the adjective addict (with the meaning of "delivered, devoted") was in 1529 and comes from Latin addictus, pp. of addicere ("deliver, yield, devote," from ad-, "to" + dicere, "say, declare"). ^[1]

Addiction is a term used to describe a devotion, attachment, dedication, inclination, etc. Nowadays, however, the term addiction is used to describe a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to the individual's health, mental state or social life. Compulsion can refer to among other things Compulsion (album, a 1965 jazz album by American pianist Andrew Hill Compulsion The term is often reserved for drug addictions but it is sometimes applied to other compulsions, such as problem gambling, and compulsive overeating. Drug addiction is widely considered a pathological state. The disorder of addiction involves the progression of acute Drug use to the development of drug-seeking Problem gambling (ludomania is an urge to gamble despite harmful negative consequences or a desire to stop Compulsive overeating, also sometimes called food addiction is characterized by a Compulsive relationship to food which is addressed by professionals with either a Factors that have been suggested as causes of addiction include genetic, biological/pharmacological and social factors. Genetics (from Ancient Greek grc-Latn genetikos, “genitive” and that from grc-Latn genesis, “origin” a discipline of Biology, is Foundations of modern biology There are five unifying principles Pharmacology (from Greek grc φάρμακον pharmakon, "drug" and grc -λογία -logia) is the study of how Drugs Sociology (from Latin: socius "companion" and the suffix -ology "the study of" from Greek λόγος lógos "knowledge"

Contents 1 History 2 Varied forms of addiction 2.1 Physical dependency 2.2 Psychological dependency 3 Addiction and drug control legislation 4 Methods of care 5 Diverse explanations 6 Neurobiological basis 7 Criticism 8 Casual addiction 9 See also 10 Notes 11 Further reading 12 External links

History

Decades ago addiction was a pharmacological term that clearly referred to the use of a tolerance-inducing drug in sufficient quantity as to cause tolerance (the requirement that greater dosages of a given drug be used to produce an identical effect as time passes). Pharmacology (from Greek grc φάρμακον pharmakon, "drug" and grc -λογία -logia) is the study of how Drugs With that definition, humans (and indeed all mammals) can become addicted to various drugs quickly. Almost at the same time, a lay definition of addiction developed. This definition referred to individuals who continued to use a given drug despite their own best interest. This latter definition is now thought of as a disease state by the medical community.

Not all doctors agree on what addiction or dependency is. Traditionally, addiction has been defined as being possible only to a psychoactive substance (for example alcohol, tobacco and other drugs) which ingested cross the blood-brain barrier, altering the natural chemical behavior of the brain temporarily. Alcoholism is a term with multiple and sometimes conflicting definitions Tobacco Smoking is the inhalation of smoke from burned dried or cured leaves of the Tobacco plant most often in the form of a Cigarette. Drug addiction is widely considered a pathological state. The disorder of addiction involves the progression of acute Drug use to the development of drug-seeking The blood-brain barrier (BBB is a metabolic or cellular structure in the Central nervous system (CNS that restricts the passage of various chemical substances and microscopic However, "Studies on phenomenology, family history, and response to treatment suggest that intermittent explosive disorder, kleptomania, pathological gambling, pyromania, and trichotillomania may be related to mood disorders, alcohol and psychoactive substance abuse, and anxiety disorders (especially obsessive-compulsive disorder). Intermittent explosive disorder ( IED) is a behavioral disorder characterized by extreme expressions of anger often to the point of uncontrollable rage that are disproportionate Kleptomania ( Greek: κλέπτειν, kleptein "to steal" μανία, " Mania " is the condition of not being able Problem gambling (ludomania is an urge to gamble despite harmful negative consequences or a desire to stop Pyromania is an impulse to deliberately start fires to relieve tension and typically includes gratification or relief afterward Trichotillomania (TTM or "trich" as it is commonly known is an impulse control disorder or form of Self-injury characterized by the repeated urge A mood disorder is the term given for a group of diagnoses in the DSM IV TR classification system where a disturbance in the person's emotional mood is hypothesised Substance abuse is the overindulgence in and dependence of a Drug or other chemical leading to effects that are detrimental to the individual's physical and mental health Anxiety disorder is a blanket term covering several different forms of abnormal pathological anxieties Fears and Phobias In clinical usage "fear" Obsessive-compulsive disorder (OCD is a Chronic Anxiety disorder most commonly characterized by obsessive Distressing Intrusive thoughts ^[2]

It is generally accepted that addiction is a disease, a state of physiological or psychological dependence or devotion to something manifesting as a condition in which medically significant symptoms liable to have a damaging effect are present. ^[3]

Many people, both psychology professionals and laypersons, now feel that there should be accommodation made to include psychological dependency on such things as gambling, food, sex, pornography, computers, work, exercise, cutting, shopping, and religion^[4] so these behaviours count as diseases as well and don't cause guilt, shame, fear, hopelessness, failure, rejection, anxiety, or humiliation symptoms associated with, among other medical conditions, depression^[5],epilepsy,^[6] and hyperreligiosity. Overeating can refer either to eating too much at one time or to eating too much on average Hypersexuality is the desire to engage in Human sexual behavior at a level high enough to be considered clinically significant Pornography addiction is a form of Sexual addiction described by its proponents as a condition characterized by the overuse or abuse of Pornography. Computer addiction is an obsessive Addiction to computer use sometimes known as Dependency A workaholic, colloquially is a person who is addicted to work Self-injury ( SI) or self-harm ( SH) is deliberate Injury inflicted by a person upon their own body without suicidal intent Shopping is the examining of Goods or services from Retailers with intent to purchase at that time A religion is a set of Tenets and practices often centered upon specific Supernatural and moral claims about Reality, the Cosmos ---- Guilt is the Fact, state or Verdict (by a Court or other Tribunal) of an Offence, Crime, Violation Shame is variously an affect emotion cognition state or condition Fear is an Emotional response to Threats and Danger. It is a basic survival mechanism occurring in response to a specific Stimulus, such as Failure ( fail, phail or flop) in general refers to the state or Condition of not meeting a desirable or intended objective Anxiety is a physiological and psychological state characterized by Cognitive, Somatic, Emotional and Behavioral components Humiliation (also called stultification) is the abasement of pride mortification Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Epilepsy is a common chronic Neurological disorder that is characterized by recurrent unprovoked seizures. ^[7] In depression related to religious addiction "The religious addict seeks to avoid pain and overcome shame by becoming involved in a belief system which offers security through its rigidity and its absolute values. "^[8] While religion and spirituality may play a key role in psychotherapeutic support and recovery, it can also be a source of pain, guilt and exclusion, and religious themes may also play a negative role in psychopathology. ^[9] Although, the above mentioned are things or tasks which, when used or performed, do not fit into the traditional view of addiction and may be better defined as an obsessive-compulsive disorder,withdrawal symptoms may occur with abatement of such behaviors. Obsessive-compulsive disorder (OCD is a Chronic Anxiety disorder most commonly characterized by obsessive Distressing Intrusive thoughts Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is It is said by those who adhere to a traditionalist view that these withdrawal-like symptoms are not strictly reflective of an addiction, but rather of a behavioral disorder. However, understanding of neural science, the brain, the nervous system, human behavior, and affective disorders has revealed "the impact of molecular biology in the mechanisms underlying developmental processes and in the pathogenesis of disease". Neuroscience is a field devoted to the scientific study of the nervous system The affective spectrum is a grouping of related psychiatric and medical disorders which may accompany bipolar, unipolar, and Schizoaffective ^[10] The use of thyroid hormones as an effective adjunct treatment for affective disorders has been studied over the past three decades and has been confirmed repeatedly. ^[11] In spite of traditionalist protests and warnings that overextension of definitions may cause the wrong treatment to be used (thus failing the person with the behavioral problem), popular media, and some members of the field, do represent the aforementioned behavioral examples as addictions.

Recently, some have modeled addiction using the tools of Economics, for instance, by calculating the elasticity of addictive goods and determining to what extent present income and consumption has on future consumption. Economics is the social science that studies the production distribution, and consumption of goods and services. In Economics, elasticity is the ratio of the percent change in one variable to the percent change in another variable Income, refers to consumption opportunity gained by an entity within a specified time frame which is generally expressed in monetary terms In economics consumption is the primary motivating force in the wealth or utility maximizing paradigm ^[12]

Varied forms of addiction

Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR). The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association It doesn’t use the word addiction at all. It has instead a section about Substance dependence:

"Substance dependence When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. According to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV substance dependence is defined as "When an individual According to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV substance dependence is defined as "When an individual Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with Substance Abuse are considered Substance Use Disorders. Substance abuse is the overindulgence in and dependence of a Drug or other chemical leading to effects that are detrimental to the individual's physical and mental health . . " ^[13]

Terminology has become quite complicated in the field. To wit, pharmacologists continue to speak of addiction from a physiologic standpoint (some call this a physical dependence); psychiatrists refer to the disease state as dependence; most other physicians refer to the disease as addiction. The field of psychiatry is now considering, as they move from DSM-IV to DSM-V, transitioning from "substance dependence" to "addiction" as terminology for the disease state.

The medical community now makes a careful theoretical distinction between physical dependence (characterized by symptoms of withdrawal) and psychological dependence (or simply addiction). Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is Addiction is now narrowly defined as "uncontrolled, compulsive use"; if there is no harm being suffered by, or damage done to, the patient or another party, then clinically it may be considered compulsive, but to the definition of some it is not categorized as "addiction". In practice, the two kinds of addiction are not always easy to distinguish. Addictions often have both physical and psychological components.

There is also a lesser known situation called pseudo-addiction. ^[14] (Weissman and Haddox, 1989) A patient will exhibit drug-seeking behavior reminiscent of psychological addiction, but they tend to have genuine pain or other symptoms that have been undertreated. Unlike true psychological addiction, these behaviors tend to stop when the pain is adequately treated.

The obsolete term physical addiction is deprecated, because of its connotations. In modern pain management with opioids physical dependence is nearly universal. While opiates are essential in the treatment of acute pain, the benefit of this class of medication in chronic pain is not well proven. Clearly, there are those who would not function well without opiate treatment; on the other hand, many states are noting significant increases in non-intentional deaths related to opiate use. High-quality, long-term studies are needed to better delineate the risks and benefits of chronic opiate use.

Physical dependency

Physical dependence on a substance is defined by the appearance of characteristic withdrawal symptoms when the substance is suddenly discontinued. Physical dependence (or drug dependence) refers to a state resulting from habitual use of a drug where negative physical Withdrawal symptoms result from abrupt discontinuation Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is Opiates, benzodiazepines, barbiturates, alcohol and nicotine induce physical dependence. For other uses see Opiate (disambiguation, or for the class of drugs see Opioid. The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic Barbiturates are drugs that act as central nervous system Depressants and by virtue of this they produce a wide spectrum of effects from mild Sedation In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon Nicotine is an Alkaloid found in the Nightshade family of plants ( Solanaceae) which constitutes approximately 0 On the other hand, some categories of substances share this property and are still not considered addictive: cortisone, beta-blockers and most antidepressants are examples. Cortisone (ˈkɔrtɨsoʊn or /ˈkɔrtɨzoʊn/ (ˈkôrtəˌsōn or -zōn (17-hydroxy-11-dehydrocorticosterone is a Steroid Hormone. Beta blockers (sometimes written as β-blocker) are a class of drugs used for various indications but particularly for the management of Cardiac arrhythmias An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression So, while physical dependency can be a major factor in the psychology of addiction and most often becomes a primary motivator in the continuation of an addiction, the initial primary attribution of an addictive substance is usually its ability to induce pleasure, although with continued use the goal is not so much to induce pleasure as it is to relieve the anxiety caused by the absence of a given addictive substance, causing it to become used compulsively. An example of this is nicotine; A cigarette can be described as pleasurable, but is in fact fulfilling the physical addiction of the user, and therefore, is achieving pleasurable feelings relative to his/her previous state of physical withdrawal. Nicotine is an Alkaloid found in the Nightshade family of plants ( Solanaceae) which constitutes approximately 0 Further, the physical dependency of the nicotine addict on the substance itself becomes an overwhelming factor in the continuation of use.

Some substances induce physical dependence or physiological tolerance - but not addiction - for example many laxatives, which are not psychoactive; nasal decongestants, which can cause rebound congestion if used for more than a few days in a row; and some antidepressants, most notably venlafaxine, paroxetine and sertraline, as they have quite short half-lives, so stopping them abruptly causes a more rapid change in the neurotransmitter balance in the brain than many other antidepressants. In Physiology, tolerance occurs when an organism builds up a resistance to the effects of a substance after repeated exposure Laxatives (or purgatives) are foods compounds or drugs taken to induce bowel movements or to loosen the stool most often taken to treat Constipation. A decongestant is a broad class of Medications used to relieve Nasal congestion. An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression Venlafaxine (Effexor Efexor is an Antidepressant of the Serotonin-norepinephrine reuptake inhibitor (SNRI class first introduced by Wyeth in 1993 Paroxetine (trade names Seroxat, Paxil, Parotin, Aropax, Xetanor, ParoMerck, Rexetin) is a Selective serotonin Half-Life (computer-game page here It's already listed in the disambiguation page Many non-addictive prescription drugs should not be suddenly stopped, so a doctor should be consulted before abruptly discontinuing them.

The speed with which a given individual becomes addicted to various substances varies with the substance, the frequency of use, the means of ingestion, the intensity of pleasure or euphoria, and the individual's genetic and psychological susceptibility. Some people may exhibit alcoholic tendencies from the moment of first intoxication, while most people can drink socially without ever becoming addicted. Opioid dependent individuals have different responses to even low doses of opioids than the majority of people, although this may be due to a variety of other factors, as opioid use heavily stimulates pleasure-inducing neurotransmitters in the brain. Nonetheless, because of these variations, in addition to the adoption and twin studies that have been well replicated, much of the medical community is satisfied that addiction is in part genetically moderated. That is, one's genetic makeup may regulate how susceptible one is to a substance and how easily one may become psychologically attached to a pleasurable routine.

Eating disorders are complicated pathological mental illnesses and thus are not the same as addictions described in this article. An eating disorder is a compulsion to eat or avoid eating that negatively affects both one's physical and mental health Eating disorders, which some argue are not addictions at all, are driven by a multitude of factors, most of which are highly different than the factors behind addictions described in this article.

Psychological dependency

Psychological dependency is a dependency of the mind, and leads to psychological withdrawal symptoms (such as cravings, irritability, insomnia, depression, anorexia, etc). Hunger is a feeling experienced usually followed by a desire to Eat. Irritability is an excessive response to stimuli. Irritability takes many forms from the Contraction of a Unicellular organism when touched to complex Insomnia is a symptom of a sleeping disorder characterized by persistent difficulty falling asleep or staying asleep despite the opportunity In the fields of Psychology and Psychiatry, the terms depression or depressed refer to both expected and pathologically chronic or severe Anorexia (deriving from the Greek "α(ν-" ( a(n-, a prefix that denotes absence + "όρεξη (orexe = appetite is the decreased sensation Addiction can in theory be derived from any rewarding behaviour, and is believed to be strongly associated with the dopaminergic system of the brain's reward system (as in the case of cocaine and amphetamines). Dopamine is a Hormone and Neurotransmitter occurring in a wide variety of animals including both vertebrates and invertebrates The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain In neuroscience the reward system is a collection of brain structures which attempts to regulate and control behavior by inducing pleasurable effects Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant Amphetamine, and related drugs such as Methamphetamine are a group of drugs that act by increasing levels of Norepinephrine, Serotonin, and Dopamine Some claim that it is a habitual means to avoid undesired activity, but typically it is only so to a clinical level in individuals who have emotional, social, or psychological dysfunctions (psychological addiction is defined as such), replacing normal positive stimuli not otherwise attained (see Rat Park). Habits are habituated routines of behavior that are repeated regularly tend to occur Subconsciously and tend to occur without directly thinking consciously Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as Rat Park was a study into Drug addiction conducted in the 1970s by Canadian psychologist Bruce K

It is considered possible to be both psychologically and physically dependent at the same time. Some doctors, and especially scientists in related fields, make little or no distinction between the two types of addiction, since the result, substance abuse, is the same, and in terms of scientific as opposed to magical thinking, the "psychological" dependence is entirely due to physical effects of the drug on the brain. Substance abuse is the overindulgence in and dependence of a Drug or other chemical leading to effects that are detrimental to the individual's physical and mental health In Anthropology, Psychology, and Cognitive science, magical thinking is nonscientific causal reasoning that often includes such ideas as the ability of

Psychological dependence does not have to be limited only to substances; even activities and behavioural patterns can be considered addictions, if they become uncontrollable, e. g. gambling, Internet addiction, computer addiction, sexual addiction / pornography addiction, reading, eating, self-harm, vandalism, drug addiction or work addiction. Computer addiction is an obsessive Addiction to computer use sometimes known as Dependency Sexual addiction is a controversial term to describe sexual behaviour that is characterized at least by two key features recurrent failure to control the behavior and continuation of the Pornography addiction is a form of Sexual addiction described by its proponents as a condition characterized by the overuse or abuse of Pornography. An eating disorder is a compulsion to eat or avoid eating that negatively affects both one's physical and mental health Self-injury ( SI) or self-harm ( SH) is deliberate Injury inflicted by a person upon their own body without suicidal intent Vandalism is the behaviour attributed to the Vandals in respect of Culture: ruthless Destruction or spoiling of anything beautiful or Venerable Drug addiction is widely considered a pathological state. The disorder of addiction involves the progression of acute Drug use to the development of drug-seeking A workaholic, colloquially is a person who is addicted to work

Addiction and drug control legislation

Most countries have legislation which brings various drugs and drug-like substances under the control of licensing systems. Typically this legislation covers any or all of the opiates, amphetamines, cannabinoids, cocaine, barbiturates, hallucinogens (tryptamines, LSD, phencyclidine(PCP), psilocybin) and a variety of more modern synthetic drugs, and unlicensed production, supply or possession may be a criminal offense. Amphetamine, and related drugs such as Methamphetamine are a group of drugs that act by increasing levels of Norepinephrine, Serotonin, and Dopamine Cannabinoids ( are a group of terpeno[[phenol]]ic compounds present in Cannabis ( Cannabis sativa L Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant Barbiturates are drugs that act as central nervous system Depressants and by virtue of this they produce a wide spectrum of effects from mild Sedation The general group of pharmacological agents commonly known as hallucinogens can be divided into three broad categories Psychedelics, Dissociatives Tryptamine is a Monoamine Alkaloid found in Plants and Animals. Phencyclidine (a complex clip of the chemical name phenylcyclohexylpiperidine, commonly initialised as PCP) is a Dissociative drug Psilocybin (IPA /saɪləˈsaɪbɪn/ (also known as psilocybine) is a psychedelic Indole of the Tryptamine family found in Psilocybin

Usually, however, drug classification under such legislation is not related simply to addictiveness. The substances covered often have very different addictive properties. Some are highly prone to cause physical dependency, whilst others rarely cause any form of compulsive need whatsoever. Typically nicotine (in the form of tobacco) is regulated extremely loosely, if at all, although it is well-known as one of the most addictive substances ever discovered.

Also, although the legislation may be justifiable on moral grounds to some, it can make addiction or dependency a much more serious issue for the individual. Reliable supplies of a drug become difficult to secure as illegally produced substances may have contaminants. Withdrawal from the substances or associated contaminants can cause additional health issues and the individual becomes vulnerable to both criminal abuse and legal punishment. Criminal elements that can be involved in the profitable trade of such substances can also cause physical harm to users.

Methods of care

Early editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) described addiction as a physical dependency to a substance that resulted in withdrawal symptoms in its absence. The American Psychiatric Association (APA is the main Professional organization of Psychiatrists and trainee psychiatrists in the United States, and the The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association Recent editions, including DSM-IV, have moved toward a diagnostic instrument that classifies such conditions as dependency, rather than addiction. The American Society of Addiction Medicine recommends treatment for people with chemical dependency based on patient placement criteria (currently listed in PPC-2), which attempt to match levels of care according to clinical assessments in six areas, including:

• Acute intoxication and/or withdrawal potential
• Biomedical conditions or complications
• Emotional/behavioral conditions or complications
• Treatment acceptance/resistance
• Relapse potential
• Recovery environment

Some medical systems, including those of at least 15 states of the United States, refer to an Addiction Severity Index to assess the severity of problems related to substance use. The American Society of Addiction Medicine is a professional organization for Physicians who specialize in the treatment of Addiction. Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is A relapse (etymologically "who falls again" occurs when a person is affected again by a condition that affected them in the past The index assesses problems in six areas: medical, employment/support, alcohol and other drug use, legal, family/social, and psychiatric.

While addiction or dependency is related to seemingly uncontrollable urges, and arguably could have roots in genetic predispositions, treatment of dependency is conducted by a wide range of medical and allied professionals, including Addiction Medicine specialists, psychiatrists, and appropriately trained nurses, social workers, and counselors. Addiction medicine is a medical specialty that deals with the treatment of Addiction. Early treatment of acute withdrawal often includes medical detoxification, which can include doses of anxiolytics or narcotics to reduce symptoms of withdrawal. Detoxification, or detox for short is the removal of Toxic substances from the body An anxiolytic is a drug prescribed for the treatment of Symptoms of Anxiety. An experimental drug, ibogaine,^[15] is also proposed to treat withdrawal and craving. Ibogaine is a naturally-occurring Psychoactive compound found in a number of plants principally in a member of the dogbane family known as iboga ( Alternatives to medical detoxification include acupuncture detoxification. Acupuncture detoxification is the use of auricular (outer ear Acupuncture to treat Drug and Alcohol Addiction. In chronic opiate addiction, a surrogate drug such as methadone is sometimes offered as a form of opiate replacement therapy. Methadone ( Dolophine Amidone Methadose Physeptone Heptadon and many others is a synthetic Opioid, used medically as an Analgesic, Antitussive Opiate Replacement Therapy (ORT is the Medical procedure of replacing an illegal Opiate drug such as Heroin with a longer acting But treatment approaches universal focus on the individual's ultimate choice to pursue an alternate course of action.

Therapists often classify patients with chemical dependencies as either interested or not interested in changing. Treatments usually involve planning for specific ways to avoid the addictive stimulus, and therapeutic interventions intended to help a client learn healthier ways to find satisfaction. Clinical leaders in recent years have attempted to tailor intervention approaches to specific influences that affect addictive behavior, using therapeutic interviews in an effort to discover factors that led a person to embrace unhealthy, addictive sources of pleasure or relief from pain.

Treatment Modality Matrix
Behavioral Pattern	Intervention	Goals
Low self-esteem, anxiety, verbal hostility	Relationship therapy, client centered approach	Increase self esteem, reduce hostility and anxiety
Defective personal constructs, ignorance of interpersonal means	Cognitive restructuring including directive and group therapies	Insight
Focal anxiety such as fear of crowds	Desensitization	Change response to same cue
Undesirable behaviors, lacking appropriate behaviors	Aversive conditioning, operant conditioning, counter conditioning	Eliminate or replace behavior
Lack of information	Provide information	Have client act on information
Difficult social circumstances	Organizational intervention, environmental manipulation, family counseling	Remove cause of social difficulty
Poor social performance, rigid interpersonal behavior	Sensitivity training, communication training, group therapy	Increase interpersonal repertoire, desensitization to group functioning
Grossly bizarre behavior	Medical referral	Protect from society, prepare for further treatment
Adapted from: Essentials of Clinical Dependency Counseling, Aspen Publishers

From the applied behavior analysis literature and the behavioral psychology literature several evidenced based intervention programs have emerged (1) behavioral maritial therapy (2) community reinforcement approach (3) cue exposure therapy and (4) contingency management strategies. In Psychology, self-esteem reflects a Person 's overall evaluation or appraisal of her or his own worth Applied behavior analysis ( ABA) is the science of applying experimentally derived principles of behavior to improve socially significant behavior Behaviorism or Behaviourism, also called the learning perspective (where any physical action is a behavior is a philosophy of Psychology based on the ^[16][17] In addition, the same author suggest that Social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious.

Diverse explanations

Several explanations (or "models") have been presented to explain addiction. These divide, more or less, into the models which stress biological or genetic causes for addiction, and those which stress social or purely psychological causes. Of course there are also many models which attempt to see addiction as both a physiological and a psycho-social phenomenon.

• The disease model of addiction holds that addiction is a disease, coming about as a result of either the impairment of neurochemical or behavioral processes, or of some combination of the two. The disease model of addiction describes an Addiction as a lifelong Disease involving biologic and environmental sources of origin A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly Neurochemistry is the branch of Neuroscience devoted to the study of Neurochemicals A neurochemical is an organic molecule that participates in neural activity Behavior or behaviour (see spelling differences) refers to the actions or Reactions of an object or Organism, usually Within this model, addictive disease is treated by specialists in Addiction Medicine. Addiction medicine is a medical specialty that deals with the treatment of Addiction. Within the field of medicine, the American Medical Association, National Association of Social Workers, and American Psychological Association all have policies which are predicated on the theory that addictive processes represent a disease state. The American Medical Association (AMA founded in 1847 and incorporated 1897 is the largest association of Physicians and Medical students in the United States The American Psychological Association (APA is a professional organization representing psychologists in the U Most treatment approaches, as well, are based on the idea that dependencies are behavioral dysfunctions, and, therefore, contain, at least to some extent, elements of physical or mental disease. Organizations such as the American Society of Addiction Medicine believe the research-based evidence for addiction's status as a disease is overwhelming. The American Society of Addiction Medicine is a professional organization for Physicians who specialize in the treatment of Addiction.

• The pleasure model proposed by professor Nils Bejerot. Pleasure is commonly conceptualized as a positive experience Happiness, Entertainment, Enjoyment, ecstasy, and euphoria, but is hard Nils Bejerot ( Stockholm, September 21, 1921 &ndash November 29, 1988) was a Swedish psychiatrist and Addiction "is an emotional fixation (sentiment) acquired through learning, which intermittently or continually expresses itself in purposeful, stereotyped behavior with the character and force of a natural drive, aiming at a specific pleasure or the avoidance of a specific discomfort. " "The pleasure mechanism may be stimulated in a number of ways and give rise to a strong fixation on repetitive behavior. Stimulation with drugs is only one of many ways, but one of the simplest, strongest,and often also the most destructive" "If the pleasure stimulation becomes so strong that it captivates an individual with the compulsion and force characteristic of natural drives, then there exists. . . an addiction" ^[18] The pleasure model is used as one of the reason for zero tolerance for use of illicit drugs

• The genetic model posits a genetic predisposition to certain behaviors. Zero tolerance is the concept of compelling persons in positions of authority who might otherwise exercise their discretion in making subjective judgments regarding the severity of a given Genetics (from Ancient Greek grc-Latn genetikos, “genitive” and that from grc-Latn genesis, “origin” a discipline of Biology, is It is frequently noted that certain addictions "run in the family," and while researchers continue to explore the extent of genetic influence, many researchers argue that there is strong evidence that genetic predisposition is often a factor in dependency.

• The experiential model devised by Stanton Peele argues that addictions occur with regard to experiences generated by various involvements, whether drug-induced or not. Stanton Peele, Ph D JD (born January 8, 1946) is a licensed Psychologist, Attorney, practicing Psychotherapist and the author This model is in opposition to the disease, genetic, and neurobiological approaches. Among other things, it proposes that addiction is both more temporary or situational than the disease model claims, and is often outgrown through natural processes.

• The opponent-process model generated by Richard Soloman states that for every psychological event A will be followed by its opposite psychological event B. Opponent-process theory is a universal psychological and neurological model proposed by Leo Hurvich and Dorothea Jameson 1957 and expanded by his co-worker at For example, the pleasure one experiences from heroin is followed by an opponent process of withdrawal, or the terror of jumping out of an airplane is rewarded with intense pleasure when the parachute opens. Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative This model is related to the opponent process color theory. If you look at the color red then quickly look at a gray area you will see green. There are many examples of opponent processes in the nervous system including taste, motor movement, touch, vision, and hearing. Opponent-processes occurring at the sensory level may translate "down-stream" into addictive or habit-forming behavior.

• The allostatic (stability through change) model generated by George Koob and Michel LeMoal is a modification of the opponent process theory where continued use of a drug leads to a spiralling of uncontrolled use, negative emotional states and withdrawal and a shift into use to new allostatic set point which is lower than that maintained before use of the drug. George F Koob, PhD (1947-) is a Professor and Chair of the Committee on the Neurobiology of Addictive Disorders at The Scripps Research Institute and ^[19]

• The cultural model recognizes that the influence of culture is a strong determinant of whether or not individuals fall prey to certain addictions. Culture (from the Latin cultura stemming from colere, meaning "to cultivate" generally refers to patterns of human activity and the symbolic For example, alcoholism is rare among Saudi Arabians, where obtaining alcohol is difficult and using alcohol is prohibited. The Kingdom of Saudi Arabia, KSA ( المملكة العربية السعودية, al-Mamlaka al-ʻArabiyya as-Suʻūdiyya) or Suudi In North America, on the other hand, the incidence of gambling addictions soared in the last two decades of the 20th century, mirroring the growth of the gaming industry. Half of all patients diagnosed as alcoholic are born into families where alcohol is used heavily, suggesting that familiar influence, genetic factors, or more likely both, play a role in the development of addiction. What also needs to be noted is that when people don't gain a sense of moderation through their development they can be just as likely, if not more, to abuse substances than people born into alcoholic families.

• The moral model states that addictions are the result of human weakness, and are defects of character. A moral is a message conveyed or a lesson to be learned from a story or event Moral character or character is an evaluation of a particular individual's moral qualities Those who advance this model do not accept that there is any biological basis for addiction. They often have scant sympathy for people with serious addictions, believing either that a person with greater moral strength could have the force of will to break an addiction, or that the addict demonstrated a great moral failure in the first place by starting the addiction. The moral model is widely applied to dependency on illegal substances, perhaps purely for social or political reasons, but is no longer widely considered to have any therapeutic value. Elements of the moral model, especially a focus on individual choices, have found enduring roles in other approaches to the treatment of dependencies.

• The habit model proposed by Thomas Szasz questions the very concept of "addiction. Habits are habituated routines of behavior that are repeated regularly tend to occur Subconsciously and tend to occur without directly thinking consciously Thomas Stephen Szasz (pronounced /sas/ born April 15, 1920 in Budapest, Hungary) is a Psychiatrist and Academic. " He argues that addiction is a metaphor, and that the only reason to make the distinction between habit and addiction "is to persecute somebody. "^[20] Cf also the life-process model of addiction. The life-process model of addiction is the view that Addiction is not a Disease but rather a habitual response and a source of gratification and security

• Finally, the blended model attempts to consider elements of all other models in developing a therapeutic approach to dependency. It holds that the mechanism of dependency is different for different individuals, and that each case must be considered on its own merits.

Neurobiological basis

The development of addiction is thought to involve a simultaneous process of 1) increased focus on and engagement in a particular behavior and 2) the attenuation or "shutting down" of other behaviors. For example, under certain experimental circumstances such as social deprivation and boredom, animals allowed the unlimited ability to self-administer certain psychoactive drugs will show such a strong preference that they will forgo food, sleep, and sex for continued access. The neuro-anatomical correlate of this is that the brain regions involved in driving goal-directed behavior grow increasingly selective for particular motivating stimuli and rewards, to the point that the brain regions involved in the inhibition of behavior can no longer effectively send "stop" signals. A good analogy is to imagine flooring the gas pedal in a car with very bad brakes. In this case, the limbic system is thought to be the major "driving force" and the orbitofrontal cortex is the substrate of the top-down inhibition.

A specific portion of the limbic circuit known as the mesolimbic dopaminergic system is hypothesized to play an important role in translation of motivation to motor behavior- and reward-related learning in particular. The mesolimbic pathway is one of the Neural pathways in the Brain that links the Ventral tegmentum in the Midbrain to the Nucleus accumbens It is typically defined as the ventral tegmental area (VTA), the nucleus accumbens, and the bundle of dopamine-containing fibers that are connecting them. The ventral tegmentum or the ventral tegmental area (VTA ( tegmentum, Latin for covering) is part of the Midbrain, lying close to the Substantia Dopamine is a Hormone and Neurotransmitter occurring in a wide variety of animals including both vertebrates and invertebrates This system is commonly implicated in the seeking out and consumption of rewarding stimuli or events, such as sweet-tasting foods or sexual interaction. However, its importance to addiction research goes beyond its role in "natural" motivation: while the specific site or mechanism of action may differ, all known drugs of abuse have the common effect in that they elevate the level of dopamine in the nucleus accumbens. This may happen directly, such as through blockade of the dopamine re-uptake mechanism (see cocaine). Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant It may also happen indirectly, such as through stimulation of the dopamine-containing neurons of the VTA that synapse onto neurons in the accumbens (see opiates). For other uses see Opiate (disambiguation, or for the class of drugs see Opioid. The euphoric effects of drugs of abuse are thought to be a direct result of the acute increase in accumbal dopamine. ^[21]

The human body has a natural tendency to maintain homeostasis, and the central nervous system is no exception. Homeostasis (from Greek: ὅμος hómos, "equal" and ιστημι istēmi, "to stand" lit Chronic elevation of dopamine will result in a decrease in the number of dopamine receptors available in a process known as downregulation. Transmembrane receptors are Integral membrane proteins which reside and operate typically within a cell's Plasma membrane, but also in the membranes of WikipediaWikipedia is not a dictionary ---> Downregulation is the process by which The decreased number of receptors changes the permeability of the cell membrane located post-synaptically, such that the post-synaptic neuron is less excitable- i. e. : less able to respond to chemical signaling with an electrical impulse, or action potential. In Neurophysiology, the action potential is a self-regenerating Wave of Electrochemical activity that allows Nerve cells to carry a signal It is hypothesized that this dulling of the responsiveness of the brain's reward pathways contributes to the inability to feel pleasure, known as anhedonia, often observed in addicts. In Psychology, anhedonia ( Greek αν- an- without + ηδονή hēdonē pleasure) is an inability to experience The increased requirement for dopamine to maintain the same electrical activity is the basis of both physiological tolerance and withdrawal associated with addiction. In Physiology, tolerance occurs when an organism builds up a resistance to the effects of a substance after repeated exposure Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is

Downregulation can be classically conditioned. If a behavior consistently occurs in the same environment or contingently with a particular cue, the brain will adjust to the presence of the conditioned cues by decreasing the number of available receptors in the absence of the behavior. It is thought that many drug overdoses are not the result of a user taking a higher dose than is typical, but rather that the user is administering the same dose in a new environment.

In cases of physical dependency on depressants of the central nervous system such as opioids, barbiturates, or alcohol, the absence of the substance can lead to symptoms of severe physical discomfort. Depressant is a chemical agent that diminishes the function or activity of a specific part of the body (see also Sedative) In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. Barbiturates are drugs that act as central nervous system Depressants and by virtue of this they produce a wide spectrum of effects from mild Sedation Withdrawal from alcohol or sedatives such as barbiturates or benzodiazepines (valium-family) can result in seizures and even death. By contrast, withdrawal from opioids, which can be extremely uncomfortable, is rarely if ever life-threatening. In cases of dependence and withdrawal, the body has become so dependent on high concentrations of the particular chemical that it has stopped producing its own natural versions (endogenous ligands) and instead produces opposing chemicals. When the addictive substance is withdrawn, the effects of the opposing chemicals can become overwhelming. For example, chronic use of sedatives (alcohol, barbiturates, or benzodiazepines) results in higher chronic levels of stimulating neurotransmitters such as glutamate. Barbiturates are drugs that act as central nervous system Depressants and by virtue of this they produce a wide spectrum of effects from mild Sedation See Chemical synapse for an introduction to concepts and terminology used in this article Very high levels of glutamate kill nerve cells, a phenomenon called excitatory neurotoxicity.

Criticism

Levi Bryant has criticized the term and concept of addiction as counterproductive in psychotherapy as it defines a patient's identity and makes it harder to become a non-addict. "The signifier 'addict' doesn't simply describe what I am, but initiates a way of relating to myself that informs how I relate to others. "

A stronger form of criticism comes from Thomas Szasz, who denies that addiction is a psychiatric problem. Thomas Stephen Szasz (pronounced /sas/ born April 15, 1920 in Budapest, Hungary) is a Psychiatrist and Academic. In many of his works, he argues that addiction is a choice, and that a drug addict is one who simply prefers a socially taboo substance rather than, say, a low risk lifestyle. In Our Right to Drugs, Szasz cites the biography of Malcolm X to corroborate his economic views towards addiction: Malcolm claimed that quitting cigarettes was harder than shaking his heroin addiction. Malcolm X (born Malcolm Little; May 19 1925 February 21 1965 also known as El-Hajj Malik El- Shabazz, was an African American Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative Szasz postulates that humans always have a choice, and it is foolish to call someone an 'addict' just because they prefer a drug induced euphoria to a more popular and socially welcome lifestyle. A drug, broadly speaking is any chemical substance that when absorbed into the body Happiness is an Emotion associated with feelings ranging from contentment and satisfaction to Bliss and intense Joy. Therefore, being 'addicted' to a substance is no different from being 'addicted' to a job at which you work everyday.

Szasz and Bryant are not alone in questioning the standard view of addiction. Professor John Booth Davies at the University of Strathclyde has argued in his book The Myth of Addiction that 'people take drugs because they want to and because it makes sense for them to do so given the choices available' as opposed to the view that 'they are compelled to by the pharmacology of the drugs they take'. The University of Strathclyde (Oilthigh Srath Chluaidh is a university in Glasgow, Scotland. ^[22] He uses an adaptation of attribution theory (what he calls the theory of functional attributions) to argue that the statement 'I am addicted to drugs' is functional, rather than veridical. Attribution theory is a Social psychology theory developed by Fritz Heider, Harold Kelley, Edward E Stanton Peele has put forward similar views. Stanton Peele, Ph D JD (born January 8, 1946) is a licensed Psychologist, Attorney, practicing Psychotherapist and the author

Experimentally, Bruce K. Alexander used the classic experiment of Rat Park to show that 'addicted' behaviour in rats only occurred when the rats had no other options. Rat Park was a study into Drug addiction conducted in the 1970s by Canadian psychologist Bruce K When other options and behavioural opportunities were put in place, the rats soon showed far more complex behaviours.

Casual addiction

The word addiction is also sometimes used colloquially to refer to something for which a person has a passion, such as books, chocolate, work, the web, running, or eating. Bibliophilia is the love of Books Accordingly a bibliophile loves books but especially "for Qualities of Format. Chocoholism is a Portmanteau of " Chocolate " and " Alcoholism," referring to an Addiction to chocolate A workaholic, colloquially is a person who is addicted to work

See also

Notes

Further reading

• Lende, D. H. & Smith, E. O. , (2002). Evolution meets biopsychosociality: an analysis of addictive behavior. Addiction 97: 447-458.
• Ornstein, C. , (2005-11-14). Quitting meth pays off. LA Times.

External links

Addiction at the Open Directory Project [Addiction]

The Open Directory Project ( ODP) also known as dmoz (from directory

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