Types of Addiction

Addiction reaches beyond alcohol and drugs. Many people suffer from all sorts of different addictions. Gambling, eating, shopping, sex, internet, work, video games, etc can all be just as addictive in many cases just as destructive to a person. Those behaviors may affect the person differently, but they can be just as devastating as substance dependence.  The fast pace of our society today leaves ever more people on the fringes looking for an answer to what we are doing here and why. People seek this in a variety of ways. Sometimes when they cannot find an answer they will be thrown into addictions. Drugs and other addictions are all around us and we must learn how to confront and deal with them.

• Caffeine

To many people this would seem a relatively trivial addiction. Caffeine is a stimulant however, which many people consume vast quantities of daily. It is possibly because it is so widely used daily that it has caused many of us to overlook its harmful side effects. There are however some clear side effects to this all too common addiction:

'The sufferer may experience fits of agitation and depression, loss of color and a haggard appearance. Loss of appetite and symptoms of gastric catarrh. Severe trembling, shaking or quivering. Also causes the heart to pulsate or throb. The only cure is to take a further dose.'
Anon.

Caffeine is also known to contribute to irritability, diarrhea and insomnia.

The recommended daily dose of caffeine is, according to research, around 250mg, equivalent to roughly two to three cups of instant coffee/day. Dosages of above 500mg/day may bring on some of the symptoms listed above

The facts and figures were obtained from a report published by a psychotherapist S. Callis, Addiction Today volume 10 No 57

• Cigarettes

Tobacco today has been proven as our most popular and most problematic drug. In 1995 there were over 97,000 adult, smoke-related deaths. It is widely known that smoking increases your risk of heart disease, can cause cancer and should be avoided during pregnancy. How can we prove these claims, is there any medical evidence for them?

There are three main components of tobacco: nicotine, carbon monoxide and tar.

Nicotine is a very powerful, highly addictive stimulant drug. This is the drug that most people are addicted to in the cigarette. When a smoker inhales, nicotine is absorbed into their bloodstream and the effects are felt on the brain seven to eight seconds later. Nicotine also affects the rest of the body in different ways. In small amounts nicotine stimulates nerve impulses in the central and autonomic nervous system (part of the nervous system which regulates heart, adrenal gland, bladder etc.) while in large amounts nicotine inhibits these nerve impulses.

The immediate effects of nicotine are:

Increase in heart rate, blood pressure and hormone production.
Constriction of small blood vessels under the skin.
Changes in blood composition and metabolism.

Carbon monoxide is a poisonous gas found in relatively high concentrations in cigarette smoke. It combines with the oxygen carrying substance in blood, hemoglobin. It will replace the oxygen in the blood so that up to 15% of the smokers blood may be carbon monoxide instead of oxygen. Oxygen is essential for body tissues and cells to function properly. If the supply of oxygen is reduced for long periods it can lead to problems with growth, repair and absorption of essential nutrients.

Smoking or passive smoking is therefore particularly harmful during pregnancy as the carbon monoxide reduces the amount of oxygen carried to the uterus and fetus. Carbon monoxide can also encourage fatty deposits to form on the walls of arteries. This can lead to the arteries becoming blocked and other circulation problems.

When a smoker inhales, the cigarette smoke condenses and about 70% of the tar contained in the smoke is deposited in the lungs. High levels of tar on the lungs, over a period of time, can lead to cancer. Irritants in tar can also damage the lungs by causing narrowing of the bronchioles, coughing, an increase in bronchiole mucus and damage to the small hairs which protect the lungs from dirt and infection.

The amount of nicotine, carbon monoxide, tar and other substances that are absorbed into the body, from a cigarette, varies greatly, and depends on how much the smoker inhales.

The facts and figures were obtained from - Smoking: The Facts. Published by Health Education Authority.

• Computers

There is no doubt that the technological advances made by man in the 20th Century equaled all the advances made in all of the previous centuries put together. There is little doubt that the invention that has and will continue to have the greatest impact on all of our lives is the computer. When the computer was developed towards the end of the 20th Century it was believed that it would reduce all of our working weeks and give us more time for leisure and being with friends and family. No one really imagined that the computer could become an addiction in itself.

Does this describe your situation:

• Your child is falling behind with homework because of always being on the computer.
• The husband or wife have become a virtual recluse and spend all their time locked away in one room for hour after hour.
• The phone bill has almost doubled over night.
• You are spending longer and longer at the computer and don't realize where the time goes.

Some of the signs of computer addiction will be very similar to other addictions:
Psychological Symptoms:

• Sense of well being while at the computer.
• Inability to stop using the computer.
• Making excuses just so that you can use the computer.
• Family and friends see you less and less and comment about your increasing use of the computer.
• Feeling lost or irritable when not at the computer.
• Lying to friends and family about the amount of time you spend at the computer.
• Problems occurring with school or job.

Other signs are more specific to the computer however:
Physical Symptoms:

• Carpal Tunnel Syndrome
• Dry eyes
• Migraine headaches
• Backaches
• Eating irregularities - maybe skipping meals
• Poor personal hygiene
• Sleep problems

The Computer is such a versatile tool that it can host a range of addictions. The internet and the World Wide Web is the addiction for the 21st Century. With slogans such as 'if you are not part of the present you are part of the past' it is clear that the marketing is all about getting us to log-on or miss out. The internet was first created in 1968 by the US Government as a defense tool. In 1992 the world wide web was created and licensed. The world wide web has increased at a phenomenal rate.

Eight years ago in 1993 there were 130 web sites; in 1996 around 100,000; in 1997 around 800,000; around 2,000,000 in 1998; around 4,000,000 in 1999; 13,000,000 in 2000 and around 29,000,000 in 2001. At the middle of 2001 there are around 4 billion web pages of information with around 1 million new pages added every day (pages as opposed to sites). At the beginning of 2001 there was 109,574,429 hosts. The millions of Web sites today offer such a vast array of information, meeting peoples needs not just in the hunger for information but for shopping, meeting people, sexual fantasies, pornography and gambling to name a few.

The Internet Relay Chat (IRC) is one increasingly popular use for the internet. It is a way of communicating with people from around the world using the internet. It is a growing worldwide problem and is highly addictive especially for people who are lonely or bored. Once the person starts communicating they can feel they are missing out by not being on-line and this can be part of the addictive nature.

On-line trading is the latest modern method of gambling. This offers an immediate form of feedback. In the past most stock market trading was done through a personal broker or a brokerage firm. Today at the merest click the shares can be brought and sold; days or weeks have been reduced to seconds.*

For many people the computer is intended purely for pleasurable pursuits. Sadly addiction is still possible. The video game was the ultimate toy of the 1980's. From there highly advanced and technological games have been developed to be used on the computer. Some of these can be downloaded or accessed in a variety of ways. Ultimately the aim is to keep people on the machine as long as possible. This is exactly what happens for many people remaining on the computer from dawn till dusk or when they get in from school or work till the early hours of the next morning. What started out as a pleasurable pursuit has become an all-consuming addiction.

The roots of this addiction are very similar to the others; the needs are not being met in other areas. It may be because of boredom or loneliness. Unlike many of the other addictions the internet can actually lead you to the answer as you can meet people, shop, gamble on-line. In addition when you see something on the internet it is hard to believe that it does not really exist. However it can also accentuate your problem leave you feeling even more distant from human company apart from the problem especially during IRC of not really knowing who the people you are communicating with really are, i.e. are they really who they say they are?

Report on online trading published in Addiction Today vol. 12 No.71 July/August 2001 by Dr J. Michael Faragher, Denver, USA

• Eating Disorders

Everybody eats. We do so because we need to and because we enjoy it. There is however, as with all human behavior extremes and huge differences. Some people eat more, some eat less, and some put on weight easily others do not. Some people go to extremes where they eat too much or not enough.

It is said that women suffer from eating disorders 10 times as much as men, which also tend to start off at home in the teenage years.* Some of the more common conditions are:

• Anorexia nervosa
• Bulimia nervosa
• Selective eating
• Restrictive eating
• Compulsive overeating

We have looked at two of the above conditions: anorexia nervosa and bulimia nervosa.

Anorexia Nervosa

Anorexia nervosa, 'nervous loss of appetite' often starts in the mid-teens, and affects one in every one hundred and fifty, fifteen-year-old girl.* Usually anorexia nervosa begins with dieting, that is so much a part of a teenager's life. There is not usually a problem with the individual's appetite so the translation can be a little misleading. Though uncommon, men can also suffer from anorexia. It has been reported by researchers that male sufferers of anorexia, are more likely to contract osteoporosis than their female counterparts.**

It is said about one third of sufferers were overweight before they started to diet.1 As the young person has not lost their appetite, they may still feel really hungry, eat a lot, then feel guilty afterwards and make themselves sick or take some laxatives. When the desired weight is reached however the anorexic continues dieting, until they are well below the normal weight/height limits for their age. Common signs include: fear of fatness, under eating, excessive loss of weight, vigorous exercise and stopping of monthly periods.

Bulimia

As the time wears on for the anorexic they may develop symptoms of bulimia nervosa. Bulimia means 'ox hunger' and refers to the fact that people suffering with bulimia seem to have ravenous appetites.*** This may involve eating, in a very short period of time, vast quantities of sugary or fattening foods. This may amount to three or four times the normal amount most people would eat in one meal.*** The person may then make him or herself sick or sometimes take a laxative treatment. It is believed, that around three out of every one hundred women, at sometime in their life, will be affected.1 Bulimia is rare before puberty, affecting around 3-4% of teenage girls.***

Unlike people with anorexia, people with bulimia are often of normal weight, so their eating difficulties may be less apparent than those of the anorexic3 Eating disorders are very often rooted in poor self-image, control factors or the individual being unable to express emotion in a correct way. Eating may also sometimes be a comfort factor, making the individual feel comfortable and/or hiding real feelings.

The facts and figures were obtained from:
* Anorexia and Bulimia published by the Royal College of Psychiatrists.
** University of Iowa, USA 2000
*** Eating disorders: A Parents Guide. By Rachel Bryant-Waugh & Bryan Lask

• Gambling

Everyone daily gambles in many ways. We take a risk when we make a choice, it may not be quite what we want, but we will chance it anyway. Even crossing the road can be a gamble sometimes. The only time when we do not gamble is when we stay at home, in bed. Even people who would not normally consider themselves to be gamblers will almost daily make wagers 'I bet this' or 'I bet you that'. Gambling is all about risk taking, and it is part of all our lives; especially men, who in many cases, seem to enjoy taking risks more than women, who are often looking for security; i.e. the opposite to gambling.

Gambling is often rooted in the desire to accumulate more, especially money, and some people see it as away out of their poverty. In so many countries around the world, it is the invariably the poorest who spend the most on gambling in relation to their income.

The most popular gambling habits today in order of popularity are:

          1. National lottery and scratch cards
          2. Football pools
          3. Other lotteries and raffles
          4. fruit machines in pubs
          5. Bingo
          6. Horse racing
          7. Casino gambling

What is very interesting however is the following, which lists the chances of the individual making a million on the different forms of gambling:

• Roulette
• Horse racing
• Black Jack casino game
• Football pools
• Scratch cards
• National lottery
• Fruit machines

• Sex

Sex addicts may be male or female young or old, appearing normal and respectable or eccentric. They may be involved in all kinds of sexual activity from domination to sex in the open air; from voyeurism to fantasy; from pornography to self-exposure. Some behaviors, for example those involving young children are illegal, though many are not.

Clearly as with all addictions we must distinguish between those who enjoy sex regularly within a relationship with no hang-ups, and those who cannot go without sex and spend much of their waking life thinking about it or activities associated with it.

There are warning signs for instance where sex is used to escape from reality; where sex is ritualized or rehearsed rather than loving and spontaneous; and where sex holds a compulsion or preoccupation which

• Shopping

A very common pattern of behavior in our western world when we are feeling depressed or out of sorts, is to go on a shopping spree. For some people however this has developed to problematic behavior. Compulsive shopping/buying or spending, is also known by the scientific term 'oniomania'.

Shopaholics are often, though not, by any means always, women. For many people, shopping provides an activity acceptable to society to change our mood. The advertisements scream out at us everywhere we look, from telephone boxes to junk mail, 'come buy me today', 'you need me now', and 'I'll heal your mood.' As with all addictions when the addictive trances wear off, the desire to get another 'fix' becomes very strong.

In her book 'I shop therefore I am' Dr. Benson states: 'that as many as 1⁄4 of us have problems with buying and studies suggest that between 1 - 6 % of the population are fully fledged compulsive buyers'*.

The addictive shopper will often have several credit/store cards; they may go out in a compulsive or uncontrolled manner and buy many of the same items all at once, items they may not want or need. They may feel guilty after a spending spree then get depressed, so to combat the depression go out and spend more money. This is a very serious addiction and should not be looked upon any differently to any other addiction.

Are you having trouble controlling your spending?

• Do you experience a sense of excitement/elevated mood while out shopping?
• Do people close to you express concern over the amount of time/money you spend shopping?
• Do you find yourself shopping even though you'd previously decided you did not want to/had vowed not to?
• Is your buying causing problems in other areas of your life such as relationships, finances or social life?

The compulsive shopper may also have various items at home, tucked away still in their original packaging. Some may be continually returning the items, or disposing of them in other ways.

There are a number of possible reasons for developing this condition known as oniomania: research in the UK has revealed that most women, who have a problem with this compulsion, shop to increase their self esteem - buying things that they think will make them seem more prosperous, glamorous or intelligent ...or whatever. It is also sometimes a cure for loneliness, sadness or possibly anger. In addition, there is research from Stanford University, California, USA, which has revealed a link between clinical depression and compulsive shopping. This has led to the prescribing, in some cases, of anti-depressant medications to help combat oniomania.

Some tips to protect yourself if you feel you may be at risk:

• Do not carry credit cards/checkbooks around with you.
• Keep only a limited amount of cash on you - for essentials.
• Don't window shop - 'lead us not into temptation!'
• Don't play games or try to justify purchases.
• Try to avoid advertisements, where possible.
• Plan alternative activities when you would normally be out shopping.
• Talk it over with someone else.

Benson Dr. A. L. (2000). 'I shop, therefore I am' compulsive buying and the search for self. Jason Aronson Inc USA.

• Substances

Today as our world gets faster, more advanced and more chaotic so it leaves many people on the fringes looking for a release, a way out, trying to find meaning. Drugs or substances for many people have provided them an escape from this 'crazy' world that they cannot understand.

The addiction to substances today has massive ramifications for all levels of society. Substances may include legal and/or illegal drugs. Alcohol is often termed 'our most popular drug' though some people do not acknowledge it as a drug. Despite this the deaths (around 33,000 every year***) attributable to this drug are only overshadowed by nicotine. Drug use is mentioned in the Bible and dates back to the dawn of creation.

There are four main ways in which substances are taken:

• Orally
• Sniffing
• Smoking
• Injecting

There are a variety of methods for classifying substances (Brands et al, 1998) such as by their origin; street name; legality or chemical structure.

It is not quite as simple to think that substances can be neatly classified into various groups depending on the effect they have on the brain or the central nervous system. Cause and effect statements are often made such as 'alcohol is a depressant and you will always feel such and such after taking it'. 'Cocaine on the other hand is a stimulant and you will always feel 'like this' after taking it'. These statements can provide a guide to what may happen to the person, in many cases they will be correct, but they can on the other hand also be misleading.

There are a number of reasons for this:

Firstly drugs affect different people in different ways: The factors may depend on, for example:

• The dose which was taken
• The specifics of the individual:
  e.g. the sex; Body weight; Mood of the person
• The atmosphere where the drugs were taken
• Whether the person was aware of what was meant to happen to them.

Secondly people who take drugs will often take more than one drug at a time, poly drug use. The reason for this may be to enhance or counter the effects of another drug.

Next the groups are very broad and generalized and are based on average people. Different substances can also have different effects on different parts of the body. Cocaine for instance has a stimulant effect on the central nervous system and anesthetic effects on the skin. In addition some of the substances (e.g. cannabis, ecstasy, solvents, ketamine) can be in more than one group.

Last in the case of illegal drugs the individual can never be totally sure exactly what they have taken and what amount. Drugs such as heroin for example may be cut or mixed with other things such as brick dust, glucose, curry powder, gravy mix, flour, and cleaning powder. This of course makes the quantity of drug go further and increases the profit. The main problems here can be twofold. Whilst injecting brick dust into the veins is not going to help them, the individual may feel they have to buy a larger quantity of heroin because it is believed to be diluted with other things. The realization it was in fact pure may come too late. Many people, in this way, have overdosed.

Interaction of drug, individual/psychological factors and social factors in determining drug effects Gossop M. 2000*

The point being made above is that the effects of the drugs on the body are unpredictable and this should always be borne in mind.

The three broad groupings mentioned above relating to the effect they have on the central nervous system or the brain are drugs that:

• Stimulate the nervous system
• Alter perceptual function.

Depressants

• Depressants have the opposite affect to stimulants they can slow down the heart rate, Lower the blood pressure and the metabolism. They can cause the person to sleep and can act as a painkiller, numbing the nerves. Some popular examples may include alcohol, heroin, methadone, temazepam and valium.

Stimulants

• Stimulants generally increase the heart rate, the blood pressure and the metabolism. They make the person more active, more alert. Some popular examples may include caffeine, cocaine, ecstasy, nicotine and speed.

Hallucinogenic

• Hallucinogenic can distort the person's visual and aural perceptions, giving them a false sense of reality and very vivid dreams and images in their brain. Some popular examples may include acid, cannabis, LSD and magic mushrooms.

Cannabis

• There has been much debate recently about cannabis and the pros and cons of the legalization of the substance which is often termed the 'gateway drug'. This site is not the place to debate the rights and wrongs, rather to give you the facts and leave you to make your own informed decisions.
• The facts are cannabis can cause cancer as it does contain four to five times the lung-cancer-producing hydrocarbons as tobacco does; it can lead to heart problems as the heart rate increases by 20-40 beats per minute; it can cause memory loss as it is absorbed into the brain tissue. Acute or chronic use leads to euphoria, decreased mental functioning, exacerbation of asthma, sore throat, paranoia and mood shifts. The debate about the prescribed medical use for cannabis is continuing, as there is evidence that it can help alleviate migraines, multiple sclerosis, glaucoma and anorexia, as it stimulates the appetite.**

Gossop M (2000) Living with Drugs 5th Ed. Ashgate
**. Health : cannabis people deserve the truth. Addiction Today vol. 12 No 67
*** Health Education Authority. March 1997

• Work

No other addiction is so willingly adopted, rewarded and praised by society as the addiction to work. It can prove quite a complicated issue, as the individual may only be looking after their family, and trying to meet all their needs. As children grow up, of course, their needs seem to get more and more expensive. What good, however, is a worn out mother, father or partner? What good if the relationship breaks up? When did a bleeding ulcer become a sign of success? Is a seventy-hour working week a sign of efficiency?

The person may be too set in their ways to slow down, not secure enough in themselves to say no, and/or find it difficult to delegate or ask for help. Even Jesus Christ needed helpers and time away to rest and relax.

Workaholism, overwork or overdoing it is a big problem, nowhere more so than in Japan where around 10,000 workers/year die from working 60-70 hour working weeks.* This is now known in Japan as Karachi, meaning death from overwork.

Society measures us by what we do, rather than by who/how we are and what we believe. Our job is more important than our view on global warming for instance. Clearly some occupations are considered in a different class than others. Sadly all this can lead us to believe that the predetermining factor to our sense of self worth is measured by what we do. This can lead us to become detached from who we really are.

Other myths, which make it difficult to recognize that overdoing it or workaholism is a major problem in our society today are that: overdoing it is a positive way of life; it is not physically or psychologically addictive; it is not harmful to health, physical or mental; that it is always caused by high pressure jobs or demanding family life of the 21st Century; that it is motivated by job loyalty or by our desire to provide a decent living for our family or to make a worthwhile contribution to society.*

Workaholism is an addictive pattern like any other addiction. Some people get an adrenaline high from juggling four or five commitments, taking care of others or simply of being busy or of being the first person in the office in the morning or of being the last to leave in the evening. Maybe they think that this is what the company expects of them, sadly this is sometimes true. Common symptoms may also be forgetfulness or inattention, with awareness impaired by stress and fatigue.

So what is behind this desire to push ourselves to the very limit, sometimes risking all we have - health, family, friends. The roots are common to all addictions, not within our fast culture or the way we were brought up, not even within our boss, or our family. They may contribute to and/or reward our self destructive behavior, but the cause lies deep within us. The roots are often in our, unfulfilled or unmet needs. The feeling within us is that we have to achieve a certain standard, or amount of work before we can become accepted as a person. The belief is that we are of little worth as we are, on our own. Taking the responsibility ourselves, not leaving it with others, and finding out what is pushing us gives us the tools to change. We may have feelings of low self esteem, or of inadequacy, believing nothing we ever do will be good enough, the result is that we keep striving trying to do more and better. Work may also provide us with temporary relief from pain from a broken relationship, or from boredom or guilt or many other feelings we may want to avoid.

Are you a workaholic? The following test was devised to help you evaluate.

Score: 1 = never true; 2 = sometimes true; 3 = often true; 4 = always true. Total up your score, then look at the scale below.

Work Addiction Risk Test1
1. I prefer to do things myself rather than ask for help
2. I get very impatient when I have to wait for other people, or am in slow moving queues
3. I seem to be in a hurry and racing against the clock
4. I get irritated when I am interrupted while I am in the middle of something
5. I stay busy and keep many 'irons in the fire'
6. I find myself doing two or three things at once, such as eating and writing a memo
7. I over commit myself by biting off more than I can chew
8. I feel guilty when I am not working on something
9. It is important that I see the concrete results of what I do
10. I am more interested in the final results of my work than in the process
11. Things just never seem to move fast enough or get done fast enough for me
12. I lose my temper when things don't go my way or work out to suit me
13. I ask the same question, without realizing it after I have already been given the answer
14. I spend a lot of time planning and thinking about future events, forgetting the here and now
15. I find myself continuing to work after my co-workers have finished
16. I get angry when people do not meet my standards of perfection
17. I get upset when I am in situations where I can not be in control
18. I tend to put myself under pressure with self imposed deadlines
19. It is hard for me to relax when I am not working
20. I spend more time working than on socializing, hobbies or leisure activities
21. I dive into projects to get a head start before all the phases have been finalized
22. I get upset with myself for making even the smallest mistake
23. I put more thought, time and energy into my work than relationships with other people
24. I forget, ignore, minimize family celebrations such as birthdays or holidays for example
25. I make important decisions before I have all the facts and have thought them through

Well how did you do? If you scored:
25 - 49 = You are not overdoing it
50 - 69 = You are mildly overdoing it
70 - 100 = You are highly overdoing it

The work addiction, like any of the other addictions is a difficult cycle to break. Like all the other addictions, however, it is possible. The first and most difficult step is acknowledging that we are responsible and the problem is within us, which must be resolved.

The implication here of course, like all addictions, is that we will never be satisfied and will always want to earn more money to buy that special item, like a butterfly that we never can quite catch, so will be our desires here.

'Work Addiction' and 'Overdoing It' - both by Bryan Robinson PhD, published by Health Communications and available from:
Airlift Book Co, 8 The Arena, Molison Ave, Enfield, Middlesex EN3 7NJ Tel: (208) 443 5333