Counselling for People with Dependence

Entering recovery from addiction and dependency is a life-changing event for people suffering from substance use disorder (SUD). This brief article will define a few key concepts to increase understanding of Substance Use Disorder (SUD) and answer questions related to dependency counselling. The alcohol abuse treatment sets the state for sustained recovery from drugs and alcohol.

Neither dependence nor addiction is present in the DSM-V criteria of a substance use disorder (SUD).

Definition of Addiction and Dependence

Addiction is a condition of craving and subsequent uncontrollable and compulsive consumption of substances/drugs despite being aware of harmful consequences.

Physical dependence is a condition of adaptation to the drug. A person who developed the physical dependence will get withdrawal syndrome upon the sudden termination of the drug. Tolerance, where the body needs more of the drug to produce the same effect, is another aspect of dependence

Most substance-addicted individuals develop dependence; thus, tolerance and withdrawal are often part of drug and alcohol addiction. However, in behavioural addiction (i.e. gambling disorder), physical dependence (tolerance and withdrawal) is not markedly present. In such a case, the physical dependence does not substantially influence the maintenance of this addiction.

Dependence Without Addiction

Yet, physical dependence can also exist without any presence of addiction. It can be developed by longer administration of prescribed medications. By using, for example, painkillers, the necessity for increased doses usually signals tolerance. Consequently, people may develop drug dependency without becoming compulsive drug addicts.

Craving and Relapse

Addiction-related detrimental processes occurring in the body are complex, as they normally result from the interaction of

• genetic effects/predisposition (such as initially abnormal functioning of the brain pathways even before the very first dose) and
• environmental factors (e.g. social environment and stress).

These interacting effects can cause alcohol cravings and relapses long after a person is not physically dependent anymore. Thus, adequately planned relapse prevention is crucial for alcohol addiction recovery. The process of planning the rehabilitation steps should be initiated during and immediately after closing the process of alcohol detoxication.

In a substance use disorder, addiction tends to co-occur with dependence. Nevertheless, a person may remain addicted long after they are not physically dependent anymore. Therefore, comprehensive relapse prevention is critical. 

FAQs about Therapies for Dependencies

CHMC’s FAQ answers the most common question about dependencies and their treatment. Our German Clinic for Psychiatry and Psychology in Dubai is specialised in the treatment of distinct psychiatric disorders, among them therapy for dependencies. For more information, call: +971 4 4574240

My husband is an alcoholic. Can you help him?

At CHMC, we have the experience and training to treat alcoholism and addictions.  The thing to consider is that many individuals are in denial about their problem.  It is not until someone wants treatment that treatment makes sense and is effective.  We strongly recommend support group attendance for people struggling with addictions (AA) as well as their family members (AL-Anon).

What is addiction?

Addiction is a complex condition characterised by compulsive drug use or engaging in a behaviour despite harmful consequences. It involves a strong craving for the substance or activity, loss of control over its use, and continued use despite negative effects on health, relationships, and other areas of life.

Will I get in trouble with the law if I get addiction treatment?

We are a mental healthcare clinic, and all our treatment providers guarantee our patients absolute confidentiality.  This is a private, discrete, and confidential setting.

Are addiction and dependence the same?

No, addiction and dependence are not the same. Addiction involves compulsive drug use despite harmful consequences and includes psychological and behavioural components. Dependence refers to physical adaptations to a substance, leading to withdrawal symptoms when the substance is stopped or reduced. While addiction often involves dependence, they are distinct concepts.

Can addiction be genetic?

Yes, addiction can have a genetic component. Research suggests that genetic factors contribute to about 40–60% of the risk for addiction. Certain genetic variations can increase susceptibility to addiction by influencing how individuals respond to drugs, their sensitivity to reward, and their ability to regulate impulses and control behaviour.

Can addiction be cured?

Addiction is considered a chronic condition, meaning there is no “cure” in the traditional sense. However, it can be effectively managed with appropriate treatment and support. Many people with addiction can achieve long-term recovery and lead fulfilling lives by abstaining from addictive substances or behaviours and engaging in ongoing therapy, support groups, and other forms of treatment.

How does addiction affect mental health?

Addiction can have profound effects on mental health, exacerbating existing mental health conditions and even contributing to the development of new ones. Substance abuse and addictive behaviours can lead to changes in brain chemistry and function, resulting in symptoms such as anxiety, depression, mood swings, paranoia, and cognitive impairments. Additionally, the guilt, shame, and isolation often associated with addiction can further worsen mental health and lead to social and interpersonal difficulties. Untreated mental health issues can also increase the risk of relapse and hinder recovery from addiction. Therefore, addressing both addiction and co-occurring mental health disorders is essential for effective treatment and long-term recovery.

What causes addiction?

Addiction can be caused by a combination of genetic, environmental, and psychological factors. Factors such as genetics, trauma, stress, and early exposure to drugs can contribute to the development of addiction.

What are the signs and symptoms of addiction?

Common signs and symptoms of addiction include cravings, loss of control over drug use, withdrawal symptoms, neglecting responsibilities, and relationship problems.

How is addiction diagnosed?

Addiction is typically diagnosed based on criteria outlined in diagnostic manuals such as the DSM-5, which include symptoms like impaired control, social impairment, risky use, and pharmacological criteria.

What types of addiction exist?

Addiction can involve substances such as drugs or alcohol, as well as behaviours such as gambling, gaming, or shopping. It is considered a chronic, relapsing disorder that requires comprehensive treatment and ongoing support for recovery.

Can addiction be treated?

Yes, addiction can be treated, although it may require long-term management and support.

What are the treatment options for addiction?

Treatment options for addiction include therapy (such as cognitive-behavioural therapy), medication-assisted treatment, support groups (such as Alcoholics Anonymous or Narcotics Anonymous), and residential or outpatient programmes.

How effective are addiction treatments?

The effectiveness of addiction treatments varies depending on individual factors such as the severity of addiction, motivation for change, and presence of co-occurring disorders.

How can I help someone with addiction?

If you suspect someone has an addiction problem, it’s important to approach them with compassion and offer support. Encourage them to seek professional help and avoid judgement or criticism.

How can addiction be prevented?

Addiction prevention efforts may include education, early intervention, promoting healthy coping mechanisms, and addressing risk factors such as trauma and mental health disorders.

What are some common misconceptions about addiction?

Common misconceptions about addiction include viewing it as a moral failing or lack of willpower rather than understanding it as a complex medical condition.

How does addiction affect relationships?

Addiction can strain relationships due to lying, manipulation, and betrayal of trust. Family therapy and support can be beneficial in addressing these challenges.