Treatment for Addiction and Dependence in Dubai

Addiction and dependence are terms often used interchangeably. Howeverthe more precice meanings are: Addiction is charachterized as the compulsive desire for specific substances or behaviors. On the other hand dependence, means that a person can no longer live without the addictive substance (such as alcohol, drugs, or medications) or-in case of behavioural addiction- without a particular behaviour like gaming.

In the article we provide a comprehensive description of distinct dependencies, their symptoms, causes, diagnostics and treatment options. Dor more information about treatment for addiction and dependence contact our specialists at CHMC.

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What psychologists and psychiatrists look at as addiction symptoms are the patterns of behaviour and their negative consequences. The leading symptom of addictions is the fact that the substances are consumed or behaviors maintained despite their negative consequences for the individual and the society.

ICD-10 Criteria of Addiction

Typical symptoms of dependency are loss of control, constant thoughts about it, planning one’s day and life around it, and ignoring negative consequences. Other symptoms can be physical and emotional pulling away and gaps in memory. 

The WHO diagnostic manual, ICD-10 defines criteria defining a dependence:

• Continued substance use despite clear evidence of its harmful effects.
• A strong desire or compulsion to consume psychoactive substances.
• Reduced ability to control the onset, termination, or quantity of substance use.
• Physical withdrawal symptoms upon reducing or stopping use, demonstrated by substance-specific withdrawal signs or the use of the same or a closely related substance to mitigate or avoid withdrawal symptoms.
• Evidence of tolerance, meaning increased doses are needed to achieve the effects that smaller doses previously produced.
• Increasing neglect of other pleasures or interests in favor of substance use, along with more time spent on activities related to obtaining, using, or recovering from the substance.

Causes of Addiction and Dependence

There are various theories about how addiction develops. Why some people become dependent on alcohol, drugs or other addictive behaviour while others do not remains unclear. Experts agree that a variety of factors contribute to the development of addiction.

Gender plays a role, as men are at a higher risk of becoming dependent on alcohol or drugs compared to women. Genetic predisposition also has a significant impact; individuals whose parents or siblings have struggled with addiction are considerably more likely to develop dependencies themselves. External and social factors influence addiction as well, such as how easily alcohol or drugs are available and how role models or peers approach their use.

Stressful situations in the family or daily life, including workplace problems, separations, bereavement, or traumatic events, can also contribute to the development of addiction. Additionally, individuals with mental health conditions, such as depression or anxiety disorders, are particularly vulnerable. They often turn to alcohol or drugs as a way to alleviate their symptoms or cope with challenges.

Neurophysiological Causes of Dependence

One of the most obvious characteristics of dependency is that the dependent person compulsively uses and abuses a substance despite negative health consequences. Research has shown that the addictive nature of nicotine is in part attributable to activation of the reward pathway. This pathway, also called the mesolimbic pathway, regSlates feelings of pleasure. Nicotine increases levels of the neurotransmitter in the reward circuit. Scientists believe this underlies the pleasurable sensations that many smokers experience (Is Nicotine, n.d.).

Psychological Role in Developing Dependence

Behavioral, psychodynamic, and environmental factors associated with smoking must be addressed as relevant aspects of nicotine dependency. A substance can become addictive if it is rewarding causing a pleasure or enjoyment. There is strong evidence that those non-pharmacological factors (opening the box, lighting the cigarette, inhaling and tasting the smoke in the throat) play an equally important role in creating the habit as nicotine.

Operant Conditioning

Dependencies, is a learned behaviour. According to the principles of operant conditioning, rewarded behaviour will increase. The danger of drugs (among them tobacco) relies on their ability to initiate an immediate reward. This also explains why the addictive substance tends to replace other, more healthy sources of rewards. These other types of rewards are frequently delayed (such as the return of good health) whilst the drugs create a short cut to the reward system. As addiction progresses, the availability of natural, healthy pleasures, which require more effort, decline. This creates a powerful addictive vicious cycle. For the smokers, the feel, smell, and sight and the ritual of obtaining, handling, lighting the cigarette – usually during a break or in a relaxed atmosphere – are all associated with the pleasurable effects contributing to the above-mentioned operant conditioning.

Psychodynamic Approach

From the psychodynamic point of view smoking is a regressive behaviour related to the earliest phase of human development which Freud called the “oral phase”. The satisfaction and relaxing effect of putting a cigarette in the mouth corresponds to the pleasure of a child suckling the mother’s breast.

Genetics in Developing Dependency

Scientists know genetics also play a role in addiction to nicotine. Inheriting different forms of 6 genes will dictate the feature of the brain receptor to which nicotine binds. This genetic variably offers an explanation for why some people develop a pack a day habit that they cannot seem to break, and others smoke a few cigarettes on occasion but do not have a compulsion to smoke.

Treatment for Alcohol Addiction and Dependence

Alcoholism, also known as alcohol use disorder, is a chronic and progressive condition that affects millions of people worldwide. Being an alcoholic can cause serious health and social problems, including physical and mental health issues, relationship problems, and financial difficulties.

Alcohol dependency (alcoholism) is a disorder and cannot be addressed with the too often heard words, “Why Don’t You Just Stop?” It is a complex disease that requires professional treatment by counselors and addiction specialists.

Here is why:

Once addiction has occurred permanent changes to the brain take place. We can say, the “off switch” in the brain is broken. More scientifically expressed: The intricate neural chemical feedback system between the pleasure reward system in the mid-brain and the decision-making part of the brain (the ventral medial prefrontal cortex/the part of the brain that is located behind the forehead) is no longer intact. This means that an addict will not be able to consume alcohol or drugs in a controlled way but will always seek more. Hence, to remain in recovery it is absolutely essential not to use any intoxicating (mind altering) substances.

Criteria of Alcoholism

If you’re wondering if you might have a problem with alcohol, or be an alcoholic here are some signs that may indicate you have an issue with alcohol.

Can’t control my drinking:

If you find that you can’t control the amount of alcohol you consume or stop drinking once you’ve started, it may be a sign of alcoholism. This can lead to binge drinking and an increased risk of alcohol-related harm.

Having strong craving for alcohol:

If you experience a strong urge or craving to drink alcohol, this could be a sign of physical dependence. This is a hallmark of alcoholism and can make it difficult to quit drinking, even if you want to.

Drinking despite negative consequences:

If you continue to drink even though it is causing problems in your personal, professional, or social life, it could be a sign of alcoholism. This can include problems such as work difficulties, strained relationships, and health problems related to drinking.

Prioritizing drinking over other activities:

If you find that you are regularly choosing to drink alcohol instead of engaging in other activities, such as spending time with friends or family, going to work, or taking care of responsibilities, it could be a sign of a problem.

Getting withdrawal symptoms when stopping drinking:

If you experience symptoms such as tremors, sweating, and nausea when you stop drinking, it could be a sign of physical dependence on alcohol. This can be a serious problem and can lead to increased risk of alcohol-related harm.”Blacking out”.

Trouble to remember what I did while drinking:

If you frequently forget what you did or said while drinking, it could be a sign of a problem with alcohol. This is known as alcohol-induced blackouts and can be a serious issue.

Drinking alone or in secret:

If you find that you are frequently drinking alone or in secret, it could be a sign of a problem. This can indicate that you are trying to hide your drinking from others, which can be a sign of shame or guilt related to your alcohol use.

Psychotherapy in Treatment for Alcohol and Drug Addictions

Psychologists use different treatment methods in dependency work. They treat this disorder with motivational interviewing, dependency education, do Cognitive Behavioral Therapy (CBT) to address distorted thinking, use Dialectical Behavioral Therapy (DBT) to effect long term change, offer psychological support, help people in recovery discover healthy ways to live, and introduce the 12 Step program as a possible recovery tool and support network.

Psychologists will help uncover personal causes of dependency and treat them. They will motivate individuals towards abstinence and redirect recovering individuals into a positive lifestyle. The reason for this is that some people who become dependent to alcohol, chemicals or behaviors have used it as a form of “self medication.” It is vital to resolve mental health issues, as this sets the stage for long-term sobriety and being clean.

Comprehensive Treatment Approach for Alcohol Addiction

We approach dependency treatment from all angles and include the family of the dependent person. The disease of dependency affects the entire family. It is vital to understand family dynamics to make positive changes and offer support. We will introduce Al-Anon; the support network for the loved ones to help every family member affected by dependency.

It would be unscientific and unprofessional to promise an alcoholic or addict a cure, because we know that underlying this disorder is a permanent neurological change in the brain. There is no remedy in that sense. Rather than speaking of a cure, it is more realistic to speak of recovery. In recovery individuals are abstaining from mind altering substances and negative behaviors because they no longer have the obsession, nor need to do so. They are enjoying full lives, living up to their potential, and are free from the shackles of addiction and the emotionally eroding cycle of shame and guilt.

We offer advice in regards to the tailored therapy and the referral to rehabs or support groups.

Recovery in Alcohol and Drug Addiction Treatment

A qualified counselor can provide addiction treatment and is able to help with and facilitate recovery through rehabilitation and counseling services. Recovery from alcohol or drugs means more than abstaining from alcohol and drugs. It is a process during which an individual, with the help of a counselor, learns to control seemingly overwhelming feelings, re-builds his/her self-esteem, learns to think in healthy ways, and acquires coping skills to deal with the world he lives in. It’s all about having control over one’s emotions, creating balance in life and a sense of inner peace. Living in an aware and balanced state is what treatment professionals call “recovery.” Recovery is a life-long process.

Support Groups for Alcohol and Drug Addiction in Dubai

There are recovery support groups in Dubai. The two support groups relating to chemical addiction (alcoholism and drug addiction) are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).

The quote below, from the AAGRAPEVINE, will shed some light on the idea and goals of the self-support group:

Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.

12 Steps Program for Alcohol Treatment

The Twelve Steps of Alcoholics Anonymous:

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory, and when we were wrong, promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

Tobacco Addiction

Drug dependency is a psychiatric disorder that affects a person’s behaviour and results in uncontrolled use of the addictive substance. Tobacco is a drug and its legal use makes the “entry barrier” significantly lower, especially for young people.

The use of tobacco is a significant contributor to poor health including cancers such as lung and pancreatic cancer, chronic lung diseases as well as heart and brain infarctions.

This article describes various aspects of tobacco dependency with the main focus on how to quit smoking. Key treatment approaches for smoking cessation are counselling, medication, and hypnosis.

In hopes of encouraging a safe and healthy lifestyle, there will also be a few words on prevention as an inspiration to the young and old not to enter this deadly loop of smoking. Better than quitting smoking is to not start in the first place!

Getting Addicted to Tobacco 

Most smokers use tobacco products regularly. This is because smokers are addicted to nicotine, crave it, and need its ongoing consumption to avoid withdrawal symptoms. Even only a few hours of smoking will trigger neurological adaptations and most smokers soon find a level of smoking that they maintain over time. A scientific study indicated that 80% of the smokers who were questioned reported that they want to stop smoking. Another 10% said they would like to cut down.

Tobbaco Addiction from Psychanalytical Standpoint

According to Freud the first stage of the psychosexual development of a child is the oral stage. It spans the first to second year of life. The erogenous zone during this phase is the mouth, lips, and tongue. This means that, during this developmental period, the mouth serves as the primary source of satisfaction. Children explore their environment by putting objects in their mouth. Beyond nursing at the mother’s breast for nourishment, the child also sucks on a bottle, pacifier, or their own thumb. These actions soothe the child, reduce stress, and help regulate emotions.

The developmental task in this phase is weaning from the aforementioned activities. According to Freud, the baby can only successfully move beyond the oral stage if this weaning process is completed effectively. Typically, this occurs gradually and step by step, with parents playing a crucial role in the process. A sudden and radical weaning can lead to significant stress and complications during this phase.

Complications during the oral stage can manifest later in life in the following ways:

• A strong tendency toward smoking or overeating, as these activities stimulate the unmet need for oral satisfaction.
• A general susceptibility to addictions.
• Low frustration tolerance.

Psychoanalytically smoking is an oral fixation in adults. While smoking the individual is temporary regressing finding pleasure puting a cigarette in his mouth to achieve an oral stimulation. Othe examples of oral fixation in adults is alcohol abuse and overeating.

Freud’s Tobacco Dependence

Freud, the inventor of the psychoanalysis, is the best example of such oral fixation. He became addicted to tobacco in his twenties. He daily often smoked more than 20 cigars. Despite doctors’ warnings about chain smoking, he was unable to quit smoking. Freud continued to smoke even after his doctor diagnosed him with oral cancer in 1923. Despite 33 surgeries over the next 16 years and a large prosthesis in his mouth to separate his sinus from his jaw, Freud never quit smoking.  

Nicotine, Tolerance, and Withdrawal

Unlike other drugs, tolerance of nicotine does not continue to build. This means that most smokers habitually come to smoke a certain number of cigarettes a day without escalating consumption to ever increasing amounts. A smoker will come to depend on smoking to feel psychologically normal and physically well and relaxed. If the smoker suddenly stops nicotine consumption withdrawal symptoms, that include negative physiological and psychological effects, will occur. This is the very reason why it is difficult to stop smoking.

Nicotine’s Stimulating Effect

Additionally, nicotine stimulates the central nervous system. The neurotransmitters play a role in this process. They affect heart rate, blood pressure, memory, learning, reflexes, aggression, sleep, sexual activity, and mental acuity. This stimulating effect can contribute to a smoker feeling more alert and mentally sharp. Smokers enjoy these feelings, which contributes to making it difficult for some to stop smoking. This is particularly true for individuals who report high levels of stress in their lives.

There are other chemicals implicated in the addiction to smoking. Scientists believe that some ingredient in tobacco causes a marked decrease in the levels of a particular enzymes (MAO). This enzyme is responsible for the breakdown of some neurotransmitters. Hence, when there is less MAO there will be higher output of the neurotransmitters which increases pleasurable feelings and the desire of repeated use (Is Nicotine, n.d.). Scientists have also found the chemical acetaldehyde in tobacco. In animal studies it was found that that this chemical reinforces the properties of nicotine and might contribute to tobacco addiction. This area of research also found that younger animals were more sensitive to the enhancing effects of acetaldehyde leading them to conclude that the brains of adolescents may be more susceptible to tobacco addiction (Is Nicotine, n.d.).

Nicotinic acetylcholine (nACH) receptors

For quite a while researcher have been studying nicotinic acetylcholine (nACH) receptors. Meanwhile scientists identified genes that serve as a blueprint of proteins that serve as subunits in nACH receptors. Variations in the DNA that encodes these genes may alter the structure or amount of the proteins produced, which in turn can modify what happens when nicotine molecules attach to the receptor. In 2007, researchers reported about genetically altered mice that had no interest in self-administering nicotine which was attributable to the removal of the protein that is held responsible for positive-reinforcement properties of nicotine. Undoubtedly, the role of genetics in nicotine addiction plays a significant role.

Tobbaco Addicition. Economics versus Healthcare

The Tobacco industry is one of the most lucrative branches of economy creating good financial rewards not only for the shareholders, but also for the governments due to tobacco taxes. Although the US government banned cigarette commercials in the US from television for over 30 years, tobacco products remain among the most heavily marketed.

According to the American Lung Association, the tobacco industry spent an estimated $12.49 billion on advertising in 2006. In 2009, the Food and Drug Administration (FDA) in the United States made importance changes to limit tobacco advertising. This same year, the FDA also began to regulate tobacco products and initiated health warnings on all tobacco packaging and advertising. A similar development can be observed in Europe and the Middle East.

There are millions of smokers who wish to quit smoking for a myriad of reasons. I will discuss the main concerns smokers have and the methods of treating smoking with hypnosis, counselling, and education. Stopping smoking will reward you with better health and appearance.

Economics Aspect of Smoking in Dubai

Money might be noteworthy, but it is not the most critical reason to treat tobacco dependence. Effective October 01, 2017, a pack of cigarettes in Dubai, and the entire UAE, will cost a smoker 20 AED per pack. Even though this cost can be absorbed for most, it is worth a thought to realize that a pack-a-day smoker will be spending 7,300 AED per year.

*A little side note on the money:  I have had many clients tell me that their smoking increased when they came to Dubai, because tobacco products here were much cheaper than in their homeland.  In my home state of California for instance, a pack of cigarettes costs $10, which is about 37AED per pack.

Smoking Cessation. Treatment for Tobacco Addiction

Of course, we know that the biggest concern is not the money, but our health.  When I ask people why they want to quit smoking, I hear the following reasons:

• Health Worries
• Pressure from Doctors
• Faster Aging of Skin
• Loss of Freedom
• Bad Smell
• Pressure from Spouse
• Worried about being a bad role model for their children
• Tarnished Image…..and more

How to stop smoking is an important question once dependency has occurred. Our hope is to educate on the prevention of nicotine addiction as well. The simplest way to avoid development of any kind of dependency (among them smoking) is not to use the addictive substances. Most smokers begin to smoke as teenagers. Research shows that young people are particularly susceptible to tobacco marketing campaigns creating the image of being mature, sophisticated, and glamorous. Schools generally provide education on the use of tobacco and other addictive substances, but their impact is unclear. Parents still have the biggest impact on their children’s decision whether to smoke. The best way to prevent a youngster from taking up smoking is to have parents who do not smoke. Children from smoking households are more likely to begin smoking than children from non-smoking households.

Withdrawal symptoms appearing immediately after smoking cessation:

• An intense craving for nicotine
• Anxiety, tension, restlessness, frustration, or impatience
• Difficulty concentrating
• Drowsiness or trouble sleeping, as well as bad dreams and nightmares
• Headaches
• Increased appetite and weight gain
• Irritability or depression (Nicotine, n.d., para. 3)

Therapy Methods for Quitting Smoking

Tobacco addiction can be treated with several methods, often combining them. Nicotine substitution by patch, tablets or chewing gum (even the intravenous application of nicotine) has only little impact on cravings. Different studies have shown that the most satisfaction and reinforcement of the smoking habit occur when the peripheral, non-pharmacological factors are combined with the nicotine’s central effect. The majority of smokers who want to quit smoking attempt it on their own. However, rates of success for self-quitters are very low. Studies show that most smokers who stop smoking on their own relapse within the first week of their quitting attempt. Only about 3-5 % of individuals who quit on their own reach prolonged abstinence at 6-12 months post-quit.

Research clearly indicates that professional treatment and prolonged support for smoking cessation yields the highest success rates (Tobacco Addiction, n.d.). These treatment professionals include counsellors, psychotherapists, addictions specialists and psychiatrists. Psychologists and psychiatrists can discuss and offer methods to smokers that to increase success rates of quitting:

Pharmacotherapy for Smoking Cessation

The idea behind pharmacotherapy is that medication is used in conjunction with therapy, such as CBT. Medications serve the purpose of reducing cravings and preventing the desired effects of smoking.

Two medications approved by the FDA (Food and Drug Administration) are:

1. A dopaminerg antidepressant with an anti-craving effect Bupropion which is marketed under the name of Zyban/Wellbutrin

2. An agonist of the nicotine receptors

As is the case with all medications, a careful assessment by an experienced physician is necessar

Nicotine Replacement Therapy

Nicotine replacement therapy is a good option for smoking cessation in addition to behavioral treatments to address withdrawal symptoms and cravings when smokers stop smoking. When nicotine consumption is abruptly stopped people can experience withdrawal symptoms within 2 – 3 hours of their last tobacco use. At the 2 – 3-day mark, these symptoms will peak. The severity of nicotine withdrawal symptoms hinges upon how long and how much a person smoked. FDA has approved a number of nicotine replacement therapies such as gum, inhalers, nasal spray, and skin patches.

Quitting Smoking with Counselling and Hypnosis

As a counsellor and clinical hypnotherapist, I have helped many people quit smoking in Dubai and the United States, treating smoking with a combination of CBT (cognitive behavioral therapy), education on dependency, and hypnotherapy.

We have to remember that smoking is an addiction and not just a bad habit, or a display of poor willpower. Treating smoking professionally will help you put this addiction into remission.

Quitting Smoking with Counselling

As a counsellor, I spend time with my clients discussing different aspects of addiction such as the underlying root cause, habit creation, mental patterns (CBT) to deal with the addition. Stopping smoking begins with uncovering the underlying root causes.

Quitting Smoking with Hypnosis

As a clinical hypnotherapist, Dr.Schonder uses hypnotherapy to help people their smoking addiction. Quitting smoking with hypnosis means that I tap into the unconscious mind to:

• deepen the resolve to quit smoking
• remove blocks to success
• increase motivation to quit smoking
• make the process easier than expected

Treating smoking with hypnosis and counselling will help you kick this habit (addiction) for a healthier life.

Fagerström Test for Tobacco Dependence

The Fagerström Test helps assess addiction severity and provides personalized tips for quitting.

Behavioural Addictions

In recent years, the term “addiction” has expanded to include extreme behaviours beyond substance use disorders. These behavioural addictions such as gambling, sex, food, Internet addiction and compulsive buying have gained recognition for their negative impact on people’s lives. Research suggests a strong neurobiological link between pathological gambling and substance use disorders. Currently DSM 5 reclassified only gambling disorder as the first and only behavioral addiction. Other behavioral addictions are still in the research stage, but their “diagnostic upgrade” will follow soon.

Psychological Consequences of Behavioural Addictions

Behavioural addictions have detrimental effects on the individual and their families, resulting in negative emotions such as shame, guilt, fear, irritability, sadness, and anxiety. At times there are also catastrophic financial consequences, e.g. gambling and shopping addictions. In other cases, when behavioral addictions consume an inordinate amount of time, people will neglect their daily responsibilities, such as homework or parenting. Frequently, patients seek treatment to reduce negative consequences rather than modifying or stopping the behaviour altogether. Clinicians can assess when excessive behavioral patterns require intervention with psychiatric and psychological care. Ideally, the patient has insight and wants to end the suffering imposed by the behavioral addiction. Otherwise, caring friends, family members, or colleagues will have to nudge the addict along to reach out for professional treatment. As is the case in chemical addictions (alcohol or drugs), denial is what stops people from getting needed treatment.

Treatment for Behavioural Addictions

The therapeutic alliance is critical in addressing behavioural addictions. Building a relationship with the patient is key to understanding the full clinical picture. Patients must understand that the behaviour is not defining but rather a symptom of an underlying issue.

Exploring destructive patterns of behaviour and psychoeducation helps patients engaging in treatment. Empathy, hopefulness, and a flexible approach can lead to improved treatment outcomes. Psychotherapy, both individual and group, provides the best results. The 12-step program used in the treatment of substance abuse, also turned out to be effective treatment of behavioural addictions. However, the behavioural addictions are frequently comorbid with depression and anxiety. In such cases psychiatrists can provide supportive treatment with medication targeting the comorbidities.

Addiction and Families with Codependency

Talking about one’s family-of-origin, which is the family you were born into, is often a topic of discussion during counseling. Our family-of-origin has a tremendous impact on how we feel about ourselves, and how we interact with others. Our childhood experiences stay with us for a life-time, for better or for worse. Ideally, we have a warm and nurturing upbringing, experience unconditional love, form fond memories, and develop a positive self-image, high self-esteem and a sense of self-worth. In healthy families mistakes are made, as to err is human, but repairs, i.e. apologies and discussions, are made to heal and move forward.

There simply is no such thing as a perfect parent. This is due to the fact that all humans are fallible, and that life circumstances, perhaps a death in the family, or an illness will temporarily curtail a person’s parenting ability. Children can pull though such adversity without lingering effects if the parents continue to show unconditional love for their children.

Dysfunctional Families and Codependency

Realistically speaking, many people come from what counselor’s call “dysfunctional” families. The most obvious dysfunctions are: verbal, physical or sexual abuse. Then there are other issues, such as being overprotective, or neglectful; loving conditionally rather than unconditionally; not letting a child grow up, or parentifying the child; and humiliating and shaming the child. At times unhealthy parenting is due chronic and debilitating illness, chemical or behavioral addictions, or due to the experiences the parents had during their own childhood. Children look to their parents to learn about their adult roles as men and women, as husbands and wives, and fathers and mothers. So when there is significant family dysfunction, children grow up with a distorted view of their adult roles and associated behaviors. The cycle of dysfunction is perpetuated when children from dysfunctional families recreate the dynamics of their childhood in their relationships with others.

Dysfunctional families can have the following characteristics:

• Family members deny problems exist
• Do not communicate about problems
• Family members repress feelings and disregard their own needs
• Use behaviors to deny, avoid, and ignore difficult emotions
• Don’t talk, trust, touch, confront, and feel

Codependency: Too Much Caretaking

Counselors often meet with clients who have grown up in dysfunctional families. Many report low self-esteem, find it hard to be themselves, look for things outside themselves to make them feel better, or begin to abuse chemicals (i.e. alcohol) and use behaviors (i.e. overeating) to feel better. These are good people, with good intentions. Often, these are individuals who are devoted to taking care of others who are experiencing difficulties.

On the surface this might seem like a good and noble quality. However, when people obsessively need to be needed, and in an effort to feel good about themselves do too much for others, they lose sight of themselves. At that point they might feel so empty inside that they feel increasingly depressed and might even contemplate ending their lives. Additionally, they become emotionally fragile, because their successes in rescuing others will determine how they feel about themselves. In the mental health field we call such persons co-dependent.

Research indicates that historically the term codependency was used to describe individuals whose lives were affected by being in a relationship with a chemically dependent person. Specifically, the codependent spouse, parent, or sibling etc. was seen as having developed a certain way of mal-adaptive coping with life in reaction to their loved one’s drug or alcohol abuse. Previously codependents were called co-alcoholic, nonalcoholic, or para-alcoholic.

Codependency Causes

Today we know that other family and life circumstances lead to codependency issues. As Melodie Beatty, the author of Codependent No More, states about the causes of codependency,

“Alcoholism in the family helped create codependency, but many other circumstances seemed to produce it, also. One fairly common denominator was having a relationship, personally or professionally, with troubled, needy, or dependent people. But a second, more common denominator seemed to be the unwritten, silent rules that usually develop in the immediate family and set the pace for relationships. These rules prohibit discussion about problems; open expression of feelings; direct, honest communication; realistic expectations, such as being human, vulnerable or imperfect; selfishness, trust in other people and one’s self; playing and having fun; and rocking the delicately balanced family canoe through growth or change-however beneficial that movement might be. These rules are common to alcoholic family systems but can emerge in other families, too (p. 33).”

Generally speaking these are rules are often held by dysfunctional families where chemical or behavioral addictions are present; where physical, sexual or emotional abuse takes place; or, if a family member suffers from a chronic mental or physical illness.

Melodie Beatty’s Groundbreaking Work

Melodie Beatty defined a codependent person in the following way: “A codependent person is one who has let another person’s behavior affect him or her, and who is obsessed with controlling that person’s behavior (p.34).

• My good feelings about who I am stem from being liked by you.
• My good feelings about who I am stem from receiving approval from you.
• Your struggles affect my serenity. My mental attention focuses on solving your problems or relieving your pain.
• My mental attention is focused on pleasing you.
• My self-esteem is bolstered by solving your problems.
• My own hobbies and interests are put aside. My time is spent sharing your interests and hobbies.
• Your behavior is dictated by my desires as I feel you are a reflection of me.
• The dreams I have for my future are linked to you.
• My fear of your anger determines what I say or do.
• I use giving as a way of feeling safe in our relationship.
• My social circle diminishes as I involve myself with you.
• I value your opinion and way of doing things more than my own.
• The quality of my life is in relationship the quality of yours.

Codependency Checklist

Melody Beattie developed the following check-list to help identify codependent behaviors, so we can stop them before they derail us.

Here is how a codependent person might behave, a quote from Recovery360 website:

1. Do you feel compelled to help people solve their problems or try to take care of their feelings?
2. Do you feel responsible for other people–their feelings, thoughts, actions, choices, wants, needs and well-being?
3. Do you find it easier to feel and express anger about injustices done to others than about injustices done to you?
4. Do you feel safest and most comfortable when you are giving to others?
5. Do you feel insecure and guilty when someone gives to you?
6. Do you feel empty, bored and worthless if you don’t have someone else to take care of, a problem to solve, or a crisis to deal with?
7. Are you often unable to stop talking, thinking and worrying about other people and their problems?
8. Do you lose interest in your own life when you are in love?
9. Do you stay in relationships that don’t work and tolerate abuse in order to keep people loving you?
10. Do you leave bad relationships only to form new ones that don’t work, either?

Therapy for Codependency

Codependent people can heal from their co-dependency through counseling and psychotherapy. Counseling explores family-of-origin dynamics and creates awareness how learned messages and behaviors from childhood have far reaching consequences into how people feel about themselves and the relationships they get into. It is through the uncovering of emotional pain and step by step healing that individuals grow. Psychologists instill confidence, self-esteem and a sense of self-worth. Insight changes mal-adaptive behaviors into positive ones. Counseling also teaches the importance of healthy and appropriate boundary setting and facilitates examining “people pleasing” behaviors.

There are free in person and online support groups for individuals who identify as co-dependent and for individuals who are in a relationship with a chemically or behaviorally dependent person. Codependent individuals can join Co-Dependents Anonymous. Family members, loved ones, or any person in a relationship with a chemically dependent person can join Al-Anon. Please see their website for general information. Both of these support groups are based on the 12 step program of Alcoholics Anonymous. The purpose of joining a support group is to share and hear other people’s stories as a means of mutual support.

Relapse in Treatment for Addiction and Dependence

Since relapse is a process, there are events we can see that precede the relapse and continue into the relapse episode. Marlatt and Gordon in 1985 developed a relapse prevention (RP) model. It is based on social learning theory and cognitive-behavioral psychotherapy.

The basic idea of relapse prevention is that people are able to acquire new skills and behaviours. What they need to do is change the way they think about situations. The goals of relapse prevention are to see a relapse coming, to prevent it and to assist recovery from a slip before it becomes a relapse.

Recovery in Proces of Prolonged Abstinence

Recovery occurs over time as the person increases his or her sense of self-efficacy and self-esteem from prolonged abstinence (Gordon, 2003, p. 8). They consider lapses and relapses are not personal failures but as temporary setbacks. From such a setback, an individual can learn and thus the lapse or relapse can serve as a prolapse. “Prolapses are defined as mistakes that clients learn from that improve their eventual chances of success (Marlatt, Parks & Witkiewitz, 2002, p.9).

According to this model, individuals are not held responsible for negative habits from the past. It does put responsibility on the patient to change his or her addictive behaviours to functional behavioural coping skills and to use cognitive restructuring, which will replace negative thoughts with positive good thoughts. Generally, a patient will pass through 3 stages, which are:

1. Commitment and motivation to prepare for the change

2. Active implementation of the change

3. Maintenance of the change (Gordon, 2003)

Relapse Triggers

RP focuses on events of factors that can bring about a relapse episode. Here factors and situations are classified that can trigger or add to the relapse episodes. According to this model, there are two categories of such factors: immediate determinants and covert antecedents.

Warning Signs of Relapse

Psychologists educate the patient during counselling, and the patient learns to identify the warning signs of entering or being in a risky situation. A psychologist assesses and enhances the patient’s ability and motivation to cope in such a situation. Additionally, self-efficacy-enhancement procedures help a patient improve his sense of mastery and of being able to cope with difficult situations without relapsing. The patient will benefit from a client-psychotherapist relationship that is collaborative rather than “top down.” Psychologists make patients aware that RP is an acquisition of skills and not a test of willpower. Patients are made aware during counselling to set small, doable tasks to increase a sense of self-efficacy. Lastly, psychologists, psychotherapists and counsellors can focus on general accomplishments to increase a patient’s sense of mastery in general and to achieve a carry-over effect into drug and alcohol-related efficacy (Larimer et al., 1999).

Relapse prevention includes speaking about a patient’s subjective expectation of the effect of alcohol. Often, positive expectations of the outcome of drinking are based on myths or placebo effects. Counsellors can assist patients in bringing thought into the experience and look at short- and long-term consequences (Larimer et al., 1999).

Immediate Determinants of Relapse

Intrapersonal high-risk situations: These are negative emotional states, such as anger, anxiety, depression, frustration, and boredom, as a result of how a person sees a situation. Such emotional states can be caused by conflict with another person. Psychologists showed that negative emotional states within people and between people formed the basis for more than 50% of all relapse episodes studied.

Social pressure: direct verbal or nonverbal pressure to consume or indirect pressure such as being around individuals who consume were responsible for more than 20% of relapse episodes.

Positive emotional states: These are things like celebrations, seeing alcohol-related ads on TV, passing one’s favourite bar, or the idea to one’s willpower.

Another aspect of relapsing risk depends on how an individual has learnt to cope with high-risk situations. If a person has behavioural and cognitive coping skills, he is more likely to get out of a risky situation and not relapse. Additionally, the expectation of the effect of drugs is important. If a person sees the alcohol or drug as an aid in coping with a risky situation without considering long-term negative consequences, a relapse might occur.

Covert Antecedents of Relapse Include

Lifestyle factors:

Here the degree of balance between what persons “should” do and what persons “want” to do is important. Too many life demands with too little joy tip the balance towards relapse and negative emotional states. Negative emotional states are part of relapse, and a person using drugs or alcohol might see using as the only way to obtain pleasure. Psychologists noted that lifestyle imbalances are strongly related to a person’s risk of relapse.

Cognitive factors:

rationalisation, denial, and a desire for immediate gratification. This faulty thinking can increase the risk of relapse because it can increase exposure to high-risk situations and decrease motivation to resist substance use. An example of such thinking is when someone thinks that he or she can drop by their favourite bar to say hi to a friend and not sit down for a drink.

Apparently Irrelevant Decisions (AID):

Seemingly inconsequential decisions set a person up for a lapse/relapse. Here the recovering dependent person makes decisions that the surface does not seem to add to a relapse risk. Denial keeps the person at risk from seeing the risk, and rationalisation provides a reason for making the decision. An example could be to have a bottle of wine on hand for cooking, thereby creating a temptation at a later point.

Urges and cravings:

The RP model proposes that urges and cravings are due to psychological or environmental stimuli. According to Marlatt and Gordon, the recovering patient’s urge is defined as a relatively sudden impulse to consume the substance of choice. Craving is the subjective desire to have the effects or consequences of using (Larimer et al., 1999).

Relapse Prevention for Addiction and 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).

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. 

Counselling and Support Groups in Relapse Prevention

A basic premise in the treatment of substance dependency called substance use disorder (SUD), that is chemical dependency, alcoholism and drug dependency, is that an addict in recovery cannot learn to consume alcohol or drugs in a controlled way. There is ample scientific evidence and stories people tell to this effect. Ongoing recovery and relapse prevention work over an long period of time is the necessary prerequisite for long-term sobriety.

Psychologists state that when it comes to relapse prevention, patients should avail themselves of all possible tools. Psychologist, psychotherapists, and counsellors with chemical dependency training can provide evidence-based relapse-prevention-education to reach long term recovery. Based on years of research and scientific discovery, it is evident that relapse prevention is an important aspect to maintain sobriety and avoiding and preventing future abuse.

The Importance of Self-Help Groups (AA Groups)

Additionally, research results also show that self-help (AA based 12-step) groups during treatment are helpful. They are a long-term support system are vital for someone’s recovery. Furthermore, psychologists show that it is good when the family system can receive counselling. The disease of alcoholism and drug dependency affects each person in the family. Self-help groups are available for the families of addicts as well, such as Al-Anon, or Alateen.

Experienced counsellors with addiction training draw from several schools of thought during drug and alcohol treatment. Avoiding and preventing relapse is the essential ingredient in sustained recovery.

Relapse Management

The relapse prevention model also includes lapse management. The idea is to halt the progression into a relapse and to help clients cognitively restructure the event. This helps them see that they have not suffered a failure of willpower or morality but failed to address a risky situation. Psychologists might want to facilitate a lapse-management-plan. This could include a limit on how much of the substance can be taken, reasons why it is important to put a halt to using, to leave the high-risk situation, and to contact the counsellor or a supportive person as soon as possible (Larimer et al., 1999).

Life-Style Change

Psychologists also bring focus to global lifestyle and self-control strategies. These strategies include helping patients balance their lifestyles so that recovering individuals achieve a balance between stress and the fun of life. During counselling, psychologists encourage their patients to tap into enjoyable activities which they pursued before they became substance dependent. Furthermore, specific cognitive-behavioral skills such as relaxation training, stress-management, and time management can improve a client’s life-style balance. Counselling also fosters positive dependencies, such as meditation or exercise, and can have long-term positive effects on mood, health, and coping ability (Larimer et al., 1999).

Stimulus Control

Psychologists also tell patients to practice stimulus control techniques to lessen urges and cravings for relapse prevention. Here they take all items connected to their use from their living from their environment. This would include alcohol, shot glasses, or any other drug or drug-related things. Recovering individuals can change the things they connected with their dependency. Patient’s can listen to different music, for example, or change the furniture to reduce cues to using. Lastly, psychologists, psychotherapists, and counsellors impart ways to decline events and places that were connected with use (Larimer et al., 1999).

Psychologists teach patients to expect and accept cravings and urges of their dependency as normal, but not to see this as a desire to drink and to see it as a conditioned response to cues in the environment. It is important that patients learn that they can ride this feeling out, as it will come, swell, and go like a wave in the ocean (Larimer et al., 1999).

Addiction and Dependency. Summary

Addiction and dependence are terms often used interchangeably. More precisely, addiction is defined as the compulsive desire for specific substances or behaviours. These substances are consumed or behaviours maintained despite their negative consequences for the individual and society. On the other hand, dependence means that a person can no longer live without the addictive substance (such as alcohol, drugs, or medications) or—in the case of behaviour-related addiction—without a particular behaviour like gaming. In medical terms, this is referred to as “dependence syndrome,” characterised by a range of psychological and/or physical symptoms.

Dependence can be classified into two types: substance-related and non-substance-related. Substance-related dependence involves the use of psychoactive substances (e.g., alcohol, nicotine, cannabis). “Psychoactive” refers to substances that can alter consciousness and mental states. Non-substance-related dependence manifests in excessive behaviours associated with a loss of control, such as gambling or excessive use of social media.

ICD 10 Definition of Dependence

According to the diagnostic criteria in ICD-10, a diagnosis of dependence can only be made if at least three of the following criteria have been present during the past year:

• Continued substance use despite clear evidence of its harmful effects.
• A strong desire or compulsion to consume psychoactive substances.
• Reduced ability to control the onset, termination, or quantity of substance use.
• Physical withdrawal symptoms upon reducing or stopping use, demonstrated by substance-specific withdrawal signs or the use of the same or a closely related substance to mitigate or avoid withdrawal symptoms.
• Evidence of tolerance means increased doses are needed to achieve the effects that smaller doses previously produced.
• Increasing neglect of other pleasures or interests in favour of substance use, along with more time spent on activities related to obtaining, using, or recovering from the substance.

Causes of Addiction and Dependence

There are many causes for dependencies. Psychiatrist and psychologists have identified genes, behaviors, and social and emotional reasons that underlie dependency. Repeated substance abuse and other harmful behaviors will cause irreversible changes in the brain. Those changes called “psychological addiction” make it impossible for anyone with a dependency to “just drink less”, or “gaming less”. To make it simple, we have to understand that the “off switch,” between the pleasure reward system and the pre-frontal cortex is broken. The only chance to stay clean and sober for the rest of your life requires full abstinence. Even a small sip of alcohol will bring the patient to “square one”.

Alcohol Addiction

There are some of the signs that may indicate you have a problem with alcohol or are an alcoholic. If you are concerned about your drinking, it is important to reach out to a healthcare professional for help. They can provide you with a formal evaluation and help you determine if you have an alcohol use disorder (alcoholism) and what steps you can take to seek treatment and recovery.

Tobacco Addiction

Tobacco smoking is one of the most addictive habits. The addiction can be established even after a few days of smoking. The smokers are inhaling thousands of carcinogenic substances responsible for a much higher cancer rate and other diseases such as chronic bronchitis. Moreover, smoking significantly increases the risk for atherosclerosis, which is the main cause of heart attacks and strokes. The physical condition of smokers is lower compared to their peer group of non-smokers. The life expectancy of long-term smokers is significantly reduced.

The best way to avoid the addiction is not to start. Smoking cessation is possible at every stage and can be successful for all smokers under all circumstances.

Counselling for smoking cessation

Among different psychotherapy methods Cognitive Behavioural Therapy (CBT) is the most frequently investigated and evidence-based treatment for quitting smoking. It trains individuals to understand their trigger situations, regulate their feelings, and identify adaptive coping mechanisms. It helps lay the foundation for a sustainable, healthy lifestyle. Therapists with addiction training will also provide general psycho-education on addiction, including relapse prevention.

Quitting Smoking with Hypnosis

Treating tobacco addiction with hypnosis is effective method for stopping smoking. Clinical hypnotherapists with 3-5 sessions can set the stage on a subconscious level to remain smoke-free. Everyone has their own unique reasons for why they began smoking and why they want to quit smoking. A clinical hypnotherapist can uncover and address subconscious causes for smoking, increase motivation to remain smoke-free, and build ego strength to cope with daily life.

Behavioural Addictions

The recognition of behavioural addictions has broadened our understanding of addiction beyond substance use disorders. It is crucial to ask the right questions and build a therapeutic alliance to address these complex and subtle patterns. Through psychoeducation, exploration of ambivalence, and a flexible approach, clinicians help patients understand the root of their behaviour. In the second step, the therapist can implement a treatment plan, providing patients with the tools necessary to overcome the destructive behaviour leading to happier and more meaningful lives.

Codependence in Family Dynamics

Codependent behaviors become inextricably entangled with being a good wife, mother, husband, brother or father. They look strong but feel helpless. They appear controlling, but in reality are controlled themselves. The codependent family members orpartners only consolidate the addictive behaviour.

Relapse Prevention

Some individuals think their relapse is due to internal factors such as lacking willpower. Dependent persons who have relapsed might come to believe they will never be able to stay sober. However, when a dependent person experiences a relapse and comes to understand it as not being able to cope with a risky situation, they can learn from their mistake. This helps them avoid such situations in the future and continue their recovery.

Counsellors encourage specific intervention strategies that address the immediate determinants of relapse and self-management strategies. This addresses the covert antecedents of relapse. These strategies fall into the categories of skills training, cognitive restructuring, and lifestyle balancing.

FAQs about Therapies for Addictions

At CHMC, we are prepared to diagnose and provide currently available treatment options for addition to support you in your recovery. We will discuss the goals of dependency treatment, give you a definition of addiction, and explain why specialists speak of recovery and not a cure for dependency.

The following 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

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.

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).

Why are AA and NA an important part of alcohol and drug treatment?

The answer is: It is an effective addiction treatment method. As a matter of fact, in California, 3 hours of support group attendance counts as 1 hour of therapy in court-mandated drug and alcohol treatment. Furthermore, anecdotal reports and scientific studies show lower rates of relapse among individuals in treatment for alcoholism and drug addiction who attend AA or NA regularly.

What is the purpose of the AA and NA meetings?

• Listening and learning
• Sharing about each other’s problems, addiction, recovery and challenges
• Getting a sponsor (a support person)

How do I find a support group for alcohol and drug addiction in Dubai?

Alcoholics Anonymous

What role does a sponsor play in AA or NA?

A sponsor is someone with whom the newcomer will build a relationship that supports his recovery. A dependent person can call his or her sponsor in a crisis or if someone needs support to remain sober. The sponsor helps the new member go through the 12-step programme.

How do you get a sponsor in Dubai?

When you attend a support meeting for alcohol or drugs in Dubai, you simply state in the meeting that you need a sponsor. Typically, someone will come up at the end of the meeting and offer sponsorship. At some meetings available, sponsors will be asked to raise their hand. If, for different reasons, the newcomer does not connect with a particular person as a sponsor, this should be communicated at the meetings. There will be always other suitable candidates ready to take over.

Are there any requirements to participate in the 12-step programme in Dubai?

The only thing required is that the alcoholic or drug addict has a desire to stop using, and attendees are obliged to observe strict confidentiality and anonymity. There are no membership fees.

How are family members and friends affected by someone’s alcohol or drug addiction?

It is important for loved ones of alcoholics and drug addicts to get help. They must learn as much as they can about the addiction treatments. It is advisable to see a counsellor or addictions specialist to gain more insights into the disease of addiction and to attend a self-help group. The more they understand about this disorder, the better they will understand what the alcoholic or drug addict is going through. When one person in the family is getting help and treatment for his/her addiction, it is important for those involved in relationships with the addict to begin their own journey of personal growth. The underlying reason for this is to begin healing the hurt and to be able to jointly move forward in a healthy way.

A very important resource for family members/friends is Al-Anon.

What is the role of Al-Anon in treatment for addictions in Dubai?

Al-Anon is based on the same principles (i.e., meetings, 12 steps, sponsorship, etc.) of AA. The purpose of this group is to give those who are in relationships with addicts an opportunity to get support from individuals in the same kind of situation. One of the main lessons new members learn is that a family member cannot make the addict better. Only the addict can make the decision to rehabilitate and work on his/her sobriety programme.

The other important lesson many learn is to STOP enabling the addict to continue his/her alcohol and drug addiction by covering for them, giving them money, or providing a place to stay. Do continue to love the addict, but do not do anything that supports the addiction or removes negative consequences. Many in Al-Anon call this “thought love.”

Al-anon meetings

Any contact persons listed on any of the AA-based support group websites will be more than happy to help. This is the strength of the fellowship to be supportive of anyone in recovery or anyone who wishes to stop abusing alcohol or drugs.

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.

Sources

Cognitive behavior therapy with Internet addicts: treatment outcomes and implications.Young KS.Cyberpsychol Behav. 2007 Oct;10(5):671-9. doi: 10.1089/cpb.2007.9971.PMID: 17927535 Clinical Trial.

Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs by Darryl S. Inaba, William E. Cohen, Elizabeth von Radics and Ellen K. Cholewa (Jul 15, 2011)

American Association of Addiction Medicine. 2022.l www.asam.org

Beattie, Melody. Codependent No More: How to Stop Controlling Others and Start Caring for Yourself. Hazelden, 1992.

National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3072794/

“Drug addiction (substance use disorder) – Symptoms and causes”. Mayo Clinic. Retrieved 21 November 2022.

American Psychiatric Association (2013). “Substance-Related and Addictive Disorders” (PDF). American Psychiatric Publishing. pp. 1–2. Archived from the original (PDF) on 15 August 2015.

Gearhardt AN, Corbin WR, Brownell KD (February 2016). “Development of the Yale Food Addiction Scale Version 2.0”. Psychology of Addictive Behaviors. 30 (1): 113–121. doi:10.1037/adb0000136. PMID 26866783.

American Psychiatric Association, American Psychiatric Association, DSM-5 Task Force (2013). Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association. p. 481. ISBN 978-0-89042-554-1

Block JJ (March 2008). “Issues for DSM-V: internet addiction”. The American Journal of Psychiatry. PMID 18316427.

Weinstein A, Lejoyeux M (September 2010). “Internet addiction or excessive internet use”. The American Journal of Drug and Alcohol Abuse. PMID 20545603.

“Addictive behaviours: Gaming disorder”. www.who.int. Retrieved 25 October 2022.

“Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) Tool”. nida.nih.gov. Retrieved 29 November 2022.

Cheetham A, Allen NB, Yücel M, Lubman DI (August 2010). “The role of affective dysregulation in drug addiction”. Clin Psychol Rev. PMID 20546986.

Hill R, Harris J (2 November 2021). “Psychological Approaches to Addiction”. In Day E (ed.). Seminars in addiction psychiatry (2nd ed.). Cambridge: Cambridge University Press. ISBN 978-1-911623-19-9.

Vassoler FM, Sadri-Vakili G (2014). “Mechanisms of transgenerational inheritance of addictive-like behaviors”. Neuroscience. 264: PMID 23920159.

Mirin SM, Weiss RD, Griffin ML, Michael JL (1 January 1991). “Psychopathology in drug abusers and their families”. Comprehensive Psychiatry. PMID 2001619.

Mayfield RD, Harris RA, Schuckit MA (May 2008). “Genetic factors influencing alcohol dependence”. British Journal of Pharmacology. PMID 18362899.

“Understanding Drug Use and Addiction”. www.drugabuse.gov. National Institute on Drug Abuse. 6 June 2018. Retrieved 29 May 2020.

Lewis M (October 2018). Longo DL (ed.). “Brain Change in Addiction as Learning, Not Disease”. The New England Journal of Medicine.

“Adverse Childhood Experiences”. samhsa.gov. Rockville, Maryland, United States: Substance Abuse and Mental Health Services Administration. Archived from the original on 9 October 2016. Retrieved 26 September 2016.

Enoch MA (March 2011). “The role of early life stress as a predictor for alcohol and drug dependence”. Psychopharmacology. PMID 20596857.

“Environmental Risk Factors”. learn.genetics.utah.edu. Archived from the original on 17 September 2018. Retrieved 17 September 2018.

Marcos AC, Bahr SJ (June 1988). “Control Theory and Adolescent Drug Use”. Youth & Society. ISSN 0044-118X. S2CID 143860602.

Spear LP (June 2000). “The adolescent brain and age-related behavioral manifestations”. Neuroscience and Biobehavioral Reviews. PMID 10817843. S2CID 14686245.

Hammond CJ, Mayes LC, Potenza MN (April 2014). “Neurobiology of adolescent substance use and addictive behaviors: treatment implications”. Adolescent Medicine. PMID 25022184.

Catalano RF, Hawkins JD, Wells EA, Miller J, Brewer D (1990). “Evaluation of the effectiveness of adolescent drug abuse treatment, assessment of risks for relapse, and promising approaches for relapse prevention”. The International Journal of the Addictions. PMID 2131328.