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Addiction

What is addiction?
Whatever the focus (alcohol, drugs, smoking, etc.), addiction means you are out of control. The term addiction may bring to mind images of drug addicts slumped over a syringe in a darkened alley. Or you may think of an alcoholic staggering down the sidewalk, panhandling for money to buy another bottle. There are various degrees and stages of addiction. However, there are some essential chemical, psychological, and social common denominators between all forms of habitual behaviours. One of the key determinants in addiction is persistence. You continue with the behaviour in spite of harmful consequences.

Addiction is a process.
Addiction seldom remains constant. As it changes, it usually takes more and more of a person’s energy and resources, to the point that it can become destructive and even fatal. Addiction is a set of experiences that produces changes within the person. The addict, responding to these internal changes, begins to act out in particular ways. As addiction develops, it becomes a way of life. To understand addiction we need to remember something very basic about human nature. We tend to want to do things that are rewarding and positive, and we tend to avoid things which are negative and aversive. When we experience loss, pain, grief, sadness and other inevitable hurt or negative experiences, then we are more susceptible to forming an addictive behaviour such as alcohol or drug dependency. Because we want to escape pain, we seek experiences that maximize the positive and eliminate the negative, (for some people, alcohol or drug use, may be some of these experiences). Since we cannot totally control the cycle of peace and pain in our lives, most of us learn to either accept these cycles or try to be happy all the time. The addict tries to control these uncontrollable events. When he uses alcohol or drugs, he believes that he can make the pain go away and bring about good feelings whenever he wants. And in the beginning he can be successful. But this is where the process becomes progressive. Addiction is the out-of-control search for either happiness or the avoidance of pain. Regardless of the addiction, every addict has a “relationship” with a substance (alcohol or drugs), in order to produce a mood change. The means by which the mood change is accomplished is called acting out (using alcohol or drugs). By acting out, the addict attempts to create feelings of relaxation, excitement, or fantasy. The change in mood resulting from the acting out (using alcohol or drugs), gives the addict the illusion of being in control. The process continues as the addict attempts to make sense out of life. He believes he is being fulfilled by his behaviour (using alcohol or drugs). Because the activity gains access to rewarding feelings, or at least helps escape pain and hurt, the process of using
alcohol or drugs is reinforced. As the addictive cycle continues, the acting out behaviour (using alcohol or drugs), is also a way to escape the shame and guilt created by knowing
that he (the addict), is out of control.

Stages of addiction.
There are three stages to the addiction process. The first involves internal changes. The personality begins to change as a result of the intoxicating experiences. The second stage involves changes in lifestyle. Now it is more obvious to those around the addict because he is behaving in ways that are unusual and counterproductive. The final stage occurs when the addict becomes out of control. Nothing matters but getting more of the mood- altering experience (alcohol or drug use). Pleasure is gone and life is only a survival ordeal. Here are some of the details of each stage.

Stage One.
For the addict, a life experience that produces a pleasurable mood change (alcohol or drug use), can give the illusion of control and comfort. This can be the start of the addictive journey. The initial experiences of alcohol or drug use are usually quite intoxicating. This euphoric experience teaches the prospective addict that one’s feelings can change through a relationship with an object or event (alcohol or drug use). This intense feeling, unfortunately, gets mistaken for intimacy, nurturance, and a sense of personal power. Addiction begins when a person repeatedly seeks the illusion of relief to avoid unpleasant feelings or situations. Emotional needs are met by seeking nurturing through avoidance. The person wants to avoid the pain, so feels the need to soothe the pain. This urge leads to acting out (alcohol or drug use), and the resulting mood change. The person starts to feel better. But pretty quickly there is the pain resulting from acting out. Now the person has experienced pain again, so feels the need to act out (more alcohol or drug use) again, does act out, feels pain and remorse, and the cycle goes on and on. At this point the addiction starts to create the very thing the person is trying to avoid—pain. However, in creating pain, the process also creates a need for the continuation of the addictive relationship. The addict seeks refuge from the pain of addiction by moving further into the addiction. This cycle causes an emotional craving
that results in mental preoccupation. The more ingrained the cycle, the greater the preoccupation and dependency. Eventually, the person forms a dependent relationship with his own addictive personality.

Stage Two.
The acting out (alcohol or drug use), is a sign that the person is out of control on an internal level. In Stage Two, the person becomes out of control on a behavioural level. The episodes of being behaviourally out of control become more frequent. The addict becomes more preoccupied with the object or event (alcohol or drug use), that can temporarily stop the pain. In this stage others start to notice something is wrong. The presence of an addictive personality becomes obvious to family and friends. The addict starts to act out his belief system in a ritualistic manner and his behaviour is more out of control. He becomes dependent on the addictive personality, mot just the mood change or the object or event (alcohol or drug use). The addictive belief system develops into a lifestyle. In this stage the person uses addictive logic to guide him. Here are some of the ways this stage shows itself: The addict lies when it would be easier to tell the truth. The person blames others, knowing it is not true. Behaviour becomes ritualised. The person withdraws from others.

Because the addict must make emotional sense to himself of the inappropriate behaviour, he turns to denial, repression, lies, rationalizations, and other defences to cope with what is happening. When the addict acts out, he must withdraw into his addictive personality to receive support. This action causes him to become even more isolated from others around him. The loneliness becomes another signal to act out (more alcohol or drugs). This vicious cycle serves to strengthen the addictive process. The behaviour becomes more ritualised. For the addict, a ritual brings a form of comfort because it is predictable. Addictive rituals make the addict feel worse about himself. Addictive rituals destroy relationships. Addictive rituals cause shame. In Stage Two, the addict surrenders to the immense power of addiction. As the addict becomes more controlled by the process, those people around the addict sense his emotional withdrawal and react to it. This is the start of people problems, as the addict manipulates people and treats them as objects. The next thing that happens is for the people around the addict to label him as irresponsible, troubled, tense, crazy, or strange. Stage two, includes the development of tolerance (not able to escape the pain). Because of this tolerance and increased anger and pain, the addict will start to act out (alcohol or drug use), more frequently and in more dangerous ways. This constant attempt to keep ahead of the tolerance level, combined with the internal emotional struggle, is a tremendous energy drain. Like any progressive illness, the addiction will take more of the addict’s energy and attention, limiting his ability to live a “normal” life.

Stage Three.
By Stage Three, the addictive personality is in total control. At this point, acting out (alcohol or drug use), no longer produces much ecstasy. Preoccupation, rituals, and acting out will still produce a mood change, but the pain never goes away. The magical intoxication begins to break down. The addict is unable to break the addictive cycle. His lifestyle is devoted to addictive ritual. The addict is preoccupied with those things that will help him maintain the addictive lifestyle. Nothing else matters. Emotions break down. Paranoia, depression, anger, rage, guilt, shame, loneliness, and hopelessness anxiety, panic attacks, hysteria and a feeling that everyone has turned against him take over. Suicide is a common consideration at this stage. Environmental problems also abound. Work is endangered, marriages are threatened or ended, health, financial, and legal problems emerge. Addicts cannot break the addictive process and will remain stuck in Stage Three, unless there is some form of intervention. Only strong, professional, and appropriate intervention has a chance of making a difference.

Global statistics on addictive behaviours: 2014 status report.
BACKGROUND AND AIMS:
Addictive behaviours are among the greatest scourges on humankind. It is important to estimate the extent of the problem globally and in different geographical regions. Such estimates are available, but there is a need to collate and evaluate these to arrive at the best available synthetic figures. Addiction has commissioned this paper as the first of a series attempting to do this.

METHODS:
Online sources of global, regional and national information on prevalence and major harms relating to alcohol use, tobacco use, unsanctioned psychoactive drug use and gambling were identified through expert review and assessed. The primary data sources located were the websites of the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC) and the Alberta Gambling Research Institute. Summary statistics were compared with recent publications on the global epidemiology of addictive behaviours.

RESULTS:
An estimated 4.9% of the world's adult population (240 million people) suffer from alcohol use disorder (7.8% of men and 1.5% of women), with alcohol causing an estimated 257 disability-adjusted life years lost per 100000 population. An estimated 22.5% of adults in the world (1billion people) smoke tobacco products (32.0% of men and 7.0% of women). It is estimated that 11% of deaths in males and 6% of deaths in females each year are due to tobacco. Of 'unsanctioned psychoactive drugs', cannabis is the most prevalent at 3.5% globally, with each of the others at <1%; 0.3% of the world's adult population (15million people) inject drugs. Use of unsanctioned psychoactive drugs accounts for an estimated 83 disability-adjusted life years lost per 100?000 population. Global estimates of problem gambling are not possible, but in countries where it has been assessed the prevalence is estimated at 1.5%.
Source

CONCLUSIONS:
Tobacco and alcohol use are by far the most prevalent addictive behaviours and cause the large majority of the harm. However, the quality of data on prevalence and addiction-related harms is mostly low, and comparisons between countries and regions must be viewed with caution. There is an urgent need to review the quality of data on which global estimates are made and coordinate efforts to arrive at a more consistent approach.

 

Researchers Release First Report on Worldwide Addiction Statistics
June 2nd, 2015
Australian researchers have released the first-ever report on worldwide addiction statistics. They found about 240 million people around the world are dependent on alcohol, more than a billion people smoke, and about 15 million people use injection drugs, such as heroin.

The report uses data from sources including the World Health Organization and the United Nations Office on Drugs and Crime, according to NPR. The researchers say the report is important because it provides a baseline of drug and alcohol use worldwide, along with comparisons among different regions.
Read more

Global statistics on addictive behaviours: 2014 status report.
BACKGROUND AND AIMS:
Addictive behaviours are among the greatest scourges on humankind. It is important to estimate the extent of the problem globally and in different geographical regions. Such estimates are available, but there is a need to collate and evaluate these to arrive at the best available synthetic figures. Addiction has commissioned this paper as the first of a series attempting to do this.

METHODS:
Online sources of global, regional and national information on prevalence and major harms relating to alcohol use, tobacco use, unsanctioned psychoactive drug use and gambling were identified through expert review and assessed. The primary data sources located were the websites of the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC) and the Alberta Gambling Research Institute. Summary statistics were compared with recent publications on the global epidemiology of addictive behaviours.

RESULTS:
An estimated 4.9% of the world's adult population (240?million people) suffer from alcohol use disorder (7.8% of men and 1.5% of women), with alcohol causing an estimated 257 disability-adjusted life years lost per 100?000 population. An estimated 22.5% of adults in the world (1?billion people) smoke tobacco products (32.0% of men and 7.0% of women). It is estimated that 11% of deaths in males and 6% of deaths in females each year are due to tobacco. Of 'unsanctioned psychoactive drugs', cannabis is the most prevalent at 3.5% globally, with each of the others at <?1%; 0.3% of the world's adult population (15?million people) inject drugs. Use of unsanctioned psychoactive drugs accounts for an estimated 83 disability-adjusted life years lost per 100?000 population. Global estimates of problem gambling are not possible, but in countries where it has been assessed the prevalence is estimated at 1.5%.

Source

CONCLUSIONS:
Tobacco and alcohol use are by far the most prevalent addictive behaviours and cause the large majority of the harm. However, the quality of data on prevalence and addiction-related harms is mostly low, and comparisons between countries and regions must be viewed with caution. There is an urgent need to review the quality of data on which global estimates are made and coordinate efforts to arrive at a more consistent approach.

The addiction can be from various sources like liquor (alcohol), tobacco or drugs.

Of course the consumption depends on the atmospheric conditions e.g. freezing cold or too much temperature or the culture e.g. people might be consuming liquor as part of their culture ....

Too little consumption leads to little more consumption, and then more consumption ..... too much of everything - even food - is not good.

We have started sharing countrywise examples of how various stakeholders have programmes that addresses addiction.