The word “addiction” is often used to refer to any behaviour that is out of control in some way. People often describe themselves as being addicted to, for example, a TV show or shopping.
Addiction is also used to explain the experience of withdrawal when a substance or behaviour (e.g., gambling) is stopped (e.g., “I must be addicted to coffee: I get a headache when I don’t have my cup in the morning”). However, experiencing enjoyment or going through withdrawal do not in themselves mean a person has an addiction.
Because the term “addiction” is commonly used in such a vague way, there have been many attempts to define it more clearly. The definition used here refers to problematic use of a substance such as alcohol.
The harms of substance use can range from mild (e.g., feeling hungover, being late for work) to severe (e.g., homelessness, disease). While each time a person uses a substance may seem to have little impact, the harmful consequences can build up over time. A person who keeps using substances despite the harmful consequences may develop a substance use problem.
The harms of substance use can affect every aspect of a person’s life. They include:
Some people may be aware that their substance use causes problems but continue to use, even when they want to stop. They may use more than they intended or in situations where they didn’t want to use.
Some people may not see that their substance use is out of control and is causing problems (denial). This so-called denial, however, may simply be a lack of awareness or insight into the situation. Whether people realize it or not, lack of control is another sign that substance use is a problem.
Researchers have tried various ways to sort out the complex causes of substance use problems. One way is to ask which factors put people at risk and which protect them substance use problems. Since substance use often begins in youth, research has focused on this age group.
Screening questionnaires (e.g., the CAGE) can help to quickly identify a substance use problem or determine the level of dependence.
Once a substance use problem is identified or suspected, health care providers will ask about:
There is no “one-size-fits-all” approach to addiction treatment.
Choosing the appropriate treatment depends on the severity and type of addiction; the support available from family, friends and others; and the person’s motivation to change.
To reach out to people who may not be ready, willing or able to give up substances, some treatment programs have adopted a harm reduction approach.
Examples of harm reduction strategies include:
Counselling comes in a variety of forms, including individual, group, couples and family therapy. Counselling generally aims to:
Alcohol and other drug education can help people learn about the effects of alcohol and other drugs, and support people in making informed choices. Some treatment programs also offer alcohol and other drug education to family members.
Treatment using medications should always be paired with at least brief counselling or, if available, a structured treatment program. Medications that can be used to treat problematic substance use and addictions include:
Medications to treat other types of addiction are limited.
People sometimes need short-term help dealing with substance use withdrawal. Withdrawal management helps them manage symptoms that happen when they stop using the substance. It helps prepare clients for long-term treatment. Clients also learn about substance use and treatment options.
Many treatment programs offer a variety of other supports and services, including information and counselling about:
Adapted from Addiction: An Information Guide © 2010 Centre for Addiction and Mental Health.
One thing that makes change so difficult is that the immediate effects of problematic substance use tend to be positive. The person may feel good, have more confidence and forget about his or her problems temporarily. The problems caused by substance use might not be obvious for some time.
When the person uses substances to escape or change how he or she feels, using can become a habit, which can be hard to break. Continued substance use, especially heavy use, can cause changes in the body and brain. A person who develops physical dependence and then stops using may experience distressing symptoms of withdrawal. These changes may explain why people continue to crave the substance long after they have stopped using, and why they may slip back into patterns of problematic use.
If you feel that substance use is causing problems in your life and that you are unable to control your use, see a trained counsellor for an assessment. This assessment gathers information about your use and related problems and other factors in your life, such as your personal strengths and supports. This information will help you and your counsellor decide whether you might benefit from treatment or other support.
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