Addiction

Current Issues , 2010 Addiction is a chronic and compulsive dependence on a substance such as alcohol, drugs, or nicotine. Addicts continue to seek out these substances despite harmful consequences. Though addiction is often associated with alcohol, tobacco, and street drugs such as heroin and crack cocaine, people can also become addicted to prescription drugs. In addition, some compulsive behaviors, such as compulsive gambling, are thought of as addictions. Until recently, addiction was generally considered the result of moral failure, and addicts were blamed for causing their condition. But advances in neuroscience have improved the understanding of addiction and shown it to be a brain disease. Addiction is one of the most serious health problems in the United States. More than 23 million Americans have an addiction to drugs or alcohol. According to the National Institutes of Health, these addictions contribute to more than 100,000 deaths per year in the United States. And addiction to tobacco contributes to some 440,000 deaths annually. The medical, economic, and social costs of addiction in the United States are estimated at some $500 billion per year.

The Process of Addiction

The human brain is structured to ensure that individuals will repeat behaviors necessary to survival and well-being. To do this, the brain associates such behaviors with a "reward," or feeling of pleasure. The brain chemical most closely associated with this reward system is dopamine, a neurotransmitter that carries messages between nerve cells in the brain. Addictive substances overstimulate the brain's reward system by flooding it with excess levels of dopamine. Indeed, such drugs can release up to ten times as much dopamine in the brain as its natural reward system does, creating feelings of extreme well-being. And the effects of this dopamine rush can also last much longer than those that the brain produces naturally. After experiencing the intense reward of a dopamine rush, a drug user or alcoholic might find normal levels of dopamine unsatisfying. The user may be motivated to seek out the intense experience again and again. But when the brain is flooded with extreme amounts of dopamine, it adjusts to this imbalance by either producing less of the chemical, or by reducing the number of brain cells that can send or receive it. In effect, the brain simulates a more normal level of the dopamine. But for addicts, this level is not enough to produce any sense of wellness. Without extreme amounts of dopamine, addicts feel lifeless and depressed. They must continue taking the addictive substance and increasing their dopamine levels just to feel normal. Addicts also develop tolerance, which means that they need larger amounts of the drug to create the dopamine rush. Certain compulsive behaviors, such as gambling or shopping, are sometimes called social addictions, but this term is imprecise. These behaviors do not appear to cause the same changes in the brain as does addiction to physical substances. Addiction also disrupts the circuits in the brain that regulate behavior. This diminishes the addict's ability to control his or her behavior and impulses, leading to risky behaviors such as drunk driving or unprotected sex.

Causes

Not every drinker or drug user becomes an addict. A person's risk of addiction varies and is influenced by both biological and environmental factors. Researchers believe that genetic factors may account for 40 to 60 percent of a person's susceptibility to addiction. It is also known that individuals with mental disorders have a higher than average risk of drug abuse and addiction. Environmental factors also play a role in increasing the risk of addiction. Individuals who grow up in families with an addicted parent or other relative are at greater risk of developing an addiction. Peer pressure can also influence a person to begin abusing drugs. Research shows that when drug abuse begins at an early age, the person is at greater risk of becoming an addict. The media have been criticized for increasing adolescents' exposure to images of drugs and drug-related behaviors. The National Youth Anti-Drug Media Campaign and Nielsen Online reported in 2008 that teens who watched videos online during a one-month period were exposed to 1.2 million drug-related videos. The report also said that 85 percent of online videos contained explicit drug use or favorable comments about such abuse. Antidrug advocates believe that such exposure increases the risk that teens will try addictive substances. No causal link between media exposure and use of illicit drugs, however, has been proven.

Health Effects
Addiction is associated with numerous health problems. Smokers, for example, inhale many carcinogens in tobacco smoke. They are at high risk for lung cancer, as well as cancers of the mouth, throat, larynx, blood, stomach, pancreas, kidneys, bladder, and cervix. According to the Centers for Disease Control and Prevention, smoking causes approximately 90 percent of all lung cancer deaths in men, 80 percent of all lung cancer deaths in women, and 90 percent of all deaths from chronic obstructive lung disease. Smokers are also two to four times more likely than average to develop coronary heart disease or stroke. Smoking is also associated with infertility problems, preterm births and stillbirths, and osteoporosis. Smoking damages almost every organ in the human body. Though moderate consumption of alcohol has been linked to health benefits such as lower cholesterol levels, longterm alcohol abuse contributes to many diseases. Alcoholics are at increased risk of dementia and stroke; hypertension; psychiatric problems, such as depression, anxiety, and suicide; cancer of the mouth, throat, esophagus, liver, colon, and breast; gastrointestinal diseases, including pancreatitis and gastritis; and social problems such as unemployment and family dysfunction. Alcoholics are at very high risk of liver disease, including alcoholic hepatitis and cirrhosis, an incurable disease. Alcoholics often have poor diets and suffer from lack of proper nutrition. In addition, alcohol impairs the body's ability to absorb and use nutrients. Addicts who use street drugs, such as heroin, also expose themselves to major health risks. The most extreme is accidental overdose and death. Other health risks arise because street drugs are often mixed with additives, including some poisons. In addition, addicts who inject drugs often share needles and equipment, exposing them to HIV, which causes AIDS, and to hepatitis C, which causes liver damage. In fact, injection drug use accounts for 70 to 80 percent of new hepatitis C infections in the United States each year. Addicts who inject drugs also have increased risk of heart infection, kidney disease, pulmonary disease, and skin infections and abscesses. Methamphetamine (meth), a highly addictive synthetic stimulant like crack cocaine, damages skin tissue and contributes to dangerous weight loss. It can cause paranoia, hallucinations, violent behavior, convulsions, liver damage, and permanent brain damage. Cocaine addiction can damage or entirely destroy the nasal septum and can also lead to cardiac arrest, seizures, and respiratory arrest. Many alcoholics and drug addicts neglect hygiene and as a result have poor dental health. They suffer from increased rates of gum disease, tooth decay, and missing teeth. Methemphetamine in particular causes extreme

damage to teeth, eroding tooth enamel and resulting in severe tooth decay. This condition is so common among meth addicts that it has its own term, "meth mouth."

Social Impacts
Addiction damages not only the addict, but the whole social fabric as well. Babies born to addicted mothers can suffer from prematurity and low birth weight. If a woman drinks alcohol during pregnancy, her baby might be born with fetal alcohol syndrome, which causes heart problems, loss of muscle tone and coordination, and lasting brain damage. Smokers expose family members to many of the health risks associated with tobacco. Because addicts are so preoccupied with their addiction, they are often unable to fulfill social obligations. It may be difficult for them to stay in school, keep a job, or meet the needs of their families. Addicted parents often create stressful home environments where children are neglected or abused. Those who use street drugs often resort to larceny, shoplifting, burglary, and other crimes to obtain money for their habit, undermining the safety and security of their neighborhoods. Those who are addicted to damaging behaviors, such as gambling, can bankrupt their families and neglect their obligations to spouses, children, and other family members because of their obsession with their compulsive behavior.

Treatment
Addiction is a chronic disease. It cannot be cured, but it can be successfully treated. The goal of treatment is to help the addict stop using the addictive substance or performing the addictive behavior. But, as with other chronic diseases such as asthma or hypertension, relapses back to the addictive behavior often occur. Successful treatment plans acknowledge the likelihood of relapses and help the addict persevere in the event of a relapse. When addicts stop abusing drugs, they often experience unpleasant physical and emotional symptoms known as withdrawal. These can include anxiety, depression, restlessness, and insomnia. Severe alcoholics can experience intense hallucinations, known as delirium tremens (DTs), as well as convulsions or seizures. Withdrawal symptoms can make it extremely difficult for addicts to give up drugs without medical supervision. According to the National Institutes of Health, the most effective treatment strategy for addiction is to combine medications, when available, with behavioral therapy. Medications can help reduce the symptoms of withdrawal, help the addict's brain gradually adapt to the absence of the drug, or help prevent relapses. Some medications used in treating addiction are nicotine replacement therapies, such as patches, which help people stop smoking; and methadone, used in treating addiction to opiates. Medications used in treating alcoholism and drug addiction include Naltrexone, Disulfiram, and Acamprosate. Giving up the addictive substance is only the first step in treatment, however. Addicts also need help in learning how to stay "clean," or sober. Counseling and therapy can teach them to recognize the triggers that typically make them crave the drug and to respond to these triggers in more healthy ways. Behavioral therapy is designed to help addicts cope with the psychological and social effects of their disease. Because getting and using drugs has been the major focus of their lives, addicts can find it extremely difficult to adjust to more normal patterns of behavior, such as holding jobs or interacting in positive ways with family members and colleagues. Behavioral therapy can also teach compulsive gamblers or shoppers to recognize and avoid circumstances where they feel compelled to engage in these actions.

Prevention
Since individuals are more likely to become addicted if they begin abusing drugs in adolescence, specialists believe that it is important to gear prevention programs to teens and pre-teens. At particular risk are adolescents who exhibited aggressive behavior in earlier childhood, who lack supervision at home, or who are in transition from lower schools to high school and therefore likely to be most sensitive to peer pressure. School and community programs that educate adolescents about the devastating consequences of addiction can reduce the numbers of teens likely to try cigarettes, alcohol, or drugs. But specialists emphasize that families play a major role in preventing addiction. Families that nurture strong bonds between parents and children, that emphasize parental involvement in children's activities, that set clear and reasonable limits, and that consistently enforce discipline are creating conditions likely to prevent a child from abusing drugs. Research also shows that teens who get regular exercise are less likely to smoke or abuse drugs or alcohol. More research is needed to determine whether exercise can be an effective tool in the prevention of addiction. Government efforts to prevent addiction are conducted through the Office of National Drug Control Policy. Its National Youth Anti-Drug Media Campaign, authorized by Congress in 1998, targets adolescents aged fourteen to sixteen. In addition to providing information to youth and parents, the Campaign has since 2008 used media advertising, including broadcast ads during the Super Bowl, to deliver its message. The organization has also launched an Anti-Meth Campaign that includes print, broadcast, and online advertising as well as billboard ads in those states with the highest rates of meth use. Evidence suggests that prevention efforts can be successful. The U.S. Office of National Drug Policy reported in 2009 that use of illicit drugs by teens had declined significantly since 2002. According to the Substance Abuse and Mental Health Services Administration's 2008 National Survey on Drug Use and Health, drug abuse by teens aged twelve to seventeen declined from 11.6 percent in 2004 to 9.3 percent in 2008. The number of teens reporting abuse of prescription drugs also decreased from 4.0 percent in 2002 to 2.9 percent in 2008. Meth use among teens in grades eight, ten, and twelve dropped from 4.7 percent in 1999 to only 1.2 percent in 2009. Cigarette smoking among teens also lessened. In 1996 some 10.4 percent of eighth graders smoked daily; by 2009 that rate had lowered to 2.7 percent. For high school seniors, the rate dropped from 24.6 percent in 1997 to 11.2 percent in 2009. Though these figures are encouraging, National Youth Anti-Drug Media Campaign Director Robert W. Denniston said, "parents need to continue to be vigilant in talking with their kids about the harms of illicit drug abuse, particularly in the face of bombardment of pro-drug messages in all forms of teens' media worldsespecially online." Full Text: COPYRIGHT 2013 Gale, Cengage Learning.

Source Citation "Addiction." Current Issues : Macmillan Social Science Library. Detroit: Gale, 2010. Opposing Viewpoints In Context. Web. 14 Apr. 2013. Document URL http://ic.galegroup.com.ez.sccd.ctc.edu:2060/ic/ovic/ReferenceDetailsPage/Refere nceDetailsWindow?failOverType=&query=&windowstate=normal&contentModu les=&mode=view&displayGroupName=Reference&limiter=&currPage=& ;disableHighlighting=true&displayGroups=&sortBy=&source=&search_ within_results=&action=e&catId=GALE%7C00000000LVUU&activityType=& ;scanId=&documentId=GALE%7CPC3021900003&userGroupName=seat92874&jsid =e854cb74a765e6bfb5acd65241298de8

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