SUBSTANCE USE DISORDER /
ADDICTION COUNSELING
Addiction can be defined as a strong need to regularly consume a substance or engage in an activity without ability to guarantee control of frequency, intensity or duration, and without the ability to stop in spite of a desire to stop and/or painful or negative consequences. An addiction can sometimes be confused with a habit. The main difference between a habit and an addiction is that with a habit you are always in control of your choices and actions, but with an addiction there are many times where you no longer have this control.
The Centre for Addiction and Mental Health has outlined a simple way of describing addiction. They describe an addiction as the presence of the 4 C’s:
- craving
- loss of control of amount or frequency of use
- compulsion to use
- use despite consequences
What causes addiction?
Addiction can be influenced by a variety of factors in an individual’s life.
These can include, but are not limited to:
Genetics – there have been studies that have shown that genetics may play a role in addiction, and that individuals who have immediate family members with addiction issues may be more likely to suffer from addiction themselves.
Chemical Makeup of the Brain – any activity that causes a good feeling (such as shopping, a sexual encounter, or a satisfying meal) stimulates the brain to release dopamine, which creates a pleasurable feeling. However, with addictive drugs, the amount of dopamine released by an addictive drug is much higher than usual. This alters the chemistry of the brain and causes the brain to develop a tolerance to the dopamine, which means it requires more and more of the substance to feel the same pleasurable feeling. This is what can lead to the compulsive actions of someone with an addiction. Additionally, even regular human behaviours that release dopamine, such as those previous examples of shopping or sex, can become addictive for certain individuals.
Environment – the attitude of your peers and family can influence an addiction, as well as the environment that you live in. Additionally, people who experience prejudice, cultural issues, or gender identity issues may turn to addictive substances as a way to cope with their overwhelming feelings.
Mental Health Issues – Research has shown that approximately half of individuals who have addiction issues also have had mental health issues (such as depression or anxiety) in their lifetime. . It has also been seen that individuals who suffer from mental health issues are more likely to engage in addictive behaviours.
Difficultly coping with feelings and thoughts – when people have troubles coping with their feelings, such as when they are bored, sad, stressed or lonely, they may turn to addictive substances or addictive activities to help alleviate those feelings. Shame is also a feeling that is closely linked with addiction.
Trauma – Deeply painful or disturbing experiences can have long-lasting effects on people. They can damage a person’s confidence, well-being and their ability to manage their emotions and relationships, making it harder to trust and get support. These emotional and psychological imprints are known as trauma. Trauma can come from many sources, such as adverse childhood experiences, childhood neglect, accidents, sexual assault, sudden unexpected loss, intergenerational events, racism, and discrimination. Some of these events can lead to or make other traumatic experiences worse. And they can lead a person to look for ways to cope with the negative effects of trauma, including through substance use.
Who is affected by addiction?
Individuals affected by addiction come from all phases and walks of life. Research as shown that adolescents and young adults (ages 15 to 24) are more likely to experience addiction disorders than any other age group. Generally, men have higher rates of addiction than women.
What are the warning signs of addiction?
The signs and symptoms of substance dependence vary according to the individual, the substance they are addicted to, their family history (genetics), and personal circumstances. Some warning signs that you or a loved one may be addicted to a substance or activity include:
- Continuing the activity despite knowing it is hurting you or your loved ones – even if the addiction is causing major problems with work, school or family, the individual continues to use the substance or engage in the activity
- No longer engaging in activities that are enjoyable – this could include hobbies, socializing or sports
- Engaging in risky behavior to fuel the addiction – this could include stealing money to support the addiction, an alcoholic driving under the influence to get more alcohol or a pornography addict choosing to engage in unsafe sex with a stranger to escalate the fantasy and subsequent high.
- Obsession around the addiction – an individual may spend an excessive amount of time and energy engaging in their addiction, so much that their life begins to revolve around it
- Seclusion – in order to hide their addiction, individuals may begin to remove themselves from social situations and will engage in their addictive activity alone
- Tolerance – many times individuals who are addicted to a substance will build up a tolerance, and need more and more of the substance to obtain the same level of pleasure they have felt in the past
- Consuming substances to avoid withdrawal – withdrawal symptoms can include nausea, insomnia, sweating and shaking
- Financial difficulties – individuals may spend all of their money on their addiction
What is treatment of addiction?
There is no “one-size-fits-all” approach to addiction treatment. Each case of addiction must be reviewed individually, and treatment plans are often created to help individuals in the manner that they will find most helpful. Treatment options for addiction include self-help methods, medication, treatment programs, spiritually focused solutions within faith communities and 12 Step groups, and counselling.
Counselling comes in a variety of forms, including individual, group, couples and family therapy. The goal of counselling is to help clients reach their goals. If a client’s goal is to stop using the substance or addictive behaviour to cope with negative life circumstances and feelings that accompany these, counsellors can help clients create a plan of action and can teach clients new skills for self-soothing and managing moods. If a client is unable to stop but desires to, or has family or friends encouraging them to change, counsellors can offer assessments of the stage of change the client is in and can engage in motivational interviewing to help the client move forward through the stages. They can also offer supportive counselling or relationship counselling if others are involved. If a client has painful feelings from their past, counsellors can help clients process these events in new ways, leading to happier, more fulfilling lives.
Narrative therapy, Psychodynamic therapy, Emotion Focused Therapy, Cognitive Behavioral Therapy and Solution Focused Therapy methods can all be helpful with addictions, along with many others. Counsellors will tailor a treatment plan for clients based upon their therapeutic framework, training and experience, along with client goals.
