In family treatment or family therapy , "enabling behaviors" can be addressed and changed.
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Enabling behaviors are the actions of family members who assist the addict in maintaining active addiction, including providing money, food, and shelter. Residential settings may be effective in initially assisting the addicted individual to stay away from the many "cues," including people, places, and things, that formed the setting for their substance use.
During the past several decades, alternatives to the complete abstinence model the generally accepted model in the United States have arisen. Controlled use programs allow addicted individuals to reduce their use without committing to complete abstinence. This alternative is highly controversial. The generally accepted position is that only by complete abstinence can an addicted individual recover. The effectiveness of addiction treatment based on behavioral and other psychotherapeutic methods, however, is well documented.
Among these are motivation-enhancing strategies, relapse-prevention strategies using cognitive-behavioral approaches, solution-oriented and other brief therapy technques, and harm-reduction approaches. Self-help groups such as Alcoholics Anonymous and Narcotics Anonymous have also developed widespread popularity. The approach of one addict helping another to stay "clean," without professional intervention , has had tremendous acceptance in the United States and other countries. Relapse and recidivism are, unfortunately, very common.
Interestingly, a classic study shows that people addicted to different substances show very similar patterns of relapse. Whatever the addictive substances, data show that about two-thirds of all relapses occur within the first 90 days following treatment. Many consider recovery to be an ongoing, lifelong process.
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Because the use of addictive substances alters brain chemistry, cravings can persist for many years. For this reason, the predominating belief is that recovery is only possible by commitment to complete abstinence from all substance use.
Prevention approaches are most effectively targeted at young teenagers between the ages of 11 and It is during these years that most young people are likely to experiment with drugs and alcohol. Hence, reducing experimentation during this critical period holds promise for reducing the number of adults with addictive disease. Effective prevention programs focus on addressing the concerns of young people with regard to the effects of drugs. Training older adolescents to help younger adolescents resist peer pressure has shown considerable effectiveness in preventing experimentation.
See also Alcohol and related disorders; Amphetamines and related disorders; Anti-anxiety drugs and abuse; Barbiturates; Caffeine-related disorders; Cannabis and related disorders; Denial; Disease concept of chemical dependency; Dual diagnosis; Internet addiction disorder; Nicotine and related disorders; Opioids and related disorders; Relapse and relapse prevention; Sedatives and related disorders; Self-help groups; Substance abuse and related disorders; Support groups ; Wernicke-Korsakoff syndrome.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Hurley, Jennifer A. Addiction: Opposing Viewpoints. Kaplan, Harold I. Sadock, M. Marlatt, G. Alan, and Judith R. Gordon Eds.
Relapse Prevention. Wekesser, Carol, ed. Chemical Dependency: Opposing Viewpoints.
Washton, Arnold M. Addiction is a persistent, compulsive dependence on a behavior or substance. The term has been partially replaced by the word dependence for substance abuse. Some researchers speak of two types of addictions: substance addictions for example, alcoholism, drug abuse, and smoking ; and process addictions for example, gambling, spending, shopping, eating, and sexual activity.
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There is a growing recognition that many addicts, such as polydrug abusers, are addicted to more than one substance or process. Substance abuse is characterized by frequent relapse, or return to the abused substance. Compared to females, males are almost four times as likely to be heavy drinkers, nearly one and a half more likely to smoke a pack or more of cigarettes daily, and twice as likely to smoke marijuana weekly.
However, among adolescents these gender differences are not as pronounced and girls are almost as likely to abuse substances such as alcohol and cigarettes. Although frequent use of tobacco, cocaine and heavy drinking appears to remain stable in the s, marijuana use has increased.
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An estimated four million Americans over the age of 12 used prescription pain relievers, sedatives, and stimulants for "nonmedical" reasons during one month. Tobacco use reportedly kills 2. According to data from the World Health Organization , there were 1. Eating disorders, such as anorexia nervosa , bulimia nervosa, and binge eating, affect more than five million American women and men.
Fifteen percent of young women have substantially disordered attitudes toward eating and eating behaviors. More than 1, women die each year from anorexia nervosa. A Harvard study found that an estimated More than one-half 7. Some substances are more addictive than others, either because they produce a rapid and intense change in mood; or because they produce painful withdrawal symptoms when stopped suddenly.
Some forms of substance abuse and dependence seem to run in families; and this may be the result of a genetic predisposition, environmental influences, or a combination of both. Addictive personality — A concept that was formerly used to explain addiction as the result of pre-existing character defects in individuals.
Process addiction — Addiction to certain mood-altering behaviors, such as eating disorders , gambling, sexual activity, overwork, and shopping.
Tolerance — A condition in which an addict needs higher doses of a substance to achieve the same effect previously achieved with a lower dose. Withdrawal — The unpleasant, sometimes life-threatening physiological changes that occur, due to the discontinuation of use of some drugs after prolonged, regular use. Although the causes of addiction remain the subject of ongoing debate and research, many experts now consider addiction to be a brain disease: a condition caused by persistent changes in brain structure and function.
Scientists may have come closer to solving the brain's specific involvement in addiction in Psychiatrists say they have found the craving center of the brain that triggers relapse in addicts. The anterior cingulated cortex in the frontal lobe of the brain is the area responsible for long-term craving in addicts. Knowing the area of the brain from which long-term cravings come may help scientists pinpoint therapies. Social learning is considered the most important single factor in addiction.
It includes patterns of use in the addict's family or subculture, peer pressure, and advertising or media influence. Many doctors now believe that these character traits develop in addicts as a result of the addiction, rather than the traits being a cause of the addiction. In addition to a preoccupation with using and acquiring the abused substance, the diagnosis of addiction is based on five criteria:. Treatment requires both medical and social approaches. Substance addicts may need hospital treatment to manage withdrawal symptoms. Individual or group psychotherapy is often helpful, but only after substance use has stopped.
Anti-addiction medications, such as methadone and naltrexone, are also commonly used. A new treatment option has been developed that allows family physicians to treat heroine addiction from their offices rather than sending patients to methadone clinics. The drug is called buprenorphine Suboxone.