A symptom is something the patient senses and describes, while a sign
is something other people, such as the doctor notice. For example,
sleepiness may be a symptom while dilated pupils may be a sign.
Substance dependence - when a person is addicted
to a substance, such as a drug, alcohol or nicotine, they are not able
to control the use of that substance. They continue taking it, even
though it may cause harm (the individual may or may not be aware of the
potential harm).
Substance dependence can cause powerful cravings. The addict may want
to give up (quit), but finds it extremely difficult to do so without
help.
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.
- The person takes the substance and cannot stop - in
many cases, such as nicotine, alcohol or drug dependence, at least one
serious attempt was made to give up, but unsuccessfully.
- Withdrawal symptoms - when body levels of that
substance go below a certain level the patient has physical and
mood-related symptoms. There are cravings, bouts of moodiness, bad
temper, poor focus, a feeling of being depressed and empty, frustration,
anger, bitterness and resentment.
- There may suddenly be increased appetite. Insomnia is a common
symptom of withdrawal. In some cases the individual may have
constipation or diarrhea. With some substances, withdrawal can trigger
violence, trembling, seizures, hallucinations, and sweats.
- Addiction continues despite health problem awareness
- the individual continues taking the substance regularly, even though
they have developed illnesses linked to it. For example, a smoker may
continue smoking even after a lung or heart condition develops.
- Social and/or recreational sacrifices - some
activities are given up because of an addiction to something. For
example, an alcoholic may turn down an invitation to go camping or spend
a day out on a boat if no alcohol is available, a smoker may decide not
to meet up with friends in a smoke-free pub or restaurant.
- Maintaining a good supply - people who are addicted
to a substance will always make sure they have a good supply of it,
even if they do not have much money. Sacrifices may be made in the house
budget to make sure the substance is as plentiful as possible.
- Taking risks (1) - in some cases the addicted
individual make take risks to make sure he/she can obtain his/her
substance, such as stealing or trading sex for money/drugs.
- Taking risks (2) - while under the influence of some substances the addict may engage in risky activities, such as driving fast.
- Dealing with problems - an addicted person commonly feels they need their drug to deal with their problems.
- Obsession - an addicted person may spend more and
more time and energy focusing on ways of getting hold of their
substance, and in some cases how to use it.
- Secrecy and solitude - in many cases the addict may take their substance alone, and even in secret.
- Denial - a significant number of people who are
addicted to a substance are in denial. They are not aware (or refuse to
acknowledge) that they have a problem.
- Excess consumption - in some addictions, such as
alcohol, some drugs and even nicotine, the individual consumes it to
excess. The consequence can be blackouts (cannot remember chunks of
time) or physical symptoms, such as a sore throat and bad persistent
cough (heavy smokers).
- Dropping hobbies and activities - as the addiction
progresses the individual may stop doing things he/she used to enjoy a
lot. This may even be the case with smokers who find they cannot
physically cope with taking part in their favorite sport.
- Having stashes - the addicted individual may have
small stocks of their substance hidden away in different parts of the
house or car; often in unlikely places.
- Taking an initial large dose - this is common with alcoholism. The individual may gulp drinks down in order to get drunk and then feel good.
- Having problems with the law - this is more a
characteristic of some drug and alcohol addictions (not nicotine, for
example). This may be either because the substance impairs judgment and
the individual takes risks they would not take if they were sober, or in
order to get hold of the substance they break the law.
- Financial difficulties - if the substance is
expensive the addicted individual may sacrifice a lot to make sure its
supply is secured. Even cigarettes, which in some countries, such as the
UK, parts of Europe and the USA cost over $11 dollars for a packet of
twenty - a 40-a-day smoker in such an area will need to put aside $660
per month, nearly $8,000 per year.
- Relationship problems - these are more common in drug/alcohol addiction.
Some substance/alcohol abusers who are not technically addicted may
also suffer from or cause some of the descriptions mentioned above, but
they do not usually have the withdrawal symptoms of an addict or the
same compulsion to consume the substance.
DR PHIL
Whether it's drug use, sex or overspending, do you
wonder if your behavior is crossing the line into addiction? Dr. Gary
Stollman, Ph.D., is a psychotherapist who helps individuals overcome
self-defeating patterns of behavior. He gives 10 key signs of having an
addiction:
1) Recurrent failure (pattern) to resist impulses.
2) Frequently engaging in those behaviors to a greater extent or over a longer period of time than intended.
3) Persistent desire or unsuccessful efforts to stop, reduce or control those behaviors.
4) Inordinate amount of time spent in obtaining the object of addiction and/or engaging in or recovering from the behavior.
5) Preoccupation with the behavior or preparatory activities.
6) Frequently engaging in behavior when expected to fulfill occupational, academic, domestic or social obligations.
7)
Continuation of the behavior despite knowledge of having a persistent
or recurrent social, academic, financial, psychological or physical
problem that is caused or exacerbated by the behavior.
8) Need
to increase the intensity, frequency, number or risk of behaviors to
achieve the desired effect, or diminished effect with continued
behaviors at the same level of intensity, frequency, number or risk.
9) Giving up or limiting social, occupational or recreational activities because of the behavior.
10) Resorting to distress, anxiety, restlessness or violence if unable to engage in the behavior at times.
A risk factor is something which increases the likelihood of
developing a condition or disease. For example, obesity significantly
raises the risk of developing diabetes type 2. Therefore, obesity is a
risk factor for diabetes type 2.
Although anybody, regardless of age, sex or social status can
potentially become addicted to some substances, there are certain
factors which may increase the risk:
- Genetics (family history) - anybody who has a close
relative with an addiction problem has a higher risk of eventually
having one themselves. It may be argued that environmental and
circumstantial factors that close family members share are the prominent
causes.
- Alcoholics are six times more likely than non-alcoholics to have
blood relatives who are alcohol dependent. Researchers from the
Universidad de Granada, Spain, in a study revealed that "the lack of endorphin is hereditary, and thus that there is a genetic predisposition to become addicted to alcohol".
- Geneticists believe that the reason some people try cigarettes and
do not become smokers, while others do so very quickly is probably
linked to the type of genes we inherit from our parents. Some people can
smoke once in a while, throughout their lives, and never seem to become
addicted, while others are unable to stop smoking without experiencing
the unpleasant withdrawal symptoms. It is most likely that the way the
receptors on the surface of our brain nerve cells respond to nicotine is
influenced by our genes.
- Gender - a significantly higher percentage of
people addicted to a substance are male. According to the Mayo Clinic,
USA, males are twice as likely as females to have problems with drugs.
- Having a mental illness/condition - people with
depression, ADHD (attention-deficit hyperactivity disorder) and several
other mental conditions/illnesses have a higher risk of eventually
becoming addicted to drugs, alcohol or nicotine.
- Peer pressure - trying to conform with other
members of a group and gain acceptance can encourage people to take up
the use of potentially addictive substances, and eventually become
addicted to them. Peer pressure is an especially strong factor for young
people.
- Family behavior - young people who do not have a
strong attachment to their parents and siblings have a higher risk of
becoming addicted to something one day, compared to people with deep
family attachments.
- Loneliness - being alone and feeling lonely can
lead to the consumption of substances as a way of copying; resulting in a
higher risk of addiction.
- The nature of the substance - some substances, such
as crack, heroin or cocaine can bring about addiction more rapidly than
others. For example, if a group of people were to take crack every day
for six months, and another identical group of people were to drink
alcohol every day for the same period, the number of crack addicts at
the end of the six months would be a lot higher than the number of
alcoholics. For some people trying a substance even once can be enough
to spark an addiction. Crack, also known as crack cocaine or rock, is a
freebase form of cocaine that can be smoked.
- Age when substance was first consumed - studies of
alcoholism have shown that people who start consuming a drug earlier in
life have a higher risk of eventually becoming addicted, than those who
started later. Many experts say this also applies to nicotine and drugs.
- Stress - if a person’s stress levels are high there
is a greater chance a substance, such as alcohol may be used in an
attempt to blank out the upheaval. Some stress hormones are linked to
alcoholism.
- How the body metabolizes (processes) the substance -
in cases of alcohol, for example, individuals who need a higher dose to
achieve an effect have a higher risk of eventually becoming addicted.
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