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If you have ever seen the show 'My Strange Addiction' you will know that people can become addicted to anything. Examples from the programs include a woman addicted to eating rocks and another to the smell of gasoline.
A cigarette butt in an ashtray, Canva.
Addiction is defined as when someone engages in a pleasurable activity that they then cannot stop doing. This can even be detrimental to their everyday life, health, wellbeing, family, and friends.
As we have previously stated, addiction is when someone cannot stop engaging in an activity they find pleasurable. There are many types of addiction, but at its core, addiction is when a person is unable to stop engaging in their addiction even though it is causing them and others harm. This is because they have become dependent on the object of their addiction.
This is when someone becomes dependent on the object of addiction for psychological and emotional functioning. It is about your mental state.
For instance, someone with alcohol addiction may become angry and aggressive if they haven't had a drink, meaning they are psychologically dependent on alcohol to behave normally and not resort to aggression.
Physical dependence is when an addict cannot physically function without the object of addiction; the body is dependent on the drug and not partaking in the addiction can result in withdrawal symptoms. The drug is the new normal, in a sense, and to regain that normal state, you need to take the drug again.
For instance, someone with alcohol addiction not being able to get out of the house unless they've had a drink.
Incidentally, this is why some people have to take more and more of their drug of choice. The new 'normal' no longer gives them the high, due to tolerance, and they have to take more drugs to achieve the same feeling. It's an endless loop.
A person becomes tolerant of something when they are physically dependent on it to achieve a sense of normality. They engage in the object of addiction so often that it no longer has the same effect. As a result, they increase their 'dosage' to achieve the same effect.
For example, someone with an alcohol addiction may move on from weak beer to strong whiskey, as beer doesn't give them the same 'buzz' anymore.
Withdrawal symptoms refer to the physical symptoms that someone experiences when they either reduce or stop partaking in the object of their addiction. They include but are not limited to, anxiety, insomnia, nausea and body aches.
Risk factors are things that might make someone more vulnerable to developing an addiction. They could be stress, genetic factors, or even family/peer group influences.
Gelkopf et al. (2002) self-medication theory states that people deliberately use certain behaviours to cope with everyday stressors. This can become addictive as a release from stress. Dawes et al. (2000) found that stress is one of the best predictors of relapse in drug use, and Kessler et al. (1995) have found a correlation between stress, addiction development and dependence.
Similarly, Sinha (2007) found that, through brain imaging techniques, the areas of the brain that activate during stress were also the same as when cravings for drugs occurred. Stress can make people more vulnerable to addiction, particularly with addictive drugs.
Genetic vulnerability is when someone inherits characteristics from their parents which may make them more likely to develop an addiction. Research from Slutske et al. (2010) and Blum and Payne (1991) has revealed that certain genes can leave us more vulnerable to addiction.
It is important to recognise that we are describing genetic vulnerability, which does not connotate certainty - meaning that someone's genes do not guarantee that they will become addicted. Rather, they make it more likely that through interaction with the environment, i.e., due to a personal event or experience, the person will become an addict.
Family can influence the likelihood of someone developing an addiction through social learning theory and parenting styles:
The first is by acting as role models.
The second is through their parenting styles.
Research from Lader and Matheson (1991) demonstrated how parents influenced smoking likelihood and habits in their children (smoking parents had children who were twice as likely to smoke).
For example, if someone's parents are addicted to drugs, the child will grow up thinking that addiction is normal behaviour.
Baer et al. (1987) found that adolescents who grew up in a household with family conflicts and stressful events were more likely to develop an alcohol dependence/addiction (alcohol helped them avoid negative events).
Peers can be a key factor in the development of addiction as they can act as role models for addictive behaviour by introducing, producing and encouraging the maintenance of using addictive substances such as drugs or alcohol. Research from Morgan and Grube (1981) and Morton et al. (2005) has supported the influential role of peers on addiction. Meanwhile, Tajfel and Turner's (1986) Social Identity Theory suggests that addiction arises out of a need to be part of influential groups and a desire for social acceptance.
If you have ever heard the phrase 'addictive personality', you may wonder what traits make someone more likely to become an addict. Eysenck and Eysenck (1976) established the three personality traits: psychoticism (P), extroversion (E), and neuroticism (N). Francis (1996), for instance, found those with addictions to heroin had higher scores of N and P compared to E.
According to Butler and Montgomery (2004), hostility and neuroticism are key indicators of an at-risk addict. Meanwhile, there is a strong correlation between addiction and anti-social personality disorder. Some psychologists even suggest that impulsivity can contribute to addiction (Ivanov et al., 2008).
Image showing the influences of addiction, Canva.
In this section, we will look at two types of addiction: nicotine addiction and gambling addiction. We will look at how different approaches explain these addictions and how we can treat them.
Nicotine addiction is when someone is addicted to nicotine, through smoking cigarettes or chewing tobacco. Specifically, the DSM 5 defines nicotine addiction as:
1. Unsuccessful efforts to quit or reduce intake of tobacco
2. Cravings for Tobacco
3. Failure to attend to responsibilities and obligations due to tobacco use
4. Continued use despite adverse social or interpersonal consequences
In this section, we will explore biological explanations for nicotine addiction.
Biological explanations of addiction centre around the mesolimbic system, or reward system in the brain. The components of this system that influence addiction are:
The prefrontal cortex
The ventral tegmental area
The nucleus accumbens
Dopamine (mesolimbic dopamine pathway)
Specifically, these systems regulate desensitisation, conditioning and tolerance, which can all contribute to addiction. Notably, serotonin is also involved in the control of impulsiveness (control lowers impulses to take drugs and engage in risky behaviours).
Learning theory explains nicotine addiction through conditioning. A person with nicotine addiction is not only rewarded with the pleasure of smoking a cigarette but may develop cue-reactivity, wherein objects associated with smoking trigger their addiction, e.g. a lighter.
Gambling addiction is when someone is addicted to gambling. DSM IV-TR (2000) considers gambling to be an impulsive disorder characterised.
This addiction could take many forms, from betting on sporting events to playing poker and slot machines. When someone is addicted to gambling there are a few approaches that could explain their behaviour, but in this section, we will explore learning theory and the cognitive approach.
Learning theory explains gambling in terms of operant and classical conditioning. When the gambler wins they are rewarded, reinforcing their gambling behaviour. Although it is true that gambling is not reinforced every time someone gambles, the thrill and risk of placing a bet are, therefore, this uncertainty reinforces addiction.
The cognitive theory explains gambling in terms of irrational thoughts, including reasoning and cognitive bias such as illusions of control (a belief that the gambler can influence the outcome of their bet) and gambler’s fallacy (a belief that after a losing streak, a win is certain). Gambling can also be seen as a coping mechanism and distraction.
There are multiple ways to treat addiction, and this is seen through addressing the biological and psychological needs of the patient.
Biological treatments for addiction usually use drug therapy. There are three main types of drugs that might be used in drug therapy:
Aversives: drugs that create a negative reaction to the object of addiction e.g. vomiting after smoking a cigarette
Agonist: a less harmful replacement for the object of addiction. These allow the sufferer to slowly withdraw from their addiction.
Antagonist: these block the effects of the object of addiction e.g., you won’t get a pleasurable feeling after smoking a cigarette. Source: Canva alt-text: a hand holding three pills
An example of agonist treatment is Nicotine Replacement Therapy (NRT). This is when the sufferer uses nicotine patches (which are less harmful as they contain a reduced amount of nicotine) to reduce their intake of nicotine without withdrawal symptoms.
An example of antagonist treatments is the use of naltrexone, an opiate antagonist in the treatment of gambling addiction. This drug blocks the pleasurable effects of gambling, enabling the sufferer to reduce their addictive behaviour.
The common behavioural treatment for addiction is aversion therapy. This involves replacing the positive association the sufferer has with their addiction with a negative or aversive association.
For example, if someone was addicted to smoking, they would be asked to smoke a cigarette (a neutral stimulus) whilst experiencing a negative stimulus (e.g., someone shouting at them). Over several sessions, smoking would become associated with the negative stimulus (a conditioned response) encouraging the sufferer to give up their addiction.
Covert sensitisation is an alternative behavioural treatment for addiction. This involves the same process as aversion therapy but the sufferer simply imagines the association rather than experiencing the aversive stimulus.
Cognitive behavioural therapy (CBT) is used as a cognitive treatment for addiction. It is based on the idea that addiction is caused by faulty thought processes, so if someone changes the way they think about their addiction, they can also break their addictive behaviour.
The therapy (CBT) aims to allow people to recognise situations in which they turn to their addiction to replace their addiction with positive behaviour, e.g., if you smoke when you are stressed, you need to recognise when you are stressed and replace smoking with a cup of tea or something similar.
This theory was a development of Ajzen and Fienbein (1970) theory of reasoned action. Ajzen (1989) proposed that behaviour is controlled by intentions which are influenced by various factors:
The individual’s subjective norms (how they think others would view their behaviour)
Perceived behavioural concerns (how much they think they can perform the behaviour)
Personal attitudes (a person’s own attitudes towards their addiction)
The theory states that behaviour can be changed by creating different attitudes towards addiction. This is achieved by showing the sufferer data about how many people engage in risky behaviour. This will give the sufferer the willpower to change their behaviour.
This model describes the six stages of behavioural change which can help a person overcome addiction. They are as follows:
A poster explaining Prochaska’s six-stage model, Canva.
Addiction is when someone engages in a pleasurable activity that they then cannot stop doing. This can even be detrimental to their everyday life, health, wellbeing, family and friends.
Behaviour can be classed as an addiction if a person cannot stop the pleasurable activity and it is beginning to negatively affect their daily life.
There are four possible risk factors: stress, family, peer group and genetic vulnerability.
Psychologists are not in agreement about why addiction forms or how to treat it. However, some approaches to it are: cognitive, biological and behavioural.
According to psychologists, to avoid addiction one must try to minimise their risk factors as much as possible. These are stress, family, peer group and genetic vulnerability but family and genetic vulnerability are hard to avoid or change meaning the risk of addiction cannot always be minimised.
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