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60-591: Junkie , a term often used as a pejorative referring to a person with an addiction , may refer to: Addiction Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use often alters brain function in ways that perpetuate craving , and weakens (but does not completely negate) self-control . This phenomenon – drugs reshaping brain function – has led to an understanding of addiction as

120-1024: A brain disorder with a complex variety of psychosocial as well as neurobiological (and thus involuntary) factors that are implicated in the development of addiction. Classic signs of addiction include compulsive engagement in rewarding stimuli, preoccupation with substances or behavior, and continued use despite negative consequences. Habits and patterns associated with addiction are typically characterized by immediate gratification (short-term reward), coupled with delayed deleterious effects (long-term costs). Examples of substance addiction include alcoholism , cannabis addiction , amphetamine addiction , cocaine addiction , nicotine addiction , opioid addiction , and eating or food addiction . Behavioral addictions may include gambling addiction , shopping addiction , stalking , internet addiction , social media addiction , video game addiction , and sexual addiction . The DSM-5 and ICD-10 only recognize gambling addictions as behavioral addictions, but

180-432: A compulsion to engage in a natural reward – which is a behavior that is inherently rewarding (i.e., desirable or appealing) – despite adverse consequences. Preclinical evidence has demonstrated that marked increases in the expression of ΔFosB through repetitive and excessive exposure to a natural reward induces the same behavioral effects and neuroplasticity as occurs in a drug addiction. Addiction can exist in

240-660: A clinical diagnosis. Hypersexuality disorder and internet addiction disorder were among proposed addictions to the DSM-5, but were later rejected due to the insufficient evidence available in support of the existence of these disorders as discrete mental health conditions. Reviews of both clinical research in humans and preclinical studies involving ΔFosB have identified compulsive sexual activity – specifically, any form of sexual intercourse – as an addiction (i.e., sexual addiction). Reward cross-sensitization between amphetamine and sexual activity, meaning that exposure to one increases

300-566: A diagnosed eating disorder. Long-term frequent and excessive consumption of foods high in fat, salt, or sugar, such as chocolate, can produce an addiction similar to drugs since they trigger the brain's reward system, such that the individual may desire the same foods to an increasing degree over time. The signals sent when consuming highly palatable foods have the ability to counteract the body's signals for fullness and persistent cravings will result. Those who show signs of food addiction may develop food tolerances, in which they eat more, despite

360-400: A form of defense against feelings of hopelessness and helplessness as well as a symptom of failure to regulate powerful emotions related to adverse childhood experiences (ACEs), various forms of maltreatment and dysfunction experienced in childhood. In this case, the addictive substance provides brief but total relief and positive feelings of control. The Adverse Childhood Experiences Study by

420-504: A lack of control. The Addictions Neuroclinical Assessment is used to diagnose addiction disorders. This tool measures three different domains: executive function , incentive salience , and negative emotionality . Executive functioning consists of processes that would be disrupted in addiction. In the context of addiction, incentive salience determines how one perceives the addictive substance. Increased negative emotional responses have been found with individuals with addictions. This

480-469: A lifetime and cause death if untreated. Substances involved with drug addiction include alcohol, nicotine, marijuana, opioids, cocaine, amphetamines, and even foods with high fat and sugar content. Addictions can begin experimentally in social contexts and can arise from the use of prescribed medications or a variety of other measures. Drug addiction has been shown to work in phenomenological , conditioning ( operant and classical ), cognitive models, and

540-452: A period of increased vulnerability for developing an addiction. In adolescence, the incentive-rewards systems in the brain mature well before the cognitive control center. This consequentially grants the incentive-rewards systems a disproportionate amount of power in the behavioral decision-making process. Therefore, adolescents are increasingly likely to act on their impulses and engage in risky, potentially addicting behavior before considering

600-790: A period of time. Dependence arises in a dose-dependent manner and produces withdrawal symptoms that vary with the type of drug that is consumed. For example, prolonged use of an antidepressant medication is likely to cause a rather different reaction when discontinued compared to discontinuation of an opioid , such as heroin . Withdrawal symptoms from opiates include anxiety, sweating, vomiting, and diarrhea. Alcohol withdrawal symptoms include irritability, fatigue, shaking, sweating, and nausea. Withdrawal from nicotine can cause irritability, fatigue, insomnia, headache, and difficulty concentrating. Many prescription and legal nonprescription substances can also cause withdrawal symptoms when individuals stop consuming them, even if they were taken as directed by

660-509: A physician. The route of administration, whether intravenous , intramuscular , oral , or otherwise can also play a role in determining the severity of withdrawal symptoms. There are different stages of withdrawal as well; generally, a person will start to feel bad (crash or come down ), progress to feeling worse, hit a plateau, and then the symptoms begin to dissipate. However, withdrawal from certain drugs ( barbiturates , benzodiazepines , alcohol , glucocorticoids ) can be fatal. While it

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720-432: A secondary consequence of the drug. When the drug is removed, these conditions may resurface and be confused with withdrawal symptoms. Genes that encode for the alpha5 nicotinic acetylcholine receptor affect nicotine and alcohol withdrawal symptoms. Homeostasis is the body's ability to maintain a certain chemical equilibrium in the brain and throughout the body. For example, the function of shivering in response to cold

780-453: A set of questions for different scenarios. In the case of a specific combination of answers, different question sets can be used to yield a more accurate answer. After the questions, the DSM-5 criteria are used to identify the likelihood of the person having substance use disorder. After these tests are done, the clinician is to give the "5 RS" of brief counseling. The five Rs of brief counseling includes: The Drug Abuse Screening Test (DAST)

840-625: A significant increase in this reward system, causing a large increase in dopamine signaling as well as increase in reward-seeking behavior, in turn motivating drug use. This promotes the development of a maladaptive drug to stimulus relationship. Early drug use leads to these maladaptive associations, later affecting cognitive processes used for coping, which are needed to successfully abstain from them. A number of genetic and environmental risk factors exist for developing an addiction. Genetic and environmental risk factors each account for roughly half of an individual's risk for developing an addiction;

900-467: A symptom of an underlying mental health condition and not a disorder in itself. Internet addiction has been described as "a psychological dependence on the Internet, regardless of the type of activity once logged on." Problematic internet use may include a preoccupation with the internet and/or digital media, excessive time spent using the internet despite resultant distress in the individual, increase in

960-442: Is a screening and assessment tool in one, assessing commonly used substances. This tool allows for a simple diagnosis, eliminating the need for several screening and assessment tools, as it includes both TAPS-1 and TAPS-2, screening and assessment tools respectively. The screening component asks about the frequency of use of the specific substance (tobacco, alcohol, prescription medication, and other). If an individual screens positive,

1020-448: Is a self-reporting tool that measures problematic substance use. Responses to this test are recorded as yes or no answers, and scored as a number between zero and 28. Drug abuse or dependence, are indicated by a cut off score of 6. Three versions of this screening tool are in use: DAST-28, DAST-20, and DAST-10. Each of these instruments are copyrighted by Dr. Harvey A. Skinner. The Alcohol, Smoking, and Substance Involvement Test (ASSIST)

1080-437: Is affected by addiction, the other twin is likely to be as well, and to the same substance. Further evidence of a genetic component is research findings from family studies which suggest that if one family member has a history of addiction, the chances of a relative or close family developing those same habits are much higher than one who has not been introduced to addiction at a young age. The data implicating specific genes in

1140-733: Is an interview-based questionnaire consisting of eight questions developed by the WHO. The questions ask about lifetime use; frequency of use; urge to use; frequency of health, financial, social, or legal problems related to use; failure to perform duties; if anyone has raised concerns over use; attempts to limit or moderate use; and use by injection. Personality theories of addiction are psychological models that associate personality traits or modes of thinking (i.e., affective states ) with an individual's proclivity for developing an addiction. Data analysis demonstrates that psychological profiles of drug users and non-users have significant differences and

1200-494: Is for neuropsychological symptoms denoting pervasive/excessive and intense urges to engage in a category of behavioral compulsions or impulses towards sensory rewards (e.g., alcohol , betel quid , drugs, sex, gambling, video gaming). Addictive disorders or addiction disorders are mental disorders involving high intensities of addictions (as neuropsychological symptoms) that induce functional disabilities (i.e., limit subjects' social/family and occupational activities);

1260-412: Is impaired in both addiction and attention deficit hyperactivity disorder . Stimulus-driven behavioral responses (i.e., stimulus control) that are associated with a particular rewarding stimulus tend to dominate one's behavior in an addiction. In operant conditioning, behavior is influenced by outside stimulus, such as a drug. The operant conditioning theory of learning is useful in understanding why

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1320-439: Is known that dopamine is involved in learning, motivation, as well as the reward system. The exact role of dopamine in gambling addiction has been debated. Suggested roles for D2 , D3 , and D4 dopamine receptors , as well as D3 receptors in the substantia nigra have been found in rat and human models, showing a correlation with the severity of the gambling behavior. This in turn was linked with greater dopamine release in

1380-444: Is no general description of individuals addicted to gambling. Internet addiction does not have any standardized definition, yet there is widespread agreement that this problem exists. Debate over the classification of problematic internet use considers whether it should be thought of as a behavioral addiction, an impulse control disorder, or an obsessive-compulsive disorder. Others argue that internet addiction should be considered

1440-670: Is opened through stressful experiences during childhood can be avoided by a change in environmental factors throughout an individual's life and opportunities of professional help. If one has friends or peers who engage in drug use favorably, the chances of them developing an addiction increases. Family conflict and home management is a cause for one to become engaged in drug use. According to Travis Hirschi's social control theory, adolescents with stronger attachments to family, religious, academic, and other social institutions are less likely to engage in delinquent and maladaptive behavior such as drug use leading to addiction. Adolescence represents

1500-462: Is related to developing a mood or anxiety disorder, as well as a substance dependence risk. Genetic factors, along with socio -environmental (e.g., psychosocial ) factors, have been established as significant contributors to addiction vulnerability. Studies done on 350 hospitalized drug-dependent patients showed that over half met the criteria for alcohol abuse, with a role of familial factors being prevalent. Genetic factors account for 40–60% of

1560-503: Is seldom fatal to the user, withdrawal from opiates (and some other drugs) can cause miscarriage, due to fetal withdrawal. The term " cold turkey " is used to describe the sudden cessation of use of a substance and the ensuing physiologic manifestations. The symptoms from withdrawal may be even more dramatic when the drug has masked prolonged malnutrition , disease, chronic pain , infections (common in intravenous drug use), or sleep deprivation , conditions that drug abusers often develop as

1620-650: Is the Internet Addiction Test developed by Kimberly Young . People with internet addiction are likely to have a comorbid psychiatric disorder. Comorbid diagnoses identified alongside internet addiction include affective mood disorders, anxiety disorders, substance use disorders, and attention deficit hyperactivity disorder. Video game addiction is characterized by the World Health Organization (WHO) as excessive gaming behavior, potentially prioritized over other interests, despite

1680-435: Is the current standard measure for assessing whether an individual exhibits signs and symptoms of food addiction. It was developed in 2009 at Yale University on the hypothesis that foods high in fat, sugar, and salt have addictive-like effects which contribute to problematic eating habits. The YFAS is designed to address 11 substance-related and addictive disorders (SRADs) using a 25-item self-report questionnaire, based on

1740-566: Is the excessive urge to shop or spend, potentially resulting in unwanted consequences. These consequences can have serious impacts, such as increased consumer debt , negatively affected relationships, increased risk of illegal behavior, and suicide attempts. Shopping addiction occurs worldwide and has shown a 5.8% prevalence in the United States. Similar to other behavioral addictions, CBD can be linked to mood disorders, substance use disorders, eating disorders, and other disorders involving

1800-461: Is to produce heat maintaining internal temperature at around 37 °C (98.6 °F). Homeostasis is impacted in many ways by drug usage and withdrawal. The internal systems perpetuate homeostasis by using different counter-regulatory methods in order to create a new state of balance based on the presence of the drug in the system. These methods include adapting the body's levels of neurotransmitters, hormones, and other substances present to adjust for

1860-502: The Centers for Disease Control and Prevention has shown a strong dose–response relationship between ACEs and numerous health, social, and behavioral problems throughout a person's lifespan, including substance use disorder. Children's neurological development can be permanently disrupted when they are chronically exposed to stressful events such as physical, emotional, or sexual abuse, physical or emotional neglect, witnessing violence in

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1920-507: The ICD-11 also recognizes gaming addictions. Signs and symptoms of addiction can vary depending on the type of addiction. Symptoms of drug addictions may include: Signs and symptoms of addiction may include: " Addiction " and " addictive behaviour " are polysemes denoting a category of mental disorders , of neuropsychological symptoms , or of merely maladaptive /harmful habits and lifestyles . A common use of "addiction" in medicine

1980-621: The cue reactivity model. However, no one model completely illustrates substance abuse. Risk factors for addiction include: The diagnostic criteria for food or eating addiction has not been categorized or defined in references such as the Diagnostic and Statistical Manual of Mental Disorders (DSM or DSM-5) and is based on subjective experiences similar to substance use disorders. Food addiction may be found in those with eating disorders, though not all people with eating disorders have food addiction and not all of those with food addiction have

2040-637: The dorsal striatum . Gambling addictions are linked with comorbidities such as mental health disorders , substance abuse , alcohol use disorder , and personality disorders . Risk factors for gambling addictions include antisocial behavior, impulsive personality, male sex, sensation seeking, substance use, and young age. Gambling addiction has been associated with some personality traits, including: harm avoidance, low self direction, decision making and planning insufficiencies, impulsivity, as well as sensation seeking individuals. Although some personality traits can be linked with gambling addiction, there

2100-501: The DSM-5, dependences differ from addictions and can even normally happen without addictions; besides, substance-use dependences are severe stages of substance-use addictions (i.e. mental disorders) involving withdrawal issues . In the ICD-11, "substance-use dependence" is a synonym of "substance-use addiction" (i.e. neuropsychological symptoms) that can but do not necessarily involve withdrawal issues. Drug addiction , which belongs to

2160-432: The absence of psychotropic drugs, which was popularized by Peele. These are termed behavioral addictions. Such addictions may be passive or active, but they commonly contain reinforcing features, which are found in most addictions. Sexual behavior, eating, gambling, playing video games, and shopping are all associated with compulsive behaviors in humans and have been shown to activate the mesolimbic pathway and other parts of

2220-1916: The addition of the drug to the body. Examples (and ICD-10 code) of withdrawal syndrome include: As noted above, many drugs should not be stopped abruptly without the advice and supervision of a physician, especially if the medication induces dependence or if the condition they are being used to treat is potentially dangerous and likely to return once medication is stopped, such as diabetes , asthma , heart conditions and many psychological or neurological conditions, like epilepsy , depression , hypertension , schizophrenia and psychosis . The stopping of antipsychotics in schizophrenia and psychoses needs monitoring . The stopping of antidepressants for example, can lead to antidepressant discontinuation syndrome . With careful physician attention, however, medication prioritization and discontinuation can decrease costs, simplify prescription regimens, decrease risks of adverse drug events and poly-pharmacy, focus therapies where they are most effective, and prevent cost-related under-use of medications. Medication Appropriateness Tool for Comorbid Health Conditions in Dementia ( MATCH-D ) warns that people with dementia are more likely to experience adverse effects, and to monitor carefully for withdrawal symptoms when ceasing medications for these people as they are both more likely to experience symptoms and less likely to be able to reliably report symptoms. The latest evidence does not have evidence of an effect due to discontinuing vs continuing medications used for treating elevated blood pressure or prevention of heart disease in older adults on all-case mortality and incidence of heart attack. The findings are based on low quality evidence suggesting it may be safe to stop anti-hypertensive medications. However, older adults should not stop any of their medications without talking to

2280-435: The adolescent population having high rates compared to other age groups. Prevalence rates have been difficult to establish due to a lack of universally accepted diagnostic criteria, a lack of diagnostic instruments demonstrating cross-cultural validity and reliability, and existing controversy surrounding the validity of labeling problematic internet use as an addictive disorder. The most common scale used to measure addiction

2340-477: The amount of internet use required to achieve the same desired emotional response, loss of control over one's internet use habits, withdrawal symptoms, and continued problematic internet use despite negative consequences to one's work, social, academic, or personal life. Studies conducted in India, United States, Asia, and Europe have identified Internet addiction prevalence rates ranging in value from 1% to 19%, with

2400-403: The class of substance-related disorders , is a chronic and relapsing brain disorder that features drug seeking and drug abuse, despite their harmful effects. This form of addiction changes brain circuitry such that the brain's reward system is compromised, causing functional consequences for stress management and self-control. Damage to the functions of the organs involved can persist throughout

2460-457: The consequences. Not only are adolescents more likely to initiate and maintain drug use, but once addicted they are more resistant to treatment and more liable to relapse. Drug withdrawal In order for the symptoms of withdrawal to occur, one must have first developed a form of drug dependence . This may occur as physical dependence , psychological dependence , or both. Drug dependence develops from consuming one or more substances over

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2520-413: The contribution from epigenetic risk factors to the total risk is unknown. Even in individuals with a relatively low genetic risk, exposure to sufficiently high doses of an addictive drug for a long period of time (e.g., weeks–months) can result in an addiction. Adverse childhood events are associated with negative health outcomes, such as substance use disorder. Childhood abuse or exposure to violent crime

2580-429: The desire for both, has been shown to occur as a dopamine dysregulation syndrome . ΔFosB expression is required for this cross-sensitization effect, which intensifies with the level of ΔFosB expression. Gambling provides a natural reward that is associated with compulsive behavior. Functional neuroimaging evidence shows that gambling activates the reward system and the mesolimbic pathway in particular. It

2640-445: The development of drug addiction is mixed for most genes. Many addiction studies that aim to identify specific genes focus on common variants with an allele frequency of greater than 5% in the general population. When associated with disease, these only confer a small amount of additional risk with an odds ratio of 1.1–1.3 percent; this has led to the development the rare variant hypothesis, which states that genes with low frequencies in

2700-585: The diagnostic criteria for SRADs as per DSM-5. A potential food addiction diagnosis is predicted by the presence of at least two out of 11 SRADs and a significant impairment to daily activities. The Barratt Impulsiveness Scale , specifically the BIS-11 scale, and the UPPS-P Impulsive Behavior subscales of Negative Urgency and Lack of Perseverance have been shown to have relation to food addiction. The term behavioral addiction refers to

2760-595: The experiences of an individual during their lifetime that interact with the individual's genetic composition to increase or decrease his or her vulnerability to addiction. For example, after the nationwide outbreak of COVID-19, more people quit (vs. started) smoking; and smokers, on average, reduced the quantity of cigarettes they consumed. More generally, a number of different environmental factors have been implicated as risk factors for addiction, including various psycho social stressors . The National Institute on Drug Abuse (NIDA) and studies cite lack of parental supervision,

2820-410: The food becoming less satisfactory. Chocolate's sweet flavor and pharmacological ingredients are known to create a strong craving or feel 'addictive' by the consumer. A person who has a strong liking for chocolate may refer to themselves as a chocoholic . Risk factors for developing food addiction include excessive overeating and impulsivity. The Yale Food Addiction Scale (YFAS), version 2.0,

2880-503: The household, or a parent being incarcerated or having a mental illness. As a result, the child's cognitive functioning or ability to cope with negative or disruptive emotions may be impaired. Over time, the child may adopt substance use as a coping mechanism or as a result of reduced impulse control, particularly during adolescence. Vast amounts of children who experienced abuse have gone on to have some form of addiction in their adolescence or adult life. This pathway towards addiction that

2940-508: The mood-altering or stimulating consequences of drug use can reinforce continued use (an example of positive reinforcement ) and why the addicted person seeks to avoid withdrawal through continued use (an example of negative reinforcement ). Stimulus control is using the absence of the stimulus or presence of a reward to influence the resulting behavior. Cognitive control is the intentional selection of thoughts, behaviors, and emotions, based on our environment. It has been shown that drugs alter

3000-676: The negative consequences that may arise, for a period of at least 12 months. In May 2019, the WHO introduced gaming disorder in the 11th edition of the International Classification of Diseases. Video game addiction has been shown to be more prevalent in males than females, higher by 2.9 times. It has been suggested that people of younger ages are more prone to become addicted to video games. People with certain personalities may be more susceptible to gaming addictions. Risk factors for video game addiction include: Shopping addiction, or compulsive buying disorder (CBD),

3060-806: The population (<1%) confer much greater additional risk in the development of the disease. Genome-wide association studies (GWAS) are used to examine genetic associations with dependence, addiction, and drug use. These studies rarely identify genes from proteins previously described via animal knockout models and candidate gene analysis. Instead, large percentages of genes involved in processes such as cell adhesion are commonly identified. The important effects of endophenotypes are typically not capable of being captured by these methods. Genes identified in GWAS for drug addiction may be involved either in adjusting brain behavior before drug experiences, subsequent to them, or both. Environmental risk factors for addiction are

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3120-532: The prevalence of peer substance use, substance availability, and poverty as risk factors for substance use among children and adolescents. The brain disease model of addiction posits that an individual's exposure to an addictive drug is the most significant environmental risk factor for addiction. Many researchers, including neuroscientists, indicate that the brain disease model presents a misleading, incomplete, and potentially detrimental explanation of addiction. The psychoanalytic theory model defines addiction as

3180-516: The psychological predisposition to using different drugs may be different. Models of addiction risk that have been proposed in psychology literature include: an affect dysregulation model of positive and negative psychological affects , the reinforcement sensitivity theory of impulsiveness and behavioral inhibition, and an impulsivity model of reward sensitization and impulsiveness. The transtheoretical model of change (TTM) can point to how someone may be conceptualizing their addiction and

3240-523: The reward system. Based on this evidence, sexual addiction , gambling addiction , video game addiction , and shopping addiction are classified accordingly. Sexual addiction involves an engagement in excessive, compulsive, or otherwise problematic sexual behavior that persists despite negative physiological, psychological, social, and occupational consequences. Sexual addiction may be referred to as hypersexuality or compulsive sexual behavior disorder . The DSM-5 does not recognize sexual addiction as

3300-509: The risk factors for alcoholism. Similar rates of heritability for other types of drug addiction have been indicated, specifically in genes that encode the Alpha5 Nicotinic Acetylcholine Receptor . Knestler hypothesized in 1964 that a gene or group of genes might contribute to predisposition to addiction in several ways. For example, altered levels of a normal protein due to environmental factors may change

3360-479: The second component will begin. This dictates the risk level of the substance. The CRAFFT (Car-Relax-Alone-Forget-Family and Friends-Trouble) is a screening tool that is used in medical centers. The CRAFFT is in version 2.1 and has a version for nicotine and tobacco use called the CRAFFT 2.1+N. This tool is used to identify substance use, substance related driving risk, and addictions among adolescents. This tool uses

3420-473: The structure or functioning of specific brain neurons during development. These altered brain neurons could affect the susceptibility of an individual to an initial drug use experience. In support of this hypothesis, animal studies have shown that environmental factors such as stress can affect an animal's genetic expression. In humans, twin studies into addiction have provided some of the highest-quality evidence of this link, with results finding that if one twin

3480-412: The thoughts around it, including not being aware of their addiction. Cognitive control and stimulus control , which is associated with operant and classical conditioning , represent opposite processes (i.e., internal vs external or environmental, respectively) that compete over the control of an individual's elicited behaviors. Cognitive control, and particularly inhibitory control over behavior ,

3540-461: The two categories of such disorders are substance-use addictions and behavioral addictions . The DSM-5 classifies addiction the most severe stage of substance use disorder, due to significant loss of control and the presence of compulsive behaviours despite the desire to stop. It is a definition that many scientific papers and reports use. " Dependence " is also a polyseme denoting either neuropsychological symptoms or mental disorders. In

3600-490: The way our brains function, and its structure. Cognitive functions such as learning, memory, and impulse control, are affected by drugs. These effects promote drug use, as well as hinder the ability to abstain from it. The increase in dopamine release is prominent in drug use, specifically in the ventral striatum and the nucleus accumbens . Dopamine is responsible for producing pleasurable feelings, as well driving us to perform important life activities. Addictive drugs cause

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