Other Addictions

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Other Common Addictions

Patrick Carnes defines addiction as, “having a pathological relationship with a mood altering chemical or behavior. Simply stated, addiction is the lack of control of some behavior or relationship.” Perhaps the most helpful definition is a practical one: behavior that has a negative effect on one’s life.
Like with alcohol or drugs, the other addictions listed below fit the classic, four-component model of what comprises an addiction: Compulsivity - the loss of control over a behavior. An addict continues in the behavior or relationship despite repeated attempts to stop.
Continuation despite negative consequences
Preoccupation or obsession
Tolerance - more of the same behavior or an escalation of progressive behaviors is required to get the same “high”.

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Eating Disorders
Each year, more than 5 million Americans are affected by serious and often life-threatening eating disorders. Left untreated, the emotional, psychological and physical consequences can be devastating, even fatal

Eating disorders know no class, cultural, or gender boundaries and can affect men, women, adolescents, and even children, from all walks of life.
There are three common eating disorders: Anorexia Nervosa, Bulimia Nervosa and Eating Disorder Not Otherwise Specified (including Binge Eating Disorder). The three disorders have in common a preoccupation with food and an over-concern with body size and shape. All represent serious underlying emotional problems that can have life threatening consequences.

Anorexia Nervosa

characterized by self-starvation and excessive weight loss. People diagnosed with Anorexia Nervosa restrict food intake and often develop elaborate rituals and routines to avoid eating. Often they see themselves as “fat” when actually they are underweight.

Bulima Nervosa

a vicious cycle of binge eating (consuming food compulsively in a discreet period of time) and purging by vomiting, laxatives, diuretics, restrictive diets, diet pills, and/or compulsive exercise. People with this disorder use binge eating and purging to manage difficult feelings and are often secretive about their eating behavior.

Eating Disorder Otherwise Not Specifed

Some examples include:

  •   For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses.
  •   All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual’s current weight is in the normal range.
  •   All of the criteria for Bulimia Nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than 3 months.
  •   The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (e.g. self-induced vomiting after the consumption of two cookies).
  •   Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
  •   Binge-eating disorder/compulsive overeating: recurrent episodes of binge eating in the absence of the of the regular use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa.
  •   Research criteria for binge-eating disorder includes the following:
    • Eating, in a discrete period of time an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating)

Individuals who suffer from eating disorders may display one or more of the following symptoms:

  •   Preoccupation with food, weight or body image
  •   Negative thoughts about body shape or size
  •   Using vomiting, exercise, diet pills, diuretics or laxatives to prevent weight gain
  •   Having a secret life which revolves around food and weight
  •   Feeling “fat” even when normal or underweight
  •   Dramatic changes in eating habits or significant weight loss
  •   Judging your self-worth by how much you weigh or your body size
  •   Fasting, refusing to eat, or binge eating
  •   Feeling out of control with eating

Dos & Don’ts for family members and friends of individuals with eating disorders

  •   DO - Realize there is not a quick and easy solution.
  •   DO - Talk to the person about your concerns, ask questions and listen.
  •   DO - Express your feelings honestly with the person; they sense how you are feeling anyway.
  •   DO - Let the person know qualities/characteristics (other than physical) you appreciate about them.
  •   DO - Plan social activities which do not involve food.
  •   DO - Empower the individual to make their own decisions and be accountable for their decisions.
  •   DO - Allow the person to be in charge of their routines of daily life, realizing that by giving up control, you’re setting the stage for the person to develop healthy self-control.
  •   DO - Encourage the person to get a professional assessment, from a practitioner experienced in eating disorders.
  •   DO - Realize the person is ambivalent about getting well, and takes comfort and feels safe in the control and rituals of the disorder.
  •   DO - Express your care and interest in seeing the person get well.
  •   DO - Inform yourself about the disorders and their treatment, attend support groups and read current literature.

  •   DON’T - Ever give up; this is a long-term illness and people recover everyday.
  •   DON’T - Ignore the problem hoping it will go away; talk about it.
  •   DON’T - Panic. Seek the support you need.
  •   DON’T - Assume there isn’t a problem if the individual doesn’t show physical symptoms.
  •   DON’T - Force the person to eat or tell them to “just eat.”
  •   DON’T - Make your love a condition of the individual’s appearance, health, weight, achievements or any other attribute.
  •   DON’T - Comment positively or negatively on appearance or weight.
  •   DON’T - Feel you must walk on “eggshells” so the person with the eating disorder won’t be upset.
  •   DON’T - Let the eating disorder disrupt family routines.
  •   DON’T - Be manipulative. DO be direct with feelings and expectations.
  •   DON’T - Try to control the person’s behavior it can intensify the problem.
  •   DON’T - Impose rules except those which are necessary for the individual’s or family’s safety and well-being. Avoid power struggles.
  •   DON’T - Blame yourself, feel guilty or dwell on causes.
  •   DON’T - Tell the anorexic who has gained weight that they look better.
  •   DON’T - Expect yourself to be a perfect parent, family member or friend.

Information provided by Recovery Television by Eating Disorder Center of Denver

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Dual Diagnosis
Dual diagnosis is when substance abuse addiction and mental illness happen at the same time.

A substance abuse patient may not find out that drug and alcohol addiction often co-occur with other disorders, until seeking drug or alcohol addiction treatment.

Dual Diagnosis can be comprised of multiple substance abuse and mental health issues affecting one person.

What’s more, many people affected by dual diagnosis can function normally and may even appear to be fine to the outside world. But in order to help someone who might be affected by these ailments, it’s important to know that different combinations of dual diagnosis can include alcoholism and depression, opiate addiction and anxiety disorder, or cocaine and sexual addiction. Whatever the combination, each disorder worsens the other and allows the user to become dependent on both.

Substance Abuse combined with a mental disorder is very common.

Almost 70% of people with drug and alcohol addictions also suffer from a mental disorder like anxiety, depression, anger or sexual addiction. It is estimated that 17.5 million Americans suffer from a mental disorder every year and about 4 million of those people also struggle with an alcohol or drug addiction.

Individuals with mental illnesses may engage in alcohol addiction or substance abuse without their families’ knowledge.

It is reported that both mental health professionals and families of mentally ill relatives underestimate the amount of substance abuse and alcohol addiction among people in their care. This could be due to the difficulty in separating the dual diagnosis behaviors of mental illness from those of drug and alcohol addiction and abuse. There may be denial of the problem, because there has been so little information and help offered to people with dual diagnosis illnesses.

It’s common for a person to only receive treatment for one ailment.

According to statistics, only 12 percent of people with a dual diagnosis receive treatment for both disorders. When a patient is only treated for one of their disorders, they may seem to progress in their recovery, but in reality, the disorder that was not treated will cause the patient to relapse. This is why treatment for both substance abuse and mental health is crucial for a patient to have a real chance at a full recovery.

Recovery achieved by detoxification and medication is superficial.

Because many patients have a dual diagnosis, simply getting the drug out of their system and putting them on a new medication is not going to cut it. Dual diagnosis experts of psychiatry, psychology, and counseling not only can educate patients on how to manage their disorder, but can also provide special psychiatric therapy to heal the troubled pasts of many.

12-step group programs are very influential during the treatment of dual diagnosis.

These groups are very therapeutic, allowing a person, not only to step outside themselves, but also they also support a community of acceptance and understanding (each person knows what the other is going through).

Some of the components of a good dual diagnosis treatment program include the following:

  •   Psycho-education - Lectures, groups, and individual sessions educate the dual diagnosis patient about the medical and psychological aspects of his/her dual diagnosis.
  •   Expert pharmacotherapy – If medications are prescribed, only the most effective medications offering the greatest benefit and the least side effects are used.
  •   12-Step programs - Patients are provided a range of quality in-house 12-Step meetings according to their specific needs.
  •   Relapse prevention programs - Programs specifically designed for ongoing recovery of the dual diagnosis patient.
  •   Adjunct groups - Focusing therapeutic work on specific areas of concern to the dual diagnosis treatment of the patient, such as; cocaine/heroin addiction, eating disorders, stop smoking, grief and trauma, healthy sexuality, compulsive gambling and women's, and men's groups.
  •   Family member participation - Dual diagnosis patients are encouraged to invite their family members to participate in the Family Program.
  •   Integrative therapies - May include acupuncture, massage, Eye Movement Desensitization and Reprocessing (EMDR), and Somatic.

Information provided by Transitions Recovery Program

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What is compulsive gambler?
A compulsive gambler is defined as an individual who suffers from a disorder in which he/she has a psychologically uncontrollable preoccupation or urge to gamble.
As in other compulsive behavioral disorders, tolerance develops and greater and more frequent gambling risks are required to maintain mood elevation. As the compulsion progresses, the urge to gamble intensifies, making it more difficult to resist. Left untreated, compulsive gambling will eventually interfere with almost every aspect of one's life. The range of compulsive gambling behaviors addressed in treatment includes sports betting, casino gambling, racetrack betting, manipulation of stocks and bonds and futures commodities, and speculative investments.

Legalized gambling is one of the fastest growing industries in the United States.
Gambling's tremendous popularity is evident in the recent increase in the number of off-track-betting parlors (OTBs) and riverboat casinos that dot the Midwest and the Mississippi Delta. Billboards on major highways depict the action and excitement available at such facilities. Families are broken, lives are ruined, all because of someone fooled into believing they can be fulfilled by a jackpot.

For most of the industry's patrons, gambling is fun and a form of harmless entertainment.
For the four to six percent of gamblers who become problem or pathological (compulsive) gamblers, however, it can be a devastating illness that negatively affects every aspect of their lives. What is unique about the current gambling situation is the speed at which it has gone from an undercurrent in American society to high-profile, socially recognized activity.

Some Characteristics of Problem Gamblers

  •   Are more likely to be male than female
  •   Usually bet larger amounts on all forms of gambling
  •   Gamble more frequently
  •   Spend more time per gambling session
  •   Are more likely to have been in trouble with the police
  •   Are more likely to say they have been rejected by family members

What is the difference between casual social gambling and pathological gambling?
Gambling can be defined as playing a game of chance for stakes. Gambling occurs in many forms, most commonly pari-mutuels (horse and dog tracks, off-track-betting parlors, Jai Alai), lotteries, casinos (slot machines, table games), bookmaking (sports books and horse books), card rooms, bingo and the stock market.
Pathological gambling is a progressive disease that devastates not only the gambler but everyone with whom he or she has a significant relationship. In 1980, the American Psychiatric Association accepted pathological gambling as a "disorder of impulse control." It is an illness that is chronic and progressive, but it can be diagnosed and treated.

Warning Signs

People who suspect a gambling problem in themselves, a friend, or a family member may recognize the following warning signs:

  •   Increasing preoccupation with gambling
  •   Use of gambling as a way to escape problems or relieve depression
  •   Inability to stop playing regardless of winning or losing, and despite constant vows to abstain
  •   Restlessness or irritability when attempting to cut down or stop gambling
  •   Use of alcohol, sleep, or drugs to escape
  •   Lying to family members or others to hide the amount of gambling
  •   Impatience with family or friends
  •   Relying on others for money to relieve a financial problem that arose due to gambling (legal and illegal sources)
  •   Absenteeism and tardiness at work
  •   Neglect of responsibility
  •   Losing or jeopardizing an important relationship due to gambling
  •   Wide mood swings
  •   Belief when winning that it will not stop
  •   Gambling another day to win back money lost gambling

Gambling Statistics

  •   The gambling industry has grown tenfold in the U.S. since 1975
  •   In 1973 state lotteries had $2 billion in sales.  By 1997, the revenues reached $34 billion
  •   Gambling profits in casinos are more than $30 billion while lotteries are about $17 billion annually
  •   “Players” with household incomes under $10,000 bet nearly three times as much on lotteries as those with incomes over $50,000
  •   Two-thirds of the adult population placed some kind of bet last year
  •   15 million people display some sign of gambling addiction
  •   Thirty-seven states now have lotteries
  •   After casinos opened in Atlantic City, the total number of crimes within a thirty-mile radius increased 100 percent
  •   The average debt incurred by a male pathological gambler in the U.S. is between $55,000 and $90,000 (it is $15,000 for female gamblers)
  •   The Internet boasts 110 sport-related gambling sites
  •   The average rate of divorce for problem gamblers is nearly double that of non-gamblers
  •   There are now approximately 260 casinos on Indian reservations (in 31 states and with $6.7 billion in revenue)
  •   The suicide rate for pathological gamblers is twenty times higher than for non-gamblers (one in five attempts suicide)
  •   Sixty-five percent of pathological gamblers commit crimes to support their gambling habit
  •   According to the American Psychological Association the Internet could be as addictive as alcohol, drugs, and gambling
  •   Gambling among young people is on the increase: 42 percent of  14-year-olds, 49 percent of 15-year-olds, 63 percent of 16-year-olds, 76 percent of 18-year-olds.

The Custer Three Phase Model
Robert L. Custer, M.D., identified the progression of gambling addiction as including three phases:

The Winning Phase
During the winning phase, gamblers experience a big win ­ or a series of wins ­ that leaves them with unreasonable optimism that their winning will continue. This leads them to feel great excitement when gambling, and they begin increasing the amounts of their bets.

The Losing Phase
During the losing phase, the gamblers often begin bragging about wins they have had, start gambling alone, think more about gambling and borrow money ­ legally or illegally. They start lying to family and friends and become more irritable, restless and withdrawn. Their home life becomes more unhappy, and they are unable to pay off debts. The gamblers begin to "chase" their losses, believing they must return as soon as possible to win back their losses.

The Desperation Phase
During the desperation phase, there is a marked increase in the time spent gambling. This is accompanied by remorse, blaming others and alienating family and friends. Eventually, the gamblers may engage in illegal acts to finance their gambling. They may experience hopelessness, suicidal thoughts and attempts, arrests, divorce, alcohol and/or other drug abuse, or an emotional breakdown.

Who is affected?
Current estimates suggest that three percent of the adult population will experience a serious problem with gambling that will result in significant debt, family disruption, job losses, criminal activity or suicide. Pathological gambling affects the gamblers, their families, their employers and the community. As the gamblers progress through the various phases, they spend less time with their family and spend more of their family's money on gambling until their bank accounts are depleted. Then they may steal money from family members.
At work, the pathological gambler misuses time in order to gamble, has difficulty concentrating and finishing projects and may engage in embezzlement, employee theft or other illegal activities.

The Solution
The compulsion to gamble is progressive. In most people, it begins slowly and grows until the victim's life becomes unmanageable. As repeated efforts to gain control fail, life for the compulsive gambler begins to fall apart.
If the compulsive gambler could stop chasing losses, he would. All compulsive gamblers can stop gambling…for a while. But most people need professional help to stop for life.

Information provided by Recovery Television by the Illinois Institute for Addiction Recovery

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History of Sexual Addiction

In recent years, largely through the pioneering work of Dr. Patrick Carnes within the secular community, and Dr. Mark Laaser within the Christian community, attention has been drawn to the often scoffed problem of sexual addiction.
The reality of an addiction to sex is gaining acceptance, much as alcoholism came to be understood as an addiction forty years ago. Programs of recovery based on the Twelve Steps originally used by Alcoholics Anonymous are rapidly expanding across the country. There have been few programs that combine sound clinical treatment with Christian principles. This gap leaves men alone to struggle with the spiritual aspects of their sexual shame.

How it Presents in Men
“Sex addiction” is an umbrella term for what's actually a collection of often overlapping behaviors. First, there's the stereotypical sex addict, which covers things like using pornography in any of its forms, visiting prostitutes and massage parlors, engaging in exhibitionism and voyeurism, and compulsive masturbation. Most think of the "sex addict" as a male. The romance addict, more often female, is addicted to the intrigue and the pursuit of romance. Think of the vast market for the romance novels, for example. This kind of addict thrives on the thrill of the chase, but finds it impossible to sustain an intimate, committed relationship. The third main type of sex addict is the love or relationship addict. This flavor affects both men and women, and the main dynamic is the belief that a particular relationship or a specific partner will be "the one." Relationship addicts repeatedly become involved in intense, enmeshed, codependent relationships, even when those partners or relationships are destructive. One way of thinking about the relationship addict is to view him or her as the ultimate codependent.

Information provided by Faithful & True

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Tobacco is a tall, leafy annual plant, originally grown in South and Central America, but now cultivated throughout the world, including southern Ontario. There are many species of tobacco; Nicotiana tabacum (or common tobacco) is used to produce cigarettes.
A powerful central nervous system stimulant found naturally in the tobacco leaf, is classified as a drug. Nicotine is one of the main ingredients in tobacco. In higher doses, nicotine is extremely poisonous. It is commonly used as an insecticide.
Tobacco leaves can be burned and inhaled (in the form of cigarettes, cigars, pipes, smoke, etc.) or absorbed through the mouth (in the form of spit tobacco, chew, or snuff). The membranes in the nose, mouth and lungs act as nicotine delivery systems - transmitting nicotine into the blood and to the brain.
Smokers usually feel dizzy and sick when they first inhale the nicotine in tobacco, but gradually build up tolerance to its effects. Other symptoms new smokers experience includes coughing, a dry, irritated throat as well as nausea, weakness, abdominal cramps, headache, coughing or gagging. These symptoms subside as the user develops a tolerance to nicotine.
Nicotine is highly addictive. The addictive effect of nicotine is the main reason why tobacco is widely used. Many smokers continue to smoke in order to avoid the pain of withdrawal symptoms. Smokers also adjust their behavior (inhaling more deeply, for example) to keep a certain level of nicotine in the body.
Smokers who usually smoke at least 15 cigarettes per day and/or smoke their first cigarette of the day within 30 minutes of waking are likely to experience nicotine withdrawal symptoms. They will likely find quitting uncomfortable.
Stopping can produce unpleasant withdrawal symptoms including depression, insomnia, irritability, difficulty concentrating, restlessness, anxiety, decreased heart rate, increased appetite, weight gain, and craving for nicotine.
Symptoms peak from 24 to 48 hours after stopping and can last from three days up to four weeks, although the craving for a cigarette can last for months.
Most smokers make an average of three or four quit attempts before becoming long-term non-smokers. Relapse is the rule rather than the exception and must be viewed as part of the process of quitting.

Why is tobacco so addictive?
Nicotine addiction is very complex and highly individual. Many smokers continue to use tobacco even though they wish they could stop. Most people who smoke want to quit and have tried to quit. Nicotine is so addictive that many people continue to smoke even when their lives are in immediate danger.

Physical Addiction
Nicotine is considered addictive because it alters brain functioning and because most people smoke compulsively. Very few people can smoke occasionally.
Nicotine is a ‘reinforcing’ drug – smokers want it regardless of its damaging effects. It is considered a reinforcer because it causes many smokers to continue to smoke in order to avoid the pain of withdrawal symptoms.
Addiction to tobacco (nicotine) is not immediate. It may take weeks or months to develop. People who begin smoking when they are in their teens tend to be more dependent than those who start smoking after age 20.
Unlike cocaine, heroin or alcohol abuse, the more dangerous effects of tobacco use are not obvious in the beginning. As well, the pleasurable effects of tobacco may outweigh the abstract possibility of health consequences in the minds of many smokers.

Psychosocial Addiction
Smoking gives pleasure: from the simple tactile and oral pleasure of handling and drawing on a cigarette to the comfort of a quick fix in times of anxiety, anger and other stress.
Many people don’t find their first experience with tobacco pleasant. Initially, social pressure may cause addiction to develop. Once addicted, there are fewer external pressures to quit than there are with other addictions. Smokers are not in immediate danger of losing their jobs or families due to their addiction. More dangerous health effects are not obvious in the beginning.

Reality Check
When you are young and strong, it’s so easy to think that cancer and heart disease only happen to other people. Much older people. You’re invincible, right? WRONG!
Here’s a reality check:
  •   Among young people, the short-term health consequences of smoking include respiratory effects – coughing and increased frequency and severity of illnesses like asthma, chest colds and bronchitis – as well as addiction to nicotine.
  •   The earlier people start smoking, the harder it is to quit when they are older.
    • People who start smoking in their teenage years run the risk of becoming life-long smokers.
      • Eighty-five percent of teenagers who smoke two or more cigarettes completely, and overcome the initial discomfort of smoking, will become regular smokers. 
    • Most young people who smoke regularly continue to smoke throughout adulthood.
  •   Smoking reduces the rate of lung growth and it can hamper the level of maximum lung function. So it should be no surprise that smoking hurts young people’s physical fitness in terms of both performance and endurance – even among young people trained in competitive running.
  •   The resting heart rates of young adult smokers are two to three beats per minute faster than non-smokers.
  •   Smoking at an early age increases the risk of lung cancer.
Spit Tobacco
Spit tobacco is a type of tobacco product that is placed inside the mouth (referred to as a “wad”). This gives the user a continuous high from the nicotine.
Spit tobacco is sold in three forms:
  •   Chew - A leafy form of tobacco sold in pouches. Users keep the chew between the cheek and gums for several hours at a time.
  •   Plug - Chew tobacco that has been pressed into a brick.
  •   Snuff - A powdered, moist form of tobacco sold in tins. Users put the snuff between the lower lip or cheek and the gum. As well, some users will sniff it. Using snuff is also called “dipping.”
Many people think using spit tobacco is safer than smoking. However, just because there is no smoke does not mean that it is safe. A person who uses eight to 10 dips or chews a day receives the same amount of nicotine as a heavy smoker who smokes 30 to 40 cigarettes a day.
Spit tobacco is made from a mixture of tobacco, nicotine, sweeteners, abrasives, salts and chemicals. It contains over 3,000 chemicals including about 28 known carcinogens.
Some of the harmful chemicals in spit tobacco are:
  •   Polonium 210 (nuclear waste)
  •   Tobacco-specific N-nitrosamines or TSNAs (cancer-causing agents only found in tobacco)
  •   Formaldehyde (embalming fluid)
  •   Nicotine
  •   Cadmium (used in car batteries)
  •   Cyanide
  •   Arsenic
  •   Benzene
  •   Lead
Like smoking tobacco, spit tobacco affects the cardiovascular system and may be associated with heart disease, stroke and high blood pressure. Long-term effects include leukoplakia, tooth abrasion, gum recession, gum and tooth disease, loss of bone in the jaw, yellowing of teeth and chronic bad breath.
Other health consequences of using spit tobacco include cancer of the mouth (including the lip, tongue, cheek and floor and roof of the mouth) and throat.

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