Types of Addiction

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Types of Addiction

Addiction is a mental health disorder characterised predominantly by a habitual pattern of behaviour and a preoccupation with a substance or activity.

There are many different types of addiction, all of which have different risk factors, withdrawal symptoms, and unique effects on the person who is struggling.

People can be addicted to substances such as alcohol, heroin, cannabis or prescription drugs like benzodiazepines which are substance use disorders or activities such as gambling, sex, shopping and gaming which fall into the diagnostic category of behavioural addiction. (3)

Addiction becomes problematic when it causes people emotional distress or interferes with their ability to carry out their day-to-day activities such as holding down a job or carrying out important domestic tasks.

Consequences of addiction

Being addicted to substances such as alcohol and drugs can cause us severe physical harm.

Alcohol damages our internal organs and tissues throughout the body, and drastically reduces the ability of our cardiovascular and immune systems which will lead to a decline in our physical functioning which can lead to a range of illnesses that reduce our quality of life.

Addiction also leads to poor mental health as the fact that we are behaving in a way that we do not wish to but cannot stop can cause us anxiety as we are unable to control our behaviour.

Also, many substances alter our brain chemistry which is responsible for regulating our mood and emotional state and consuming substances such as cannabis and alcohol can exacerbate any existing mental health problems.

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about the different types of addiction, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

What causes addiction?

Experts researching types of addiction feel that it is a complex mental health condition that does not have just one predominant cause.

Many factors contribute to the development of an addiction and there is a huge variation between patients making it very difficult trying to establish the reasons why people become addicted.

The factors that cause addiction can be: (4)

1. Biological – Such as a genetic disposition to engage in impulsive and addictive behaviour, or suffering from a low mood, depression or bipolar disorder and therefore use drugs to improve their mood
2. Social – Unable to develop or sustain positive relationships in life, possibly due to an insecure attachment during their formative years. Periods of loneliness and isolation can also act as a trigger for people to become addicted to a substance or activity. People are vulnerable to seeking alternative ways of coping with their anxiety if they have nothing meaningful to focus on in their lives. Social pressures to conform also play a strong role in initiating and maintaining substance use as the need for belonging acts as an important motivation for adolescents and young adults to conform to the accepted behaviours of their peer group
3. Psychological – Having low self-esteem, displaying irrational and unhelpful thinking patterns and struggling to deal with stress or strong negative feelings can lead to substance use. Each person has a unique reason for the development of their addiction which sets them apart from any other patient diagnosed with an addictive disorder (11)

Traumatic experiences can cause many types of addiction

It is now widely acknowledged within the medical community that many people who become addicted to alcohol, drugs or behavioural patterns/activity have experienced some form of trauma in their lives.

Experiencing trauma can be very stressful and can evoke strong physical and emotional symptoms further down the line as people seek to deal with the trauma, mostly by taking substances or engaging in behaviours that may be classed as self-soothing. (6)

For example, many people with post-traumatic stress disorder drink alcohol or take drugs to numb emotional pain and to help them cope with the intense emotions they are experiencing as a result of their previous traumatic experience. (12)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about the different types of addiction, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Diagnosing addiction

All types of addiction share common behaviours and characteristics, regardless of whether the patient has an alcohol addiction, drug addiction or behavioural addiction such as gambling.

The main symptoms that medical and mental health professionals look for when diagnosing an addiction include: (2)

• A preoccupation with the behaviour, where the substance/activity dominates the person’s mind for a large proportion of the day
• People who are addicted are unable to stop or reduce their behaviour despite wanting to do so, so the addiction is now controlling them
• Their preoccupation with the substance/behaviour is causing significant disruption to their lives and affecting other people around them. They may for example forget about important work and family duties because they are psychologically distracted
• They will develop an increased tolerance for the substance or activity (e.g gambling) meaning that they will slowly need to escalate this behaviour to experience the satisfying effects that they initially experienced when they first engaged in the behaviour
• They will experience physical and psychological withdrawal symptoms when they cannot take the substance or engage in the activity
• They will continue to engage in the behaviour despite being aware of the harm they are doing to themselves and the physical and psychological consequences they are experiencing
• They have lost interest in activities that they once found pleasurable as their preferred substance/activity has taken over their lives

The process of diagnosis

The criteria for all types of addiction are similar and only vary slightly depending on the type of addiction (behavioural or substance).

Overall, there are 11 criteria set down by esteemed psychiatric professionals for each addictive disorder that can be found in the most recent version of the Diagnostic and Statistical Manual for Mental Health Disorders (DSM5). (2)

If 2 or 3 of the set criteria apply to the patient then they will be diagnosed with a mild addictive disorder, if 4 or 5 of the criteria apply to them they will be diagnosed with a moderate addictive disorder.

Any patient who meets 6 or more of the 11 criteria will be judged to have a severe addictive disorder. (2)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about the different types of addiction, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Characteristics of addiction

There are three central concepts to understanding the nature of addiction, these are physical dependence, psychological dependence and a loss of control. (8)

Physical dependence – Tolerance and withdrawal

The concepts of tolerance and withdrawal are central to explaining how substance dependence develops.

When an individual increases the amount of a substance they consume their brain and body respond over time by becoming more efficient at processing the substance via a process called neuroadaptation.

The result of this is that the chemical properties in the substance do not affect us as much as they did when we first consumed the substance, this means that we will need to consume more of the substance for it to have the desired effect on us. (8)

Withdrawal

When this occurs it can be said that a person has increased their tolerance to the substance.

If having increased their tolerance a person decided to stop consuming the substance for 1-2 days then they would start to experience withdrawal symptoms such as nausea, headaches, fatigue, irritability, insomnia and insomnia.

These symptoms can be relieved immediately by consuming their preferred substance, which illustrates that the person is now physically dependent on the substance regardless of whether it is alcohol or drugs.

Behavioural addictions – Tolerance and withdrawal

Research indicates that individuals with a behavioural addiction do develop a tolerance to the activity and therefore do need to escalate their level of engagement with the activity to satisfy their needs.

This can be evident in gamblers who begin to place higher bets to increase their level of excitement.

Patients diagnosed with behavioural addictions also report experiencing withdrawal symptoms when they stop engaging in the activity or are unable to participate in the activity.

Physical symptoms may include headaches and physical tension and psychological symptoms may include anxiety and irritability (1,10)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about the different types of addiction, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Types of addiction – Psychological dependence

Everyone who is diagnosed with an addictive disorder regardless of whether it is a substance or an activity will have developed a psychological reliance on the substance or activity that maintains their addictive behaviour and makes it very difficult for them to stop.

For example, cannabis users will find that over time they need to take the drug regularly to help them cope with stressful situations or when they are experiencing strong emotions as they believe that there are no other alternative ways of achieving this available to them.

People with behavioural addictions tend to rely on activities such as gambling, sex and gaming to provide a sense of excitement for them or to provide relief from a low mood or anxious feelings.

This suggests that they have become reliant on the activity to change their state of mind and emotional state and so will continue to engage in this pattern of behaviour when they are experiencing negative feelings until they receive treatment. (8,11)

Types of addiction – Substance Use Addictions (Disorders)

The main substances that people become addicted to are alcohol, recreational drugs such as heroin, cocaine (including crack cocaine), cannabis, LSD, crystal meth and ecstasy and prescription drugs such as benzodiazepines.

Alcohol addiction / Alcohol use disorder

This form of substance use is now referred to now as alcohol use disorder rather than alcoholism or alcohol addiction since DSM5 was published in 2013.

Alcohol is a central nervous system depressant which slows down brain activity which results in many aspects of our physical functioning including respiration and muscular activity also slowing down, leaving us in a relaxed state. (7,11)

Anyone that regularly drinks over the recommended level of 14 units of alcohol per week and beyond is likely to become physically dependent on alcohol very quickly and in danger of being diagnosed with alcohol use disorder if they are unable to stop their drinking.

Medical research into alcohol use has established that people can become dependent on alcohol by drinking six pints of alcohol a day for one week, so moderate or heavy drinkers can quickly become dependent on alcohol. (7)

It is vitally important for people with alcohol use disorder to receive treatment for their condition and not attempt to give up alcohol themselves as they can experience life-threatening symptoms such as brain seizures if they suddenly stop drinking alcohol.

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about the different types of addiction, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Types of addiction – Drug addictions

All drugs generate a psychoactive effect on people’s brains and the chemical characteristics of drugs mean that they will produce effects that are highly sought after by recreational who need a mind-altering experience, or who are looking to improve their mood and/or emotional state. (8)

Drugs that elicit a psychoactive effect tend to act on the brain and other parts of the central nervous system and cause a change in the way we feel, think, behave and experience the world around us. (4)

Cocaine (Now referred to as Stimulant Use Disorder)

People take cocaine for its ability to provide them with positive emotions including excitement and euphoric feelings which increase its addictive properties.

As a fast-acting central nervous system stimulant, cocaine also boosts a user’s confidence and significantly enhances their mental capabilities such as concentration and alertness.

Cocaine has thes ability to delay the need for sleep and suppress appetite, which gives the user more physical energy and higher levels of focus to push on with important tasks. (2,10)

Crack cocaine provides an even greater high for users and is more fast-acting than cocaine meaning substance users will develop an addiction to it much more quickly. (4)

Cannabis (Now referred to as Cannabis use disorder)

Cannabis users are seeking to gain a sense of calmness and relaxation and to help relieve any feelings of stress and anxiety.

Cannabis is not viewed as harmful as other drugs, but it can significantly impact the physical and mental health of long-term users and affect many areas of their life including education, work/career and the quality of their social and family relationships.

A great deal of research suggests that cannabis use triggers psychotic episodes, particularly in adolescent users and has also been linked to schizophrenia, depression and aggressive behaviour. (2,5)

Opioid addiction (opioid use disorder)

Opioid drugs are the most powerful form of drugs to be addicted to as they can seriously harm your physical and emotional health.

Opioid drugs also tend to have a high relapse rate and so they are not so easy to give up, even if clients are making good progress they are not too far away from relapsing as even a minor setback can be catastrophic. (12)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about the different types of addiction, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Opioid drugs generate feelings of euphoria

Opioid drugs are so powerful because they can alleviate mild to moderate pain and there are stronger opioids available that can treat severe pain.

However recreational drug users are drawn to the intense feelings of euphoria they experience when consuming opioid drugs such as heroin which significantly enhances their mood from the usual day-to-day low to moderate mood they regularly experience.

Once they have experienced these pleasurable feelings they are motivated to seek this experience again.

Opioid drugs have a short half-life and act quickly when taken, and because of this, users can build up a tolerance to the drug quickly which results in them needing to take higher doses to achieve the desired effect. (12)

Within a short timeframe, they can become physically dependent on heroin and will as a result experience unpleasant withdrawal symptoms when they stop taking the drug.

This is a sign that they should consult with a GP and/or drug rehab services for an assessment of their condition. (4,12)

Types of addiction – Behavioural addictions

Behavioural addictions, also known as process addictions are regular patterns of behaviour people habitually engage in that will eventually cause them harm, and disrupt many different areas of their life.

Patients who develop a behavioural addiction are not physically dependent on substances like alcohol or drugs but instead, become obsessed and preoccupied with a specific activity that takes over their life and causes them many negative consequences. (1,10)

Examples of behavioural addictions include:

• Gambling
• Internet gaming disorder
• Shopping (Compulsive shopping)
• Sex and love addiction

In the most recent version of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM5) only gambling and internet gaming disorder are included as official behavioural addictions.

This is mainly because they have a stronger evidence base behind them that offers explanations for the condition and established treatment to help patients. (1,2)

Behavioural addictions – Explanations

Individuals are drawn to the psychological buzz they obtain from engaging in the activity. Engaging in the activity provides people with relief from internal anxiety and tension.

Any individuals with poor mental health and low mood (which may have a biological basis) will need to elevate their mood by focusing on an activity that appeals to them at some deep level.

Experiencing loneliness and having a lack of meaning in life does predispose some individuals to find an activity that provides stimulation and excitement. (1,10)

Multiple types of addiction

There are occasions when individuals can have more than one addiction, this may be an addiction to alcohol and a drug such as cocaine, or alcohol and a behavioural disorder such as gambling.

This makes devising an appropriate treatment programme for that patient very challenging as many patients who enter treatment may have different combinations of addiction, with each combination possessing its own unique set of challenges for treatment providers.

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about the different types of addiction, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Types of addiction – Dual diagnosis

Any type of addiction is a mental health condition, and it is common to find that many people who have been diagnosed with addiction have also been diagnosed with another mental health condition which co-exists alongside their addictive disorder.

These include:

• Mood disorders, such as depression
• Anxiety
• Eating disorders such as Anorexia Nervosa and Bulimia Nervosa
• Schizophrenia
• Anxiety
• Borderline personality disorder
• Anti-social personality disorder
• Obsessive-compulsive disorder
• Post-traumatic stress disorder

All of these mental health conditions have their own separate symptoms and behavioural patterns although there is some degree of overlap between many of the conditions. (4,7)

Our rehab centres have specially designed individual programmes to treat dual diagnosis patients as it is vitally important to understand the way a patient’s addiction interacts with their mental health condition as this influences the content of their treatment programme.

It is difficult to establish which condition came first

On many occasions having one mental health condition will lead to the patient developing another disorder.

It is very common for patients diagnosed with anxiety and depression to become addicted to alcohol or drugs as they use the physical effects provided by the substances to alleviate the distressing symptoms of their condition.

It is also common for heavy drinkers to develop depression and anxiety due to the depressive effects that alcohol has on central nervous system functioning, which over time can. significantly lower a person’s mood. (2,7)

Each person’s addiction and mental health condition is unique and this is reflected in the treatment programme we devise for the client.

For example, a patient diagnosed with alcohol use disorder and post-traumatic stress disorder would follow an entirely different treatment plan compared with a patient diagnosed with cannabis use disorder and schizophrenia. (4)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about the different types of addiction, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

 

References

(1) Alavi, S.S. et al (2012) Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views. International Journal of Prevention Medicine. April 3(4) pp290-204 available @ Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views – PMC (nih.gov)

(2) Black, D., Grant, J. (2013) DSM5 Guidebook: The Essential Companion to Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition. APP. London.

(3) Ghodse, H. (2002) Drugs and Addictive Behaviour: A guide to treatment Cambridge University Press.

(4) Herie, A. & Skinner, W. (ed) (2014) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada.

(5) Kahan, M. (2014) Physical Effects of Alcohol and Other Drugs. In Herie, M. & Skinner, W. (ed) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada

(6) Khantzian, E., Albanese, M. (2008) Understanding Addiction as Self-Medication: Finding hope behind the pain. Rowman & Littlefield. Maryland.

(7) Mack, A.H., Harrington, A.L. & Frances, R.J. (2010) Clinical Manual for Treatment of Alcoholism and Addictions. APP. London.

(8) Moss, A, Dyer, K (2010) The Psychology of Addictive Behaviour. Palgrave McMillan. New York.

(9) Orford, J. (2001) Excessive Appetites: A Psychological View of Addictions. John Wiley & Sons. Chichester.

(10) Pinna, F. et al (2015) Behavioural addictions and the transition from DSM-IV-TR to DSM-5. Journal of Psychopathology. V 21:380-389

(11) Rassool, G.H. (2011) Understanding Addictive Behaviours. Palgrave MacMillan. New York.

(12) Van der Kolk, B. (2014) The Body Keeps the Score. Viking Press. New York.

(12) Yoon, R. (2014) Opioid Addiction, in Herie, M. & Skinner, W. (ed) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada.