The Cycle of Addiction

The Cycle of
Addiction
Sources:
http://www.getcured.com/addict.htm
Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love
Them by David N. Greenfield. 1999. New Harbinger Publications, Inc.
Gambling and Gaming Addiction in Adolescence by Mark Griffiths. 2002.
BPS Blackwell Publishing, Ltd.
Comments and additions by Gao Laoshi

What is Addiction?
 When the word “Addiction” is mentioned,
most people think of alcohol, drugs or
smoking.

What is Addiction?
 But “Addictions” can be related to a vast number
of behaviors as well as substances:
– Internet/video games
– Eating problems (bulimia, compulsive eating,
compulsive dieting, etc.)
– Gambling
– Exercise
– Watching movies/TV
– Shopping
– Sex
– Work/studying
– Etc.

What is Addiction?
 One good definition of addiction (Marlatt et al. 1988. P. 224
cited by Griffiths) is:
“….a repetitive habit pattern that increases the risk of disease
and/or associated personal social problems
Addictive behaviors are often experienced subjectively as ‘loss
of control’ – the behavior contrives to occur despite volitional
attempts to abstain or moderate use.
These habit patterns are typically characterized by immediate
gratification (short term reward), often coupled with delayed
deleterious effects (long term costs).
Attempts to change an addictive behavior (via treatment or self
initiation) are typically marked with high relapse rates.”

What is Addiction?
 Powerlessness and unmanageability are two
common effects of a prolonged addiction.
 Often people report being “out of control” of their
behavior, almost as if the addiction takes
precedent over their better judgment.

What is Addiction?
 Addiction, both substance and behavioral,
produce the same type of
»tolerance and
»withdrawal
as other addictions.

What is Addiction?
 Tolerance and Withdrawal can only be noticed
from within.
 Thus, a simpler definition of addiction provided
by David Greenfield is:
– Addiction involves a behavior or substance on which
you are dependent and that is painfully difficult to stop.
– Abuse (preceding actual addiction) may simple be a
repeated pattern of use without tolerance or pain
(withdrawal) as a result of trying to stop.

What is Addiction?
 Tolerance:
over time the addictive substance or behavior becomes
less and less effective in being able to produce the
original pleasurable sensation or relief from unpleasant
feelings.
the “need” for the addictive substance or behavior
increases to produce the same effect.

What is Addiction?
 Withdrawal:
It is very difficult to end an addiction. Doing so
means having to tolerate some discomfort and
pain.
Most of us don’t like to experience pain; we like
PLEASURE.

What is Addiction? (Greenfield)
 The Paradox of Addiction is that the initial
pleasure (or relief from pain/unpleasant
feelings) is gradually replaced by an
endless cycle of discomfort, guilt and
shame…relieved only by continuing the
addictive behavior or substance….which
causes more pain and discomfort.
 It is this unrelenting cycle that is the most
difficult part of ending an addiction.

What is Addiction?
 Withdrawal:
Occurs when the substance or behavior is
reduced or stopped and results in two or more
of symptoms that vary according to the specific
addiction.
 Examples of typical ones:
• Insomnia
• Nervousness/restlessness
• Irritation
• Anxiety

What is Addiction? (Greenfield)
 Addiction is usually serious before it is
recognized as a problem because of
DENIAL.
 Denial is a psychological defense
mechanism that enables someone to
continue to do something that has
obvious negative consequences.

Three Characteristics
of Addiction (Greenfield)
There are many characteristics, but these are
primary ones associated with all addictions:
• Loss of control: The user cannot predict what will happen
when he uses the substance. One day he may be able to stop
after one drink, or after one line of cocaine; the next day he
may not be able to control his use at all.
• Compulsive preoccupation: The addict spends a great deal
of time thinking about the substance.
• Continued use despite negative consequences: If drinking
or drug use causes problems but one continues to do it, one
is tempting addiction or is already addicted. The person has
lost voluntary control of the use of that substance.

Definition of TermsVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 Real-time living: living in your reality; it
is using the Internet (and other
technologies) in a way that doesn’t
overwhelm or consume your life

The Dark Side of the InternetVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 People can become addicted to the use of
the Internet.
 There’s the risk of social isolation and
withdrawal, possible increase in depression,
family separation, marital problems, reduced
job/school performance (it’s hard to do your
job/study if you’re spending four hours a day
surfing the Internet!).

Internet: Pros and ConsVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 It’s quick and easy to
access
 It’s relatively
inexpensive.
 It’s available anytime,
day and night.
 You can buy or
download things not
available elsewhere
 Sometimes you wait forever
to download information.
 The Internet can still be a
nightmare to navigate, even
with the new and improved
search engines.
 The increasing user traffic
can slow the electronic
highway to a virtual parking
lot.
 There is plenty of annoying
electronic junk mail (Spam).

Internet: Pros and ConsVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 You can shop for things and
invest from the comfort of
your home.
 It’s intellectually stimulating.
 It can change your mood
and make you feel good.
 You can an communicate
with friends, family and for
business.
 Some people can become
addicted.
 There is not currently
adequate protection for
children who are online.
 When you are online, you
are not doing other important
things
 It can negatively affect
marriages and relationships.

The Nature of AddictionVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 The two most common effects of
addiction are:
• Powerlessness and
• Unmanageability.
 The same addictive phenomenon of
“tolerance” that occurs with drug and
alcohol addiction also occurs in Internet
addiction.

ToleranceVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 “The psychological dependence that
occurs when someone becomes
habituate (tolerant) to a behavior or
substance is very powerful.”
 Many people, for whom the Internet use
has become unmanageable, report that
the Internet has taken a central and
dysfunctional position in their lives.

What kinds of behaviors are
potentially addictive?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
– Work
– Sex
– Gambling
– Food
– Exercise
– Shopping
– Television
– Computers
– The Internet
– Drugs
– Alcohol

Why is Internet use soooo
addictive? Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N.
Greenfield, Ph.D. 1999. New Harbinger Publications.
 Everyone likes to experience pleasurable things and
to avoid unpleasant ones.
 Normal life can seem very uninteresting and boring
compared with the excitement that is produced by an
addiction.
 Many addictions begin as an escape from boredom.
 Addiction starts out to be the “solution” for a problem
(like boredom or some other negative feeling/thought
such as emotional pain), and eventually becomes,
itself, a much bigger problem that the original one.

DenialVirtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 “What problem? I don’t have a
problem!”
 Denial is a psychological defense
mechanism that makes it possible to
“not see” that a problem (addiction) is
clearly a big problem in one’s life.
 Denial is present (to a greater or lesser
extent) in all addictions.

What makes the Internet so
attractive?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
The Virtual World of the Internet is like
nothing else. Why?
– It is stimulating (produces a “high”).
– 24 hour-a-day accessibility
– It is intense! (It creates a sense of power, exhilaration and
intensity. It provides instant and anonymous intimacy.)
– Time disappears (dissociation).
– Anonymity (You can be anyone you create. 35-50% of Internet
users are lying about themselves!)

What makes the Internet so
attractive?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
The Virtual World of the Internet is like
nothing else. Why?
– Dis-inhibition (Social norms can be ignored without negative
consequences.)
– Instant Intimacy with no accountability.
– Ease of access/comfort of access
– Infinite (never ending: “incomplete Gestalts”)
– Interactive (You can be both participant and observer.)
– Hypnotic (some preliminary evidence show that staring at a
monitor can induce a form of hypnotic trance.)

Are YOU addicted?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 Do you find yourself spending all your
time alone with your computer?
 Has your life begun to become
unmanageable because of your Internet
use?
 Do you feel powerless to stop or cut
down your use?

Are YOU addicted?Virtual Addiction: Help for Netheads, Cyberfreaks, and Those Who Love Them by David N. Greenfield, Ph.D. 1999. New Harbinger
Publications.
 Use the following questions to evaluate
whether or not you are experiencing an
addiction.
– Does a substance or behavior elicit a clear change
in your mood? And is that substance or behavior
later sought and utilized to achieve its mood-
altering effects?
– Does ingesting the substance or performing the
behavior interfere with your life in any way, shape
or form? That is, does it have a negative impact
on your work, school, family, friends, relationships,
etc.?

What is Internet Addiction?
David Greenfield. P. 55)
The Seven Critical Signs of Internet
Addiction:
1. You spend many hours online, often
neglecting or in place of other crucial areas in
your life (the more hours spent online, the more
likely it is that you’ll be addicted).

Addiction:
2. Your friends and loved ones think you have a
problem with your Internet use (the more people
who think you have a problem, the greater the
chance that you’re addicted).

Addiction:
3. Your age matters – the younger you are, the
greater the likelihood you’ll be addicted (you are
more likely to be addicted if you’re in your
twenties).

Addiction:
4. You’ve had serious negative consequences
from your Internet use. (Missing class, low grades
from lack of studying, etc.)

Addiction:
5. You perceive your Internet experience as
intensely intimate.

Addiction:
6. You keep the amount of time you sepnd online
a secret.

Addiction:
7. You CAN’T WAIT to get on the computer or
Internet on a regular, even daily, basis.
If all 7 criteria are true of you, there’s a very high
likelihood that you are Internet addicted or at
least seriously abusing the Internet.

There are 12 Warning Signs that you may be too
involved with the Internet. If you can answer yes
to between three and five of them, then it would
be a very good idea to take a look at the time and
energy you are spending online.
If you answer positively to six or more, you may
have a more serious problem.

There are 12 Warning Signs that you may be too
involved with the Internet. If you can answer yes
to between three and five of them, then it would
be a very good idea to take a look at the time and
energy you are spending online. (Greenfield p.57)
If you answer positively to six or more, you may
have a more serious problem.

(Griffiths pp. 3-4)
What is the established criteria for all
addictions?
Salience: the particular activity becomes the
most important activity in someone’s life and
dominates that person’s thinking (preoccupations
and cognitive distortions), feelings (cravings) and
behavior (deterioration of socialized behavior).
For instance, even if not actually engaged in the
behavior, the person will be thinking about the
next time he or she will be.

addictions?
Mood modification: subjective experiences
produced by doing/using the addictive
behavior/substance: e.g., a coping strategy that
produces a “buzz” or “high” or else a
tranquillizing feeling of “escape” or “numbing”.
People use the same activity or substance to
achieve different effects at different times.

addictions?
Tolerance
Withdrawal
Conflict in interpersonal relationships
Relapse

Who Is at Risk of Becoming
Addicted?
 (Nearly) Everyone
 With the “right” circumstances and painful
life experiences, nearly anyone could
become addicted to a substance or a
behavior.
Many people struggle with an
addiction…many with several.
 Since many addictions are known only to
the individual, they are not apparent to
other people.

What is Alcohol Addiction?
ALCOHOL/DRUGS/SUBSTANCES:
 Once it was thought that a person was a drug addict
or alcoholic only if he needed the drug daily, or if he
went through withdrawal symptoms (vomiting,
seizures, cramps, death) when he abruptly stopped
using the substance. It was thought that alcoholics
and drug addicts were unemployed, poor, and from
the inner city.
 These are misconceptions. Many drug addicts do
not use drugs or alcohol daily and do not experience
physical withdrawal when they stop using. The
majority of addicted people are employed and
appear to be functioning normally.

http://www.getcured.com/addict.htm
 Another former misconception dealt with the
differences between physical and psychological
addiction.
 Physical addiction was thought to be the
determining factor in addiction, and little attention
was paid to psychological addiction.
 It is now known that all addictions are
characterized by physical and psychological
changes.
 Addiction is far more than physical or psychological
dependency: it is a primary disease.

Why doesn’t he/she just stop?!
 A nonuser or casual alcohol/drug user may
have difficulty understanding why addicts
don't just stop.
 Use and abuse of psychoactive (mood-
altering) drugs seem to be voluntary;
addiction seems to be characterized by
involuntary, compulsive use.
 In most cases, drug addicts don't stop
because they are addicted. They cannot
stop on their own.

What Causes Addiction?
 There has been controversy over the cause
of addiction. Historically, it was thought that
addiction was caused by lack of willpower, by
poverty, moral weakness, mental illness,
genetics, family socialization, anti-social
personalities, and societal problems.
 Some scientists believe drug addiction is a
disease, although the evidence to support
this theory is weak.

 The Drug: Some drugs are more
addictive than others. This is due to the
pharmacology of the substance, and
how it affects the mood of the user.

 The Addict:
– People who have low self-concepts, who feel bad about
themselves, have a higher rate of addiction.
– People with low self-concepts use psychoactive substances
either to enhance or create pleasure in their lives, or to
decrease the constant emotional pain they live with.
– The better a person feels about himself, the less likely he will
be to use or abuse psychoactive substances.
– A society that has easy access to drugs, that has a
population that is "addiction-prone" due to genetics or
emotional pain, and that has pro-use or unclear norms, is a
society prone to addiction.

 The Environment: In our biochemical
society, we hear mixed messages about
the use of psychoactive drugs. Some,
such as alcohol and tobacco, are
accepted, while use of hard drugs is
condemned. Some drug use is
glamorized in the media. All of this
makes it easier for people to accept
drug use as "normal".

The Cycle of Addiction
How it Happens
 No one wants to be a drug
addict or alcoholic, but this
doesn't stop people from
getting addicted.
 The most commonly asked
question is simply - how?
How could my son, daughter,
father, sister, or brother
become a liar, a thief,
someone who cannot be
trusted? How could this
happen? And why won't they
stop?

Drug Addiction At Its Roots
 The first thing you must
understand about
addiction is that mind-
altering drugs are
basically painkillers.
For drugs to be
attractive to a person,
there must first be some
underlying unhappiness,
sense of hopelessness,
or physical pain.

 Drug addiction follows
a cycle like this:
 A person has some problem,
sense of unhappiness or
hopelessness, or physical
discomfort. It could be a
teenager experiencing his
first romantic rejection, or a
grandmother with arthritis, or
it could be a man in his prime,
wondering why he keeps
failing on the job. Or it could
be someone at any age in
between.

What is the underlying dynamic to
addiction?
 People who turn to drugs to relieve their
emotional pain are most often people who
have not learned how to “sit with”
(tolerate) their painful feelings (anger,
sadness, loss, fear, embarrassment, etc).
 Emotional maturity is about learning to “sit
with” one’s feelings…and in doing so, putting
“time” between “impulse and action”
 The “time” allows one to choose how to deal
with one’s negative emotions in a constructive
way.

 This person drinks or
tries drugs. The alcohol
or drugs APPEAR to
solve his problem. He
feels better. Because
he now SEEMS better
able to deal with life, the
drugs become valuable
to him.

 The person gradually
increases his usage of his
drug of choice. He is then
trapped. Whatever problem
he was initially trying to solve
by using drugs or alcohol
fades from memory. At this
point, all he can think about
is getting and using drugs.
He loses the ability to control
his usage and disregards the
horrible consequences of his
addiction.

 The addict will now
attempt to withhold the
fact of his drug use from
friends and family
members. He will begin
to suffer the effects of
his own dishonesty and
guilt. He may become
withdrawn and difficult
to reason with. He may
behave strangely.

 The more he drinks and
uses drugs, the more
guilty he will feel, and the
more depressed he will
become. He will sacrifice
his personal integrity,
possibly lying and stealing
to finance his drinking or
drug habit. His
relationships with friends
and family and his job
performance will go
drastically downhill.

Addiction and Tolerance
 The drugs and alcohol are
now the most important thing
in his life. He has thrown
away his job, his life-savings,
his dreams and ambitions, all
in an effort to maintain the
painkilling and emotion killing
effects he once obtained from
the drugs. But ironically, his
ability to get "high" from the
alcohol or drugs gradually
decreases as his body adapts
to the presence of foreign
chemicals. He must take more
and more, and he now has to
have them to be able to
function at all.

 As he continues to drink
or use drugs, his body
continues to adapt to the
presence of the drugs.
This is when the newly
created addict begins to
experience drug cravings.
He will experience an
overwhelming obsession
with getting and using his
drugs, and will do
anything to avoid the pain
of withdrawing from them.

 He has crossed
an invisible and
intangible line.
He is now a drug
addict or
alcoholic.

Progression of Addiction
 Whether he wants to
stop or not, he is now
trapped. By now, the
drugs he abuses will
have changed him
both physically and
mentally.

Personality Changes
Long-term
addiction can
cause one's
personality to
change. This is
called the
Biochemical
Personality. Some
of the
characteristics are:
 Mood swings
 Unreliable. Unable to finish
projects.
 Unexpressed resentment and
secret hatreds.
 Dishonesty. Lies to family,
friends, employers.
 Withdraws from those who
love him. Isolates self.
 May appear chronically
depressed.
 May begin stealing from
family and friends. (Drug/
alcohol addiction)

Personality Changes
Addicts cannot stop
using drugs for
two reasons.
These are:
 Cravings caused by drug
residues which remain in
the body.
 The Biochemical
Personality caused by
drugs and the lifestyle of
the addict.

Bio-Chemical Aspects of Addiction
and Drug Cravinghttp://www.getcured.com/addict.htm
 When a person
continuously drinks or
uses drugs, his body
becomes supersaturated
with metabolites (the
chemicals the body
converts the drugs or
alcohol into). These
metabolites, although
removed rapidly from most
bodily tissues, may
become trapped in the
fatty tissues and remain
there for years.

Bio-Chemical Aspects of Addiction
and Drug Cravinghttp://www.getcured.com/addict.htm
 Presence of these metabolites in the blood, even in
microscopic amounts, cause the brain to react as if
the addict were withdrawing from the drug.
 Receptor sites in brain cells that have adapted to
large amounts of the drug metabolite are now forced
to deal with having only a small amount of the drug
metabolite available.
 The brain "requests" the addict to give it more of the
drug. This is called drug craving. The only way to
end this is to take more drugs or drink more, and the
cycle begins all over again.

Facts about Drinking
(Source: Internet)
 It causes more deaths than any other drug (about 200,000
per year).
 It is responsible for 70% of drownings and chokings.
 It is involved in 50% of all “freak accidents.”
 It causes some 27,000 deaths a year by liver disease
 30% of all suicides are alcohol related
 20% of all airplane car crashes are alcohol related.
 50% of all murders are drunk when they kill.
 50% of all fire deaths are alcohol related.

(Source: Internet)
 It causes about a third of all traffic deaths. (It
would be higher, if blood tests were given to the
dead, too.)
Statistics based on US Govt. reports
 It leads to drug addiction (18 million in the USA
= 8.5% of the population).
 It is involved in both spouse and child abuse.
 It contributes to mental and physical diseases.
 45% of the homeless are alcoholics.
 It causes 500,000 injuries per year.

(Source: Internet)
 1 in 10 social drinkers will become addicts. (Would you
get on an airplane if there was a 10% chance it would
crash?)
 Alcohol is the number three health problem (in the
US).
 Alcohol results in ½ million hospital admissions.
 Alcohol impairs the function of vital organs.
 Alcohol causes liver diseases.
 It contributes to heart attacks.
 It increases the chances of cancer 3-6 times.
 It is the number three cause of birth defects.
 It can cause insanity.

Facts about Smoking(based on US Brands) (Source:
Internet:
http://www.realtruth.org/articles/0201ttas.html?gclid=CLzA5tPp7IQCFQNjDgodmGnHmQ
and
http://www.rgj.com/news/printstory.php?id=106481 )
 Clinical data studies tend to confirm the
relationship between heavy and prolonged
tobacco smoking and incidence of lung cancer
(this was known in 1953).”
 • “Tobacco companies put ammonia in
cigarettes which makes your brain absorb more
nicotine than it normally would”
(www.thetruth.com).
 • “[Other] additives are used to make cigarettes
that provide high levels of ‘free' nicotine which
increases the addictive ‘kick' of the nicotine.)”

Internet:
and
 Research has proven that teens become more
quickly addicted to cigarettes (within four
weeks of their first cigarette) than do adults.
 It takes about two years for the average adult
smoker to become fully addicted.
 It also takes less time for teens to experience
withdrawal symptoms when trying to quit
(usually within hours of their last cigarette).

Internet:
and
 Tobacco companies know that nicotine
changes your brain so, eventually, your brain
can't function normally without it”
(Brain/nicotine: Tobacco: Biology and Politics,
Stanton A. Glantz, Ph.D., 1992).
 • “According to a…report issued by the Office
of the Surgeon General, 400,000 adults die
every year from smoking-related illnesses,
making smoking the number one cause of
preventable disease and death in the nation”
(www.sciencefriday.com).”

Internet:
and
 “Many smokers think that ‘light' cigarettes are
safer than regular cigarettes, and that by
smoking ‘light' cigarettes they will inhale fewer
cancer-causing chemicals, or less nicotine.
 B.C.'s [British Columbia Ministry of Health] new
smoking tests have shown how wrong this
belief can be.
 The reports filed by the tobacco companies
show that light cigarettes are likely to deliver as
many (or more) poisons or toxins to smokers as
regular cigarettes” (Nov. 1998).

Internet:
and
 “In addition to tobacco, which contains nicotine…599
ingredients have been identified in tobacco industry
documents as being added to tobacco in the
manufacturing of cigarettes by the five major American
cigarette manufacturing companies.
 While some of these chemicals, such as sugars, vanilla
extract, prune juice, and vinegar, are generally
recognized as safe when used in food products, all
produce numerous additional chemical compounds when
burned. None, probably, is more deadly than nicotine.”
(www.drugs.indiana.edu).

The Cycle of Addiction

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