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Encyclopedia > Addiction
Heroin bottle
Heroin bottle

Addiction, as a word, is a noun which in modern sense was first attested in 1906, in reference to opium (there is an isolated instance from 1779, with ref. to tobacco). The first use of the adjective addict (with the meaning of "delivered, devoted") was in 1529 and comes from Latin addictus, pp. of addicere ("deliver, yield, devote," from ad-, "to" + dicere, "say, declare").[1] Image File history File links Broom_icon. ... Image File history File links Merge-arrow. ... Drug addiction, or dependency is the compulsive use of drugs, to the point where the user has no effective choice but to continue use. ... Image File history File links Download high resolution version (539x790, 120 KB) Summary Self-made photo of pre-war Heroin bottle, originally containing 5 grams of Heroin substance Licensing File history Legend: (cur) = this is the current file, (del) = delete this old version, (rev) = revert to this old version. ... Image File history File links Download high resolution version (539x790, 120 KB) Summary Self-made photo of pre-war Heroin bottle, originally containing 5 grams of Heroin substance Licensing File history Legend: (cur) = this is the current file, (del) = delete this old version, (rev) = revert to this old version. ... For other uses, see Heroin (disambiguation). ... This article is about the drug. ... 1779 was a common year starting on Friday (see link for calendar). ... Events April 22 - Treaty of Saragossa divides the eastern hemisphere between Spain and Portugal, stipulating that the dividing line should lie 297. ...


Addiction was a term used to describe a devotion, attachment, dedication, inclination, etc. Nowadays, however, the term addiction is used to describe a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to the individual's health, mental state or social life. The term is often reserved for drug addictions but it is sometimes applied to other compulsions, such as problem gambling, and compulsive overeating. Factors that have been suggested as causes of addiction include genetic, biological/pharmacological and social factors. For other things named OCD, see OCD (disambiguation). ... This article or section is not written in the formal tone expected of an encyclopedia article. ... Problem gambling is an urge to gamble despite harmful negative consequences or a desire to stop. ... Binge eating disorder is a medical syndrome in which, according to currently accepted definitions, people: feel their eating is out of control; eat what most people would think is an unusually large amount of food; eat much more quickly than usual during binge episodes; eat until so full they are... This article is about the general scientific term. ... For the song by Girls Aloud see Biology (song) Biology studies the variety of life (clockwise from top-left) E. coli, tree fern, gazelle, Goliath beetle Biology (from Greek: βίος, bio, life; and λόγος, logos, speech lit. ... Pharmacology (in Greek: pharmakon (φάρμακον) meaning drug, and lego (λέγω) to tell (about)) is the study of how drugs interact with living organisms to produce a change in function. ... Sociology (from Latin: socius, companion; and the suffix -ology, the study of, from Greek λόγος, lógos, knowledge [1]) is the systematic and scientific study of society, including patterns of social relationships, social action, and culture[2]. Areas studied in sociology can range from the analysis of brief contacts between anonymous...


Decades ago addiction was a pharmacological term that clearly referred to the use of a tolerance-inducing drug in sufficient quantity as to cause tolerance (the requirement that greater dosages of a given drug be used to produce an identical effect as time passes). With that definition, humans (and indeed all mammals) can become addicted to various drugs quickly. Almost at the same time, a lay definition of addiction developed. This definition referred to individuals who continued to use a given drug despite their own best interest. This latter definition is now thought of as a disease state by the medical community. Pharmacology (in Greek: pharmacon is drug, and logos is science) is the study of how chemical substances interfere with living systems. ...


Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR). Terminology has become quite complicated in the field. To wit, pharmacologists continue to speak of addiction from a physiologic standpoint (some call this a physical dependence); psychiatrists refer to the disease state as dependence; most other physicians refer to the disease as addiction. The field of psychiatry is now considering, as they move from DSM-IV to DSM-V, transitioning from "dependence" to "addiction" as terminology for the disease state. The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association. ...


The medical community now makes a careful theoretical distinction between physical dependence (characterized by symptoms of withdrawal) and psychological dependence (or simply addiction). Addiction is now narrowly defined as "uncontrolled, compulsive use"; if there is no harm being suffered by, or damage done to, the patient or another party, then clinically it may be considered compulsive, but to the definition of some it is not categorized as "addiction". In practice, the two kinds of addiction are not always easy to distinguish. Addictions often have both physical and psychological components. Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...


There is also a lesser known situation called pseudo-addiction.[2] (Weissman and Haddox, 1989) A patient will exhibit drug-seeking behavior reminiscent of psychological addiction, but they tend to have genuine pain or other symptoms that have been undertreated. Unlike true psychological addiction, these behaviors tend to stop when the pain is adequately treated.


The obsolete term physical addiction is deprecated, because of its connotations. In modern pain management with opioids physical dependence is nearly universal. While opiates are essential in the treatment of acute pain, the benefit of this class of medication in chronic pain is not well proven. Clearly, there are those who would not function well without opiate treatment; on the other hand, many states are noting significant increases in non-intentional deaths related to opiate use. High-quality, long-term studies are needed to better delineate the risks and benefits of chronic opiate use.


Not all doctors agree on what addiction or dependency is. Traditionally, addiction has been defined as being possible only to a psychoactive substance (for example alcohol, tobacco and other drugs) which ingested cross the blood-brain barrier, altering the natural chemical behavior of the brain temporarily. However, "Studies on phenomenology, family history, and response to treatment suggest that intermittent explosive disorder, kleptomania, pathological gambling, pyromania, and trichotillomania may be related to mood disorders, alcohol and psychoactive substance abuse, and anxiety disorders (especially obsessive-compulsive disorder).[3] Alcoholism is the consumption of, or preoccupation with, alcoholic beverages to the extent that this behavior interferes with the drinkers normal personal, family, social, or work life, and may lead to physical or mental harm. ... The cigarette is the most common method of smoking tobacco. ... Drug addiction, or dependency is the compulsive use of drugs, to the point where the user has no effective choice but to continue use. ... The blood-brain barrier (BBB) is a membranic structure that acts primarily to protect the brain from chemicals in the blood, while still allowing essential metabolic function. ... This article is about a psychiatric disorder. ... Kleptomania (Greek: κλέπτειν, kleptein, to steal, μανία, mania) is an inability or great difficulty in resisting impulses of stealing. ... Pathological gambling, as defined by American Psychiatric Association is an impulse control disorder associated with gambling. ... Property damage caused by fire Pyromania is an obsession with fire and starting fires in an intentional fashion. ... Trichotillomania (TTM), or trich as it is commonly known, is an impulse control disorder characterized by the repeated urge to pull out scalp hair, eyelashes, facial hair, nose hair, pubic hair, eyebrows or other body hair. ... A mood disorder is a condition where the prevailing emotional mood is distorted or inappropriate to the circumstances. ... Also see Alcoholism and Drug addiction. ... Anxiety disorder is a blanket term covering several different forms of fear, phobia and nervous condition, that come on suddenly and prevent pursuing normal daily routines including: general anxiety disorder social anxiety, sometimes known as social phobia or social anxiety disorder (SAD) specific phobias agoraphobia claustrophobia panic disorder separation anxiety...


It is generally accepted that addiction is a disease, a state of physiological or psychological dependence or devotion to something manifesting as a condition in which medically significant symptoms liable to have a damaging effect are present.[4]


Many people, both psychology professionals and laypersons, now feel that there should be accommodation made to include psychological dependency on such things as gambling, food, sex, pornography, computers, work, exercise, cutting, shopping, and religion[5] so these behaviours count as diseases as well and don't cause guilt, shame, fear, hopelessness, failure, rejection,anxiety, or humiliation symptoms associated with, among other medical conditions, depression[6],epilepsy,[7] and hyperreligiosity.[8] In depression related to religious addiction "The religious addict seeks to avoid pain and overcome shame by becoming involved in a belief system which offers security through its rigidity and its absolute values."[9] While religion and spirituality may play a key role in psychotherapeutic support and recovery, it can also be a source of pain, guilt and exclusion, and religious themes may also play a negative role in psychopathology.[10] Although, the above mentioned are things or tasks which, when used or performed, do not fit into the traditional view of addiction and may be better defined as an obsessive-compulsive disorder,withdrawal symptoms may occur with abatement of such behaviors. It is said by those who adhere to a traditionalist view that these withdrawal-like symptoms are not strictly reflective of an addiction, but rather of a behavioral disorder. However, understanding of neural science, the brain, the nervous system, human behavior, and affective disorders has revealed "the impact of molecular biology in the mechanisms underlying developmental processes and in the pathogenesis of disease".[11] The use of thyroid hormones as an effective adjunct treatment for affective disorders has been studied over the past three decades and has been confirmed repeatedly.[12] In spite of traditionalist protests and warnings that overextension of definitions may cause the wrong treatment to be used (thus failing the person with the behavioral problem), popular media, and some members of the field, do represent the aforementioned behavioral examples as addictions. Gamble redirects here. ... Satyriasis redirects here. ... Pornography addiction is a hypothesized form of sexual addiction defined by its proponents as a condition resulting from the overuse or abuse of pornography. ... Youth spending seemingly endless hours leveling up lumber skills in RuneScape Computer addiction is an obsessive addiction to computer use. ... A workaholic is a person addicted to work. ... Shopping is the examining of goods or services from retailers with intent to purchase. ... “Guilty” redirects here. ... For other uses, see Shame (disambiguation). ... For other uses, see Fear (disambiguation). ... Look up despair in Wiktionary, the free dictionary. ... Fail and Phail redirect here. ... Rejection may mean: In psychology, rejection is an emotion felt by most humans (and possibly other higher animals) when another person denies a personal request, particularly if it is an emotional advance. ... This article is about state anxiety. ... Etymology: Late Latin humiliatus, past participle of humiliare, from Latin humilis low. ... On the Threshold of Eternity. ... Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ... This page is a candidate for speedy deletion, because: If you disagree with its speedy deletion, please explain why on its talk page or at Wikipedia:Speedy deletions. ... The affective spectrum is a grouping of related psychiatric and medical disorders which may accompany bipolar, unipolar, and schizoaffective disorders at statistically higher rates than would normally be expected. ...


Recently, some have modeled addiction using the tools of Economics, for instance, by calculating the elasticity of addictive goods and determining to what extent present income and consumption has on future consumption.[13] Face-to-face trading interactions on the New York Stock Exchange trading floor. ... In economics, elasticity is the ratio of the proportional change in one variable with respect to proportional change in another variable. ... Income, generally defined, is the money that is received as a result of the normal business activities of an individual or a business. ... In economics, consumption refers to the final use of goods and services to provide utility. ...

Contents

Varied forms of addiction

Image File history File links Question_book-3. ...

Physical dependency

Physical dependence on a substance is defined by the appearance of characteristic withdrawal symptoms when the substance is suddenly discontinued. Opiates, benzodiazepines, barbiturates, alcohol and nicotine induce physical dependence. On the other hand, some categories of substances share this property and are still not considered addictive: cortisone, beta-blockers and most antidepressants are examples. So, while physical dependency can be a major factor in the psychology of addiction and most often becomes a primary motivator in the continuation of an addiction, the initial primary attribution of an addictive substance is usually its ability to induce pleasure, although with continued use the goal is not so much to induce pleasure as it is to relieve the anxiety caused by the absence of a given addictive substance, causing it to become used compulsively. An example of this is nicotine; A cigarette can be described as pleasurable, but is in fact fulfilling the physical addiction of the user, and therefore, is achieving pleasurable feelings relative to his/her previous state of physical withdrawal. Further, the physical dependency of the nicotine addict on the substance itself becomes an overwhelming factor in the continuation of use. Physical dependence refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation. ... Withdrawal refers to the characteristic signs and symptoms that appear when a drug that causes a physical dependency is regularly used for a long time and then suddenly discontinued or decreased in dosage. ... An opioid is any agent that binds to opioid receptors found principally in the central nervous system and gastrointestinal tract. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ... Barbiturates are drugs that acts as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... This article does not cite any references or sources. ... This article is about the chemical compound. ... Cortisone (IPA:ˈkôrtəˌsōn) is a steroid hormone. ... Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... An antidepressant is a medication used primarily in the treatment of clinical depression. ... This article is about the chemical compound. ...


Some substances induce physical dependence or physiological tolerance - but not addiction - for example many laxatives, which are not psychoactive; nasal decongestants, which can cause rebound congestion if used for more than a few days in a row; and some antidepressants, most notably venlafaxine, paroxetine and sertraline, as they have quite short half-lives, so stopping them abruptly causes a more rapid change in the neurotransmitter balance in the brain than many other antidepressants. Many non-addictive prescription drugs should not be suddenly stopped, so a doctor should be consulted before abruptly discontinuing them. In physiology, tolerance occurs when an organism builds up a resistance to the effects of a substance after repeated exposure. ... Laxatives (or purgatives) are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation. ... A decongestant is a broad class of drugs designed to symptomatically treat ailments affecting the respiratory system. ... An antidepressant is a medication used primarily in the treatment of clinical depression. ... Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ... Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ... Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... Half-Life For a quantity subject to exponential decay, the half-life is the time required for the quantity to fall to half of its initial value. ...


The speed with which a given individual becomes addicted to various substances varies with the substance, the frequency of use, the means of ingestion, the intensity of pleasure or euphoria, and the individual's genetic and psychological susceptibility. Some people may exhibit alcoholic tendencies from the moment of first intoxication, while most people can drink socially without ever becoming addicted. Opioid dependent individuals have different responses to even low doses of opioids than the majority of people, although this may be due to a variety of other factors, as opioid use heavily stimulates pleasure-inducing neurotransmitters in the brain. Nonetheless, because of these variations, in addition to the adoption and twin studies that have been well replicated, much of the medical community is satisfied that addiction is in part genetically moderated. That is, one's genetic makeup may regulate how susceptible one is to a substance and how easily one may become psychologically attached to a pleasurable routine.


Eating disorders are complicated pathological mental illnesses and thus are not the same as addictions described in this article. Eating disorders, which some argue are not addictions at all, are driven by a multitude of factors, most of which are highly different than the factors behind addictions described in this article. Eating disorders are a group of mental disorders that interfere with normal food consumption. ...


Psychological dependency

Psychological dependency is a dependency of the mind, and leads to psychological withdrawal symptoms (such as cravings, irritability, insomnia, depression, anorexia, etc). Addiction can in theory be derived from any rewarding behaviour, and is believed to be strongly associated with the dopaminergic system of the brain's reward system (as in the case of cocaine and amphetamines). Some claim that it is a habitual means to avoid undesired activity, but typically it is only so to a clinical level in individuals who have emotional, social, or psychological dysfunctions (psychological addiction is defined as such), replacing normal positive stimuli not otherwise attained (see Rat Park). For the 1983 horror film, see The Hunger. ... Irritability is an excessive response to stimuli. ... This article is about the sleeping disorder. ... For other uses, see Depression. ... This article is about the symptom of decreased appetite. ... This article or section is in need of attention from an expert on the subject. ... For other uses, see Brain (disambiguation). ... A reward is something that an animal will work to obtain, for example, food. ... For other uses, see Cocaine (disambiguation). ... Amphetamine is a synthetic drug originally developed (and still used) as an appetite suppressant. ... Habits are automatic routines of behavior that are repeated regularly, without thinking. ... A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ... Dr. Bruce K. Alexander Rat Park was a study into drug addiction conducted in the 1970s by American psychologist Bruce K. Alexander at Simon Fraser University in British Columbia, Canada. ...


It is considered possible to be both psychologically and physically dependent at the same time. Some doctors make little distinction between the two types of addiction, since the result, substance abuse, is the same. However, the cause and characteristics of each of the two types of addiction is quite different, as is the type of treatment preferred. Also see Alcoholism and Drug addiction. ...


Psychological dependence does not have to be limited only to substances; even activities and behavioural patterns can be considered addictions, if they become uncontrollable, e.g. gambling, Internet addiction, computer addiction, sexual addiction / pornography addiction, reading, eating, self-harm, vandalism or work addiction. Gamble redirects here. ... Computer addiction is a field of psychotherapy that studies impacts of extensive or obsessive computer use on the user/addict. ... Youth spending seemingly endless hours leveling up lumber skills in RuneScape Computer addiction is an obsessive addiction to computer use. ... Sexual addiction (sexual compulsion)—a postulated form of psychological addiction—is a hotly debated topic with numerous critics and evidence on both sides of the debate. ... Pornography addiction is a hypothesized form of sexual addiction defined by its proponents as a condition resulting from the overuse or abuse of pornography. ... This article is about the learning activity. ... An eating disorder is a complex compulsion to eat, or not eat, in a way which disturbs physical and mental health. ... Self-harm (SH) is deliberate injury to ones own body. ... Vandalism is the conspicuous defacement or destruction of a structure, a symbol or anything else that goes against the will of the owner/governing body. ... A workaholic is a person addicted to work. ...


Addiction and drug control legislation

Most countries have legislation which brings various drugs and drug-like substances under the control of licensing systems. Typically this legislation covers any or all of the opiates, amphetamines, cannabinoids, cocaine, barbiturates, hallucinogens (tryptamines, LSD, phencyclidine(PCP), psilocybin) and a variety of more modern synthetic drugs, and unlicensed production, supply or possession may be a criminal offense. Image File history File links Question_book-3. ... Amphetamine is a synthetic drug originally developed (and still used) as an appetite suppressant. ... Cannabinoids are a group of terpenophenolic compounds present in Cannabis (Cannabis sativa L). ... For other uses, see Cocaine (disambiguation). ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Hallucinogenic drug - drugs that can alter sensory perceptions. ... Tryptamine (3-(2-aminoethyl)indole) is a monoamine compound that is widespread in nature. ... Lysergic acid diethylamide, commonly called LSD, LSD-25, or acid. ... “Angel Dust” redirects here. ... PCP may refer to: In politics: Partido Comunista del Peru, also known as Shining Path Partido Comunista Paraguayo, Paraguayan Communist Party Partido Comunista Peruano, Peruvian Communist Party Partido Comunista Português, Portuguese Communist Party Partido Comunista Puertorriqueño, Puerto Rican Communist Party Partit Català Proletari, Proletarian Catalan Party In science... Psilocybin (also known as psilocybine) is a psychedelic alkaloid of the tryptamine family, found in psilocybin mushrooms. ...


Usually, however, drug classification under such legislation is not related simply to addictiveness. The substances covered often have very different addictive properties. Some are highly prone to cause physical dependency, whilst others rarely cause any form of compulsive need whatsoever. Typically nicotine (in the form of tobacco) is regulated extremely loosely, if at all, although it is well-known as one of the most addictive substances ever discovered.


Also, although the legislation may be justifiable on moral grounds to some, it can make addiction or dependency a much more serious issue for the individual. Reliable supplies of a drug become difficult to secure as illegally produced substances may have contaminants. Withdrawal from the substances or associated contaminants can cause additional health issues and the individual becomes vulnerable to both criminal abuse and legal punishment. Criminal elements that can be involved in the profitable trade of such substances can also cause physical harm to users.


Methods of care

Early editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) described addiction as a physical dependency to a substance that resulted in withdrawal symptoms in its absence. Recent editions, including DSM-IV, have moved toward a diagnostic instrument that classifies such conditions as dependency, rather than addiction. The American Society of Addiction Medicine recommends treatment for people with chemical dependency based on patient placement criteria (currently listed in PPC-2), which attempt to match levels of care according to clinical assessments in six areas, including: Due to the epidemic of medical errors, readers are cautioned to be aware that the American Psychiatric Association isnt immune to this. ... The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association. ... This page is a candidate for speedy deletion, because: it is patent nonsense. ...

  • Acute intoxication and/or withdrawal potential
  • Biomedical conditions or complications
  • Emotional/behavioral conditions or complications
  • Treatment acceptance/resistance
  • Relapse potential
  • Recovery environment

Some medical systems, including those of at least 15 states of the United States, refer to an Addiction Severity Index to assess the severity of problems related to substance use. The index assesses problems in six areas: medical, employment/support, alcohol and other drug use, legal, family/social, and psychiatric. Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ... A relapse (etymologically, who falls again) occurs when a person is affected again by a condition that affected them in the past. ...


While addiction or dependency is related to seemingly uncontrollable urges, and arguably could have roots in genetic predispositions, treatment of dependency is conducted by a wide range of medical and allied professionals, including Addiction Medicine specialists, psychiatrists, and appropriately trained nurses, social workers, and counselors. Early treatment of acute withdrawal often includes medical detoxification, which can include doses of anxiolytics or narcotics to reduce symptoms of withdrawal. An experimental drug, ibogaine,[14] is also proposed to treat withdrawal and craving. Alternatives to medical detoxification include acupuncture detoxification. In chronic opiate addiction, a surrogate drug such as methadone is sometimes offered as a form of opiate replacement therapy. But treatment approaches universal focus on the individual's ultimate choice to pursue an alternate course of action. Please wikify (format) this article or section as suggested in the Guide to layout and the Manual of Style. ... Detox, short for detoxification, in general is the removal of toxic substances from the body. ... An anxiolytic is a drug prescribed for the treatment of symptoms of anxiety. ... Ibogaine is an indole alkaloid, a long-acting hallucinogen which has gained attention due to its application in the treatment of opioid addiction and similar addiction syndromes. ... Acupuncture is widely used as an adjunct treatment for drug and alcohol addiction. ... Methadone (Dolophine®, Amidone®, Methadose®, Physeptone®, Heptadon® and many others) is a synthetic opioid, used medically as an analgesic, antitussive and a maintenance anti-addictive for use in patients on opioids. ... Opiate Replacement Therapy (ORT) is the medical procedure of replacing an illegal opiate drug such as heroin with a longer acting but less euphoric opiate such as methadone or buprenorphine. ...


Therapists often classify patients with chemical dependencies as either interested or not interested in changing. Treatments usually involve planning for specific ways to avoid the addictive stimulus, and therapeutic interventions intended to help a client learn healthier ways to find satisfaction. Clinical leaders in recent years have attempted to tailor intervention approaches to specific influences that affect addictive behavior, using therapeutic interviews in an effort to discover factors that led a person to embrace unhealthy, addictive sources of pleasure or relief from pain.

Treatment Modality Matrix
Behavioral Pattern Intervention Goals
Low self-esteem, anxiety, verbal hostility Relationship therapy, client centered approach Increase self esteem, reduce hostility and anxiety
Defective personal constructs, ignorance of interpersonal means Cognitive restructuring including directive and group therapies Insight
Focal anxiety such as fear of crowds Desensitization Change response to same cue
Undesirable behaviors, lacking appropriate behaviors Aversive conditioning, operant conditioning, counter conditioning Eliminate or replace behavior
Lack of information Provide information Have client act on information
Difficult social circumstances Organizational intervention, environmental manipulation, family counseling Remove cause of social difficulty
Poor social performance, rigid interpersonal behavior Sensitivity training, communication training, group therapy Increase interpersonal repertoire, desensitization to group functioning
Grossly bizarre behavior Medical referral Protect from society, prepare for further treatment
Adapted from: Essentials of Clinical Dependency Counseling, Aspen Publishers

From the applied behavior analysis literature and the behavioral psychology literature several evidenced based intervention programs have emerged (1) behavioral maritial therapy (2) community reinforcement approach (3) cue exposure therapy and (4) contingency management strategies.[15][16] In addition, the same author suggest that Social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious. In psychology, self-esteem or self-worth is a persons self-image at an emotional level; circumventing reason and logic. ... Applied Behavior Analysis (ABA) is a systematic process of studying and modifying observable behavior through a manipulation of the environment. ... Behaviorism (or behaviourism) is an approach to psychology based on the proposition that behavior is interesting and worthy of scientific research. ...


Emotionalism is not spirituality:

 Most often ignored is the spiritual aspect of the various difficulties we are working to overcome. There is the awareness of the importance of existence which underlies most addictions. Destructive impulsive expression of excitement and pleasures (as a counteraction to the overload of fear, pain, and distress) is not so much an addiction as it is a trauma induced compulsion. We use the term "addiction" to isolate a problem in order to separate the human aspect of an individual from the adverse behaviour. This causes a temptation to identify with the "darkness of the disease". Therefore, disgust for the difficulty must be turned into compassion for the people involved in order to heal the indiscretions. A positive approach dealing with reorientation to constructive patternws of practice will benefit the fading of distortions. 

Diverse explanations

Several explanations (or "models") have been presented to explain addiction. These divide, more or less, into the models which stress biological or genetic causes for addiction, and those which stress social or purely psychological causes. Of course there are also many models which attempt to see addiction as both a physiological and a psycho-social phenomenon.

  • The disease model of addiction holds that addiction is a disease, coming about as a result of either the impairment of neurochemical or behavioral processes, or of some combination of the two. Within this model, addictive disease is treated by specialists in Addiction Medicine. Within the field of medicine, the American Medical Association, National Association of Social Workers, and American Psychological Association all have policies which are predicated on the theory that addictive processes represent a disease state. Most treatment approaches, as well, are based on the idea that dependencies are behavioral dysfunctions, and, therefore, contain, at least to some extent, elements of physical or mental disease. Organizations such as the American Society of Addiction Medicine believe the research-based evidence for addiction's status as a disease is overwhelming.
  • The genetic model posits a genetic predisposition to certain behaviors. It is frequently noted that certain addictions "run in the family," and while researchers continue to explore the extent of genetic influence, many researchers argue that there is strong evidence that genetic predisposition is often a factor in dependency.
  • The experiential model devised by Stanton Peele argues that addictions occur with regard to experiences generated by various involvements, whether drug-induced or not. This model is in opposition to the disease, genetic, and neurobiological approaches. Among other things, it proposes that addiction is both more temporary or situational than the disease model claims, and is often outgrown through natural processes.
  • The opponent-process model generated by Richard Soloman states that for every psychological event A will be followed by its opposite psychological event B. For example, the pleasure one experiences from heroin is followed by an opponent process of withdrawal, or the terror of jumping out of an airplane is rewarded with intense pleasure when the parachute opens. This model is related to the opponent process color theory. If you look at the color red then quickly look at a gray area you will see green. There are many examples of opponent processes in the nervous system including taste, motor movement, touch, vision, and hearing. Opponent-processes occurring at the sensory level may translate "down-stream" into addictive or habit-forming behavior.
  • The allostatic (stability through change) model generated by George Koob and Michel LeMoal is a modification of the opponent process theory where continued use of a drug leads to a spiralling of uncontrolled use, negative emotional states and withdrawal and a shift into use to new allostatic set point which is lower than that maintained before use of the drug.[17]
  • The cultural model recognizes that the influence of culture is a strong determinant of whether or not individuals fall prey to certain addictions. For example, alcoholism is rare among Saudi Arabians, where obtaining alcohol is difficult and using alcohol is prohibited. In North America, on the other hand, the incidence of gambling addictions soared in the last two decades of the 20th century, mirroring the growth of the gaming industry. Half of all patients diagnosed as alcoholic are born into families where alcohol is used heavily, suggesting that familiar influence, genetic factors, or more likely both, play a role in the development of addiction. What also needs to be noted is that when people don't gain a sense of moderation through their development they can be just as likely, if not more, to abuse substances than people born into alcoholic families.
  • The moral model states that addictions are the result of human weakness, and are defects of character. Those who advance this model do not accept that there is any biological basis for addiction. They often have scant sympathy for people with serious addictions, believing either that a person with greater moral strength could have the force of will to break an addiction, or that the addict demonstrated a great moral failure in the first place by starting the addiction. The moral model is widely applied to dependency on illegal substances, perhaps purely for social or political reasons, but is no longer widely considered to have any therapeutic value. Elements of the moral model, especially a focus on individual choices, have found enduring roles in other approaches to the treatment of dependencies.
  • The habit model proposed by Thomas Szasz questions the very concept of "addiction." He argues that addiction is a metaphor, and that the only reason to make the distinction between habit and addiction "is to persecute somebody."[18] Cf also the life-process model of addiction.
  • Finally, the blended model attempts to consider elements of all other models in developing a therapeutic approach to dependency. It holds that the mechanism of dependency is different for different individuals, and that each case must be considered on its own merits.

The disease model of addiction describes addictions as a biologically based, lifelong disease that involve a loss of control over behavior and requires medical or spiritual treatment for recovery. ... This article is about the medical term. ... Neurochemistry is a branch of neuroscience that is heavily devoted to the study of neurochemicals. ... Behavior (U.S.) or behaviour (U.K.) refers to the actions or reactions of an object or organism, usually in relation to the environment. ... Please wikify (format) this article or section as suggested in the Guide to layout and the Manual of Style. ... The American Medical Association (AMA) is the largest association of medical doctors in the United States. ... The American Psychological Association (APA) is a professional organization representing psychology in the US. It has around 150,000 members and an annual budget of around $70m. ... This page is a candidate for speedy deletion, because: it is patent nonsense. ... This article is about the general scientific term. ... Stanton Peele, J.D., Ph. ... Opponent colors based on experiment. ... For other uses, see Heroin (disambiguation). ... George F. Koob, Ph. ... For other uses, see Culture (disambiguation). ... The Kingdom of Saudi Arabia is a country on the Arabian Peninsula. ... Gamble redirects here. ... This article is about the use of the moral in storytelling. ... Habits are automatic routines of behavior that are repeated regularly, without thinking. ... Szasz redirects here. ... The life-process model of addiction is the view that addiction is not a disease but rather a habitual response and a source of gratification and security that can be understood only in the context of social relationships and experiences. ...

Neurobiological basis

The development of addiction is thought to involve a simultaneous process of 1) increased focus on and engagement in a particular behavior and 2) the attenuation or "shutting down" of other behaviors. For example, under certain experimental circumstances such as social deprivation and boredom, animals allowed the unlimited ability to self-administer certain psychoactive drugs will show such a strong preference that they will forgo food, sleep, and sex for continued access. The neuro-anatomical correlate of this is that the brain regions involved in driving goal-directed behavior grow increasingly selective for particular motivating stimuli and rewards, to the point that the brain regions involved in the inhibition of behavior can no longer effectively send "stop" signals. A good analogy is to imagine flooring the gas pedal in a car with very bad brakes. In this case, the limbic system is thought to be the major "driving force" and the orbitofrontal cortex is the substrate of the top-down inhibition. Image File history File links Question_book-3. ... Deprivation may refer to: Poverty Sleep deprivation This is a disambiguation page: a list of articles associated with the same title. ...


A specific portion of the limbic circuit known as the mesolimbic dopaminergic system is hypothesized to play an important role in translation of motivation to motor behavior- and reward-related learning in particular. It is typically defined as the ventral tegmental area (VTA), the nucleus accumbens, and the bundle of dopamine-containing fibers that are connecting them. This system is commonly implicated in the seeking out and consumption of rewarding stimuli or events, such as sweet-tasting foods or sexual interaction. However, its importance to addiction research goes beyond its role in "natural" motivation: while the specific site or mechanism of action may differ, all known drugs of abuse have the common effect in that they elevate the level of dopamine in the nucleus accumbens. This may happen directly, such as through blockade of the dopamine re-uptake mechanism (see cocaine). It may also happen indirectly, such as through stimulation of the dopamine-containing neurons of the VTA that synapse onto neurons in the accumbens (see opiates). The euphoric effects of drugs of abuse are thought to be a direct result of the acute increase in accumbal dopamine.[19] The mesolimbic pathway is one of the neural pathways in the brain that link the ventral tegmentum in the midbrain to the nucleus accumbens in the limbic system. ... The ventral tegmentum or the ventral tegmental area (VTA) is part of the midbrain, lying close to the substantia nigra and the red nucleus. ... For other uses, see Dopamine (disambiguation). ... For other uses, see Cocaine (disambiguation). ... An opioid is any agent that binds to opioid receptors found principally in the central nervous system and gastrointestinal tract. ...


The human body has a natural tendency to maintain homeostasis, and the central nervous system is no exception. Chronic elevation of dopamine will result in a decrease in the number of dopamine receptors available in a process known as downregulation. The decreased number of receptors changes the permeability of the cell membrane located post-synaptically, such that the post-synaptic neuron is less excitable- i.e.: less able to respond to chemical signaling with an electrical impulse, or action potential. It is hypothesized that this dulling of the responsiveness of the brain's reward pathways contributes to the inability to feel pleasure, known as anhedonia, often observed in addicts. The increased requirement for dopamine to maintain the same electrical activity is the basis of both physiological tolerance and withdrawal associated with addiction. Homeostasis (from Greek: ὅμος, homos, equal; and ιστημι, histemi, to stand lit. ... Transmembrane receptors are integral membrane proteins, which reside and operate typically within a cells plasma membrane, but also in the membranes of some subcellular compartments and organelles. ... Down regulation is the process by which a cell decreases the number of receptors to a given hormone or neurotransmitter to reduce its sensitivity to this molecule. ... A. A schematic view of an idealized action potential illustrates its various phases as the action potential passes a point on a cell membrane. ... In psychology, anhedonia is a patients inability to experience pleasure from normally pleasurable life events such as eating, exercise, and social/sexual interactions. ... In physiology, tolerance occurs when an organism builds up a resistance to the effects of a substance after repeated exposure. ... Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...


Downregulation can be classically conditioned. If a behavior consistently occurs in the same environment or contingently with a particular cue, the brain will adjust to the presence of the conditioned cues by decreasing the number of available receptors in the absence of the behavior. It is thought that many drug overdoses are not the result of a user taking a higher dose than is typical, but rather that the user is administering the same dose in a new environment.


In cases of physical dependency on depressants of the central nervous system such as opioids, barbiturates, or alcohol, the absence of the substance can lead to symptoms of severe physical discomfort. Withdrawal from alcohol or sedatives such as barbiturates or benzodiazepines (valium-family) can result in seizures and even death. By contrast, withdrawal from opioids, which can be extremely uncomfortable, is rarely if ever life-threatening. In cases of dependence and withdrawal, the body has become so dependent on high concentrations of the particular chemical that it has stopped producing its own natural versions (endogenous ligands) and instead produces opposing chemicals. When the addictive substance is withdrawn, the effects of the opposing chemicals can become overwhelming. For example, chronic use of sedatives (alcohol, barbiturates, or benzodiazepines) results in higher chronic levels of stimulating neurotransmitters such as glutamate. Very high levels of glutamate kill nerve cells, a phenomenon called excitatory neurotoxicity. A depressant, referred to in slang as a downer, is a chemical agent that diminishes the function or activity of a specific part of the body. ... A diagram showing the CNS: 1. ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ...


Criticism

Levi Bryant has criticized the term and concept of addiction as counterproductive in psychotherapy as it defines a patient's identity and makes it harder to become a non-addict. "The signifier 'addict' doesn't simply describe what I am, but initiates a way of relating to myself that informs how I relate to others."


A stronger form of criticism comes from Thomas Szasz, who denies that addiction is a psychiatric problem. In many of his works, he argues that addiction is a choice, and that a drug addict is one who simply prefers a socially taboo substance rather than, say, a low risk lifestyle. In Our Right to Drugs, Szasz cites the biography of Malcolm X to corroborate his economic views towards addiction: Malcolm claimed that quitting cigarettes was harder than shaking his heroin addiction. Szasz postulates that humans always have a choice, and it is foolish to call someone an 'addict' just because they prefer a drug induced euphoria to a more popular and socially welcome lifestyle. Therefore, being 'addicted' to a substance is no different from being 'addicted' to a job at which you work everyday. Szasz redirects here. ... Malcolm X, born Malcolm Little, also known as Detroit Red and Al-Hajj Malik El-Shabazz (Omaha, Nebraska, May 19, 1925 – February 21, 1965 in New York City) was a Muslim Minister and National Spokesman for the Nation of Islam. ... For other uses, see Heroin (disambiguation). ... For other uses, see Drug (disambiguation). ... For other uses, see Happiness (disambiguation). ...


Szasz and Bryant are not alone in questioning the standard view of addiction. Professor John Booth Davies at the University of Strathclyde has argued in his book The Myth of Addiction that 'people take drugs because they want to and because it makes sense for them to do so given the choices available' as opposed to the view that 'they are compelled to by the pharmacology of the drugs they take'.[20] He uses an adaptation of attribution theory (what he calls the theory of functional attributions) to argue that the statement 'I am addicted to drugs' is functional, rather than veridical. Stanton Peele has put forward similar views. The University of Strathclyde (Scottish Gaelic: ) is a university in Glasgow, Scotland. ... Attribution theory is a social psychology theory developed by Fritz Heider, Harold Kelley, Edward E. Jones, and Lee Ross. ... Stanton Peele, J.D., Ph. ...


Experimentally, Bruce K. Alexander used the classic experiment of Rat Park to show that 'addicted' behaviour in rats only occurred when the rats had no other options. When other options and behavioural opportunities were put in place, the rats soon showed far more complex behaviours. Dr. Bruce K. Alexander Rat Park was a study into drug addiction conducted in the 1970s by American psychologist Bruce K. Alexander at Simon Fraser University in British Columbia, Canada. ... == Stock Options == wiktionarypar|option}} An option is the right, but not the obligation, to do something. ...


Casual addiction

The word addiction is also sometimes used colloquially to refer to something for which a person has a passion, such as books, chocolate, work, the web, running, or eating. Bibliophilia is the love of books; a bibliophile is a lover of books. ... Chocoholism is a faceitious word refering to an addiction to chocolate. ... A workaholic is a person addicted to work. ... Webaholism is a dependency on the world-wide web (internet) characterized by craving (a strong need to use the internet for web browsing and chatting), loss of control (being unable to stop staying away from the internet despite a desire to do so), loss of interest in everything else. ...


See also

There are a variety of addiction recovery groups and methods other than those that follow the Twelve Steps and Twelve Traditions of Alcoholics Anonymous. ... Please wikify (format) this article or section as suggested in the Guide to layout and the Manual of Style. ... Akrasia, occasionally transliterated as acrasia (from Greek, lacking command (over oneself)) is the state of acting against ones bet. ... Alcoholism is the consumption of, or preoccupation with, alcoholic beverages to the extent that this behavior interferes with the drinkers normal personal, family, social, or work life, and may lead to physical or mental harm. ... Alcohol tolerance refers to a decreased response to the effects of ethanol in alcoholic beverages. ... Codependence (or codependency) is a popular psychology concept popularized by Twelve-Step program advocates. ... Cold turkey is a slang expression describing the actions of a person who gives up a habit or addiction all at once. ... Youth spending seemingly endless hours leveling up lumber skills in RuneScape Computer addiction is an obsessive addiction to computer use. ... The disease model of addiction describes addictions as a biologically based, lifelong disease that involve a loss of control over behavior and requires medical or spiritual treatment for recovery. ... Drug addiction, or dependency is the compulsive use of drugs, to the point where the user has no effective choice but to continue use. ... This article does not cite any references or sources. ... The Drug Intervention Program is a key part of the United Kingdoms strategy for tackling drug abuse[1]. It aims to engage substance misusing individuals involved in the Criminal Justice system in formal addiction treatment, thereby reducing drug related harm and reducing offending behaviour [2]. Introduced in 2003, it... Elvin Morton Jellinek (1890-1963), or more commonly E. Morton Jellinek, was a biostatistician, physiologist, and a researcher into alcoholism. ... Free-Will is a Japanese independent record label founded in 1986. ... In his famous paper Freedom of the Will and the Concept of a Person, Harry Frankfurt explains higher order desires. ... Ibogaine is an indole alkaloid, a long-acting hallucinogen which has gained attention due to its application in the treatment of opioid addiction and similar addiction syndromes. ... Look up junkie, junky in Wiktionary, the free dictionary. ... The life-process model of addiction is the view that addiction is not a disease but rather a habitual response and a source of gratification and security that can be understood only in the context of social relationships and experiences. ... A love-hate relationship is a personal relationship between humans or organizations, or figuratively between a human and an inanimate object, like a computer, a field of study, a body of ideas, or a profession, involving simultaneous or alternating emotions of love and enmity. ... This article is about the chemical compound. ... Problem gambling is an urge to gamble despite harmful negative consequences or a desire to stop. ... This article focuses on repetitive self-injury, not severe self-injury inflicted during psychosis, such as eye enucleation and amputation. ... Self-medication is the use of drugs, sometimes illicit, to treat a perceived or real malady, often of a psychological nature. ... Sexual addiction (sexual compulsion)—a postulated form of psychological addiction—is a hotly debated topic with numerous critics and evidence on both sides of the debate. ... For the food preparation, see Smoking (cooking). ... Taṇhā (Pāli: तण्हा) or Tṛṣṇā (Sanskrit: तृष्णा) means thirst, desire, craving, wanting, longing, yearning. Synonyms: 愛 Cn: ài; Jp: ai; Vi: ái Tibetan: The most basic of these meanings (the literal meaning) is thirst; however, in Buddhism it has a technical meaning that is much broader. ... Treatment Improvement Protocols (TIPs) are a series of best-practice manuals for the treatment of substance use and other related disorders. ... // A Twelve-step program is a set of guiding principles for recovery from addictive, compulsive, or other behavioral problems, originally developed by the fellowship of Alcoholics Anonymous (AA) for recovery from alcoholism. ...

Notes

  1. ^ Harper, Douglas (2001). Addiction (HTML). Online Etymology Dictionary. Retrieved on 2008-03-24.
  2. ^ Weissman, D.E.; J.D. Haddox (1989). "Opioid pseudoaddiction--an iatrogenic syndrome". Pain 36 (3): 363-366. International Association for the Study of Pain. 2710565. Retrieved on 2008-03-24. 
  3. ^ McElroy, S.L.; J.I. Hudson, Hg. Pope Jr, P.E. Keck Jr and H.G. Aizley (1992). "The DSM-III-R impulse control disorders not elsewhere classified: clinical characteristics and relationship to other psychiatric disorders". American Journal of Psychiatry 149: 318-327. American Psychiatric Publishing Inc.. Retrieved on 2008-03-24. 
  4. ^ Summerall, P., Leshner, Dr. A.. (2003). Alcohol, Drugs and the Brain [Audio/Transcript]. The Dana Foundation.
  5. ^ Taylor, C.Z. (March 2002). "Religious Addiction: Obsession with Spirituality". Pastoral Psychology 50 (4): 291-315. Springer Netherlands. doi:10.1023/A:1014074130084. Retrieved on 2008-03-24. 
  6. ^ "Depression". The Columbia Electronic Encyclopedia. (2007). Columbia University Press. Retrieved on 2008-03-24. 
  7. ^ Nowack, W.J. (2006-08-29). Psychiatric Disorders Associated With Epilepsy (HTML). eMedicine Specialities. WebMD. Retrieved on 2008-03-24.
  8. ^ Beck, D.A. (2007). Psychiatric Disorders due to General Medical Conditions (PDF). Department of Psychiatry, University of Missouri-Columbia. Retrieved on 2008-03-24.
  9. ^ Vanderheyden, P.A. (2004). "Religious Addiction: The Subtle Destruction of the Soul". Pastoral Psychology 47 (4): 293-302. Springer Netherlands. doi:10.1023/A:1021351428976. Retrieved on 2008-03-24. 
  10. ^ Keks, N.; R. deSouza (June 2003). "Spirituality and psychosis". Australasian Psychiatry 11 (2): 170-171. Blackwell Synergy. doi:10.1046/j.1039-8562.2003.00510.x. Retrieved on 2008-03-24. 
  11. ^ Kandel, E.R.; J.H. Schwartz, T.M. Jessell (2000). Principles of Neural Science. Magraw-Hill Professional. ISBN 978-0071120005. 
  12. ^ Bauer, M.; A. Heinz, P.C. Whybrow (2002). "Thyroid hormones, serotonin and mood: of synergy and significance in the adult brain". Molecular Psychiatry 7 (2): 140-156. Nature. doi:10.1038/sj/mp/4000963. Retrieved on 2008-03-24. 
  13. ^ Chaloupka, Frank; Taurus, J; Grossman, M.. Economic Models of Addiction and Applications to Cigarette Smoking and Other Substance Abuse. University of Illinois at Chicago. Retrieved on 2006-09-01.
  14. ^ K.R. Alper, H.S. Lotsof, C.D. Kaplan (2008). "The Ibogaine Medical Subculture". J. Ethnopharmacology 115: 9-24. Retrieved on 2007-12-28. 
  15. ^ O'Donohue, W; K.E. Ferguson (2006). "Evidence-Based Practice in Psychology and Behavior Analysis". The Behavior Analyst Today 7 (3): 335-350. Joseph D. Cautilli. Retrieved on 2008-03-24. 
  16. ^ Chambless et al, D.L. (1998). "[www.apa.org/divisions/div12/est/newrpt.pdf An update on empirically validated therapies]". Clinical Psychology 49: 5-14. American Psychological Association. Retrieved on 2008-03-24. 
  17. ^ Koob, G.F.; M Lemoal (Feb 2001). "Drug addiction, dysregulation of reward, and allostasis.". Neuropsychopharmacology 24 (2): 97-129. American College of Neuropsychopharmacology. 11120394. Retrieved on 2008-03-24. 
  18. ^ Buckley, William F., Szasz, Professor Thomas Stephen. (1973). Drugs and Freedom [Partial transcript]. Hoover Institution Archives Firing Line Television Program Collection.
  19. ^ Wise, R.A. (April 1996). "Neurobiology of addiction". Current Opinion in Neurobiology 6 (2): 243-251. Elsevier Science Ltd. doi:10.1016/S0959-4388(96)80079-1. Retrieved on 2008-03-24. 
  20. ^ Davies, John Booth (1998-01-18). The Myth of Addiction. Psychology Press Ltd (2nd rev edition). ISBN 978-9057022371. 

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Further reading

External links

Addiction at the Open Directory Project The Open Directory Project (ODP), also known as dmoz (from , its original domain name), is a multilingual open content directory of World Wide Web links owned by Netscape that is constructed and maintained by a community of volunteer editors. ...


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HBO: Addiction (305 words)
The Addiction Project is produced by HBO in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
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Addiction: A chronic relapsing condition characterized by compulsive drug-seeking and abuse and by long-lasting chemical changes in the brain.
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