"All sins tend to be addictive, and the terminal point of addiction is damnation."
W. H. Auden

Addiction is a very broad term and today apart from drugs & alcohol, people seem to be getting hooked to videogames, internet etc. I would limit my self to:

DRUGS

Drug addictions are rising throughout the world. It is seen across all social classes but tends to be more pravelent amongst the super rich and poor. Addiction can disturb a person's perceptions, attitudes and personality. This is not just because substances such as alcohol, nicotine, cocaine, heroin and valium interfere with the levels of chemicals in the brain.


People can die from addiction

It's important to remember that people can die from addiction. This can be suddenly - as from an overdose of heroin - or slowly, for example, from cancer in later years brought on by smoking or getting infections like AIDS. The psychological health is also impacted. If you're unemployed, homeless and physically unwell, your psychological health is likely to suffer more than if you've a home, a job and a supportive family. If the drug, say alcohol, is particularly damaging to the brain, long term psychological harm may result. When brain damage occurs it may not be repairable. The harm from chemical dependency should be measured not just in how the addiction harms the body (the physical effects), but also in the way it affects an individual's mental health (the 'psychological' effects) and also his or her social health - their family and work environment.Much of the physical harm from addiction can be indirect. For instance, some people turn to criminal activity and prostitution for money.

Psychological effects

The psychological effects of addiction can be divided into those that relate to feeling, thoughts and Behaviour.

Feeling

An addicted person may avoid others. This leads to a feeling of isolation. He may also feel ashamed of feeling unable to cope, and of the addiction that's causing this. To deal with the feeling, he takes more of the drug. His relationship with the drug excludes people, so people avoid him. The result is increased isolation - a vicious circle.
It's important to realise that the psychological effects of addiction aren't only experienced by the person who misuses alcohol and/or drugs, but also by those who are personally involved with them, such as families, friends, colleagues.
It's not so easy living with the knowledge that you've stolen money
Many of the feelings experienced in addiction derive from a sense of being unable to gain control of yourself or the use of the drug. Some, like shame and guilt, come from finding yourself behaving in ways that are at odds with your personal values and beliefs. It's not so easy living with the knowledge that you've stolen money from your loving grandmother to buy drugs. Unless you take more drugs.
Other feelings come simply from the daily misery of being in the kind of mess that's harming most, if not all, areas of your life.
Drugs are often referred to as mood-altering. People take them because they change mood in the short term. However, there can be a long-term effect from continuing to use drugs for this purpose. Addicted people often report an increase in the feeling they were trying to escape, such as:

  • depression - ranges from feeling very down and helpless to suicidal
  • anxiety - ranges from feeling generally fearful to loss of trust and paranoia
  • low self-esteem - may become self-loathing and links to shame and guilt
  • no confidence - a state of mind related to anxiety and depression
  • anger - from touchy and irritated to explosive, often with blaming
  • boredom - the pattern of addiction becomes relentlessly, tediously the same

Thinking

Many of the thought patterns are defensive and negative.

Thoughts include:

  • dependency - believing others are responsible and can fix you - like the drug
  • denying reality - convincing oneself and maybe others that it's not as bad as it is
  • obsessive - exclusive focus on the substance and getting enough of it
  • grandiosity - thinking your concerns are more important than anything else
  • if only... - focussing on everything but the real thing that needs changing
  • self harm - ideas about ways to relieve or escape the suffering
  • mental ability - loss of memory and concentration

Behaviour

In many instances behaviour is simply about avoiding the discomfort of withdrawal. Typical behaviours include:

  • avoiding - isolating yourself and not taking responsibility
  • controlling - including various kinds of manipulation and even violence
  • betrayal - anyone can be sacrificed because the drug comes first
  • self harm - deliberate acts to hurt yourself for relief or punishment
  • deceiving - self and others to keep ahead of the consequences

Cocaine
Cocaine is obtained from the juice of the coca plant, which grows on the eastern slopes of the Andes. Purified cocaine is now consumed in two forms, either powder cocaine or crack cocaine.
Powder cocaine is usually inhaled nasally, either through a rolled up tube off a surface such as a mirror, or directly off a tiny spoon. It produces intense euphoria, disinhibition and prolific but not well-focused energy for up to 30 minutes. Street supplies vary in purity. The free base of cocaine, known as crack or rock cocaine, is nearly 100 per cent pure and reaches the brain even more quickly than powder cocaine. The effects are the same as those of cocaine, only more intense and only last a few minutes. It's usually smoked in a small pipe, but both forms of cocaine may be injected, often mixed in with heroin (snowballing).
Cocaine raises blood pressure and also constricts blood vessels. It may therefore, with heavy long-term use, lead to heart problems, even sudden death, as well as stroke and hardening of the arteries. Extensive nasal inhalation can destroy the cartilage of the nose. Cocaine users often undergo changes in personality that can be subtle, but may include overbearance, grandiosity and more serious psychiatric changes, such as paranoia and psychosis.

Opiates (such as heroin)
The most commonly abused opiate is heroin, a partially modified version of the drug morphine, which is derived from the juice of the opium poppy. Known also as smack, gear, skag or brown sugar, for example, heroin can be consumed nasally, by smoking (chasing) or by intravenous injection. Another meathod is drinking cough syrups with high concentration of codiene.
Heroin is strongly addictive and the dose needs to be repeated several times each day to avoid the distressing withdrawal symptoms of painful cramps, eye and nose watering, shivers and sweats. In ordinary addiction dosing, progressive weight loss and a tendency toward infections is perhaps all that's usually encountered. These are also the sort of problems found in those who become addicted to clean pharmaceutical opiates, such as codeine and methadone.However, the harm to the body from the method of using heroin is enormous. Smoking heroin often causes an asthma-like condition and a severe cough. But injecting street heroin, with all the impurities that it contains and with unsterile injecting equipment, is fraught with dangers.
Vein damage can be extensive, with abscess formation, and thromboses can lead to gangrene and amputations. Infection can also be spread through the blood to other parts of the body, including the heart, bone and brain.
Finally, by sharing injecting equipment with other individuals who've been infected, or through prostitution, injecting heroin users are prone to serious liver disease - hepatitis B and hepatitis C - and HIV (AIDS).

Sedatives
These include Valium (diazepam), alprazolam etc.
They produce little in the way of physical harm, but with long-term use can lead to a variety of psychiatric problems; withdrawal may lead to severe anxiety reactions, nightmares, panic attacks, seizures, hallucinations and other frightening symptoms that can last many weeks, months or even years.

What is the treatment
Various forms of treatment are avaliable and include:

Controlled consumption

Clearly, if excessive consumption is doing harm, then consuming less will, by and large, be less harmful. However, one of the problems for nearly all addicts is that they lose the ability to control their consumption, and regaining control is rarely achieved for any length of time. In a few cases this can work, but in most attempting to control consumption is at best only a useful demonstration to the denying individual that he is, indeed, addicted.

Abstinence

Once confronted, addicts will rarely consider abstinence at first, and it may take repeated efforts at controlled consumption together with a general deterioration of health to compel them to realise that their only prospect of recovery is total abstinence.
The transition from dependency to abstinence is invariably traumatic, frightening, painful and sometimes dangerous. Some achieve this on their own, others with the support of friends, and others may need a period of medical supervision that includes supportive medication, a process known as 'detoxification'.
However, giving up taking the substance is not the end of addiction and relapse is common. That is why the best chance of maintaining abstinence is when withdrawal is accompanied by psychological treatments.

Substitute medication

Most of the physical harm from heroin comes from the accidental injection of viruses and harmful bacteria through sharing and reusing injecting equipment. The aim here is to get heroin addicts to stop injecting altogether.
Synthetic opiates such as methadone can be prescribed to addicts, and a daily dose taken by mouth will prevent craving and withdrawal. However, these drugs are also addictive.
Nonetheless, methadone prescribing has been shown to lower deaths and infection rates among heroin addicts, as well as reducing criminality.

Antagonistic Medication

Naltrexone blocks the effects of heroin and takes away the incentive to use the drug.

Medically supervised withdrawal (Detoxification)

Patients who are heavy, consistent users and who are likely to experience withdrawal complications require medically supervised withdrawal (detoxification). A withdrawal syndrome that can develop on stopping use of a drug will vary according to the type of drug the person was using. Common features include craving for the substance, anxiety, restlessness, irritability, insomnia and impaired attention.
Medically supervised withdrawal can be provided in a community or a residential (inpatient) setting, according to the needs of the patient.

Counselling
Counselling can be very effective, and may involve anything up to 12 sessions or more.
It involves helping the person to look at all aspects of their problem, and then helping them build strategies for overcoming it. The therapist-client relationship seems to be a critical ingredient for successful treatment.
Counselling can be provided by a community advice and treatment centre. It is also a component of residential treatment programmes.

Residential treatment
The most widely used approach for long term rehabilitation is the Therapeutic Community (TC) model and programmes based on the 12-step Minnesota model of addiction recovery treatment (this is the model used by Alcoholics Anonymous).
Residential rehabilitation programmes are quite diverse in the way that they operate, but most share some of the following basic features:

  • A ban on drugs (and alcohol) in a controlled or semi-controlled therapeutic environment.
  • Communal living with other drug users in recovery.
  • Emphasis on shared responsibility by peers and group counselling.
  • Counselling and support aimed at preventing relapse.
  • Individual support.
  • Promotion of education, training and vocational experience.
  • Improved skills for activities of daily living.
  • Housing advocacy and resettlement work.
  • Aftercare and support.



Some residential programmes combine a medically supervised withdrawal programme as the first stage of a rehabilitation programme.
Treatment is provided on a 24-hour-a-day basis, and medical care is available. This treatment usually has a planned duration of between six and twelve weeks depending on the complexity of need.

ALCOHOLISM

"I made a commitment to completely cut out drinking and anything that might hamper me from getting my mind and body together. And the floodgates of goodness have opened upon me-spiritually and financially."
Denzel Washington 1954-, American Actor

Alcoholism is an illness marked by drinking alcoholic beverages at a level that interferes with physical health, mental health, and social, family, or occupational responsibilities.
People with alcohol dependence usually experience tolerance and withdrawal. Tolerance is a need for markedly increased amounts of alcohol to achieve intoxication or the desired effect. Withdrawal occurs when alcohol is discontinued or intake is decreased. Alcohol dependents spend a great deal of time drinking alcohol, and obtaining it. Alcohol abusers may have legal problems such as drinking and driving. Men who consume 15 or more drinks a week, women who consume 12 or more drinks a week, or anyone who consumes 5 or more drinks per occasion at least once a week are all at risk for developing alcoholism. (One drink is defined as a 12-ounce bottle of beer, a 5-ounce glass of wine, or a 1 1/2-ounce shot of liquor).

How to diagnose it

The following questions are used by the National Institute on Alcohol Abuse and Alcoholism to screen for alcohol abuse or dependence:

  • Have you felt that you should cut down on your drinking?
  • Do you ever drive when you have been drinking?
  • Is someone in your family concerned about your drinking?
  • Have you ever had any blackouts after drinking?
  • Have you ever been absent from work or lost a job because of drinking?
  • Do you have to drink more than before to achieve intoxication or the desired effect?

There are some blood tests which can be helpful in diagnosis:

  • Blood alcohol level confirms recent alcohol ingestion, which does not necessarily confirm alcoholism.
  • Liver function tests can be elevated. GGPT (glutaryl transaminase) is often elevated more than other liver function tests.
  • MCV can be elevated (mean corpuscular volume or size of the red blood cells).
  • Serum magnesium, uric acid and folate tests may be abnormal.

What are the complications

There is both physical and psychological dependence with this addiction. Physical dependence reveals itself by withdrawal symptoms when alcohol intake is interrupted, tolerance to the effects of alcohol, and evidence of alcohol-associated illnesses.
Alcohol is a depressant of mental processes , resulting in a decrease of activity, anxiety, tension, and inhibitions. Even a few drinks can result in behavioural changes, a slowing in motor performance, and a decrease in the ability to think clearly. Concentration and judgment become impaired. In excessive amounts, intoxication may result.
Alcohol also affects other body systems. Irritation of the gastrointestinal tract can occur causing nausea, vomiting and possibly bleeding. Vitamins are not absorbed properly, which can lead to nutritional deficiencies with the long-term use of alcohol. Liver diseases, like hepatitis, may also develop and can progress to liver faliure. The heart muscle may be affected. Sexual problems may also occur, causing problems with erections in men and cessation of menstruation in women.
Alcohol affects the nervous system and can result in nerve damage and dementia. Chronic alcohol use also increases the risk of cancer of the larynx, oesophagus, liver, and colon. Alcohol consumption during pregnancy can cause severe birth defects. The most serious is foetal alcohol syndrome.
The social consequences of problem drinking and alcohol dependence can be as serious as the medical problems. People who abuse or are dependent on alcohol have a higher incidence of unemployment, domestic violence and problems with the law. About half of all traffic deaths are related to alcohol use.
The development of dependence on alcohol may occur over a period of years, following a relatively consistent pattern. At first, a tolerance of alcohol develops. This results in a person being able to consume a greater quantity of alcohol before its adverse effects are noticed. Memory lapses (black-outs) relating to drinking episodes may follow tolerance. Then, people may lose control over drinking and find it difficult or impossible to stop if they try. The most severe drinking behavior includes prolonged binges of drinking with associated mental or physical complications. Some people are able to gain control over their dependence in earlier phases before a total lack of control occurs. The problem is, no one knows which heavy drinkers will be able to regain control and which will not.
Withdrawal develops because the brain has physically adapted to the presence of alcohol and cannot function adequately in the absence of the drug. Symptoms of withdrawal may include elevated temperature, increased blood pressure, increased heart rate, restlessness, anxiety, seizures, and rarely even death

What causes it

There is no known common cause of alcoholism. However, several factors may be causative in its development. A person who has an alcoholic parent is more likely to become an alcoholic than a person without alcoholism in the immediate family. Research suggests that certain genes may increase the risk of alcoholism but which genes or how they exert their influence is controversial. Psychological factors may include a need for relief of anxiety, ongoing depression, unresolved conflict within relationships, or low self-esteem. Social factors include availability of alcohol, social acceptance of the use of alcohol, peer pressure, and stressful lifestyles.

What is the treatment

Treatment is similar to that of drug addiction. The first step is to recognise that there is a problem which needs to be tackled.

There are a few medicacation specific for alcoholism:

  • Naltrexone is an opioid antagonist that decreases alcohol cravings.
  • Disulfiram (Antabuse) works by producing very unpleasant side effects if even a small amount of alcohol is ingested within 2 weeks after taking the drug.
  • Acomprosate is a new drug that has been shown to lower relapse rates in those who are alcohol dependent.