The 10 Most Common Questions About Addiction

It is estimated that 1 in 10 individuals experience an alcohol or drug addiction at some point in their life.  When other addictions such as gambling addiction, technology addiction, food addiction, or other common forms of addiction are taken into account the statistic of those suffering from an addiction increases substantially.  Although someone you know likely experiences some form of an addiction, addictions continue to be stigmatized and are a seldom discussed topic among family and friends.  Addiction all too often lacks basic understanding and education in our soceity, and common myths continue to circulate.  Below are some of the most common questions and answers about addiction.

What is Addiction?

Addiction occurs when an individual continues to engage in a behavior with difficulty stopping or moderating.  Addiction involves compulsive engagement in the behavior, such as drinking alcohol or gambling.  The compulsive nature of an addiction surfaces as a result of rewarding stimulation in the brain, and a subsequent desire for the brain to crave that stimulation in order to induce pleasure.  Addiction also often involves obsessive psychological preoccupation with getting, using, and recovering from the addictive substance or behavior.

A common cornerstone of addiction is continued engagement in the addictive behavior despite adverse consequences such as career problems, deterioration of relationships, legal issues, financial troubles, or health concerns, among many other negative impacts.  Another common component of addiction involves tolerance, meaning that over time an individual requires more of the substance or behavior in order to produce the same desired pleasurable effects.  Addiction also often involves withdrawal, meaning that when an individual is not engaged in their substance use or behavioral addiction they experience psychological or physiological withdrawal symptoms.  Such symptoms vary from person to person as well as between various forms of addiction.

What is a Substance Use Disorder and What is the Difference Between an Addiction and a Dependence?

In the field of substance use and addiction there are many terms that are commonly used. For example, among addiction therapists and other addiction specialists the term regularly used to classify someone with an addiction to alcohol or drugs is “substance use disorder,” or more specifically may be “alcohol use disorder” if the addiction is to alcohol or “stimulant use disorder” if the addiction is to Adderall, etc.  The term “substance use disorder” was updated from older terms such as “substance abuse” and “substance dependence.

The term used by addiction professionals for gambling addiction is “gambling disorder.”  Other addictions, such as gaming addiction, cryptocurrency addiction, social media addiction and other addictions are not officially recognized as a disorder by the American Psychiatric Association and are currently left out of the Diagnostic Statistical Manual that is used by addiction professionals to render a clinical diagnosis.  This is not to say that such behaviors are not problematic nor that individuals with such addictions are not deserving of treatment, but rather serves as a continued area of research among medical and addiction professionals.

Nonetheless, addictions are widespread and have a far-reaching impact beyond substance use disorder and gambling disorder.  Two terms commonly used to discuss various problematic behaviors are addiction and dependence.  The difference between addiction and dependence can be difficult to understand, and some may even use the words interchangeably.  The term dependence is most notably used to refer to a physical dependence or physical reliance, most notably characterized by tolerance and withdrawal.

The term addiction is usually used to also include a psychological component, such as a mental obsession or preoccupation with a behavior.  An individual can be physically dependent to a substance, such as opiates for example, but may not have breached the mental component of addiction.  Such individuals are able to detox from their substance and not think about it thereafter once the substance is out of their body.

Why Do People Become Addicted?

There is not one reason why an individual becomes addicted, and anyone can become addicted to anything. However, two primary factors that may make someone vulnerable to become addicted are environmental factors and genetic factors.  Environmental variables include a home environment in which there is trauma, abuse, or addictive behaviors occurring; a living environment in which drugs, alcohol or other addictions are readily available and taking place; friends, family members or other peer influences of individuals who are addicted or regularly engage in problematic behaviors; social acceptance of problematic behaviors; or a culture that generally accepts addiction.  Genetic variables include a family history of mental health or addiction.

Aside from genetic and environmental risk factors, there are other variables that may make someone at higher risk of developing an addiction.  Underlying mental health issues such as anxiety or depression certainly can make individuals at higher risk of developing an addiction.  A history of physical, sexual, or emotional abuse or other trauma can also be a risk factor for addiction.  Also, the earlier someone begins to engage in a problematic behavior the more likely they are to develop an addiction to that behavior.

What Is The Worst Addiction?

The term addiction is most commonly used in relation to substance dependence such as alcohol addiction, cocaine addiction, Adderall addiction, and other such drug addictions, but it is also used in regard to behavioral addictions such as gambling addiction, technology addiction, porn addiction, sex addiction, food addiction and other such addictions.  Furthermore, there are subcategories of addictions, so for example types of gambling addiction may involve sports betting, poker, cryptocurrency addiction, or day trading addiction.  A technology addiction may involve social media addiction, internet addiction, phone addiction or gaming addiction.

Addiction comes in many different forms, and there is no “worse” addiction.  Yes, there are more deadly addictions.  For example, an addiction to alcohol or heroin is more deadly and dangerous than an addiction to video games.  However, all addictions can have a substantial negative impact on the individual suffering from the addiction, and impact them and their loved ones in a variety of ways from their mental health to physical health to spiritual health to financial health to relational health and every which way in-between.   Instead of asking what type of addiction is the worst, one should be asking how the addiction is negatively impacting their life and the life of their loved ones.

Can You Get Addicted if You Do It Just Once?

This question is often posed for drug addiction.  While just one use of a substance contributes to chemical changes in the brain, one does not become addicted or dependent after one use.  However, after one use an individual may experience a sense of pleasure that they want to feel again, and the habitual nature of addiction can begin to take effect after continued use.  Some individuals may also be at higher risk of addiction, for example, if they have an underlying mental health issue or if there is a history of addiction in their family.

This question is also often posed with the question, “Is marijuana addictive?”  The answer is yes.  Although marijuana is a natural substance, it does not mean that it is harmless nor does it mean that it is not addictive.  Marijuana can change brain chemistry and take over the pleasure center of the brain in the same way as other drugs, and is especially dangerous for the development of the adolescent and young adult brain.

Another common question in this line of questioning is, “Are prescription drugs safe?”  Before answering this question, it is important to always discuss your medication regiment with your prescribing doctor and to take medication safely as prescribed.  That being said, prescription drugs can be highly addictive, especially Opioids such as Oxycodone or Oxycontin, Benzodiazepines such as Xanax, Klonopin or Ativan, and Amphetamines such as Adderall.

How Do You Know If Someone Is Addicted?

Addiction comes in many different severities, and can be classified as mild, moderate or severe.  An individual may not fit into the box of having an alcohol use disorder or an addiction to alcohol, but they may be a binge drinker or problem drinker.  In other words, they may on occasion be unable to control their alcohol use or their alcohol use may occasionally cause problems in their life.  If alcohol, drugs, gambling, TikTok, gaming or other behaviors are causing a problem in your life or a loved one’s life then it should be enough to recognize that there is a problem that needs to be addressed.

If you answer yes to any of the below questions, your relationship with an addictive substance or addictive behavior is something you should take a closer look at.

  1. Have you had times when you ended up engaging in your behavior more, or longer, than you intended?
  2. Have you more than once wanted to cut down or stop your behavior, or tried to, but couldn’t?
  3. Have you spent a lot of time engaging in your behavior or spent time recovering from the aftereffects of your behavior?
  4. Have you wanted to engage in your behavior so badly you couldn’t think of anything else?
  5. Have you found that engaging in your behavior often interfered with taking care of your home or family? Or caused career troubles? Or Financial Problems?
  6. Have you continued to engage in your behavior even though it was causing trouble with your family or friends?
  7. Have you given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to engage in your behavior?
  8. Have you continued to engage in your behavior even though it was making you feel depressed or anxious or adding to another health problem?
  9. Have you had to engage in your behavior much more than you once did to get the effect you want? Have you increased the frequency, duration or quantity of use or engagement in the behavior?
  10. Have you found that when you stopped engaging in your behavior for hours or days you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, irritability, agitation, depression, sweating, or other unwanted psychological or physiological symptoms?

Can Addiction Lead to Mental Health Disorders?

Yes.  Addiction can lead to a variety of mental health concerns including depression and anxiety as well as other psychological problems.  In some instances, such as with alcohol or drugs, mental health issues can be induced while under the influence of the substance or in other cases the mental health issues may continue to persist long-term.

Mental health issues can also serve as an underlying issue that existed prior to the addiction, and therefore can sometimes be a “chicken or the egg” scenario in which one is not certain if the mental health issue contributed to the addiction or if the addiction contributed to the mental health issue.  In both cases it is important that the addiction and the mental health concerns are both addressed in treatment. 

Is Addiction Treatable?

There is no cure for addiction, but addictions are treatable.  In other words, an addiction can go into remission when an individual has abstained from their addictive behavior for some time, but there can be a recurrence. Individuals with a history of addiction will always be vulnerable to relapse, and unfortunately relapse rates for addictive disorders are quite high.  Depending on the type of addiction, the severity of the addiction, and the history of the individual’s relationship with their addiction there are moderation management approaches, and many individuals are able to live a thriving life while moderating their addictive behavior.  In other cases, and more widely accepted by the addiction recovery community and addiction specialists, are abstinence-based approaches to recovery involving complete abstinence from the addictive behavior.

Addictions are treated in various settings such as medical detox clinics, inpatient rehabilitation centers, and outpatient rehabilitation centers.  Some individuals choose to work privately with an addiction therapist, addiction psychiatrist, or addiction recovery coach (sober coach).  Common methods of treatment involve various behavioral therapeutic approaches such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Motivational Interviewing (MI), or Rational Emotive Behavior Therapy (REBT), among many other forms of therapy.  Medication can also play an important role in recovery in curbing withdrawal symptoms, curbing cravings, and addressing underlying mental health concerns.  There are also mutual help groups available such as Alcoholics Anonymous, SMART Recovery, Refuge Recovery, Gamblers Anonymous and many other twelve-step programs that are specific to the addiction.

What Do I Do If My Loved One Is Addicted?

Addictions are chronic, progressive and can be fatal, so it is always recommended that individuals encourage their loved ones to get help for their addiction if they are unable to stop on their own.  If your loved one is in denial about their addiction or if they are unwilling to get help, then an intervention may be needed.  There are different forms of intervention, but most commonly involve gathering loved ones to help encourage the addicted individual to seek out some form of help for their addiction.  During the intervention process loved ones may be expected to express their love and concern for the individual and set boundaries that they are going to hold with the addicted individual should that individual choose not to get help.  Lastly, it is also important for loved ones to seek out their own source of support regardless of if the addicted individual seeks out help or not.  Such forms of help for loved ones can be with a family therapist who specializes in addiction, family therapy, or mutual help groups such as Al-Anon, Gam-Anon, or SMART Recovery Family & Friends.

To learn more about the impact of addiction on loved ones, please read “The Impact of Alcoholism and Addiction on Family, and How to Protect Yourself.”

How Can I Support Someone with an Addiction?

It is not your job to get a person sober or to get them to stop destroying their life via their addictive behavior; your job is to take care of yourself.  If your loved one is ready and willing to receive help or is in recovery, you can serve as a great source of strength and support.  Some healthy behaviors you can implement are to actively listen, express empathy, set healthy boundaries, reduce environmental triggers, encourage healthy habits, role-model healthy behaviors, and educate yourself about addiction.  For more information on supporting someone struggling with addiction, please read “10 Tips For How To Support Someone In Recovery From Addiction.”

For more information on New York City addiction treatment and to find the best addiction counselor in NYC, or for general therapy and mental health counseling, or to inquire about Family Addiction Specialist’s private concierge sober coach Manhattan, recovery coach Manhattan, sober companion Manhattan, Manhattan addiction therapy services and/or our Manhattan teletherapy services (online therapy/virtual therapy) for drug addiction, alcohol addiction, gambling addiction, or digital addiction and technology addiction, as well as our Manhattan hypnosis services in New York City please contact our undisclosed therapy office location in the Upper East Side of NYC today at (929) 220-2912.

Lin Sternlicht & Aaron Sternlicht

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