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✍🏽 Aaditi Kumbhar | MPH Epidemiology
What is addiction?🧠
Addiction is classified as a chronic brain disorder and can negatively impact quality of life.
Addictions can be sorted into two categories: substance abuse disorders and behavioural addictions.
Substance abuse disorders occur when an individual forms a dependency on the incited feeling of a specific substance (e.g. alcohol, prescription drugs, narcotics). The brain experiences positive emotions as a side effect of substance use. The release of happy brain chemicals like serotonin and dopamine play a role in creating an addictive cycle.
Behavioural addictions occur when an individual is unable to resist an impulse. The repetitive impulsive action triggers the same positive emotions associated with substance abuse, but a specific substance is not required for the experience. Individuals crave a specific action or impulse and experience a build up of tension or emotion until completion of the urge. Once complete, the satisfaction experienced encourages repetitive behaviour and creates an addictive cycle.
What are the epidemiological aspects of addiction? 🌍
10% of Americans experience a lifetime prevalence of substance use disorder.
A multitude of surveys such as the National Survey of Drug Use and Health, the National Epidemiological Survey on Alcohol and Related Conditions, and Monitoring the Future Survey are used to study the burden of substance abuse disorders within the United States. Factors including the COVID-19 pandemic, mental health decline, and systemic oppression play a role in the increase of substance abuse prevalence.
Prevalence of behavioural addictions are highly variable across different demographics.
A five year study was conducted to study the prevalence of a multitude of behavioural disorders such as exercise, sex, shopping, online chatting, video gaming, and eating. Each wave consisted of a year, and surveys were taken each year to record the burden of each specific behavioural disorder. While this is one of many longitudinal studies, the general consensus is that environmental, social, and mental health factors directly impact the prevalence of behavioural addictions.
What are the barriers to treatment? ❌
Barriers to treatment include cost, geographic location, stigma, and comorbidity.
Many individuals are affected by socioeconomic factors, making it difficult or nearly impossible to get the help they need. Exposure to higher rates of unemployment and unstable housing presents as a risk factor not only for addiction, but also for the likelihood of untreated addiction.
Certain states have more addiction facilities than others, significantly limiting the ability to even seek out help. As of 2020, California has 2,350 treatment facilities while lower populated states such as Montana only have 162. This disparity makes it exceedingly difficult for individuals in sparse geographic locations to seek out resources for addiction treatment.
Stigma plays a massive role in addiction treatment. Many addicts struggle with self-confidence and don't see themselves as worthy of improvement. Others fear the response from friends, families, and surrounding peers and refuse to seek out treatment facilities. There is a lack of available treatment for pregnant women or mothers with children, and societal backlash plays an additional role in discouragement.
Having a co-occurring mental illness can make seeking help for addiction incredibly difficult. Also known as a dual diagnosis, this occurs when an individual develops an addiction disorder while already suffering from an existing mental or behavioural disorder. As of 2016, 3.4% of individuals in the United States had a dual diagnosis . Because a dual diagnosis introduces confounding effects, it becomes more complicated to try to treat multiple co-existing illnesses at once. Additionally, some mental health disorders can worsen symptoms of addiction and decrease the likelihood of effective treatment.
Treatment Resources 📑
Seeking treatment for substance abuse disorders or behavioural addictions is incredibly important. If left untreated, addictions can complicate existing health problems and decrease quality of life. Individuals can apply for a twelve-step facilitation program, seek outpatient therapy, and access inpatient rehabilitation. While barriers to treatment still exist, the available options can greatly reduce the burden of addiction within the population.
If you or someone you know struggles with addiction and don't know where to start, reach out to a trusted individual, healthcare professional, or utilize helplines.
SAMHSA National Helpline: 1-800-662-4357
American Addiction Centres: (888)-638-1803
Edited by Zoe Davies | Associate Content Editor | BSc Pharmacology, University of Leeds
