Alcohol Addiction and the Addiction Process
Despite the general tendency to assume that we can recognize addiction when we encounter it, the idea of addiction is not well defined. No matter what the addiction, all addiction begins as a habit and progresses from there. Even if there is a genetic component, the initial expression of the addiction is expressed as a habit. Some habitual addictions end up as chemical imbalances in the body, others as changes at one or more receptor sites and so on.
The concept of addiction as it is often portrayed and used is unclear. Finagarette (1988) and Davies (1992) proposed that the concept of addiction as it is generally viewed is a myth. Other researchers have presented similar ideas. (Szasz, 1974; Peele, 1985) Since the 1970s, some have suggested that the concept of addiction requires revision in that it combines social discourse, moral dilemmas, psychological states and pharmacology in an awkward manner.
(Hammersley and Reid) The typical view of addiction is generally viewed as a myth. (Szasz, 1974; Peele, 1985; Finagarette, 1988; Davies, 1992) The general view of the concept of addiction may be of little value and require major revision. (Akers, 1991) Today, terms such as “substance abuse” and “drug dependence” are subtly replacing the idea of addiction. (Edwards and Gross, 1976)
Theoretically, there are at least two general classes of addiction: 1) physical dependence and 2) psychological dependence. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR) defines substance dependence as “a cluster of symptoms that indicate that the individual has a pattern of impaired control over substance use.
The seven DSM-IV TR criteria for Dependence can be separated into physiological dependence and compulsive use. Addiction is considered to be the “uncontrolled, compulsive use” of a substance. Physical and psychological addictions are not always easy to distinguish, especially as there is certainly some degree of overlap between the two.
Each type of addiction has its own cause. This report will focus on alcohol addiction. We will look at the addiction process from beginning to end. We will ask, “What causes addiction” or “Why does addiction begin,” “Why does addiction persist” and finally, “Why does it end?” Our approach will be to take a general look at addictions so we will know and understand what we are dealing with and then to focus on one type of addiction, alcohol addiction, for an in-depth consideration and review.
We will begin by looking at the concept of addiction and defining what the means and we will proceed from there. Overall, we will discuss the general aspects of alcohol addiction and then apply what has been discussed to a hypothetical case.
In what follows, we will create a hypothetical case that will exemplify the addiction process from the initial stages to addiction to treatment. If we are to follow the Alcoholics Anonymous (AA) model, the process cannot go beyond treatment because the AA model does not allow for a cure. Addicts are always recovering and never recover, so we will follow the AA model and its treatment throughout the life of the addict. We will create our hypothetical addict after defining what is generally meant by the term “addiction”.
Substance abuse is widely viewed as addiction, but Hammersley and Reid (2002) point out that addiction is a dramatic, dangerous and chronic condition caused by the biological effects of drugs. Hammersley and Reid suggest that substance use is a normal behavior with social causes and should be viewed as such without perpetuating any unhelpful moral issues and the unsuccessful solutions suggested by the myth.
Hammersley and Reid suggest that the myth of addiction continues and prevails because it is functional in western cultures and can be used to deal with issues of ‘control’. According to the generally accepted myth, addictive drugs are supposed to meet six criteria. They are 1) supposed to lead to addiction quickly and easily, 2) force addicts to resort to crime to finance their drug habit, 3) have psychoactive effects, 4) cause serious health damage or death, 5) supplied by ruthless criminals and 6) addiction is long lasting if not permanent. For the most part, these ideas appear to be mainly fiction.
These ideas are essentially a myth based on exaggeration and distortion regarding the effects of certain drugs. Such myths are common. They arise, in part, because evidence counter to these ideas is ignored and individual cases of “mythical figures and events” that support the myth are commonly projected before the public.
As a result of these myths, the public is led to believe that drug users started out as naïve you people who were persuaded to use drugs, then become addicted and then turn to a life of depravity and crime because they are unable to control their habit and they need to finance their drug use. (McAdams, 1993)
Although a number of drugs have been used to perpetuate this myth, cannabis is perhaps the most common and widespread example of the myth. In the late 1960s and 1970s, many believed that cannabis use would lead to serious psychological harm. Research failed to confirm this belief. (Johnson, 1973) Other drugs that have been involved in this myth include heroin, cocaine and ecstasy.
Research to understanding drug abuse often focuses on changes at a specific receptor site. The studies will investigate those changes and seek to determine how to control them with medications. However, in contrast to many other commonly abused drugs, alcohol does not bind to specific receptors (Kranzler and Ciraulo, 2005), but it appears to modify neuronal membranes and neurotransmitter receptors embedded in those membranes in a variety of neurotransmitter systems, including virtually all the major system found to be associated with psychiatric symptoms (Kranzler, 1995)
If we were to apply this information to the hypothetical case of a male alcoholic since, even though both males and females become alcoholic, males are two or three times more likely than females to become alcoholic, we would arrive at the situation of a male in his mid to late twenties who began drinking socially and quickly became an alcoholic. Subsequently, he turned to crime to support his drinking habit.
His habit is now long lasting and permanent. This would be the hypothetical example of an alcoholic that supports the myth of addictive drugs discussed by Hammersley and Reid. Viewed from the perspective of an alcoholic, we can see that this model would not apply well to alcoholics.
Although his habit may have begun socially, and other aspects of the generally accepted myth might sometimes hold true, becoming addicted was a gradual process, the drug was legally sold at liquor stores and perhaps even in grocery stores and may even have been provided in small amounts in the community church. No “ruthless criminals” were involved and the alcoholic had no need to resort to crime to finance their drug habit. Therefore, the myth, although consistent with some aspects of reality, is misleading and inaccurate.
We can see that the characteristics of alcohol addiction are sufficiently consistent with the generally accepted myth as to allow individuals to assume that it supports the myth. However, none of the components of the myth need to occur in order for an individual to become alcoholic.
Perhaps the one characteristic that may always apply is that alcohol is psychoactive, but in small amounts, not even that characteristic need apply. Alcohol addiction is a gradual process, it is relatively inexpensive, it is psychoactive, it has beneficial effects as well as harmful ones, is legally sold in liquor stores and in supermarkets and may even be found in the neighborhood church during communion and finally, alcohol addicted individuals are not always doomed to a permanent or long lasting addiction.
Yes, each of these things can occur although the idea of a drug pusher selling alcohol is far-fetched. Our alcohol addict is merely an individual, in this case a male but it could have been either sexual gender, who began drinking for whatever reason and then, somehow went overboard. We have already touched upon causes and treatment and will now move on to those considerations below.