Introduction

Addiction is a strong, uncontrollable need to take drugs, drink alcohol or carry out a particular activity, such as gambling.

It becomes the most important thing in your life and leads to problems at home, work and school.

There's no single reason why addictions develop. Some people experience particularly intense feelings for pleasurable or relaxing activities, such as:

  • regularly drinking alcohol
  • smoking
  • using drugs or other substances
  • spending time gambling
  • using the internet (including porn sites)
  • sex and love
  • shopping

This can lead to a strong desire to repeat these activities more often.

From enjoyment to addiction

Many people regularly use addictive substances or engage in potentially addictive activities without having major problems.

However, in some people it can cause damaging physical and psychological effects, as their behaviour becomes more frequent and intense and turns into an addiction. This occurs as a result of chemical changes in the brain.

If you carry on using the substance or engaging in the behaviour, your brain and body become tolerant and you need more drugs, or spend more time on the behaviour to get the same effect. What started out as something you can control develops into an uncontrollable need or addiction.

If you try to stop, you'll experience physical or psychological withdrawal symptoms, or both. Withdrawal symptoms are wide ranging and vary depending on the substance involved, but generally you'll experience:

  • feelings of discomfort
  • distress
  • an intense craving for the substance

Withdrawal from alcohol is often particularly difficult because it can sometimes be complicated by seizures (fits) and hallucinations.

Treating addiction

There are many organisations that provide help in treating addictions. Your GP is a good first point of contact. They'll be able to provide you with help and advice, and can recommend specialist addiction services both nationally and locally.

Treatment for addiction focuses on the individual and their needs. Talking therapies and medication are recommended treatments. The most effective talking therapies for treating addiction include:

MET is a counselling technique that can help you overcome any mixed feelings you have about taking part in a treatment programme and stopping your drug use.

It aims to draw out self-motivational statements. A plan for change can then be made based on a commitment to move forward and find a solution to the problem.

Treatment usually starts by encouraging you to think about how you want to change. It's important your counsellor is non-judgemental and a supportive listener. You need to believe that you want to – and can – overcome your addiction and your life will be better as a result.

An addiction counsellor will discuss:

  • how you see your life in the future
  • what obstacles you feel you face as you work towards changing
  • what you think will help you deal with those obstacles

The addiction counsellor will also help you understand that stopping a drug or behaviour may involve major lifestyle changes and support will be needed in the long term to prevent relapse.

It's important to involve family and friends in supporting you to overcome your addiction.

At-risk groups

You're more at risk of developing an addiction if:

  • other members of your family have addiction problems
  • you experienced stress or abuse while growing up
  • you have mental health problems
  • you have unemployment and financial worries
  • you're experiencing relationship problems

Addictive behaviour often occurs when people try to deal with or forget about these difficult issues.

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Q&A

Treating addiction Q&A

When is it time to get help?
The sooner the better. Some people say you have to hit rock bottom before you’re ready to change, but the evidence shows that the earlier the intervention, the more successful it will be.

What can friends and family do?
Whether you're a relative, friend or an employer, as soon as you detect a problem relating to addiction you should tell the person that you've noticed a worsening pattern in their drinking, drug use, mood or physical health. If this is said in an accusing way, the person is likely to be defensive and will distance themselves. The more positive and constructive you are, the more likely it is that you will be able to help the addicted person and get them into treatment.

The evidence for the benefit of support from people close to the addict is so strong that many specialist services offer treatment that's based on recruiting a network of family and friends. It's important that the person with drug and alcohol problems is helped by people who are concerned, constructive and who don’t have problems themselves.

Who should the person go to first?
A GP can refer an addicted person at any stage, not just when they're willing to stop. GPs can give advice about sensible drinking, and use their own surgery's resources, such as nurses or counsellors. GPs may also recommend national helplines and support groups.

These groups enable many people to deal with their addiction. In addition, there are specialist NHS agencies that will see people, even if they’re not ready to stop. These units encourage people to talk about their addiction and try to change their motivation.

How is an addict treated?
Treatment is adapted to suit the individual. There are several treatments that are proven to work. These mainly combine talking therapies with medication. Cognitive behavioural treatments are typically used because they work very well with addiction problems. 

Treatment usually starts with getting the person with the problem to think about how they want to change. It's important to avoid condemning them. They need to believe that they can do it, and that their life will be better as a result. 

Professionals will discuss how the addicted person sees their life in the future, what obstacles they feel they face in changing, and what methods they think will help them to deal with those obstacles. Then they can identify the situations the addicted person will find difficult, and make plans to deal with those situations. Through this process, they can set the target, which is ultimately abstinence.

Once you’ve identified the target and what the person needs to do to reach it, you set up all the resources available. As well as treatment agencies, resources include family and friends who support change. You want people who won't encourage the person to "just have one drink because it won’t matter" but instead offer to take them to the cinema.

When people engage in dependent behaviour, their whole lifestyle revolves around using and obtaining the substance, and dealing with the after-effects. Therefore, changing that lifestyle is a very big step. Often the hardest part is not stopping the addiction but maintaining the change.

How do self-help groups and residential rehab work?
Some self-help groups are extremely useful because they provide a network, often in the absence of family and friends. Groups are very useful for giving support during aftercare.

Residential rehabilitation helps many people to overcome the initial phases of withdrawal and to start making lifestyle changes that will allow them to continue in recovery.

Do the self-help or home-based recovery programmes work?
Most definitely. People are more likely to find a way to recovery that suits them if there's a wide range of options available. People don't respond well when they feel they're being pushed into a corner. However, a self-help manual can rarely replace being with supportive people in a social setting that rewards abstinence or control.  

Does recovery always have to mean abstinence?
For a minority of people with moderate drinking problems, a controlled drinking goal is possible. However, most people at treatment centres need to aim for abstinence. With heroin and cocaine, abstinence is the only option.

How does an addict guard against relapse?
Lots of ways. One would be removing or avoiding the triggers of addiction. Another might be making contact with new people who don't use drugs. That’s a big step to take, and some will advise the opposite, saying it's important to stick with people who are in recovery because they understand and can offer support. This is fine as long as they're supporting your abstinence rather than stimulating your addiction.

In the case of drug users, the people who recover successfully are the ones who change their drug-using surroundings. This can be very difficult, especially if their partner is a drug user (unless they change their habit too).

It's also important for recovering addicts to change their activities so that they have alternative ways of feeling rewarded, alternative ways of coping with feeling down or lonely and alternative ways of having a good time. Very often, people get into drug and alcohol addiction simply to relax and enjoy themselves, but then they lose control. When that happens, they have to find alternative ways to relax.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 04/11/2015 11:39:41