Thinking about what you already know about addiction, can you think of any treatments that could help someone in reducing an addiction? Are your suggestions specific to one type of addiction or can they be addiction generalised to others? Can you think of treatments that work well alongside others? When attempting to look at reducing addiction, we discuss drug therapy, behavioural treatments like aversion therapy, and cognitive treatments like cognitive behavioural therapy (CBT) for different addictions.
- First, we will look at some characteristics of addiction psychology.
- Then we will explore a few risk factors of addiction in psychology.
- Following on, we will discuss mention biological methods for reducing addiction.
- After, we will delve into the psychological methods of reducing addiction using drug therapy, aversion therapy and CBT.
- Finally, we will analyse research on hormones that reduces addiction.
Fig. 1 - There are various ways in which a person can reduce their addiction.
Characteristics of Addiction in Psychology
The Diagnostic and Statistic Manual of Mental Disorders 5th Edition (DSM-5, 2013) from the American Psychological Association (APA) states that there are 11 categories of substances that can lead to addiction and a diagnosis of a Substance-Related Disorder. The 11 classes of substances are:
- Alcohol.
- Tobacco (nicotine).
- Caffeine.
- Cannabis.
- Sedatives.
- Stimulants.
- Hallucinogens.
- Opioids.
- Inhalants.
- Hypnotics.
- Anxiolytics.
- Or other/unknown substances.
Addiction does not only relate to substance use but behaviour seen in other Addictive Disorders, such as gambling. The DSM-5 definition of addiction involves behaviour surrounding excessive engagement in risky activities due to cravings or relieving withdrawal symptoms.
Addiction is an inability to stop engaging in pleasurable activities that activate the brain's reward system, leading to physical or psychological dependence.
Addiction can lead to harm for the individual or others around them. Substance-Induced Disorders such as chronic intoxication inducing physiological changes in the body after using a substance, or withdrawal experienced after not using the substance and the failure to reduce or stop behaving in risky ways, can lead to issues in daily life.
The International Classification of Disease (ICD-11) is a classification of medical diseases and includes gaming disorders under the category of addictive behaviour disorders.
Other disorders which may be included in this list in the future if more sufficient scientific evidence is found include problematic internet use and compulsive buying.
Risk Factors of Addiction in Psychology
Addiction risk factors are considered vulnerabilities that can make someone more susceptible to developing addictive behaviour. These can include a combination of internal and external factors:
- Genetic vulnerability: Inheriting genes/characteristics that make developing an addiction more likely.
- Stress: Experiencing chronic high-stress levels increases the likelihood of pleasurable behaviour becoming addictive.
- Personality: While there is not one 'addictive personality type', characteristics such as impulsivity and openness may lead to developing addictive behaviour.
- Family influences: Learning theory suggests observing addiction in the living environment normalises the behaviour and so creates a vulnerability to engaging in this behaviour also.
- Peers: Again, learning theory suggests behaviour is learnt from others in our environment, plus peer pressure to engage in risky behaviour could develop into addiction.
Having one or several vulnerabilities does not guarantee someone will become addicted to a certain behaviour once they try it, it all depends on individual differences and their environment. There are various ways in which people can attempt to reduce their addictions, and they usually fall into psychological methods and biological methods.
Biological Methods for Reducing Addiction
Biological methods refer to the areas of psychology studying the physical and physiological aspects and changes to the brain and body that occur when addicted to a substance or behaviour. This includes effects on functions such as the immune and nervous systems, plus links between genetics and addiction.
Biological investigations relating to addiction have led to many great discoveries, such as the function of neurotransmitters i.e., dopamine, in reward systems in the brain, known as the mesocorticolimbic pathway.
The mesocorticolimbic pathway is made up of the ventral tegmental area, nucleus accumbens, prefrontal cortex, hippocampus and amygdala.
Fig. 2 - The mesocorticolimbic pathway is made up of various systems in the brain.
By learning about how the brain reacts when taking substances and when they are removed, biological treatments such as drug therapies can help treat addiction, as we understand the biological processes behind the disorder.
Reducing Addiction: Drug Therapy
There are three main types of drug therapy used to treat addiction:
- Aversive drugs trigger an unpleasant consequence that a person associates with the substance taken.
- Agonists act as a substitute for the substance related to the addiction with less serious side effects.
- Antagonist drugs prevent the individual from feeling the effects of the substance taken, such as the euphoric feeling that some drugs produce, by blocking receptors.
For nicotine addiction, nicotine replacement therapy (NRT) uses gum, inhalers, or patches to deliver nicotine in a less harmful way than smoking cigarettes, which is an example of agonist drug therapy.
No medications have yet been approved for gambling addiction, but opioid antagonists such as naltrexone are being trialled. They reduce the release of dopamine in the nucleus accumbens, thereby reducing the gambler’s euphoric response to gambling.
Although there is research supporting the use of medications to treat addiction, individual differences, the stigma surrounding addiction and physical side effects influence the effectiveness of medications used in drug therapy. A combination of other therapies, such as behavioural and cognitive discussed below, can also be used as a more effective way of reducing addiction.
Reducing Addiction: Behavioural Interventions
Multiple behavioural therapy interventions are available for addiction treatment, including aversion therapy, covert sensitisation, and cognitive behavioural therapy (CBT). These are psychological interventions.
Aversion Therapy
Aversion therapy uses classical conditioning to treat addiction by creating an association between the addiction and an unpleasant stimulus. This can also be paired with drug therapy, as medication can be given that causes unpleasantness when paired with addictive substances.
In the case of alcohol addiction, being given an emetic, a drug that induces vomiting when taken while drinking alcohol, can associate the unpleasant response of vomiting with alcohol intake (negative association).
In gambling, the unpleasant stimuli used are often small electric shocks given to try and prevent further gambling.
Building a negative association with behaviour related to addiction can help people avoid and reduce addictive behaviours because they want to avoid the associated unpleasantness.
Covert Sensitisation
In covert sensitisation, the unpleasant stimulus is imagined rather than experienced directly. Covert sensitisation can still generate a negative association between the behaviour and negative association.
In
nicotine addiction, for example, a therapist would read a script in which the client smokes a cigarette and then experiences an unpleasant stimulus, such as vomiting, described in vivid detail. The client then imagines that they are ‘turning their back’ on smoking and experiences relief as they are relieved of the unpleasant stimuli.
However, there are ethical issues with aversive therapy, as it could cause suffering to the patient. There are also methodological problems and problems with treatment adherence. However, research supports the effectiveness of aversive therapy (Meyer & Chesser, 1970).
Reducing Addiction: Cognitive Behavioural Therapy (CBT)
CBT aims to challenge faulty thinking patterns that lead to addiction. It achieves this through:
- Functional analysis, in which with the help of a therapist people learn to identify situations in which they may be at risk (assessment and engagement).
- Skills training where people are encouraged to replace their addiction with constructive, positive habits and ways of thinking. This step involves cognitive restructuring (challenging false beliefs), specific skills (e.g., assertiveness training so that they can say no to substances in social situations) and social skills training (helping people to avoid falling into addiction in high-risk social situations).
Cognitive behavioural therapy helps prevent relapse but often only works short-term. In addition, people can find it difficult to adhere to the demanding schedule of this therapy and drop out. So, although research supports CBT, it has its limitations in treating addiction.
Fig. 3 - Various therapies can be used to treat addiction.
Hormones that Reduce Addiction
Biomedical research into addiction suggests that there are certain hormones that can reduce the effects of addiction and may improve the withdrawal and overall recovery process in substance addictions. Stress, thyroid, sex and nutritional hormones may all play a role in the exasperation and reduction of an addiction.
In a review of human and animal research on hormones in addiction by Famitafreshi and Karimian (2021), there is a range of hormones of varying functions that all affect substances in the body differently.
One example of this is oxytocin, which is suggested to decrease the effects of some drugs and alcohol by blocking certain neurotransmitter receptors.
Hormones involved in metabolism, food regulation and building a strong immune system, such as resistin, leptin, and adiponectin, are suggested to help an individual recover from an addiction. Imbalances of these hormones have been found to have a negative effect on those undergoing methadone treatments.
Research in this field of study is relatively new, and like all other topics in scientific research, is continually ongoing in order to discover new ways people can be helped.
Reducing Addiction - Key takeaways
- Addiction is defined as an inability to stop engaging in a behaviour that has pleasurable effects, characterised by physical and psychological dependence, tolerance, and withdrawal symptoms.
- Risk factors for addiction include genetic vulnerability, stress, personality traits, plus family and peer influence.
- Biological methods for reducing addiction include drug therapy, using aversive, agonist, and antagonist drugs.
- Other methods of reducing addiction include behavioural therapies that use classical conditioning to associate addiction with an unpleasant stimulus (aversion therapy). Cognitive behavioural therapy (CBT) aims to resolve the faulty thought patterns that lead to addiction.
- Hormones that are suggested to reduce addiction include oxytocin, resistin, leptin, and adiponectin, but research into hormones and addiction reduction is relatively new.
References
- Fig. 2: Mesocorticolimbic pathway by GeorgeVKach, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons
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