Addictions

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Posted by r2d2 04/13/2009 @ 05:07

Tags : addictions, health

News headlines
More Canberrans seek help for addictions - ABC Online
A new report shows the number of Canberrans receiving treatment for drug addiction has nearly doubled in the past decade. The Australian Institute of Health and Welfare has provided data on the number of people receiving medication for addiction to...
Addiction hides in Edmond - Edmond Sun
EDMOND — At this moment, an unknown number of Edmond residents — a family member, a friend, a co-worker, a classmate — are suffering from an addiction or a substance abuse problem. You might have an addiction or substance abuse problem and not even...
A Different Kind of Help: The Dog That Changed a Teen Addict's Life - WEAU-TV 13
What isn't nearly as evident is the effort it took for Danielle to shake her addictions. "I was doing drugs. I was partying. I had under-ages. I went to juvey like every other week," Danielle tells us. The 15 year old from Mondovi says she was expelled...
Hilton: 'Pornography as addicting as any drug' - Davis County Clipper
“If we simply diagnose pornography addiction as a bad habit, we fail to diagnose it properly,” he told the anti-pornography group, headed by Bountiful resident John Harmer. Harmer underscored Hilton's concerns and reiterated the importance of setting...
Authorities: Drug addiction motivation for trio of bank robbers ... - NJ.com
Hiles, Hedden and Corney committed the bank robberies to support drug addictions, authorities said. All three were unemployed. Corney was found to be in possession of a hypodermic needle and four bags of heroin when he was arrested in February at...
Battling drug addiction in city - Peterborough Examiner
There are people that legitimately need opioids, he said, but it can also be a crushing addiction. "My prescription causes someone else to die," he said. Some wanted to share their stories about addiction. Others expressed frustration at a problem that...
IBS, Scampi Fries and maggots - weird phobias, addictions and ... - Mirror.co.uk
30-a-day smoker Darren Corbett had his cigarette cravings cured by a hypnotist at his local pub, but ended up with an addiction to seafood-flavoured snack Scampi Fries instead. He now spends £11 a day on them, almost twice as much as he used to spend...
What Happens When an Addiction Involves Pain to Ease Pain? - TransWorldNews (press release)
Most addictions stem from a conscious or subconscious desire to ease pain, but what happens when the addiction itself involves the infliction of pain? Injuring your self physically in an effort to relieve psychological pain seems like a contradiction....
Town faces lawsuit - Garner News
The US Justice Department filed a discrimination suit against the town of Garner and the board of adjustment there Tuesday, alleging the town unfairly limited the number of residents in a group home for those recovering from addiction....
Science expands definition of addiction - Edmond Sun
EDMOND — When science first studied addictive behavior individuals who became addicted to a substance commonly were viewed as being morally flawed human beings lacking willpower. Pat Nichols, founder of the Edmond chapter of Parents Helping Parents,...

My 3 Addictions

My 3 Addictions cover

My 3 Addictions is the third official CD release from antifolk music group Elastic No-No Band and their first studio album.

It is a concept album inspired partially by the 2-part structure of Willie Nelson's Phases and Stages album. My 3 Addictions has a 3-part structure, based on the three addictions listed in the title song: food, movies, and women.

On September 3, 2007, Elastic No-No Band's lead singer and songwriter, Justin Remer, started posting a blog called "My 3 Addictions: An interactive album". The first entry contained an mp3 download of the title song, in addition to various anecdotes about the making of the song and additional mp3 downloads of alternate versions of the song. Each successive entry included streaming audio of one of the album's songs, anecdotes related to that song, and mp3 downloads of alternate versions of that song. Now, the entire album can be heard, mostly as streaming audio, from the blog.

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Sexual addiction

Sexual addiction refers to a phenomenon in which individuals report being unable to manage their sexual behavior. It has also been called "hypersexuality," "sexual dependency," and "sexual compulsivity." The existence of the condition is not universally accepted by sexologists and its etiology, nature, and validity have been debated.

Proponents of the concept have offered varying descriptions, each according to their favored model of the putative phenomenon. Proponents of an addiction model of the phenomenon refer to it as "sexual addiction" and offer definitions based on substance addictions; proponents of lack-of-control models refer to it as "sexual compulsivity" and offer definitions based on obsessive-compulsive disorder (OCD); etc. Skeptics believe that it is a myth that the phenomenon exists as a disease or disorder at all and is instead a by-product of cultural and other influences.

Some sexual addiction proponents have commented that the concept faces many obstacles to being viewed seriously by the general public. One of these obstacles is the manner in which it is portrayed in popular media. Daily media sources sensationalize and denigrate people who are reported to be sex addicts. This portrayal typically extends into fictional television shows and movies.

Sexologists have not reached any consensus regarding whether sexual addiction exists or, if it does, how to describe the phenomenon. Some experts believe that sexual addiction is literally an addiction, directly analogous to alcohol and drug addictions. Other experts believe that sexual addiction is actually a form of obsessive compulsive disorder and refer to it as sexual compulsivity. Still other experts believe that sex addiction is itself a myth, a by-product of cultural and other influences.

The American Psychiatric Association publishes and periodically updates the Diagnostic and Statistical Manual of Mental Disorders (DSM), a widely recognized compendium of acknowledged mental disorders and their diagnostic criteria. The most recent version of that manual, DSM-IV-TR, was published in 2000 and does not recognize sexual addiction as a diagnosis. Some experts have expressed that excluding sexual addiction from the DSM represents a problem. The DSM does, however, include a miscellaneous diagnosis called Sexual Disorders Not Otherwise Specified, and includes as one of the examples of it: "distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used." Other examples include: compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships, and compulsive sexuality in a relationship.

The World Health Organization produces the International Classification of Diseases (ICD)), which is used globally and is not limited to mental disorders. The most recent version of that document, ICD-10, includes "Excessive sexual drive" as a diagnosis (code F52.7), subdividing it into satyriasis (for males) and nymphomania (for females).

Alfred Kinsey (NOT verbatim): "...can be diagnosed in someone who has more sex than you.", viz. it is rather subjective.

An abstract on the problem of the DSM IV's exclusion of sexual compulsive behavior has been outlined by Irons and Schneider (1996).

Irons and Schneider have noted that "Addictive sexual disorders which do not fit into standard DSM-IV categories can best be diagnosed using an adaptation of the DSM-IV criteria for substance dependence." Similarly, Lowinson and colleagues use the addiction model and define sexual addiction as a condition in which some form of sexual behaviour is employed in a pattern that is characterized at least by two key features: recurrent failure to control the behaviour and continuation of the behaviour despite harmful consequences. Patrick Carnes, another proponent of the addiction model of sexual addiction, argued that most professionals in the field agree with the World Health Organization's definition of addiction.

Schneider identified three indicators of sexual addiction: compulsivity, continuation despite consequences, and obsession.

Sexual addiction is hypothesized to be (but is not always) associated with Obsessive-compulsive disorder (OCD), Narcissistic personality disorder, and manic-depression. There are those who suffer from more than one condition simultaneously (known as a dual diagnosis or a co-occurring disorder), but traits of addiction are often confused with those of these disorders, often due to most clinicians not being adequately trained in diagnosis and characteristics of addictions, and many clinicians tending to avoid use of the diagnosis at all.

Specialists in obsessive-compulsive disorder (OCD) and addictions use the same terms to refer to different symptoms. In addictions, obsession is progressive and pervasive, and develops along with denial; the person usually does not see themselves as preoccupied, and simultaneously makes excuses, justifies and blames. Compulsion is present only while the addict is physically dependent on the activity for physiological stasis. Constant repetition of the activity creates a chemically dependent state. If the addict acts out when not in this state, it is seen as being spurred by the obsession only. Some addicts do have OCD as well as addiction, and the symptoms will interact.

Addicts often display narcissistic traits, which often clear as sobriety is achieved. Others do exhibit the full personality disorder even after successful addiction treatment.

According to the book Synopsis of Psychiatry, sex addicts are unable to control their sexual impulses, which can involve the entire spectrum of sexual fantasy or behavior. Eventually, the need for sexual activity increases, and the person's behavior is motivated solely by the persistent desire to experience the sex act and the history usually reveals a long-standing pattern of such behavior, which the person repeatedly has tried to stop, but without success. Although a patient may have feeling of guilt and remorse after the act, these feelings do not suffice to prevent its recurrence and the patient may report that the need to act out is most severe during stressful periods or when angry, depressed, anxious, or otherwise dysphoric. Eventually, the sexual activity interferes with the person's social, vocational, or marital life, which begins to deteriorate.

Proponents of the concept have described sufferers as repeatedly and compulsively attempting to escape emotional or physical discomfort by using ritualized, sexualized behaviors such as masturbation, pornography, including obsessive thoughts. Some individuals try to connect with others through highly impersonal intimate behaviors: empty affairs, frequent visits to prostitutes, voyeurism, exhibitionism, frotteurism, cybersex, and the like.

Earle has argued that neurochemical changes, similar to an adrenaline rush in the brain, temporarily reduce the discomfort an individual experiences with urges and cravings for sexualized behaviors that can be achieved through obsessive, highly ritualized patterns of sexual behavior.

Patrick Carnes (2001, p.40) argues that when children are growing up, they develop “core beliefs” through the way that their family functions and treats them. If a child is brought up in a family where his or her parents take proper care of him or her, he or she has good chances of growing up, having faith in other people and having self worth. On the other hand, if a child grows up in a family where he or she is neglected by his or her parents he or she will develop unhealthy and negative core beliefs. He or she will grow up to believe that people in the world do not care about him or her. Later on in life, the person will have trouble keeping stable relationships and will experience feelings of isolation. Generally, addicts do not perceive themselves as worthwhile human beings (Carnes, Delmonico and Griffin, 2001, p. 40). They cope with these feelings of isolation and weakness by engaging in excessive sex (Poudat, 2005, p.121).

According to Carnes, for many addicts, this dark emotion brings on depression and feelings of hopelessness. One easy way to cure feelings of despair is to start obsessing all over again. The cycle then perpetuates itself.

Self-help groups such as Sex Addicts Anonymous, Sexaholics Anonymous, Masturbators Anonymous and Sex and Love Addicts Anonymous are popular with proponents of the sexual addiction concept. These are large groups based on the 12-step system of Alcoholics Anonymous. There are various online support forums as well as real-life help through an out- or in-patient program or private counselor.

Sexual Addiction and Compulsivity: The Journal of Treatment and Prevention, a journal in which proponents explore the topic, has devoted an entire issue to AIDS and sex addiction as a worldwide problem.

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Addiction

The term "addiction" is used in many contexts to describe an obsession, compulsion, or excessive physical dependence or psychological dependence, such as: drug addiction, video game addiction, crime, money, alcoholism, work addiction,compulsive overeating, problem gambling, computer addiction, pornography addiction, etc.

In medical terminology, an addiction is a state in which the body relies on a substance for normal functioning and develops physical dependence, as in drug addiction. When the drug or substance on which someone is dependent is suddenly removed, it will cause withdrawal, a characteristic set of signs and symptoms. Addiction is generally associated with increased drug tolerance. In physiological terms, addiction is not necessarily associated with substance abuse since this form of addiction can result from using medication as prescribed by a doctor.

However, common usage of the term addiction has spread to include psychological dependence. In this context, the term is used in drug addiction and substance abuse problems, but also refers to behaviors that are not generally recognized by the medical community as problems of addiction, such as compulsive overeating.

The term addiction is also sometimes applied to compulsions that are not substance-related, such as problem gambling and computer addiction. In these kinds of common usages, the term addiction is used to describe a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences, as deemed by the user him self to his or hers individual's health, mental state or social life.

Not all doctors agree on the exact nature of addiction or dependency however the biopsychosocial model is generally accepted in scientific fields as the most comprehensive theorem for addiction. Historically, addiction has been defined with regard solely to psychoactive substances (for example alcohol, tobacco and other drugs) which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain. However, "studies on phenomenology, family history, and response to treatment suggest that intermittent explosive disorder, kleptomania, pathological gambling, pyromania, and trichotillomania may be related to mood disorders, alcohol and psychoactive substance abuse, and anxiety disorders (especially obsessive-compulsive disorder)." However, such disorders are classified by the American Psychological Association as impulse control disorders and therefore not as addictions.

Many people, both psychology professionals and laypersons, now feel that there should be accommodation made to include psychological dependency on such things as gambling, food, sex, pornography, computers, work, exercise, spiritual obsession (as opposed to religious devotion), cutting and shopping so these behaviors count as 'addictions' as well and cause guilt, shame, fear, hopelessness, failure, rejection, anxiety, or humiliation symptoms associated with, among other medical conditions, depression and epilepsy. Although, the above mentioned are things or tasks which, when used or performed, do not fit into the traditional view of addiction and may be better defined as an obsessive-compulsive disorder, withdrawal symptoms may occur with abatement of such behaviors. It is said by those who adhere to a traditionalist view that these withdrawal-like symptoms are not strictly reflective of an addiction, but rather of a behavioral disorder. However, understanding of neural science, the brain, the nervous system, human behavior, and affective disorders has revealed "the impact of molecular biology in the mechanisms underlying developmental processes and in the pathogenesis of disease". The use of thyroid hormones as an effective adjunct treatment for affective disorders has been studied over the past three decades and has been confirmed repeatedly. Modern research into addiction is generally focused on Dopaminergic pathways. There is great and sometimes heated debate around the definition of addiction with parties falling into two main camps the Disease model of addiction and the behaviorists, explanations of various models can be found in the article on Drug rehabilitation.

Terminology has become quite complicated in the field. Pharmacologists continue to speak of addiction from a physiologic standpoint (some call this a physical dependence); psychiatrists refer to the disease state as psychological dependence; most other physicians refer to the disease as addiction. The field of psychiatry is now considering, as they move from DSM-IV to DSM-V, transitioning from "substance dependence" to "addiction" as terminology for the disease state.

The medical community now makes a careful theoretical distinction between physical dependence (characterized by symptoms of withdrawal) and psychological dependence (or simply addiction). Addiction is now narrowly defined as "uncontrolled, compulsive use"; if there is no harm being suffered by, or damage done to, the patient or another party, then clinically it may be considered compulsive, but to the definition of some it is not categorized as 'addiction'. In practice, the two kinds of addiction are not always easy to distinguish. Addictions often have both physical and psychological components.

There is also a lesser known situation called pseudo-addiction. A patient will exhibit drug-seeking behavior reminiscent of psychological addiction, but they tend to have genuine pain or other symptoms that have been under-treated. Unlike true psychological addiction, these behaviors tend to stop when the pain is adequately treated. The obsolete term physical addiction is deprecated, because of its connotations. In modern pain management with opioids physical dependence is nearly universal. While opiates are essential in the treatment of acute pain, the benefit of this class of medication in chronic pain is not well proven. Clearly, there are those who would not function well without opiate treatment; on the other hand, many states are noting significant increases in non-intentional deaths related to opiate use. High-quality, long-term studies are needed to better delineate the risks and benefits of chronic opiate use.

Physical dependence on a substance is defined by the appearance of characteristic withdrawal symptoms when the substance is suddenly discontinued. Opiates, benzodiazepines, barbiturates and alcohol induce physical dependence. On the other hand, some categories of substances share this property and are still not considered addictive: cortisone, beta blockers and most antidepressants are examples. So, while physical dependency can be a major factor in the psychology of addiction and most often becomes a primary motivator in the continuation of an addiction, the initial primary attribution of an addictive substance is usually its ability to induce pleasure, although with continued use the goal is not so much to induce pleasure as it is to relieve the anxiety caused by the absence of a given addictive substance, causing it to become used compulsively.

Some substances induce physical dependence or physiological tolerance - but not addiction - for example many laxatives, which are not psychoactive; nasal decongestants, which can cause rebound congestion if used for more than a few days in a row; and some antidepressants, most notably venlafaxine, paroxetine and sertraline, as they have quite short half-lives, so stopping them abruptly causes a more rapid change in the neurotransmitter balance in the brain than many other antidepressants. Many non-addictive prescription drugs should not be suddenly stopped, so a doctor should be consulted before abruptly discontinuing them.

The speed with which a given individual becomes addicted to various substances varies with the substance, the frequency of use, the means of ingestion, the intensity of pleasure or euphoria, and the individual's genetic and psychological susceptibility. Some people may exhibit alcoholic tendencies from the moment of first intoxication, while most people can drink socially without ever becoming addicted. Opioid dependent individuals have different responses to even low doses of opioids than the majority of people, although this may be due to a variety of other factors, as opioid use heavily stimulates pleasure-inducing neurotransmitters in the brain. Nonetheless, because of these variations, in addition to the adoption and twin studies that have been well replicated, much of the medical community is satisfied that addiction is in part genetically moderated. That is, one's genetic makeup may regulate how susceptible one is to a substance and how easily one may become psychologically attached to a pleasurable routine.

Eating disorders are complicated pathological mental illnesses and thus are not the same as addictions described in this article. Eating disorders, which some argue are not addictions at all, are driven by a multitude of factors, most of which are highly different than the factors behind addictions described in this article. It has been reported, however, that patients with eating disorders can successfully be treated with the same non-pharmacological protocols used in patients with chemical addiction disorders. Gambling is another potentially addictive behavior with some biological overlap. Conversely gambling urges have emerged with the administration of Mirapex (pramipexole), a dopamine agonist.

Psychological dependency is a dependency of the mind, and leads to psychological withdrawal symptoms (such as cravings, irritability, insomnia, depression, anorexia, etc). Addiction can in theory be derived from any rewarding behaviour, and is believed to be strongly associated with the dopaminergic system of the brain's reward system (as in the case of cocaine and amphetamines). Some claim that it is a habitual means to avoid undesired activity, but typically it is only so to a clinical level in individuals who have emotional, social, or psychological dysfunctions (psychological addiction is defined as such), replacing normal positive stimuli not otherwise attained (see Rat Park study).

A person who is physically dependent, but not psychologically dependent can have their dose slowly dropped until they are no longer dependent. However, if that person is psychologically dependent, they are still at serious risk for relapse into abuse and subsequent physical dependence.

Psychological dependence does not have to be limited only to substances; even activities and behavioural patterns can be considered addictions, if they become uncontrollable, e.g. problem gambling, Internet addiction, computer addiction, sexual addiction / pornography addiction, eating, self-injury, or work addiction.

Most countries have legislation which brings various drugs and drug-like substances under the control of licensing systems. Typically this legislation covers any or all of the opiates, amphetamines, cannabinoids, cocaine, barbiturates, hallucinogens (tryptamines, LSD, phencyclidine(PCP), psilocybin) and a variety of more modern synthetic drugs, and unlicensed production, supply or possession may be a criminal offense.

Usually, however, drug classification under such legislation is not related simply to addictiveness. The substances covered often have very different addictive properties. Some are highly prone to cause physical dependency, whilst others rarely cause any form of compulsive need whatsoever. Typically nicotine (in the form of tobacco) is regulated extremely loosely, if at all, although it is well-known as one of the most addictive substances ever discovered.

Also, although the legislation may be justifiable on moral grounds to some, it can make addiction or dependency a much more serious issue for the individual. Reliable supplies of a drug become difficult to secure as illegally produced substances may have contaminants. Withdrawal from the substances or associated contaminants can cause additional health issues and the individual becomes vulnerable to both criminal abuse and legal punishment. Criminal elements that can be involved in the profitable trade of such substances can also cause physical harm to users.

Some medical systems, including those of at least 15 states of the United States, refer to an Addiction Severity Index to assess the severity of problems related to substance use. The index assesses problems in six areas: medical, employment/support, alcohol and other drug use, legal, family/social, and psychiatric.

While addiction or dependency is related to seemingly uncontrollable urges, and arguably could have roots in genetic predispositions, treatment of dependency is conducted by a wide range of medical and allied professionals, including Addiction Medicine specialists, psychiatrists, psychologists, and appropriately trained nurses, social workers, and counselors. Early treatment of acute withdrawal often includes medical detoxification, which can include doses of anxiolytics or narcotics to reduce symptoms of withdrawal. An experimental drug, ibogaine, is also proposed to treat withdrawal and craving. Alternatives to medical detoxification include acupuncture detoxification. In chronic opiate addiction, a surrogate drug such as methadone is sometimes offered as a form of opiate replacement therapy. But treatment approaches universal focus on the individual's ultimate choice to pursue an alternate course of action.

Therapists often classify patients with chemical dependencies as either interested or not interested in changing. Treatments usually involve planning for specific ways to avoid the addictive stimulus, and therapeutic interventions intended to help a client learn healthier ways to find satisfaction. Clinical leaders in recent years have attempted to tailor intervention approaches to specific influences that affect addictive behavior, using therapeutic interviews in an effort to discover factors that led a person to embrace unhealthy, addictive sources of pleasure or relief from pain.

From the applied behavior analysis literature and the behavioral psychology literature several evidenced based intervention programs have emerged (1) behavioral maritial therapy (2) community reinforcement approach (3) cue exposure therapy and (4) contingency management strategies. In addition, the same author suggest that Social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious.

Several explanations (or "models") have been presented to explain addiction. These divide, more or less, into the models which stress biological or genetic causes for addiction, and those which stress social or purely psychological causes. Of course there are also many models which attempt to see addiction as both a physiological and a psycho-social phenomenon.

The development of addiction is thought to involve a simultaneous process of 1) increased focus on and engagement in a particular behavior and 2) the attenuation or "shutting down" of other behaviors. For example, under certain experimental circumstances such as social deprivation and boredom, animals allowed the unlimited ability to self-administer certain psychoactive drugs will show such a strong preference that they will forgo food, sleep, and sex for continued access. The neuro-anatomical correlate of this is that the brain regions involved in driving goal-directed behavior grow increasingly selective for particular motivating stimuli and rewards, to the point that the brain regions involved in the inhibition of behavior can no longer effectively send "stop" signals. A good analogy is to imagine flooring the gas pedal in a car with very bad brakes. In this case, the limbic system is thought to be the major "driving force" and the orbitofrontal cortex is the substrate of the top-down inhibition.

A specific portion of the limbic circuit known as the mesolimbic dopaminergic system is hypothesized to play an important role in translation of motivation to motor behavior- and reward-related learning in particular. It is typically defined as the ventral tegmental area (VTA), the nucleus accumbens, and the bundle of dopamine-containing fibers that are connecting them. This system is commonly implicated in the seeking out and consumption of rewarding stimuli or events, such as sweet-tasting foods or sexual interaction. However, its importance to addiction research goes beyond its role in "natural" motivation: while the specific site or mechanism of action may differ, all known drugs of abuse have the common effect in that they elevate the level of dopamine in the nucleus accumbens. This may happen directly, such as through blockade of the dopamine re-uptake mechanism (see cocaine). It may also happen indirectly, such as through stimulation of the dopamine-containing neurons of the VTA that synapse onto neurons in the accumbens (see opiates). The euphoric effects of drugs of abuse are thought to be a direct result of the acute increase in accumbal dopamine.

The human body has a natural tendency to maintain homeostasis, and the central nervous system is no exception. Chronic elevation of dopamine will result in a decrease in the number of dopamine receptors available in a process known as downregulation. The decreased number of receptors changes the permeability of the cell membrane located post-synaptically, such that the post-synaptic neuron is less excitable- i.e.: less able to respond to chemical signaling with an electrical impulse, or action potential. It is hypothesized that this dulling of the responsiveness of the brain's reward pathways contributes to the inability to feel pleasure, known as anhedonia, often observed in addicts. The increased requirement for dopamine to maintain the same electrical activity is the basis of both physiological tolerance and withdrawal associated with addiction.

Downregulation can be classically conditioned. If a behavior consistently occurs in the same environment or contingently with a particular cue, the brain will adjust to the presence of the conditioned cues by decreasing the number of available receptors in the absence of the behavior. It is thought that many drug overdoses are not the result of a user taking a higher dose than is typical, but rather that the user is administering the same dose in a new environment.

In cases of physical dependency on depressants of the central nervous system such as opioids, barbiturates, or alcohol, the absence of the substance can lead to symptoms of severe physical discomfort. Withdrawal from alcohol or sedatives such as barbiturates or benzodiazepines (valium-family) can result in seizures and even death. By contrast, withdrawal from opioids, which can be extremely uncomfortable, is rarely if ever life-threatening. In cases of dependence and withdrawal, the body has become so dependent on high concentrations of the particular chemical that it has stopped producing its own natural versions (endogenous ligands) and instead produces opposing chemicals. When the addictive substance is withdrawn, the effects of the opposing chemicals can become overwhelming. For example, chronic use of sedatives (alcohol, barbiturates, or benzodiazepines) results in higher chronic levels of stimulating neurotransmitters such as glutamate. Very high levels of glutamate kill nerve cells, a phenomenon called excitatory neurotoxicity.

A strong form of criticism comes from Thomas Szasz, who denies that addiction is a psychiatric problem. In many of his works, he argues that addiction is a choice, and that a drug addict is one who simply prefers a socially taboo substance rather than, say, a low risk lifestyle. In Our Right to Drugs, Szasz cites the biography of Malcolm X to corroborate his economic views towards addiction: Malcolm claimed that quitting cigarettes was harder than shaking his heroin addiction. Szasz postulates that humans always have a choice, and it is foolish to call someone an 'addict' just because they prefer a drug induced euphoria to a more popular and socially welcome lifestyle.

Szasz is not alone in questioning the standard view of addiction. Professor John Booth Davies at the University of Strathclyde has argued in his book The Myth of Addiction that 'people take drugs because they want to and because it makes sense for them to do so given the choices available' as opposed to the view that 'they are compelled to by the pharmacology of the drugs they take'. He uses an adaptation of attribution theory (what he calls the theory of functional attributions) to argue that the statement 'I am addicted to drugs' is functional, rather than veridical. Stanton Peele has put forward similar views.

Experimentally, Bruce K. Alexander used the classic experiment of Rat Park to show that 'addicted' behaviour in rats only occurred when the rats had no other options. When other options and behavioural opportunities were put in place, the rats soon showed far more complex behaviours.

The word addiction is also sometimes used colloquially to refer to something for which a person has a passion, such as books, chocolate, work, the web, running, postage stamp collecting, or eating.

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Video game addiction

Video game addiction, or more broadly video game overuse, is excessive or compulsive use of computer and video games that interferes with daily life. Instances have been reported in which users play compulsively, isolating themselves from, or from other forms of, social contact and focusing almost entirely on in-game achievements rather than broader life events.

Video game addiction is not included as a diagnosis in either the DSM or the International Statistical Classification of Diseases and Related Health Problems. However, effects (or symptoms) of video game overuse are similar to those of other proposed psychological addictions. Video game overuse may be, like compulsive gambling, an impulse control disorder.

In 2007, the American Psychological Association reviewed whether or not video game addiction should be added in the new DSM to be released in 2012. The conclusion was that there was not enough research or evidence to conclude that video game addiction was a disorder.

A report by the Council On Science And Public Health to the AMA cited a 2005 Entertainment Software Association survey of computer gaming players, and noted that players of MMORPGs were more likely to play for more than 2 hours per day than other gamers. In its report, the Council used this 2 hour per day limit to define "gaming overuse", citing the American Academy of Pediatrics guideline of no more than 1 to 2 hours per day of "screen time". It may be worth noting that the ESA document cited in the Council report does not contain the 2 hour per day data.

In a 2005 Tom's Games interview, Dr. Maressa Orzack estimated that 40% of the players of World of Warcraft (an MMORPG) were addicted, but she did not indicate a source for the estimate. She may have derived the estimate from the informal survey managed by Nick Yee at the The Daedalus Project, who notes that caution should be exercised when interpreting this data.

Michael Cai, director of broadband and gaming for Parks Associates (a media/technology research and analysis company), said in 2007 that "Video game addiction is a particularly severe problem in Asian countries such as China and Korea". Results of a 2006 survey suggested that 2.4% of South Koreans aged 9 to 39 suffer from game addiction, with another 10.2 percent at risk of addiction.

A 2007 Harris Interactive online poll of 1,187 US youths aged 8-18 gathered detailed data on youth opinions about video game play. About 81% of youths stated that they played video games at least once per month. Further, the average play time varied by age and sex, from 8 hours per week (responses from teen girls) to 14 hours per week (responses by teen boys). "Tweens" (8-12 year olds) fell in the middle, with boys averaging 13 hours per week of reported game-play, and girls averaging 10. Harris concludes that 8.5% "can be classified as pathological or clinically 'addicted' to playing video games", but did not explain how this conclusion was reached.

Since the American Psychological Association decision in 2007, studies have been conducted at Stanford University School of Medicine related to video game play. Researchers found evidence that video games do have addictive characteristics. An MRI study found that the part of the brain that generates rewarding feelings is more activated in men than women during video-game play.

The press has reported concerns over online gaming since at least 1993, when Wired Magazine mentioned a college student who was playing a MUD for 12 hours a day instead of attending class.

Press reports have noted that some Finnish Defence Forces conscripts were not mature enough to meet the demands of military life, and were required to interrupt or postpone military service for a year. One reported source of the lack of needed social skills is overuse of computer games or the Internet. Forbes termed this overuse "Web fixations", and stated that they were responsible for 12 such interruptions or deferrals over the 5 years from 2000-2005.

In a July 2007 article, Perth, Western Australia parents stated that their 15-year-old son had abandoned all other activities to play RuneScape, a popular MMORPG. The boy's father compared the condition to heroin addiction.

On March 6, 2009, the CBC's national newsmagazine program the fifth estate aired an hour-long report on video game addiction and the Brandon Crisp story, titled "Top Gun", subtitled "When a video gaming obsession turns to addiction and tragedy".

In August of 2005, the government of the People's Republic of China, where more than 20 million people play online games, introduced an online gaming restriction limiting playing time to 3 hours, after which the player would be expelled from whichever game they were playing. In 2006, it relaxed the rule so only citizens under the age of 18 would face the limitations. Reports indicate underage gamers found ways to circumvent the measure. In July, 2007, the rule was relaxed yet again. Internet games operating in China must require that users identify themselves by ID numbers. After 3 hours, players under 18 are prompted to stop and "do suitable physical exercise." If they continue, their characters gain 50% of the usual experience. After 5 hours, their characters gain no experience at all.

In 2008, one of the 5 FCC Commissioners, Deborah Taylor Tate, stated that online gaming addiction was "one of the top reasons for college drop-outs". However, she did not mention a source for the statement, nor identify its position in relation to other top reasons.

Theorists focus on the built-in reward systems of the games to explain their addictive nature.

Researchers at the University of Rochester and Immersyve, Inc. (a Celebration, FL computer gaming Think-tank) investigated what motivates gamers to continue playing video games. According to lead investigator Richard Ryan, they believe that players play for more reasons than fun alone. Ryan, a motivational psychologist at Rochester, says that many video games satisfy basic psychological needs, and players often continue to play because of rewards, freedom, and a connection with other players.

Some countries, like South Korea, China, the Netherlands and the United States, have responded to the perceived threat of video game addiction by opening treatment centers.

Because few clinical trials and no meta-analyses have been completed, research is still in the preliminary stages for excessive gaming treatment. The most effective treatments seem to be, as with addictions or dependencies, a combination of psychopharmacology, psychotherapy and twelve-step programs.

The Chinese government operates several clinics to treat those addicted to online games, chatting and web surfing. Treatment for the patients, most of whom have been forced to attend by parents or government officials, include various forms of pain or uneasiness.

In June 2006, the Smith and Jones Clinic in Amsterdam became the first treatment facility in Europe to offer a residential treatment program for compulsive gamers. Keith Bakker, founder and head of the clinic, has stated that 90% of the young people who seek treatment for compulsive computer gaming are not addicted.. The clinic focuses on excess gaming being a result of social situations rather than an addictive dependency.

McLean Hospital in Belmont, Massachusetts has set up "Computer Addiction Services". Elsewhere, gamers may seek services at generalized addiction support centers.

Online Gamers Anonymous, an American non-profit organization formed in 2002, is a twelve-step, self-help, support and recovery organization for gamers and their loved ones who are suffering from the adverse effects of excessive computer game playing. The organization provides a variety of message boards, several on-line meetings and other tools for healing and support.

At a "Computer Addiction Services" center in Richmond, British Columbia, Canada, excessive gaming accounts for 80% of one youth counselor's caseload.

There have been a variety of well-documented deaths around the world caused directly by exhaustion from playing games for excessive periods of time. Also, there have been deaths of gamers and/or others directly related to excessive and/or compulsive playing of video games.

There were a number of deaths related to exhaustion from playing games for too long without food and rest. In Jinzhou, China, Xu Yan died after playing online games continuously for over 15 days during the Lunar New Year holiday. Also, an unnamed 30 year-old male died in Guangzhou, China after playing continuously for 3 days.

In 2005, Lee Seung Seop (Hangul: 이승섭) visited an Internet cafe in the city of Taegu and played StarCraft almost continuously for fifty hours. He went into cardiac arrest, and died at a local hospital. A friend reported: "...he was a game addict. We all knew about it. He couldn't stop himself." About six weeks before his death, his girlfriend, also an avid gamer, broke up with him, and he had been fired from his job for repeated tardiness.

Police say that Dinh The Dan, a 13 year old boy, "strangled Mai Thi Mau, 81, with a piece of rope and took 100,000 dong ($6.20) from her". Also, he "confessed that he needed money to play online games and decided to kill and rob the woman".

Gregg J. Kleinmark, 24, plead "guilty to two counts of involuntary manslaughter". He "left fraternal twins Drew and Bryn Kleinmark unattended in a bathtub for 30 minutes, in order to go three rooms away and play on his Game Boy Advance console" while "in the mean time, the two ten-months old kids drowned".

Tyrone Spellman, 27, of Philadelphia, was convicted of third-degree murder for killing his 17-month old daughter in a rage over a broken Xbox. He "killed Alayiah Turman with at least five blows to the head" that "cracked the toddler's skull several times".

Ohio teen Daniel Petric shot his parents, killing his mother, after they took away his copy of Halo 3 in October 2007. In a sentencing hearing after the teen was found guilty of aggravated murder, Judge James Burge said "I firmly believe that Daniel Petric had no idea at the time he hatched this plot that if he killed his parents they would be dead forever".

Brandon Crisp, an Ontario 15-year-old, ran away from home on Thanksgiving Monday in 2008 after his parents took away his Xbox 360 due to falling grades and excessive play of Call of Duty 4. He was last seen alive on a bicycle trail. His body was found weeks later, about 3 miles away, by a party of hunters. An autopsy determined that he died in a fall from a tree.

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Source : Wikipedia