The addiction or dependency is, quite phenomenological, conduct which is based on a repeated and irrepressible desire, despite the motivation and efforts of the subject to evade.
This is anglicism meaning, synonymous with the drug and is any commitment to a harmful substance or activity.
The problems caused by addiction can be physical, psychological, relational, familial, and social. The gradual and continuous at all levels makes a return to controlled behavior increasingly problematic.
In psychoanalysis, the term addiction is used more broadly as it is more of an attitude intrapsychic, a mechanism, rather than means to satisfy them. Parallel mechanisms may be involved in determining such as anorexia mental.
Addiction refers to both pipelines such as gambling, addiction to Internet gaming and role-play, e-risk or exercises involving inappropriate sports a syndrome of overtraining that the reliance on products such as alcohol, tobacco and psychotropic drugs.
The origin and introduction of the term psychopathology
The term addiction is of Latin etymology, ad-dicere "say". In Roman civilization, the slaves had no name and were known for their Pater familias. Addiction expresses a lack of independence or even slavery.
Be addicts in the Middle Ages was an obligation of a debtor who could not otherwise pay off its debt to pay his creditor for his work following a court order.
Thereafter, in the English language, from the fourteenth century, addiction was able to describe the contractual relationship of submission of an apprentice to his master, then gradually bring the modern sense, designating passions fed and morally reprehensible.
Also in English, the word addiction is totally integrated into the popular language for all the passion and dependencies for example is a sex addict. This popularity of the term in Anglo-Saxon which explains its ambiguity: English psychiatrists are often reluctant to use it (it was removed from the DSM-IV, to the term "dependency").
This is Sigmund Freud who first used the term to illustrate a "primary need" (Letters to Wilhelm Fliess) which is part of the condition of every human being: the infans is dependent on its mother for its survival. It is this crucial state that would have evolved mal que derive the "addiction".
Karl Abraham in 1908, Sandor Rado in 1933, Otto Fenichel in 1945 and Herbert Rosenfeld in 1968 are psychoanalysts who have contributed to the definition of the term in depth. It was for them to analyze the mechanisms unconscious impulses, and other regressive in theory and clinical.
Defined by WHO
In 1975 the World Health Organization defines addiction as:
"A psychological and sometimes physical, resulting from the interaction between a living organism and a product, characterized by behavioral and other responses which include a compulsion to take the product on a regular or routine to feel its psychic effects and sometimes avoid discomfort of its absence (withdrawal). Tolerance may be present or not. "
Dependence according to DSM-IV
The DSM-IV addiction as a form of inappropriate use of a product resulting in physical and psychological. It is manifested by the appearance of at least three of the following signs over a period of one year.
* A tolerance (or addiction), which is reflected by an increase in dose for a similar effect, either by a decreased effect if the doses are maintained at their original state.
* A withdrawal syndrome when stopping or taking the product to avoid a withdrawal syndrome.
* An inability to manage its own use, the user consumes longer or more than it wanted.
* Unsuccessful efforts to control consumption.
* A time of increasing importance is devoted to searching for the product.
* The social, cultural and leisure are abandoned because of the importance of taking the product in everyday life.
* A continued consumption despite the awareness of the problems it creates.
Tolerance and withdrawal are the physical dependence, and cover only two tests on 7. It is therefore possible to be dependent as defined in DSM without having developed a physical tolerance.
Dependence according to ICD-10
The ICD-10 showed the drug as a manifestation of at least three of the following signs over a period of one year and has persisted at least a month or so have occurred repeatedly.
* A compulsive desire to consume the product.
* Difficulties in controlling consumption.
* The appearance of a withdrawal syndrome when stopping or reducing doses or taking the product to avoid a withdrawal syndrome.
* Tolerance to effects (increased doses to achieve a similar effect).
* An overall disinterest in all matters not related to the product or its research.
* A continued consumption despite the awareness of the problems it creates.
Types of dependency
There are two types of addiction:
* Physical dependence: state in which the body assimilates to its own operations the presence of a developing some serious physical disorder in the absence (non-presence of the product in the body), these disorders constitute the so-called syndrome. Physical dependence results from the coping mechanisms of the body to a prolonged and consumption can be accompanied by an addiction, ie the need to increase doses to experience the same effect.
* The psychological dependence that is divided into two subgroups:
o psychological dependence: insistent and persistent desire to eat which can sometimes lead to psychological and somatic manifestations (real physical pain without physical cause). The psychological dependence is more related to characteristics of individuals (affective states, lifestyles) and the product itself. Examples of psychological dependence are widespread addiction to work, the physical or intellectual activity, which can sometimes lead to overwork. An Anglo-Saxon term designating as the "workaholic";
o behavioral dependence: stimulation is generated by the habits or the environment as a factor in relapse.
Long regarded as a character trait characterized by the absence of will, the psychological mechanisms of addiction are now better known and we begin to distinguish better the centers of the brain involved in addiction research even though these remain very complex to interpret.
The pattern originates from behaviourism For its part, highlighted the dysfunction of the reward would be the pivot of the phenomena of dependency.
The psychoanalytic interpretation is based on the question of ontogenetic developments relating to the satisfaction of needs (hunger, love, etc..) And their entanglement with the sex drive (libido) and destructiveness. Freud in the second topical attempted to elucidate the repetition compulsion as a manifestation of the death instinct. His successors have adopted these theories in terms of object relations (the absence of Peter Fedida) or unconscious ordeal as a mechanism underlying the interplay between life and death.
The data from family studies, twin or adoption show a significant heritability of all addictions, ranging from 30% to 60% depending on the work [ref. necessary]. The genes specifically involved, their role and their numbers are still to be determined. These genetic factors interact with many environmental factors in determining addiction.
Many theories of psychological, neurological and biological attempt to explain the mechanisms of addiction and dependency.
The simple explanation of the cycle defined by the regulation of internal and external endorphins is inadequate and outdated. All studies [ref. necessary] are in favor of a central role of dopamine in the mesolimbic path. However, these mechanisms are likely to be modulated by many others.
Treatment of addiction
Treatment aims first abstinence for drug addicts through detoxification obtained by different means, with or without substitution treatment in hospital or ambulatory, with or without support from psychotherapy. These rules relate primarily to persons dependent on opiates to the 1980s, where the policy change for all treatments.
The emergence of AIDS and the need to fight against its spread cause the treatment of heroin in the field of medical epidemics. Substitution treatment with methadone take precedence over any other form of therapy. We begin to talk about risk reduction policy favoring a particular approach to health by the distribution of syringes, the expansion of indications of substitution with methadone, even the controlled distribution of heroin in some countries (Switzerland, England, Canada ) with provision of local injection supervised by paramedical personnel.
Until the emergence and recognition of the importance of AIDS and its spread through sharing injection equipment, treatment of drug addiction was the subject of much controversy.
* For some, the opiate addicts are required via an analogy with the diabetic and insulin. These are widely distribute methadone, which must stabilize the drug in helping patients to break the law and allowing them to access a certain autonomy.
* For others following Claude Olievenstein this drug legal or medical replaces alienation by another. For them, the aim must be to help addicts break their addiction to find their freedom. It is also counter sects and therapeutic communities, some of which advocate a brutal deconditioning.
The emergence of AIDS will promote the development of methods to limit transmission of the virus, relegating to second place the question and the psychological and social significance of drug addiction.
It is also since that time we talk more dependence and that this category covers all forms of conduct and / or abuse. Some believe that this extension has the disadvantage of throwing the trouble on the issue from a psychological and it is not easy to establish the link between "needs" of an addict to video games or Internet and a cocaine addict or an alcoholic. These two approaches are the source of controversy sometimes virulent.
Most countries have established a care planning often mainly based on legislative measures more or less law enforcement and information campaigns and prevention. In France, the Mildt preparing government plans to fight against drugs and ensure their implementation, under the Prime Minister.
Criteria for addiction
They are numerous and vary as much as the views and theoretical references that underlie them. But most of them are built on the model called "Bio-Psycho-Social" which refers to biological (addictogene potential of the product, possible genetic background), the sociological aspects (context, family environment, school, etc.). and psychological aspects (personality of the subject).
For example, depending on the model of mechanistic Aviel Goodman, American psychiatrist describes:
* Unable to resist the impulse to action.
* Sensation of growing tension immediately preceding the start of the behavior.
* Pleasure or relief during the period.
* Loss of control at the outset of the crisis.
* Presence of at least five of the nine criteria:
o Monopolisation of thought by the addictive behavior.
o Intensity and duration of episodes greater than originally desired.
o Repeated attempts to reduce, control or abandon behavior.
No significant time spent preparing the episodes, to undertake or to recover.
o The involvement in the conduct is such that the person can no longer perform basic actions (washing, eating) and led to a disinvestment social, occupational and family.
o Occurrence of frequent episodes where the subject must perform professional duties, family or social.
o Continuation of the behavior despite the worsening of social problems and despite knowledge of negative consequences.
o Tolerance marked, is need to increase the intensity or frequency to get the desired effect, or decrease the effect obtained by conduct of the same intensity.
o Restlessness, irritability and anxiety especially if the transition to the addictive act is delayed, prevented.
* The craving (the English "burning desire, insatiable appetite") is the compulsive desire to reproduce the behavior of addiction after a period of abstinence.
* Often associated with physical symptoms of opioid withdrawal, lack a broader definition where it refers to a state where the individual feels a sense dependent vacuum could be filled by the performance behavior addictogene.
* Alienation means the dispossession of the individual and loss of control over its own forces for the benefit of higher powers.
Here is a list of addictive substances:
Read also Drug Rehab