The+Nature+of+Addiction


 * Melanie Murphy**
 * Student number: n8846430**
 * Tutor: Jey Rodgers**

The Nature of Addiction CULTURAL ARTEFACT:

In 1997 ‘K’s Choice’, a Belgian formed band released a song entitled ‘Not an Addict’, which simply but clearly depicts many levels of addiction as well as drug preference.

‘I’m Not an Addict’

//Breathe it in and breathe it out and pass it on, it's almost out,// //We're so creative, so much more we’re high above but on the floor,// //It's not a habit, it's cool, I feel alive// //if you don't have it you're on the other side.// //I'm not an addict (maybe that's a lie)// //The deeper you stick it in your vein// //The deeper the thoughts, there's no more pain, I'm in heaven,// //I'm a god I'm everywhere, I feel so hot!// //It's not a habit, it's cool,// //I feel alive If you don't have it you're on the other side...// //It's over now, I'm cold, alone I'm just a person on my own.// //Nothing means a thing to me (Nothing means a thing to me).// //Free me, leave me watch me as I'm going down,// //free me, see me, look at me, I'm falling and I'm falling...// //It's not a habit, it's cool, I feel alive!// //It's not a habit, it's cool, I feel alive// //If you don't have it you're on the other side,// //I'm not an addict (maybe that's a lie)...//

[|I'm Not An Addict]

THE PUBLIC HEALTH ISSUE

The incidence and prevalence of drug addiction in Australia is an important issue, as it can have a serious impact on the individual drug user and their links to society and culture, as part of a dynamic, intrinsic and complex system. (Anglin, Brown, Dembo, & Leukefeld, 2009).

Several aspects explaining the concept and nature of drug addiction will be discussed including the connections and relationships with different drug users in our society. We look at the difference between recreational and problematic drug use and examine the social, psychological and physiological contributing factors for the development of drug addiction at an individual level.The content of the literature review contains relevant statistical evidence based research, scientific journals, websites and also includes interviews and information from counselling services provided by former and current drug users, to demonstrate how autonomy reveals a more personalised perspective on the solutions and/or management of drug addiction.

Defining Addiction:

//"The Compulsive physiological//

//and psychological need//

//for a habit-forming substance".//

Farlex (2009).

REVIEWING THE LITERATURE Addiction comes in many different forms and is classed into two specific types; dependence on a psychoactive substance (drug) and behavioural addictions. Behavioural addictions focus on a psychological compulsion or obsession and drug addiction involves compulsive prolonged use of a substance leading to a physiological change in the neuro-circuitry of the brain; once the psychoactive chemical wears off the dependant person needs the drug to feel physically well and uses the drug again to achieve a similar high. For example, over time a heroin addict cannot achieve the same high due to a physiological tolerance to the drug, therefore more of the same substance is needed to feel the desired effect. The Concept of Addiction Explained (2013).

Robinson and Berridge (2003, p. 25) question historical theories of drug addiction that suggest feelings of pleasure and fear of withdrawal are what drive drug use, these theories include reviewed findings by Torregrosser, Corlett and Taylor; the aberrant learning model (2011, p. 959), which suggests memory of drug use overrides knowledge that using the drug is detrimental to ones health. This model states that frontal cortical dysfunction causes impairment of judgement and compulsive behavioural tendencies that are responsible for drug addiction.

DRUG USERS IN SOCIETY Australian society consists of diverse and culturally unique groups of individuals. Within these groups there are some that are more sensitive to addiction, from experiences with experimentation of drugs and from frequent drug use. In a statistical monograph written by Ritter, Matthew-Simmons and Carragher, (2012, p. 79), the most susceptible are individuals identifying as Gay, Lesbian, Bisexual, Transgender, Intersex and Queer (GLBTIQ) in comparison to their heterosexual counterparts. Homosexual and bisexual men and women diagnosed with drug abuse problems were at a rate of 15.4% compared to heterosexual respondents at 6.8%. Ritter et al., (2012, p 104) also demonstrates the correlation between mental health issues and drug use, including victims of childhood physical and sexual abuse. In an anonymous interview with a heroin addict (October, 2011), a number of important factors were communicated and observed; the person referred to themselves as being labelled an ‘addict for life’, they discussed feelings of self-loathing, social phobia and the behavioural tendency to lie pathologically as a learned cognitive experience stemming from drug seeking behaviours and consequently the need for the drug to stay well.

One disturbing aspect of mental health issues in relation to GLBITQ groups and drug use is suicide, as findings from the national transgender discrimination surveys’ report on health and health care (2010, p 1), reveal a 41% suicide attempt rate in contrast to 1.6% of the general population. Transgender identified persons as well as groups with low socio-economic stature and indigenous groups are currently the most vulnerable. Smith and White, (2008), found 23% of Indigenous Australians aged 12 to 15 have used illicit drugs, a difference of 11.4% for non indigenous individuals. Consequently, the origins of drug abuse may be based fundamentally on endogenous or exogenous prolonged depression, or depressive episodes.

A bisexual indigenous woman was interviewed on her perspective of drug use and discrimination of sexuality in indigenous communities (personal communication, June, 2012):

//"I would never tell anyone I was bisexual, but the people I used ‘Go’ (speed) with that knew about me were usually sex workers or other people that weren’t straight. You would be shamed in our culture for things like that". // <span style="font-family: Arial,Helvetica,sans-serif; font-size: 190%;">ILLICIT DRUGS <span style="font-family: Georgia,serif; font-size: 140%;">The Australian Institute of Criminology (AIC), (2011), rates cannabis as the most widely used illicit drug in Australia but there are numerous other drugs commonly used in our society all falling under one of the following categories; amphetamines (stimulants), narcotics (depressants) and hallucinogenic (psychedelics, dissociatives, and deliriants). To demonstrate the trends and societal implications of drug addiction and abuse, we will look at some subgroups of drugs and the health implications of overdose.

<span style="font-family: Georgia,serif; font-size: 140%;">Just as mental health issues like depression can influence drug seeking tendencies, so too can the use of drugs alone, in fact the use of amphetamines can progressively lead to episodes of psychosis and paranoid delusions. Not only does the use of amphetamines affect the mind but psychotic episodes as mentioned place a massive strain on organs of the body such as the heart possibly leading to heat attack stroke or may even be fatal, keep this in mind when considering that more than 9% of Australians over the age of 14 years have used amphetamines and 3% in the last 12 months. Illicit drug types. (2011).

<span style="font-family: Georgia,serif; font-size: 140%;"> Methamphetamine use began to rise in the year 2000 as the street value for heroin increased and the purity of the drug decreased. Today the most preferred method of use is smoking the drug. Psychotic episodes are also seen in the use of methylenedioxymethamphetamine (MDMA), also known as ecstasy. This drug also affects the heart, sometimes leading to renal failure in overdose situations. Heroin use although not as common as in previous years, is still a concern mainly because of how addictive this drug is. The drug has an effect on the opiate receptors of the brain, changing brain physiology. Heroin and the use of other addictive illicit drugs have numerous other physical and psychological implications for health, which reach beyond the scope of this topic, however all factors discussed place a huge demand on Australia’s health budget, staffing needs and whilst problems within treatment and management of drug use under the health system continue, so too does the individuals addiction problems.

<span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 190%; text-align: center;">METHODS OF DRUG USE <span style="font-family: Georgia,serif; font-size: 140%;">Drugs can be snorted, eaten, smoked, inhaled, sniffed, they can be absorbed via delicate mucous membranes rectally and they can also be used intra-venously (IV). IV drug use is the fastest way of delivering the effect of the drug, although not all drugs can be used this way. IV methods of use poses its own individual and societal threats as blood borne viruses such as Hepatitis B and C, HIV and can be transmitted this way through sharing needles and other drug paraphernalia. When an individual has a drug addiction and another drug related health issue (such as mental health or hepatitis C), the person is then known as having co-morbidity, individuals can also have multiple co-morbidities which extend to mental health issues or other physical illnesses. Alcohol And Drug Information Service (ADIS) is a telephone drug information service provided to the community by drug users, for drug users to ensure safety, appropriate drug disposal and harm minimisation strategies for the use of illicit substances. ADIS discourages the use of alcohol during drug use to minimise risk of transmission of blood borne viruses and recommends not using more than one drug at a time. This telephone service is provided on a 24 hour basis nationally.

<span style="font-family: Georgia,serif; font-size: 140%;">The literature clearly supports the complex relationship between, mental health, drug use and addiction. The following figure (1.1) demonstrates the cyclic nature of drug addiction; as mentioned previously origins of drug seeking can be psychological/emotional, releasing an emotional trigger, or a consequence of initiating drug use. Ritualistic behaviours demonstrate a cognitive associative process that precedes drug use and therefore, may become a cognitive trigger, thus perpetuating the cyclic nature of addiction.

Fig 1.1

. Patterson- Sterling, 2012.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 190%;">THE RATE AT WHICH ADDICTION DEVELOPS IS UNIQUE TO THE INDIVIDUAL, AS IS DIFFERENTIATION BETWEEN RECREATIONAL AND PROBLEMATIC DRUG USE <span style="font-family: Georgia,serif; font-size: 140%;">The rate at which a drug addiction can develop depends largely on the addictive properties of the drug, how much of the drug is used and the frequency of use and on the person. <span style="font-family: Georgia,serif; font-size: 140%;">The Concept of Addiction Explained (2013).

<span style="font-family: Georgia,serif; font-size: 140%;">Robinson and Berridge (2003), argue the relationship between the compulsion to use drugs and a transitional period where physiological changes in the brain develop into a psychologically addictive state are reasonable, yet does not explain how compulsive drug use can also be flexible or why the drug addicted person may relapse after not having the drug in their system for some time. It is clear that there is a definite transition period into addiction. Robinson and Berridges’ (2003) conclusions suggest, in contrast to traditional theories that addiction may be driven by the area of the brain that mediates incentive salience. Even though this circuitry can remain normal in drug addicted persons, a neural stimulus may drive the compulsive desire for drug use, suggesting a pathological association between neural triggers and the brains response to ‘satiate’ the compulsive effort. This explains the characteristic ‘ritual’ of addictive behaviour being a familiar process, often triggered by cues. Moreover drug induced frontal dysfunction that inhibits decision making and control mechanisms in drug addicted persons, may further the effect of the neural response of ‘desire’, explaining why after a period of rehabilitation a person may relapse.

<span style="font-family: Georgia,serif; font-size: 140%;">These limitations may seem hopeless when lacking the psychological associative aspects of drug use as there is a level of agency and genuine desire to be drug free needed to control addiction. Drug dependency issues can originate from a psycho-social experience of the world and environment, therefore if social experiences and structures are at the very least non-inclusive of basic human needs (ref fig 1.2 & 1.3), it is very difficult for the addicted person to apply self agency.

<span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 190%; text-align: center;">BASIC HUMAN NEEDS Figure 1.2, 1.3

Maslow's hierarchy of needs, (2007).

//<span style="font-family: Arial,Helvetica,sans-serif; font-size: 190%;">CULTURAL AND SOCIAL ANALYSIS AND PERSONAL REFLECTION //



<span style="font-family: Georgia,serif; font-size: 140%;">Society and culture are crucial in addressing the nature and complexities of addiction. Social structures, ideas and groups largely form the basis of personal judgement. If our social group and beliefs deviate from the moral majority, we are then faced with the constant battle of acceptance. As mental health forms a fundamental basis for drug seeking and addictive tendencies, it is important social structures and ethical opinions of society en mass, support our cultural, political, sexual and racial differences without judgement. This alone has been demonstrated as an effective tool for change and better management of drug addiction, research, statistics and data are merely an evaluation of the current state of health in relation to drug use and groups at risk. There is a enormous gap in research from qualitative statistics and autonomous perspectives of drug users; simply answering questions that quantify thet nature of addiction is helpful from a clinical perspective, however since psychological wellness is imperative to management of addiction, it is questionable as to why autonomous perspectives are scarce and also concludes the current societal question of moral panic as to why addiction isn’t managed well in Australia.

<span style="font-family: Georgia,serif; font-size: 140%;">From a philosophical perspective originating in the 1600’s, Dr J. A. Carroll explains Descartes Dualism, which suggests that the physical world and mind are independent of each other, however a medium is needed for the physical world and the mind to become dynamic. This is where the notion of ‘god’ emerged. From a perspective of autonomy and self agency, I conclude that awareness of self and identity is deemed god, as we are our own agents; given the support, resources & humanitarian social justice, addiction, currently a world health issue could at least be reduced to coincide with the present research, data and statistics.

<span style="font-family: Georgia,serif; font-size: 140%;">People are not affected equally by this health issue and most research on drug addiction emerges from the United States of America, moreover data from Australia is not concentrated on all groups at risk, for example one survey disqualified rural areas, leaving out a large proportion of indigenous people. In another, a survey conducted into drug use amongst GLBTIQ communities, transgender persons were contrasted to binary genders. It is unreasonable to expect adequate treatment for this health issue with simple flaws such as these.

<span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 190%; text-align: center;">ANALYSIS OF CULTURAL ARTEFACT The cultural artefact represents a good case in point for the ‘downward spiral’ of addiction, the cycle of addiction and how once someone is addicted, they lead a different way of life; ‘**If you don't have it you're on the other side’**.

Perception of self, society and surroundings is mostly one of delusion; ‘**we’re so creative, so much more, we're high above but on the floor.** Feelings of Grandeur are common, which is why the drug becomes so attractive initially; **‘I'm in heaven, I'm a god I'm everywhere, I feel so hot’.**

There is an increased ability to cope and thought patterns that once caused distress are either non-existant or minimal, as thoughts become positive and more meaningful ; **‘The deeper the thoughts, there's no more pain’.**

represents the denial of addiction and the ‘game’ or ‘circus’ of addiction. The person will do whatever it takes to support their habit and often the compulsion to lie (or to be dishonest) becomes a learned behavioural problem.
 * ‘I'm not an addict (maybe that's a lie)**

‘**It's over now I'm cold alone, I'm just a person on my own nothing means a thing to me’.** Represents the reality of the drug addicts life - the drug wears, off frequently eliciting feelings of isolation, guilt and remorse.

‘**Free me, leave me, watch me as I'm going down, look at me I'm falling and falling’;** the desperation and desire for sobriety and physical effects of ‘coming down’ from the drug. The artist then follows on with demonstrating the cycle of addiction, the drug addicted person achieves their next high and once again the individual is feeling euphoric.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 190%;">REFERENCE LIST Anglin, M., Brown, B., Dembo, R., & Leukefeld, C. (2009). Criminality and addiction: selected issues for future policies practice and research. //Journal of Drug Issues, 39//, 89-99. Retrieved from []

Carroll, J. (2013). PUB209 Health, culture and society. The body in space and time: Socio-temporal dimensions of anatomy and physiology [lecture notes] retrieved from[|__http://blackboard.qut.edu.au/bbcswebdav/pid-4958873-dt-content-rid__]-1061744_1/courses/PUB209_13se2/PUB209%20Lecture%20Two%20The%20Body%20in%20Space%20and%20Time%20FINAL%202013%20edits.pdf

Farlex. (2009). Addiction. The American Heritage Dictionary of the English Language. 4th ed. Houghton Mifflin Company. Retrieved Oct 14, 2013, from [|__www.thefreedictionary.com/addiction__]

Grant, J., Mottet, L., Tanis, J., Herman, J., Harrison, J., Keisling, M., (2010, October). //National// //Transgender// //Discrimination Survey Report on health and health care//. National Centre for Transgender Equality and the National Gay and Lesbian Task Force. Retrieved from [|__http://transequality.org/PDFs/NTDSReportonHealth_final.pdf__]

Illicit drug types. (2011). Australian Institute of Criminology. Retrieved from[|__http://www.aic.gov.au/index.html__]

Le Foll, B. Boileau, I. (2013). Repurposing buspirone for drug addiction treatment. //International// //Journal of// //Neuropsychopharmacology, 16,// 251-253. doi:10.1017/S1461145712000995

Makkai, T. (1999). Separating drug addiction from criminal behaviour. Retrieved 11 Oct, 2013, from[|__www.afp.gov.au/media-centre/publications/platypus/previous-editions/1999/march-1999/study.aspx__]

Mc Leod, S., (2007). Maslows Heirachy of needs. Retrieved from[|__http://www.simplypsychology.org/maslow.html__]

O'Brian, C. (2008). Evidence-based treatments of addiction. //Philosophical transactions of the// //Royal Society of London, 363,// 3277-3286.10.1098/rstb.2008.0105

Patterson-Sterling, C. (2012). Self help. Sunshine coast health centre. Retrieved from [|__http://www.sunshinecoasthealthcentre.ca/recovery-behaviours.html__]

Ritter, A., Matthew-Simmons, F., Carragher, N. (2012, December). //Prevalence of and// //interventions for mental health and alcohol and other drug problems amongst the gay,// //lesbian, bisexual and transgender community//: a review of the literature. National Drug and Alcohol Research Centre. Retrieved from[|__http://ndarc.med.unsw.edu.au/resource/23-prevalence-and-interventions-mental-health-and-alcohol-and-other-drug-problems-amongst__]

Robinson, T., Berridge, K. (2003). Addiction. //Annual Review of Psychology, 54//, 25-53. Retrieved from[|__http://search.proquest.com/docview/205819384?accountid=13380__]

Smith, G., White, V. (2008). Use of tobacco, alcohol, and over-the counter and illicit substances among Indigenous students participating in the Australian Secondary Students Alcohol and Drug Survey[|__http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/indig-stu-surv08__]

//The Concept of Addiction Explained.// (2013). Retrieved Oct 12, 2013, from[|__www.jcpc.info/the-concept-of-addiction-explained.php__]

Torregrossa, M. Corlett, P. Taylor, J. (2011). Aberrant learning and memory in addiction. //Neurobiology of learning and memory, 96//, 609-23. doi: 10.1016/j.nlm.2011.02.014

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