This subject has provoked many debates among experts and the general conclusion has always found a selection of possible answers. It is agreed that there is not one singular component that can be attributed to an addiction beginning. Most individuals have their own explanations for why they have become dependent on something though sometimes the cause is never known nor understood.

How Do They Start?

Many activities that lead to addiction can be triggered by something as simple as a social event; this may be trying alcohol, the first experimentation with cannabis, a one night stand, or any of the other substances or activities that people become addicted to.

A person may become psychologically or physically dependent on a prescribed drug that was initially given for legitimate reasons. They may be scared of the withdrawal or coping with everyday life without it; this is especially true for pain relief and anti-depressants.

Experimentation and peer pressure explain why many individuals try substances for the first time, with items such as tobacco, cocaine and heroine. In other circumstances, or with a different circle of friends, some of these addictions may never have started.

The psychological ‘high’ experienced from certain activities may cause the person to crave the feeling again, emotions such as those felt when making a new purchase, winning a bet or sleeping with someone new can excite the senses and trigger a yearning.

Causes Of Addiction

Genetic disposition has been explored as a legitimate reason for an addiction, and though most experts agree that it has some credibility, there is no conclusive evidence that this is so.

Peer pressure is highly accountable for triggering an addiction and many smokers apportion this with the blame for their addiction.

The environment in which we grow up and are exposed to may be answerable for some addictions; continuous exposure to alcohol and heavy drinkers, might be experienced through living above a pub and may permit this addiction to seem easily accessible and exempt of blame or title.

Many people blame their addiction as a way of managing stress; it is easy to excuse a few drinks after work as a way of relieving troubles but for how long and to what volume can stress take the blame?

A person’s self-esteem and body image may have a role to play in addiction; those whom are overly enthusiastic about diet and exercise (particularly those suffering with anorexia), may have started their addictive behaviour as a result of low or altered body image.

The chemistry of the brain is accountable for many addictions as the receptors in the brain can cause the individuals to crave a substance such as heroine, and gaining control over these cravings can be a very difficult struggle. Personality can take a part in addiction as many people simply have the type of personality that becomes addicted to something.

For many people suffering from an addiction, the cause is never known though it is important to discover the root of the problem hence the cause before an effective plan of care is prepared.

Nicotine is the most addictive and psychoactive chemical in tobacco, a plant native to the New World. Early European explorers learned to smoke its leaves from indigenous peoples who had been using tobacco for hundreds of years. They took tobacco back to Europe, where it became immensely popular. Tobacco became a major source of income for the American colonies and later for the United States. Advances in cigarette-making technology caused a boom in cigarette smoking in the early 1900s. Before the early twentieth century, most people who smoked had used pipes, cigars, or chewing tobacco.

Pure nicotine is a colourless liquid that turns brown and smells like tobacco when exposed to air. Nicotine can be absorbed through the skin, the lining of the mouth and nose, and the moist tissues lining the lungs. Cigarettes are the most efficient nicotine delivery system. Once tobacco smoke is inhaled, nicotine reaches the brain in less than 15 seconds. Since people who smoke pipes and cigars do not inhale, they absorb nicotine more slowly. Nicotine in chewing tobacco and snuff is absorbed through the mucous membranes lining the mouth and nasal passages. In 2002 a new smokeless tobacco product was test-marketed in the United States. Called Arriva, it is compressed tobacco powder about the size of a vitamin pill that is placed between the cheek and gum until it dissolves completely. The nicotine it contains is also absorbed through the mucous membranes of the mouth.

Nicotine is both a stimulant and a sedative. It is a psychoactive drug, meaning that it works in the brain, alters brain chemistry, and changes mood. Once tobacco smoke is inhaled, nicotine passes rapidly through the linings of the lungs and into the blood. It quickly circulates to the brain where it indirectly increases the supply of dopamine, a chemical in the brain that affects mood. Dopamine is normally released in response to pleasurable sensations. Nicotine, like cocaine or heroin, artificially stimulates the release of dopamine. This release accounts for the pleasurable sensation that most smokers feel almost as soon as they light up a cigarette. Nicotine also decreases anger and increases the efficiency of a person’s performance on long, dull tasks.

At the same time nicotine is affecting the brain, it also stimulates the adrenal glands. The adrenal glands are small, pea-sized pieces of tissue located above each kidney. They produce several hormones, one of which is epinephrine, also called adrenaline. Under normal circumstances, adrenaline is released in response to stress or a perceived threat. It is sometimes called the “fight or flight” hormone, because it prepares the body for action. When adrenaline is released, blood pressure, heart rate, blood flow, and oxygen use increase. Glucose, a simple form of sugar used by the body, floods the body to provide extra energy to muscles. The overall effect of the release of these hormones is strain on the cardiovascular (heart and blood vessels) system. Stressed this way many times a day for many years, the body responds by increasing the build-up of plaque, a sticky substance, in the blood vessels. These deposits of plaque significantly increase a person’s risk of stroke or heart attack.

Most people begin smoking between the ages of 12 and 20. Surprisingly few people start smoking as adults over 21. Adolescents who smoke tend to begin as casual smokers, out of rebelliousness or a need for social acceptance. Dependence on nicotine develops rapidly, however; one study suggests that 85–90% of adolescents who smoke four or more cigarettes become regular smokers. Nicotine is so addictive that being tobacco-free soon feels uncomfortable. In addition, smokers quickly develop tolerance to nicotine. Tolerance is a condition that occurs when the body needs a larger and larger dose of a substance to produce the same effect. For smokers, tolerance to nicotine means more frequent and more rapid smoking. Soon most smokers develop physical withdrawal symptoms when they try to stop smoking. Users of other forms of tobacco experience the same effects; however, the delivery of nicotine is slower and the effects may not be as pronounced.

Amphetamines are a group of powerful and highly addictive substances that dramatically affect the central nervous system. They induce a feeling of well-being and improve alertness, attention, and performance on various cognitive and motor tasks. Closely related are the so-called “designer amphetamines,” the most well known of which is the “club drug” MDMA, best known as “ecstasy.” Finally, some over-the-counter drugs used as appetite suppressants also have amphetamine-like action. Amphetamine-related disorders refer to the effects of abuse, dependence, and acute intoxication stemming from inappropriate amphetamine and amphetamine-related drug usage.

Amphetamines are also known as sympathomimetics, stimulants, and psychostimulants. Methamphetamine, the most common illegally produced amphetamine, goes by the street name of “speed,” “meth,” and “chalk.” When it is smoked, it is called “ice,” “crystal,” “crank,” and “glass.” Methamphetamine is a white, odourless, bitter-tasting crystalline powder that dissolves in water or alcohol.

Amphetamines were initially produced for medical use, and were first used in nasal decongestants and bronchial inhalers. Early in the 1900s, they were also used to treat several medical and psychiatric conditions, including narcolepsy,  attention-deficit disorders, obesity, and depression.

The structure of amphetamines differs significantly from that of cocaine, even though both are stimulants with similar behavioural and physiological effects. Like cocaine, amphetamine results in an accumulation of the neurotransmitter dopamine. It is this excessive dopamine concentration that appears to produce the stimulation and feelings of euphoria experienced by the user. Cocaine is much more quickly metabolized and removed from the body, whereas amphetamines have a much longer duration of action. A large percentage of the drug remains unchanged in the body, leading to prolonged stimulant effects.

The DSM-IV recognises four forms of Amphetamine Disorder:

• Amphetamine dependence, which refers to chronic or episodic binges (known as “speed runs”), with brief drug-free periods of time in between use.
• Amphetamine abuse, which is less severe than dependence. Individuals diagnosed with amphetamine abuse have milder but nevertheless still substantial problems due to their drug usage.
• Amphetamine intoxication, which refers to serious maladaptive behavioral or psychological changes that develop during, or shortly after, use of an amphetamine or related substance.
• Amphetamine withdrawal, which refers to symptoms that develop within a few hours to several days after reducing or stopping heavy and prolonged amphetamine use. Withdrawal symptoms are, in general, opposite to those seen during intoxication and include fatigue, vivid and unpleasant dreams, insomnia or hypersomnia (too much sleep), increased appetite and agitation or slowing down.

Caffeine belongs to a class of compounds called xanthines, its chemical formula being 1,3,7-trimethylxanthine. Caffeine is classified together with cocaine and amphetamines as an analeptic, or central nervous system stimulant. Coffee is the most abundant source of caffeine, although caffeine is also found in tea, cocoa, and cola beverages as well as in over-the-counter and prescription medications for pain relief.

When a person ingests caffeine it is absorbed from the digestive tract without being broken down. It is rapidly distributed throughout the tissues of the body by means of the bloodstream. If a pregnant woman drinks a cup of coffee or tea, the caffeine in the drink will cross the placental barrier and enter the baby’s bloodstream.

When the caffeine reaches the brain, it increases the secretion of norepinephrine, a neurotransmitter that is associated with the “fight or flight” stress response. The rise in norepinephrine levels and the increased activity of the neurons, or nerve cells, in many other areas of the brain creates symptoms which resemble those of a panic attack.

The effects of caffeine are thought to occur as a result of competitive antagonism at adenosine receptors. Adenosine is a water-soluble compound of adenine and ribose; it functions to modulate the activities of nerve cells and produces a mild sedative effect when it activates certain types of adenosine receptors. Caffeine competes with adenosine to bind at these receptors and counteracts the sedative effects of the adenosine. If the person stops drinking coffee, the adenosine has no competition for activating its usual receptors and may produce a sedative effect that is experienced as fatigue or drowsiness.

To meet DSM-IV-TR criteria for caffeine intoxication, a person must develop five or more of the twelve symptoms listed below; the symptoms must cause significant distress or impair the person’s social or occupational functioning; and the symptoms must not be caused by a medical disorder or better accounted for by an anxiety disorder or other mental disorder.

• restlessness
• nervousness
• excitement
• insomnia
• flushed face
• diuresis (increased urinary output)
• gastrointestinal disturbance
• muscle twitching
• talking or thinking in a rambling manner
• tachycardia (speeded-up heartbeat) or disturbances of heart rhythm
• periods of inexhaustibility
• psychomotor agitation

The precise amount of caffeine necessary to produce symptoms varies from person to person depending on body size and degree of tolerance to caffeine. Tolerance of the stimulating effects of caffeine builds up rapidly in humans; mild withdrawal symptoms have been reported in persons who were drinking as little as one to two cups of coffee per day. As a rough guide though; caffeine can produce a range of physical symptoms following ingestion of as little as 100 mg, and amounts of 250 mg or higher are usually needed to produce symptoms that meet the criteria of caffeine intoxication.
As well as the above list people have reported ringing in the ears or seeing flashes of light at doses of caffeine above 250 mg. And if a person continues to ingest caffeine they may experience seizures, breathing difficulty and eventually death.

Alcoholism is defined as alcohol seeking and consumption behaviour that is harmful. The hallmarks of this disorder are addiction to alcohol, inability to stop drinking, and repeated interpersonal, school or work-related problems that can be directly attributed to the use of alcohol. Alcoholism can have serious consequences, affecting an individual’s health and personal life, as well as impacting society at large.

Alcohol dependence is a complex disorder that includes the social and interpersonal issues mentioned above, and also includes biological elements. These elements are related to tolerance and withdrawal, cognitive problems that include craving, and behavioural abnormalities including the impaired ability to stop drinking. Withdrawal is a term that refers to the symptoms that occur when a person dependent on a substance stops taking that substance for a period of time; withdrawal symptoms vary in type and severity depending on the substance, but alcohol withdrawal symptoms can include shaking, irritability, and nausea. Tolerance is a reduced response to the alcohol consumed and can be acute or chronic. Acute tolerance occurs during a single episode of drinking and is greater when blood alcohol concentration rises. Chronic tolerance occurs over the long term when there is greater resistance to the intoxicating effects of alcohol, and, as a result, the affected person has to drink more to achieve desired effect.

Behaviourally, alcohol consumption is related to internal or external feedback. Internal feedback is the internal state a person experiences during and after alcohol consumption. External feedback is made up of the cues that other people send the person when he or she drinks. Internal states pertaining to alcohol can include shame or hangover. Alcohol-related external cues can include reprimands, criticism, or encouragement. People may drink to the point of dependence because of peer pressure, acceptance in a peer group, or because drinking is related to specific moods (easygoing, relaxed, calm, sociable) that are related to the formation of intimate relationships.
Biologically, repeated use of alcohol can impair the brain levels of a “pleasure” neurotransmitter called dopamine. When a person is dependent on alcohol, his or her brain areas that produce dopamine become depleted and the individual can no longer enjoy the pleasures of everyday life – his or her brain chemistry is rearranged to depend on alcohol for transient euphoria

Individuals who are alcohol-dependent compulsively drink ethanol alcohol to the level of intoxication. Intoxication occurs at blood alcohol levels of 50 to 150 mg/dl and is characterized by euphoria at first, and then if blood concentrations of alcohol continue to rise, a person can become explosively combative. Neurologically, acute intoxication causes impaired thinking, lack of coordination, slow or irregular eye movements, and impaired vision. As the person repeatedly drinks, the body develops a reduced response to ethanol called tolerance
People with chronic tolerance may apparently be sober even after consumption of alcohol that could cause death in non-drinkers.

People with alcohol dependence also develop alcohol withdrawal syndrome. The nervous system adapts to chronic ethanol exposure by increasing the activity of nerve cell mechanisms that counteract alcohol’s depressant effects. Therefore, when drinking is abruptly reduced, the affected person develops disordered perceptions, seizures and tremors (often accompanied by irritability, nausea, and vomiting). Tremor of the hands called “morning shakes,” usually occurs in the morning due to overnight abstinence. The most serious manifestation of alcohol withdrawal syndrome is delirium tremens, which occurs in approximately 5% of people dependent on alcohol. Delirium tremens consists of agitation, disorientation, insomnia, hallucinations, delusions, intense sweating, fever, and increased heart rate (tachycardia). This state is a medical emergency because it can be fatal, and affected persons must be immediately hospitalized and treated with medications that control vital physiological functions.

One in three people suffer from an addiction. It breaks up families, damages communities and destroys lives. In some way it touches us all.

Despite this, there is a great deal of misunderstanding about addiction – what it is, who it effects and how to get help and support. Addiction is characterised by a consuming relationship with a substance or behaviour that is driven by a conscious or unconscious desire to feel something different, which results in a range of harmful consequences.

An addiction is defined as a recurring compulsion by an individual to engage in some specific activity. It can therefore refer to more than just alcohol, drugs and nicotine.

Gambling addiction is the fastest growing addiction problem in the UK. Like any other addiction it can be tackled effectively through treatment and rehabilitation.
Addictive relationships can include other behaviours such as sex, shopping and exercise. It is important for an addicted person to understand the connections between different compulsive behaviours as they can reinforce addictive behaviour and increase the risk of relapse.

Types of addiction

Physical dependency

This is caused when repeated use of a substance changes your body’s chemistry and you become physically dependent.

Psychological dependency

This is caused when you repeat certain behaviour, such as drug and alcohol use, until your mind is hooked on that pattern of behaviour, causing mental cravings.