Addiction

The word “addiction” gets thrown around a lot and is often used incorrectly. People use the term “addiction” or other addiction-related language to describe things that are “out of control” or “extreme”, or to talk about things that they really, really like. Examples include: “I’m addicted to this new app…” or “I have a chocolate addiction” or “I’m having Netflix withdrawal” or “I’m a Bookaholic”

Actual addiction is a complicated mental illness that has a profound impact on a person’s life. It’s when a person feels out of control with something that is psychologically and/or physically habit-forming.

The Four Cs of Addiction

Addiction is a tough thing to pinpoint, so attempts have been made to figure out an easy way to define it. One way people try and identify whether something is an addiction or not is to look for the Four Cs:

• Craving
• Loss of Control of amount or frequency of use
• Compulsion to use
• Use continues despite Consequences.

To define addiction according to the Four Cs, you’d be looking for all of these behaviours. That means that if a person only fits some of these criteria, they might not be “addicted”. For instance, someone who gets a headache after skipping their afternoon tea break isn’t necessarily “addicted” to tea, even though they’re having a craving/withdrawal symptom.

Addiction Behaviours

The other complicated thing about addiction is that it’s not just about drugs or alcohol. Addiction can describe all sorts of behaviours, like problem gambling, compulsive use of pornography or excessive gaming or internet use. If you can apply the “Four Cs” to behaviours like this, it might be an addiction.

Understanding addiction can be complicated. People and their behaviours don’t usually fit neatly into a “category”. The world is not divided into “healthy people” vs. “addicts”. Instead, it might help to look at addiction as part of a “spectrum” or sliding scale.

The effects of addiction are going to vary according to what a person is addicted to. Addiction to substances will cause a wide range of physical and emotional health issues, but so does addiction to things like gambling, gaming, pornography etc.

When someone has an addiction, it can affect every aspect of their life (see image below).

Resource Issues

People who have an addiction can experience serious issues with money, housing, employment and school. For example gambling compulsively leads to money loss, substance addiction means spending money on drugs, etc. Money problems can be connected to a whole host of other issues, like housing, school, food security, employment, mental health, goals, hobbies, legal issues, etc.

Relationship Issues

Regardless of what the focus of the addiction is, it can cause serious issues with family and friends. It can be hard to cope with seeing a loved one have an addiction and feeling powerless to do anything about it. Addictions can cause resentment, avoidance, betrayal, anger, worry, shame, sadness, isolation and guilt for all involved. Strained relationships can complicate recovery, support, emotional wellbeing etc.

Physical and Mental Health Issues

Addiction is often linked to mental and physical health issues or illnesses. People struggling with a mental health issue turn to coping strategies (e.g. substances) which can lead to addiction. Addiction can lead to emotional distress and turmoil, and cause things like anxiety, depression and stress-related problems such as poor sleep, ulcers, digestion issues, headaches and muscle pains.

Addiction to substances can cause more immediate health issues, which vary widely depending on the type of addiction. People who have an addiction are at a higher risk of suicide than those who do not struggle with addiction.

What would be some signs that someone is struggling with addiction?

Here are some behaviours that might indicate that someone is struggling with addictive behaviours:

• Chasing a thrill from the behaviour/substance (in addition to other symptoms)
• Taking increasingly bigger risks to keep up the habit
• Preoccupation with the behaviour/substance
• Frequently talking about and reliving past experiences with the behaviour/substance
• The behaviour/substance is used as a way to escape problems or feelings of helplessness, guilt or depression
• Concealing or lying about the behaviour/use of substances
• Feeling guilt or remorse about the behaviour/use of substances
• Borrowing money or stealing to engage in the behaviour/get access to substances
• Failed efforts to cut back
• Compulsive behaviour related to the behaviour/substance, even when there are negative consequences
• Not doing activities they previously enjoyed
• Moodiness, anxiety, angry outbursts, giddiness or hyperactivity
• Changes in eating and sleeping patterns
• Changes in relationships with family and friends
• Leaving old friend group to hang out with new friends connected with the addictive behaviour (for example: hanging out with others who use substances)
• Trouble attending school or work
• Changes in appearance or level of self-care
• Physical symptoms (with substance use: tooth decay, sores in nose/mouth, breathing/coughing issues, marks/sores, weight loss/gain etc.)
• Irritable, ill or feeling withdrawal when not using substances or engaging in the behaviour
• Abandoning responsibilities

Myth: Doing something regularly or in excess means you are an “addict”.

Fact: Addiction is a lot more complicated than that. The world is not divided into “those who don’t use” and “addicts”. Addiction is not measured by what the behaviour/drug is, or how much or how often it’s being used. It’s more helpful to think of addiction in terms of how it’s affecting your health and life. If there’s craving, a loss of control, a compulsion and the behaviour continues despite consequences, it might be an addiction.

Myth: Addiction is a choice. People who “can’t stop” their behaviour are just lacking in willpower.

Fact: Lots of people choose to use substances, gamble, spend time gaming etc. but not everyone develops an addiction. Addiction is not a choice and is caused by a lot of complicated factors including genetics, mental health issues, environmental factors etc. Recovering from an addiction is possible, but it is a process and includes long-term support. Relapse is common for those attempting to recover from an addiction. Quitting on one’s own is rare and judging someone for not being able to do so can make them feel shame and guilt that can make the problem worse.

Myth: Many people relapse, so treatment obviously does not work.

Fact: Like any other medical treatment, addiction treatment cannot guarantee lifelong recovery. Relapse is often a part of the recovery process. Most people who have an addiction require long term treatment and, in many cases, repeated treatments are necessary. The first few months after treatment are when people are at the biggest risk of relapse. Youth, in particular, can struggle with relapse because they often have to return to their homes/environments where the use was happening in the first place and have less options for “starting fresh” because of this. Despite these challenges, people can, and do, make full recoveries from addiction.

Myth: Addiction is for life.

Fact: Recovery from addiction can be ongoing. Many who have struggled with addiction need continued support and coping strategies to avoid relapse, but this does not mean that addiction is “forever”. Some may struggle for years to overcome an addiction, but many more people manage to put the past behind them and lead productive lives.

Myth: You need to be religious in order to overcome an addiction.

Fact: Some treatment groups and strategies are faith-based, and they work for a lot of people. However, getting help doesn’t require you to believe in a god or subscribe to any organized religion. It might help, however, to believe in humanity, family, community, and the good aspects of yourself – beliefs/supports that can help you to overcome your addiction.

Myth: You have to hit ‘rock bottom’ before you commit to getting better.

Fact: If we wait until a person “bottoms out,” it could be too late to help them. Every person has a different “bottom.” This could mean anything from losing an important relationship, losing a job or dropping out of school, doing something that interferes with your ability to parent or reach a goal, getting arrested, to ending up homeless. It’s not as if the worse you have it, the better your chances are at recovering. Waiting to see what “bottom” looks like for you is not going to make it easier to recover from an addiction.

Addiction is treatable. If a person’s pattern of behaviours/use of substances is interfering with physical health, relationships, and/or the ability to live a comfortable life, it’s time to talk to someone. That someone could be a friend you trust, a teacher, your family doctor, a crisis line, or counsellor. You don’t have to wait until things get really “bad” before seeking help.

Helping a Friend with an Addiction

If it is a friend you are concerned about, they may resist help or not even recognize that they need it. Someone who has an addiction may not recognize that they have a problem or deny having an issue. They might need you to make the first step.

How to Approach the Conversation

If you feel like you need to talk to a friend about their potential addiction, here are some tips that might help:

• Wait for a time when they are not high, drunk, or engaging in whatever the potential addiction is.
• Pick a place and time that is calm and neutral to talk with them.
• Be prepared to give solid examples as to why you are concerned about their behaviour.
• Come prepared with some suggestions of resources for them.
• If you are willing or able, decide to stop putting yourself into situations where you are normalizing or enabling your friend’s behaviour (example: If substance use is the concern, don’t invite them out to the bar with you).
• If you feel comfortable, talk to an adult you trust or find helpful, or other people in your friend’s life who are concerned, for some support.

As always, if you feel like your friend might hurt themselves or someone else, it’s time to seek emergency services.

Visit our Help Section to find out how to get addiction help for yourself or a friend.

Types of Addiction Treatment Options

People who seek treatment for addiction can do so in a number of ways. Treatment could include:

• Group therapy or meetings (like 12-step programs such as Alcoholics Anonymous, Narcotics Anonymous, Gamblers Anonymous, etc.)
• Counselling
• Peer support
• Medical intervention (to address critical or immediate physical health issues that have happened because of substance use)
• Detox: A safe place where medical professionals help someone through the physical symptoms of withdrawal (which can often happen when someone stops using and the substance is clearing from their system)
• Spending time in a hospital or other treatment centre
• Medication (to manage cravings or ease withdrawal)
• Family and social support or intervention
• A combination of all of the above

Specialized Addiction Treatment Programs

More and more addiction treatment centres have developed programs specific to addictions like gambling, gaming, internet, pornography, etc. Depending on the addiction, treatment might be available in your area to target specific issues.

Treatment for addiction might be geared toward what a person’s goals are. For example, some people might have the goal to completely stop, and for others a more gradual approach is needed to help them decrease their use in smaller steps.

Addressing Co-occurring Mental Health Issues

Addiction can also be complicated by other mental health concerns. Treatment strategies may include addressing these issues as well as the addictions issue.

Family members of someone who has an addiction may participate in therapy or support groups, or benefit from learning about it and ways to support their loved one at home.

Every story is different, and sometimes people need to try different types of supports before they find the right addiction treatment plan for them.

A person living with an addiction, like any other person, will benefit from maintaining wellness and having good supports in their life.

After having the initial conversation with someone about your concerns, it can be hard to know how to support them during this difficult time. Here are some tips that may be helpful:

Educate Yourself

Learn about addiction and try to see things from the perspective of someone struggling with it.

Foster Open Communication

Ask your friend what they think would be helpful (it may be as easy as providing a distraction or asking them to join you in something simple like going for a walk or watching a movie). You may also want to ask what they find unhelpful. Be a sounding board. Listening without judgement and without trying to “fix” their problems can be incredibly helpful.

If you have been hurt, inconvenienced, or put at risk because of someone else’s addiction, you might feel angry or frustrated with them. It’s okay to own that, and it can be helpful to express it when you feel ready.

If you worry that your friend is relapsing into unhealthy behaviours, let them know you are worried and encourage them to check in with their professional supports or family. If you’re really worried about their health and safety, tell an adult you trust, directly.

Create a Safe Environment

A lot of social situations can be centered around, or trigger, the behaviours/activities that people are addicted to (e.g. many parties include alcohol, some events include gambling, etc.), try and hang out with your friend in environments that will be less triggering. If you are willing or able, avoid situations that might be normalizing their behaviour, e.g. if substance use is the concern, don’t invite them out to the bar with you.

Acknowledge Past Behaviors

Even if you’ve done things in the past that might have encouraged the behaviour involved in this person’s addiction, it’s okay for you to express concern now. For example, you might have used substances or gambled with your friend before and feel like it would be weird to tell them you’re worried about their behaviour now, but you may not have recognized it as a problem for your friend at first.

Stopping Addiction-Enabling Behaviour

Be prepared to stop enabling behaviour, too. This means not “helping” them to live comfortably with their addiction, e.g. don’t help them make excuses for school or work, don’t give them money to engage in their behaviour, don’t participate in their behaviour with them etc. This is harder than it sounds, and could cause tension in your relationship, but it may be necessary in order to help your friend get better.

Encourage Professional Help and Be There During Recovery

Encourage professional help for your friend when needed (see our Help Section). If your friend is in the hospital/rehab, try to visit them if you can. The hospital may be scary and overwhelming for them, and a friendly face can help. Make sure to ask about visitor rules first.

Remember that treatment and healing is a process. Relapse is common, so be aware of this and try to be supportive as your friend adjusts.

Set Boundaries

Set some boundaries for yourself and take care. You can’t help someone if you’re feeling overwhelmed yourself. Don’t be afraid to seek help if you need it.

Sometimes, if the situation is becoming unhealthy for you, it’s okay to walk away respectfully. You are under no obligation to “save” your friend or continue trying to help them if they are resistant, hostile or affecting your ability to live your own life. You need to look after yourself too.

See our Help Section for more info about helping a friend and for tips on self care while supporting someone else.

Interactive Tools:

Getting High? is a tool is about making decisions about drug use and is not intended to be medical advice.

Other:

• 7 Strategies for Facing your Internet/TV Addiction is a blog by Leo Babauta, creator and writer of Zen Habits.
• Everyone Drinks is a blog about recovery in a world where social drinking is the norm.

Find more about Addiction.

The information on this page is a simple overview of a complicated health issue. For more in-depth information on addiction, please visit these resources and references or speak to a medical professional.

To learn more about substance use, check out Mental Health: A to Z Substance Use on mytoolkit.ca

Ontario – call ConnexOntario to find out where there are mental health supports for addiction in your community. They have information directly related to Problem Gambling and Substance Use.

Crisis – in any situation where someone is at risk of hurting themselves or others, call 911 or a local crisis line. You can find resources near you on the free and confidential Be Safe App.

Please see the Help Section for more addiction information and resources.