Research Into Self-Destructive Behaviour and Addiction
Why Research Into Addiction Is Important
There are some behaviours that, to someone without first-hand experience, can seem difficult to understand. Many find it difficult to comprehend what motivates people to smoke, take drugs or gamble, for example.
While to many people self-destructive behaviours like gambling make little sense, for those affected they feel like important coping mechanisms.
By trying to better understand these different forms of self-destructive behaviours, researchers hope to be able to provide people with alternative, more helpful coping strategies. One problem is that many people who engage in self-destructive behaviours feel ashamed or guilty about doing so, and this drives them to hide their actions or describe them to healthcare professionals in a certain way because they don’t want to cause alarm.
New approaches to research are now providing us with a more realistic estimate of the prevalence of these behaviours, as well as identifying the support services that people are most likely to turn to. Research is also helping in risk assessment by describing the factors that make people more vulnerable to, or more likely to engage in, these behaviours.
Addictive Behaviours
According to Your Mental Health, addiction covers a wide range of behaviours and does not relate only to drugs and alcohol. It includes behaviours such as gambling, overeating, sex, exercise, playing video games, love, internet use, social media use and work. It affects people of all ages and, as with other self-destructive behaviours, it is surrounded by various myths and preconceptions
This July the NHS has raised concerns about the crisis in demand for treatment for gambling addiction.
"Record numbers of people are coming to the NHS for help to treat their gambling addiction, a cruel disease which has the power to destroy people's lives, with referrals up by more than a third compared to last year.” - Amanda Pritchard CEO NHS England
Peter Higgins’ Story In Your Mental Health
“Peter Higgins is a 56-year-old gambling addict who began his gambling at the age of 17 and has finally stopped (fingers crossed, as he says himself)."
"In the initial stages, I knew I had an addiction problem, but brushed it off. However, it was the first thing I thought about in the morning and started to take up every moment of my life. I played football for the local team, and even on the journey there and while playing I’d be thinking about betting. Then online betting came on the scene. In the early days, it wasn’t regulated and you could bet on anything, at any time. I didn’t need to know the teams or the form; often I wasn’t even watching the game or the race. I’d skip meeting up with friends so I could put bets on and started lying to cover it up. When I did go out socially, I would get agitated because I couldn’t put a bet on and I was imagining what had happened. Gambling is the most private disease out there. There’s no giveaway sign.”
Read more of Peter Higgins’ story in Your Mental Health.
Defining Addiction
Addiction varies person-to-person, however, researchers have conceptualised addiction to be grouped by certain components to form a model of addiction. When people behave in a way that fulfils these six components they can be defined as being addicted to that behaviour.
There are 6 components of addictive behaviours according to Your Mental Health:
- Salience: This refers to how important the behaviour is to the individual. Addictive behaviours become the most important activity for a person, so that even when they are not doing it, they are thinking about it.
- Mood modification: This is the experience that people report having when carrying out their addictive behaviour. People with addictive behaviour patterns commonly report a ‘rush’, ‘buzz’ or ‘high’, for example, when they take drugs or are gambling.
- Tolerance: This refers to the increasing amount of activity that is required to achieve the same effect. The classic example of tolerance is a heroin addict’s need to increase the size of their ‘fix’ to get the type of feeling they once got from much smaller doses. In gambling, tolerance may involve the gambler gradually having to increase the size of the bet or spending longer periods gambling.
- Withdrawal symptoms: These are the unpleasant feelings and physical effects that occur when the addictive behaviour is suddenly discontinued or reduced. They can include ‘the shakes’, moodiness and irritability. These symptoms are commonly believed to be a response to the removal of a chemical that the person has become dependent on. However, these effects can also be experienced by gamblers, so the effects may be due to withdrawal from the behaviour as well as the substance.
- Conflict: People with addictive behaviours develop conflicts with the people around them, as well as within themselves. Continual choosing of short-term pleasure and relief leads to disregard of adverse consequences and long-term damage, which in turn increases the apparent need for the addictive activity as a coping strategy.
- Relapse: This refers to the tendency towards repeated reversions to earlier patterns of the particular activity. Even the most extreme patterns typical of the height of the addiction can be quickly restored after many years of abstinence or control. Such relapses are common in all addictions, including behavioural addictions such as gambling
‘In very simple terms, the difference between an excessive enthusiasm and an addiction is that enthusiasm adds to life whereas addiction takes away from it.’ - Professor Mark Griffiths, Your Mental Health.
Treatments and Therapies
Research has led to a number of treatment approaches for addiction. Depending on the substance, behaviour and circumstance, a number of treatments are available to people suffering with addiction.
Your Mental Health highlights 4 key treatment methods:
Cognitive Behavioural Therapy
Cognitive behavioural therapy can be used to address the patterns in thinking and behaviour that are central to any addiction. Addiction often involves conflicted behaviour, where people engage in behaviours or use substances despite knowing the risks and consequences. CBT helps the person to examine their thoughts, feelings and triggers, and develop different thinking patterns that lead to alternative behaviours. As addiction often starts as a way of coping with difficult feelings and situations, CBT also teaches new coping skills, including for cravings and relapses.
Medication
Medication can be used to help re-establish normal brain function and decrease cravings in opioid (heroin, prescription pain relievers), tobacco (nicotine) and alcohol addiction. For heroin addiction, morphine, methadone and buprenorphine act on the same receptors in the brain as heroin but suppress withdrawal symptoms and relieve cravings. Other medications are in development to treat stimulants (cocaine, methamphetamine) and cannabis (marijuana) addiction.
Detoxification
The aim of detox is to enable a safe and humane withdrawal from addiction to substances and to prepare the person for ongoing treatment. Before starting detox, an initial medical assessment evaluates the likely severity of withdrawal alongside any other physical and mental health conditions. While medication is often used to help with withdrawal, it is not the only component of treatment. Psychological support is also important in reducing the patient’s distress during detoxification.
Reducing Harm
Harm reduction refers to interventions aimed at reducing the negative health effects of addiction, without necessarily extinguishing the addiction completely. Most research and initiatives in this area focus on drug addiction, with strategies including overdose prevention and information on safer drug use. As a philosophy, harm reduction focuses on working with people without judgement or the requirement that they stop their addictive behaviours.
Assessing Recovery
Researchers within the mental health field have grappled with what recovery actually means within addiction and how it can be assessed.
The Substance Use Recovery Evaluator (SURE) was developed by researchers at King’s College London to provide some level of common understanding around the concept of recovery. Aimed at use with alcohol and drug addiction, it consists of 21 questions that measure five key dimensions of recovery: alcohol and other drug use; self-care; relationships; material resources; and outlook on life.
The app is now available to download, just search ‘SURE Recovery’ on the App Store or Google Play.
Addiction can lead to harm, to not only the one suffering with addiction, but also their families and communities. Research is key to conceptualising the components of addiction leading to better treatment outcomes and recovery.
For more information on addiction and the support available, visit:
FRANK provides advice about drugs and substance abuse issues.
Call FRANK on 0300 123 6600, 24 hours a day, 7 days a week.
Forward Trust provide online resources and information about how to move forward from addiction issues. They also offer a web-based chat service Monday to Friday 9am – 3pm.
Mind provides advice and support to empower anyone experiencing a mental health problem.
Visit Mind’s Get Help Now page: https://www.mind.org.uk/need-urgent-help/using-this-tool/
Mind's Infoline is an information and signposting service that can help with information on the following:
- Mental health problems
- Where to get help near you
- Treatment options
- Advocacy services
Contact Infoline on 0300 123 3393
They are open 9am to 6pm, Monday to Friday (except for bank holidays).
The Mix is a UK-based charity that provides free, confidential support for young people under 25 via online, social and mobile. Visit their support services page here:
Sane offer support for both people experiencing mental illnesses and also their carers, friends and family.
You can call them every day between 4pm and 10pm on 0300 304 7000.
