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No one sets out to become addicted, whether to drugs, alcohol, cigarettes or any other substance. Rather, ordinary people like you or me can develop unhealthy relationships with substances or harmful behaviours that may stem from many contributing factors over decades, many of which are beyond an individual’s control.

While certain drugs, such as nicotine or opioids, are physically addictive, we can also develop an emotional dependency when we reach for certain substances – legal or otherwise – or addictive behaviours in times of stress, trauma, anxiety, or depression.

Whether someone needs help is not always so much about the type of substance or quantities used; it is more about the relationship the person has with the substance or behaviour. The desire to use substances in times of distress for emotional regulation or comfort can often be an indication that a person has lost connection with themselves and others. Over time, addiction shapes the person’s behaviour and they often become secretive, self-sabotaging and avoidant, further alienating themselves.

Graeme Hart, an addiction counsellor at Netcare Akeso Stepping Stones

 

Addiction can also take a toll on a person’s physical appearance. People suffering from substance use disorders will often neglect themselves and may become less reliable in their responsibilities. If someone is isolating themselves, dealing with loneliness, engaging in risky behaviour, displaying resentment, moodiness, a lack of purpose, or low self-esteem, it could be another indication that professional support may be needed. Many have attempted to describe where substance use disorders or addiction stem from. There is no universally accepted single theory to explain why certain people fall into these dangerous relationships with substances that can threaten relationships, livelihoods and lives. However, the most widely held hypothesis internationally at present is the bio-psycho-social-spiritual model. Let’s unpack the dimensions encompassed in this term. Bio refers to a possible biological component that could predispose some people to addiction, suggesting it could be handed down in our genes. In any population group, there is an estimated 10% of people predisposed to having a substance use disorder. People with a mental health disorder have a high predisposition towards substance use to deal with unwanted emotions. The psycho or psychiatric/psychological aspects of substance dependency refer to the potential influence of comorbid mental health conditions, such as bipolar mood disorder, generalised anxiety disorder, attention-deficit/hyperactivity disorder (ADHD) or major depressive disorder. Long-term or severe substance misuse may trigger these conditions, or the conditions may already be present and could be the precursor.

 

The social or socioeconomic factors that may increase a person’s chances of developing a problem with drug addiction or alcoholism are external circumstances like political uncertainty, the environment we grow up in and economic stressors, particularly those associated with poverty.

What we experience when we are young can play a role in what we see as common or socially acceptable, and so living in a gangland environment, for example, or peer pressure can be significant influencers. When people close to us, such as our parents and siblings, or those in the community, such as school friends and teachers, use substances to cope, there is an even greater risk of developing an unhealthy relationship with drinking or drug use.

The other major cause of addiction is childhood trauma. Parental or sibling abuse, which may be physical or emotional, bullying at school, or growing up in a dysfunctional family, are just a few examples of trauma that can remain unresolved into adulthood. While this trauma remains unspoken, we continue to experience it as if we were the same age as when it happened.

Incidents may become fixed in our memories, and emotions can remain unresolved. Trauma, importantly, is not always tied to specific events, it can be a feeling of loneliness, isolation, othering or hopelessness built up over time. Even without abuse, a disconnected or ‘cold’ family environment may be traumatic to its members, which may contribute to emotional dependency or substance use disorder later in life.

There is also a spiritual dimension to addiction disorders, as a loss of spirituality, particularly in more materialistic Western societies, can lead to feelings of disconnectedness or alienation. Feelings of anhedonia, which are when someone stops enjoying things they used to like, are associated with depression and a lack of meaning or purpose in life, and can certainly lead us towards addiction.

Whether we believe that addiction is a mental disorder, a physical disease or simply maladaptive behaviour shaped by circumstance, there is no doubt that addiction to substances requires lifetime management. Even with professional treatment, the possibility of relapse unfortunately remains, and ongoing support is recommended.

The dual diagnosis unit at Netcare Akeso Stepping Stones runs an inpatient programme to assist individuals with various types of substance use or behavioural addictions, together with a psychiatric condition such as depression, anxiety, or post-traumatic stress disorder (PTSD), among others. The multidisciplinary team includes psychologists, psychiatrists, occupational therapists, addiction counsellors and general practitioners who work closely together to provide comprehensive treatment, supported by experienced nursing staff.

Progress is possible, even though many people in the grip of substance use disorders may not be able to imagine a life where they can reintegrate without the need for their drug of choice. If any of this sounds familiar to you or raises concerns about someone close to you, professional help and community support are available to help before things inevitably get worse.

In the event of a psychological crisis, Netcare Akeso’s 24-hour Crisis Line is here for you. To speak confidentially with a registered counsellor or discuss support options for yourself or a loved one, please call 0861 435 787, at any time for emergency support.

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About Netcare Akeso
Netcare Akeso operates a network of private inpatient mental health facilities and is part of the Netcare Group. Netcare Akeso provides individual, integrated and family-oriented treatment in specialised inpatient treatment facilities, as well as certain outpatient services, for a range of psychiatric, psychological and substance use conditions. Please visit www.akeso.co.za or contact [email protected] for further information.

In the event of a psychological crisis, call 0861 435 787, 24 hours a day for emergency support. Psychiatrist consultations can be made through Netcare appointmed™, online at www.netcareappointmed.co.za or by calling 0861 555 565.

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