Who is Addicted is No Longer Free

Addiction means being dependent – on drugs, gambling, computers, shopping, eating. If you are addicted, you risk your health, your personality changes. In the long run, one becomes lonely and eventually isolated. Those who are addicted are stuck in a vicious circle and need help, because addiction is a disease. Addiction can affect anyone.

The vicious circle: addiction is a process

The beginning of addiction is a process that gradually develops into a vicious circle. For example, it may start with a harmless sleep disorder due to stress that is treated with over-the-counter sleeping pills. Gradually, the dose is increased in order to be able to sleep through the night. The next day, you feel floppy and tired and lie down for a nap. In the evening, you can’t fall asleep and reach for pills again. The vicious circle of addiction almost always looks like this: After consuming drugs or alcohol or going on a shopping spree, the person affected experiences that an unsatisfactory or unbearable situation or mood improves – apparently. But the effect wears off, “disillusionment” sets in. Now the desire for improvement is greater than before, the craving for the drug increases from time to time.

Addiction facts: Numbers and data

In first place among all addictive substances is alcohol: 7.8 million Germans drink excessive amounts of alcohol; 1.8 million are already considered dependent. The number is so high because addiction begins very early: according to the German government’s Drug and Addiction Report, about one in ten adolescents and one in three young adults drink alcohol regularly – that is, at least once a week. Around 16 million Germans smoke regularly, 2.93 million of whom need more than 20 cigarettes a day for their addiction. According to estimates by the German Centre for Addiction Issues (DHS), there are currently around 1.5 to 1.9 million drug addicts in Germany. Because of the high number of unreported cases, the number of people affected is probably much higher. Cocaine and cannabis appear to be the most popular stimulant drugs in Europe. This is according to the European Union’s drug report. Some 87.7 million Europeans aged 15 to 64 have smoked or swallowed marijuana or used hashish at some time, estimates the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Last year alone, 23.5 million adults did so. Cocaine, on the other hand, has been used by around 17.5 million Europeans. In Germany, more than 440,000 people suffer from an eating disorder such as anorexia or bulimia.

Gambling addiction, shopping addiction and Internet addiction in numbers

According to the SUCHT yearbook published by the DHS, more than 455,000 people in Germany have problems with addiction to gambling. Of these, around 215,000 people belong to the category of pathological gambling, while problem gambling behavior is observed in more than 240,000 people. Around 800,000 Germans suffer from shopping addiction, according to the Techniker Krankenkasse (TK) health insurance fund, citing a study by the Ludwigshafen University of Applied Sciences. About four million Germans, i.e. slightly less than five percent, are at risk of shopping addiction. Estimates assume that more than 560,000 people use the Internet compulsively. The so-called Internet junkies spend up to 60 hours a week on the Net. Almost 14 percent of the German population uses the Internet at least to a “problematic” extent.

Addiction is a disease

“Addiction,” as defined by the Gesamtverband für Suchtkrankenhilfe, “does not come from “seek,” but from “siech,” meaning “sick.” Addiction as a creeping process is nothing other than a “going away.” No one suddenly becomes addicted; rather, addiction develops gradually. Usually, addiction starts harmlessly: a couple of beers every evening, just a few cigarettes, just this one tablet. At first, the positive effects of a drug are used – relaxation, being loose, sleeping through the night, and for many it actually remains harmless. For some, however, habit and abuse develop, and for some addiction and dependence. Experts see the dependence career like this: first use, then abuse, finally addiction.

When is one addicted?

According to the World Health Organization (WHO), addiction refers to an unavoidable craving for a particular state of experience. The powers of the mind become subordinate to this desire. The WHO requires that people suffering from addiction should not be assumed to have either a weakness of will or a weakness of character.Addiction is a disease that can affect anyone – an often chronic disease that can be understood from the interaction of biological and environmental factors. It usually appears simultaneously and linked to other somatic or psychological disorders. According to WHO, these are the four criteria that classify someone as an addict:

  1. There is an uncontrollable desire to obtain and take the addictive substance.

  2. Higher and higher dosages are needed.

  3. It comes to mental and physical dependence.

  4. There is harm to others and society.

Signs of addiction can be physical and psychological disorders: sweating and nausea, sleep disturbances, loss of interest, mood swings, restlessness and anxiety or indifference. Addicts deny and hide their addiction, others gloss over it.

What is addictive?

First of all, a distinction is made between substance-related and substance-unrelated addiction:

  • Alcohol, drugs, medications are substances that are addictive.
  • Substance-unrelated addictions are addictions such as work, shopping, gambling or sex addiction.

Most addictions begin in the mind: the hallmarks of psychological dependence are the irresistible desire to take an addictive substance, the loss of control and the centering of thought and action on the addictive substance. The transition from psychological to physical dependence is fluid. It is often only noticed at a late stage. If the regular supply of addictive substances is suddenly interrupted (for example, due to hospitalization), physical dependence results in typical withdrawal symptoms such as restlessness, tremor, nausea and vomiting.

Addiction also affects the environment

Drugs not only affect the life of the addict, but without meaning to, close people such as family members and closest friends are affected. Relatives are literally co-sufferers, because they have to experience how the addict slowly ruins himself. When talking about addiction and dependence, the concept of co-dependence inevitably plays an important role. Particularly stressful for family and friends is the disappointment: most of the time, all attempts to dissuade the addict from his addiction are doomed to failure. Others ignore the addiction, help cover it up out of shame, and even support the patient in his addiction. The relatives, like the addict himself, can then also only be helped by outside counseling and support.

What can be done about addiction?

A sobering figure in advance: sustained abstinence is achieved by only one-third of those affected. The first step is the most difficult: admitting to yourself that you are addicted. Four steps characterize therapy:

  1. Motivation
  2. physical withdrawal

  3. weaning

  4. Aftercare

The first path can lead through the family doctor to the psychiatrist or in a clinic. Important in the withdrawal phase is the psychotherapeutic care: self-confidence and personal responsibility should be strengthened to be able to say “no”. This phase lasts weeks to months. Only then does rehabilitation begin in the familiar environment. Addiction counseling centers and self-help groups are often important companions for years during this phase.

What do health insurance companies pay?

Health insurance companies cover the costs of alcohol, medication, drug or multiple addiction, for example. In the case of non-substance-related addiction disorders such as gambling or work addiction, it is more difficult to get adequate long-term treatment funded. The Gesamtverband für Suchtkrankenhilfe further explains, “People with eating disorders are the responsibility of the health insurance funds, and the service providers treat them like a psychosomatic disease rather than an addiction disease. However, inpatient psychosomatic treatments usually only last a few weeks, which is not always sufficient. People with eating disorders have the option of applying for outpatient psychotherapy or taking part in special offers at some counseling centers. People affected by gambling addiction can get long-term treatment in specialized clinics paid for by pension insurance providers if necessary, but only in individual cases an outpatient measure.” The decisive factor in any form of addiction is help for those affected, because “self-withdrawal” is almost never successful.