With Dr Peter Hall
When my grandkids get those boxes of chocolates to fundraise for school, they give them to me. The assumption is that I will either sell them or eat them, but they don’t really care either way. The problem is that I do eat them, and if I know they are in the house I really can’t resist. Them, or gingernuts.
At those times I observe in myself some disturbing signs of addiction – thinking constantly about when I can get my next “fix”, scoffing uncontrollably when I get the chance, and hiding the wrappers so I don’t get caught. While this might seem like a trivial example, it goes to show that any of us can be prone to compulsive or addictive behaviour.
I hate the addictions. They cause so much shame and loss of dignity, and often result in a painful cycle of hope and failure which is very disheartening for the patient, as well as everybody else in their life. This dependence might be to a substance or a behaviour. The traditional characteristics of substance abuse were tolerance (the person needed more and more of the drug to get the same result) and withdrawal symptoms if deprived of it.
But as we’ve recognised that behaviours can be addictive, the definition has been extended to gambling, sex and thrill-seeking (the so-called adrenaline junkie) and others. We even talk about workaholics. The defining features are loss of control and harm.
The biological basis of addiction is slowly becoming clearer. Whereas historically it was perceived as primarily a choice or moral problem, science is now revealing the genetic, neurological and psychosocial factors that are causative.
Many patients really want to stop, make promises to do so and recognise the harm they are doing. But if they relapse into the same old patterns, then to my mind that person is an addict. They are likely to start demonstrating the secondary features of denial, lying, risk-taking and neglect of other parts of their lives. The fallout financially, healthwise and for relationships, can be devastating.
I’ve walked through this with families numerous times and all I can say is that it is important to seek help early. There is evidence that the longer an addiction goes on, the more entrenched the neurological changes that drive it.
I feel extremely proud of people who are willing to face up to a problem like this. And I am very confident that, with the right support, we can do something about it.