Habits and Behaviors

views updated

Habits and Behaviors

A habit is defined as a way of behaving that is repeated so often it no longer involves conscious thought. A habit might be a person brushing her teeth every night before bed, or walking the dog every morning before school or work. These habits would typically be considered "good" habits to have because they are of benefit to the person performing them. Other kinds of habits might be a person stealing one item from a department store every time he visits the store, or drinking alcohol every weekend at a friend's house. These habits would typically be considered "bad" habits because they may bring harm to the person performing them.

Another definition of habit is an addiction. Both good and bad habits can be addictive in nature. When someone eats a favorite cereal for breakfast every morning, that person has established a good habit because it is important to eat breakfast every day. If, though, the person became so dependent on eating a particular brand of cereal every morning that his mood changed for the worse if he was unable to eat the cereal one morning, his habit would be more serious. One could argue that he was addicted to the cereal. Of course one can't become physically addicted to a brand of cereal the way one can become physically addicted, for example, to the nicotine in cigarettes, but this does serve as an example of how a habit can sometimes turn in to a dangerous behavior.

This chapter will focus on several types of negative habits and behaviors and ways to treat them. From drugs and alcohol to internet addiction and gambling, these habits pose potentially life-threatening risks to all who partake of them.

ADDICTION

Addiction is most commonly defined as dependence on harmful, habit-forming drugs (although drugs do not always have to be the object of the addiction). When most people think of the word addiction, they conjure images of a world they expect never to know. They imagine emaciated heroin addicts in dark alleys or remember rock stars long dead from overdoses. Addiction doesn't always look as menacing as public-service announcements or after-school television programs depict it to be. In fact, many people come into contact with some kind of addiction every day or are addicted to some substance they might consider benign (harmless). While addiction is common,

Habits and Behaviors: Words to Know

Addiction:: The state of needing to compulsively repeat a behavior.
Altered consciousness:: A state of awareness that is different from typical, waking consciousness; often induced with the use of drugs and alcohol.
Benign:: Harmless; also, non-cancerous.
Compulsive behavior:: Behavior that is repeated over and over again, uncontrollably.
Crash:: Coming down from being high on drugs or alcohol.
Cut:: The habit of mixing illegal drugs with another substance to produce a greater quantity of that substance.
Delirium:: Mental disturbance marked by confusion, disordered speech, and even hallucinations.
Dependent:: A reliance on something or someone.
Detoxification:: The process of freeing an individual of an intoxicating or addictive substance in the body or to free from dependence.
Euphoric:: Having the feeling of well-being or elation.
Genetic:: Something inherited through one's genes.
Habit:: A behavior or routine that is repeated.
Hallucination:: The illusion of seeing or hearing something that does not really exist.
Hangover:: The syndrome that occurs after being high on drugs or drinking alcohol, often including nausea, headache, dizziness, and fuzzy-mindedness.
Inhalants:: Substances that people sniff to get high.
Kleptomania:: Habitual stealing.
Mantra:: A phrase repeated during meditation to center the mind.
Meditation:: A practice that helps one to center and focus the mind; sometimes used to help recovering addicts.
Overdose:: A dangerous, often deadly, reaction to taking too much of a certain drug.
Perception:: One's consciousness and way of observing things.
Predisposition:: To be susceptible to something.
Prohibition:: An era in the 1920s when alcohol was made illegal.
Psychoactive:: Something that affects brain function, mood and behavior.
Psychological vulnerability:: Used to describe individuals who are potential candidates for drug addiction because of prior experiences or other influences.
Pyromania:: Habitual need to start fires.
Ritual:: Observances or ceremonies that mark change, renewal, or other events.
Self-medicate:: When a person treats an ailment, mental or physical, with alcohol or drugs rather than seeing a physician or mental health professional.
Synthetic:: Human-made; not occurring in nature.
Tolerance:: The build-up of resistance to the effects of a substance.
Withdrawal:: The phase of removal of drugs or alcohol from the system of the user.

becoming addicted to a substance or an activity can have serious consequences. And it's not something that just happens to "other" people.

Many adults, and an increasing number of teenagers, drink coffee first thing every morning. In fact, many people feel that without their first cup, normal daily functioning seems impossible. This reflects the problem inherent to addiction—the need itself. The subject of the addiction may seem harmless or even healthy (such as exercise addiction), but too much of anything can be dangerous. Having a cup of coffee once in a while because it tastes good is not a problem; however, caffeine (the addictive substance in coffee) addiction can eventually make people sick.

In the case of alcoholics (those addicted to alcohol), many feel that they must have a drink before they can socialize. Similarly, sugar addicts cannot go for very long without eating something sweet. In fact, they can get depressed, anxious, and irritable when deprived of sugar. Addictions of all types, whether they are to hard drugs, such as heroin, or everyday substances, such as caffeine or sugar, can disrupt a person's life and ruin his or her mental and physical well-being. Addiction to drugs and alcohol, because they are mind-altering substances, poses more of a direct threat to the user than do substances that don't immediately change one's perception.

Dependence

Addiction is dependence on something or someone. Infants, for example, are dependent on their parents for sustenance and other basic needs, such as shelter. Addicted people are dependent on a substance to function normally and feel good. Addicts are scared of the consequences of separation from their substance of choice. Addicted people exist at many levels of functioning and degrees of healing. There are addicts in all walks of life, from physicians and attorneys to schoolteachers and actors. Some of these individuals are able to perform their jobs without anyone else becoming aware of a problem. They are able to fool others into thinking they can function normally. For other individuals, however, their addictions prevent them from holding onto a job or even engaging in activities with family and friends.

Whatever the case, whatever a person's level of functioning, to truly heal, addicts need to admit to themselves that they need help. Healing from addiction is a process of really taking a good look at one's own self. Self-examination can be quite intimidating, and many people would rather avoid it and hide in drinking, drugging or codependence. Self-discovery means not only uncovering the positive attributes a person may not be aware of; it also means coming to terms with shortcomings, flaws, and inadequacies and learning to accept those things.

Learning about the different forms of addiction and tools for healing can help those suffering from it. These coping strategies can help friends and family of people with addictions, too.

SUBSTANCE ABUSE

Most people who use drugs are seeking an altered state of consciousness. The need to alter consciousness is not a new phenomenon. Historical evidence shows that people of all cultures and eras have experimented with mind-altering substances, both natural and synthetic (human-made or artificial). People who use drugs seek to make the world around them look and feel different. This might mean trying to make a bleak life seem better or simply more interesting.

Drugs often make people feel powerful. That's why taking drugs is called "getting high." Drugs endow a user with a false sense of power that, of course, recedes when the artificial high ends. Addiction occurs when a person compulsively attempts to continue that high by taking a drug over and over again.

People use drugs for many, many reasons. For example, adolescents have reported that they experimented with marijuana to enhance sexuality; to feel more confident; for pleasure and relaxation; to make themselves more comfortable in social situations; to understand themselves better; for acceptance by their peers or to achieve elevated social status; to defy authority; and to expand their minds.

There are many theories governing an individual's choice to use drugs when others do not. Initial experimentation and addiction are two very different behaviors, though. The reason many people continue to seek out drugs after their first use is, again, an attempt to reproduce the same pleasure and an altered state of consciousness initially achieved the first time a certain drug was used. The second time and each instance thereafter, a user is trying to recapture the intensity of that first experience. Ultimately, these feelings cannot be replicated, and this is where an addiction starts. Drug users in search of that elusive pleasure will continue to search for the feelings inspired by their first time, even if all the consecutive uses affect them adversely; this is particularly dangerous with crack cocaine. (Many drug experts suggest that the initial experience of using crack cocaine is so intense that it takes only one use to kick-start an addiction.) Furthermore, over time, addicts' bodies develop a tolerance for a drug, meaning they will eventually have to take more and more of their drug of choice each time they use in order to achieve the same high.

Addiction counselors and others who work with substance abusers consider drug use and abuse to be a self-destructive behavior. According to this model, the user may not be consciously aware of being deeply depressed and engaging in self-destructive activities. Psychoanalytic counselors (see Chapter 15: Mental Health Therapies) also interpret drug abuse as a form of suicidal behavior. Proponents of psychoanalysis believe that an addict is usually unaware of his or her deep-rooted problems, and the addiction is a symptom of unreleased pain resulting from these buried problems.

Causes of Substance Abuse

There isn't one single cause that lies at the root of drug addiction. This is why drug addiction is so very hard to understand and treat. Several years ago a term called "addictive personality" became very popular in the media. Those in the drug and alcohol field dislike this term because they consider it overly simplistic and unfair to addicts. It implies that drug abusers are to blame for their illness because they have a defective personality. A better term to describe a person's predisposition to drug abuse might be psychological (mind-related) vulnerability. This means that the addict had some prior psychological factor that made a pattern of substance abuse more likely to begin.

LOST TO DRUGS

Many actors and musicians have waged well-documented battles with addiction, whether it be to drugs or alcohol. Some have come out triumphant, such as Drew Barrymore, who battled alcoholism at a very young age, and Matthew Perry, who triumphed over an addiction to painkillers. Unfortunately, though, many talented individuals have lost their lives to drugs. In the early 1970s, the world of rock-and-roll mourned the overdose deaths of three musical giants, Jimi Hendrix, Janis Joplin, and Jim Morrison. In recent years, Shannon Hoon, lead singer of the rock group Blind Melon, died of a heroin overdose. Hollywood has lost its share of beloved performers as well. Actress Judy Garland, who played Dorothy in The Wizard of Oz, died in 1969 of an overdose from drugs as did actor River Phoenix in 1995 at the age of 23. In 1997, comedian Chris Farley, age 33, died of a drug overdose as well, following in the footsteps of his own idol, actor/comedian John Belushi, who overdosed in 1982 also at the age of 33.

For example, people who have mood disorders (see Chapter 12: Mental Illness) sometimes self-medicate (make themselves feel better or more in balance) by using drugs. There are a number of personality traits that are thought to be shared by drug abusers (and alcoholics, too). These traits include high emotionality; anxiety; immaturity in relationships; low frustration tolerance; inability to express anger; problems with authority; low self-esteem; perfectionism; compulsiveness; feelings of isolation; sex-role confusion; depression; hostility; and sexual immaturity. Stress is also thought to be a factor contributing to drug abuse. This is not referring to run-of-the-mill, everyday stress from work or school, but the kind of stress that is the result of traumatic experiences, such as the sudden loss of a loved one. Stress in early childhood, such as having been sexually or physically abused, can also lead to drug abuse.

A sense of self is one of the most important factors in the potential for drug addiction. A person with a strong sense of self will have several obvious qualities. One will have a sense of one's own individuality and be aware of talents and a place in the world. Also, one will be able to begin, develop, and complete projects and to coexist comfortably in different types of relationships. Those with a weak sense of self are more likely to seek out drugs as way of giving them a sense of self, which quickly vanishes once the drug wears off.

According to addiction counselors and researchers, preventing substance abuse in kids is more about giving them something to live for and helping them to foster a strong sense of self rather than keeping them away from what is deemed as the dangerous and enticing world of drugs.

Families and Drug Abuse

Family history of drug abuse is another risk factor for potential substance abusers. Some experts theorize that human beings may possess a genetic predisposition to drug dependence. But a poorly functioning family system may contribute to the development of an addiction just as powerfully. Children of alcoholics and drug abusers are more likely to develop their own addictions later in life. However, it remains unclear as to whether this development is a result of nature (inherited biologically) or nurture (environmental factors, such as a person's family relations and social environment).

SHARING NEEDLES

Injecting drugs (using drugs by shooting them directly in to a vein with a needle) carries an even more deadly threat to the body than administering them in other ways, such as smoking or snorting. Heroin addicts, and others, who shoot drugs and share needles are in one of the highest risk groups for infection with hepatitis and human immunodeficiency virus (HIV), which can lead to acquired immune deficiency syndrome (AIDS). HIV and hepatitis are transferred from person to person via bodily fluids. If the blood from an infected person is transferred to another person via a dirty needle, that person is at great risk for contracting these life-threatening diseases.

Adolescence, specifically, is a time of change and risk. Because teens are just beginning to develop their fragile sense of self, they are more prone to fall victim to drug abuse. This vulnerability is heightened because teens are exploring identity, social skills, and independence. Peer pressure, the need to fit in and be liked, often causes teens to experiment with drugs. If a teen is at a party and everyone around is partying, one might feel compelled to take a drink or smoke cigarettes or use marijuana. Usually these situations do not occur as they do in the movies, where other kids actually pressure their peers; rather, peer pressure tends to work in more subtle ways. If a teen is feeling left out and alone at a party, he or she might believe that joining others in smoking a marijuana cigarette will help in latching onto a group of friends. This is a reflection of teens' needs to feel as though they are part of a group—that they belong.

A teen feeling like the odd one out might even turn to doing drugs in private as a way to escape the pain of loneliness. Since drugs and alcohol are often easily available to teens, and avoiding contact with them is often difficult, many teens will have encounters with substance abuse either with themselves or someone they know. Willpower and a strong sense of self seem to be the only things that keep people, in general, away from the trap of substance abuse and addiction.

DEPRESSANTS

Depressants are the family of substances that slow down, or depress, bodily functions. They tend to make the user sleepy or sluggish. The following drugs fall in to the category of depressants.

Narcotics

Narcotics include opiates, the class of drugs derived from the poppy plant. Opiates have been used for thousands of years in Asia both for pleasure and medicinal uses. Natural opiates include morphine, codeine, and heroin. Synthetic opiates include codeine, oxycodone, and meperidine. They cause a wide variety of effects and side effects, such as pain relief, euphoria, respiratory depression, drowsiness, constriction of the pupils, nausea and vomiting, itching, and constipation. Narcotics tend to be easily addictive when used regularly because of their quick and powerful effects.

Narcotics can be ingested, injected, snorted or smoked. When opiates are smoked, it takes just five seconds for the drug to reach the brain. If a person addicted to narcotics is without that drug for even four to six hours after the narcotic use stops, he or she can feel the beginnings of withdrawal.

TOLERANCE TO NARCOTICS. Tolerance (the ability to resist the effects of something) develops quickly with the use of narcotics. Users must take more and more of the drug to get back to the desired effect. This can lead to overdose. Detoxification (cleansing the body of a toxic substance) is necessary for the user if one wants to return to a normal life. In order to detoxify and cleanse the body of the drug, withdrawal must occur. Withdrawal is the experience of ridding one's body of any substance it has become accustomed to. Withdrawal from opiates can cause the following symptoms: appetite suppression; nausea and vomiting; dilated pupils; gooseflesh; restlessness; intestinal spasm; abdominal pain; muscle spasms; kicking movements (reason for the expression, "kicking the habit"); diarrhea; increased heart rate and blood pressure; chills, hot flushes and sweating; irritability; insomnia; violent yawning; severe sneezing and runny nose; crying and tearing, nasal inflammation; and depressive moods and tremors. Medical treatment is sometimes sought because of extreme weight loss, dehydration, body chemistry disturbances, and stress on the heart. Without treatment, withdrawal symptoms can last from seven to ten days.

Anti-anxiety Drugs and Sleep Aids

Barbiturates and benzodiazepines are in the sedative-hypnotic class of drugs and are usually prescribed by doctors for anxiety disorders (see Chapter 12: Mental Illness) or to induce sleep, although benzodiazepines are prescribed more often because they are safer. (It is important to remember that even if a doctor prescribes a drug for someone, that person can abuse the drug and become addicted to it.) In the 1960s and 1970s barbiturates began to seep into the black market (that is, they were being sold on the street without a doctor's prescription). Prescription names for barbiturates are Amobarbital, Pentobarbital, Butubarbital, Phenobarbital, Secobarbital, and Pento-secobarbital.

Anti-anxiety drugs and sleep aids are taken orally, in pill form. They cause drowsiness, relaxation, and a sense of well-being. Effects are similar to those of alcohol. If used over any extended period of time, barbiturates can cause extreme physical and psychological dependence. Tolerance to the euphoric effects occur quickly, so more and more must be used to develop the desired effect. Withdrawal causes dizziness, weakness, sleeplessness, anxiety, tremors, nausea, vomiting, delirium, delusions, and hallucinations.

IT IS IMPORTANT TO REMEMBER THAT EVEN IF A DOCTOR PRESCRIBES A DRUG FOR SOMEONE, THAT PERSON CAN ABUSE THE DRUG AND BECOME ADDICTED TO IT.

DRUGS: IN THE MEDICINE CABINET AND ON THE STREET

Psychoactive drugs are those that affect brain functions, mood and behavior. Non-psychoactive drugs are substances that in normal doses do not directly affect the brain. There are several different categories of psychoactive drugs. There are both over-the-counter and prescription drugs that fall into the category of psychoactive agents so people should be aware that so-called street drugs (such as marijuana, heroin or cocaine) aren't the only drugs that cause addiction. It's important to remember that the effects of any drug depend on several variables. They are the amount taken at one time, the user's past drug experience, the method of administration (how the drug is taken—inhaled, smoked, swallowed, etc.), and the circumstances under which the drug is taken.

Overdose is common with these types of drugs. In fact, they are often the drugs of choice for people wanting to commit suicide. Symptoms of overdose are severe mood alteration; confusion and disorientation; slurred speech; impaired motor coordination; involuntary rapid eye movement from side to side; dilated pupils; and respiratory depression.

There are other drugs with barbiturate-like effects that are not classified as barbiturates, such as methaqualone, better known by the trade name Quaaludes, or the street name ludes. Quaaludes were thought to be a nonaddictive alternative to barbiturates when they were introduced in the 1960s. They turned out to have high abuse potential. They're very popular with college and high school students and have been illegal since 1984. They are often mixed with alcohol, creating a deadly combination. They produce sedation and sleep. Methoqualone induces headaches, hangovers, fatigue, dizziness, drowsiness, menstrual disturbances, dry mouth, nosebleeds, diarrhea, skin eruptions, numbness, and pain in the arms and legs. Eight to twenty grams can produce severe toxicity, coma, and death. Tolerance builds quickly, and withdrawal is much like detoxification from barbiturates.

MEDICAL MARIJUANA

Native Americans have used marijuana medicinally for thousands of years. Since it was made illegal in the United States, the use of marijuana for medical reasons has been extremely controversial. Extensive research has been done about the use of THC to treat people undergoing chemotherapy (a cancer treatment). It has been proven that THC is the best cure for the nausea and vomiting associated with this type of cancer treatment. There has also been research in the area of using medical marijuana as a treatment for the pain of glaucoma (an eye disease) and the wasting syndrome (chronic weight loss and the inability to substantially gain weight once it sets in) associated with AIDS. Less researched, but still potentially useful, is the use of marijuana for asthma relief, spasm relief, and anxiety reduction, and relief of alcohol withdrawal symptoms.

As of 1998, thirty-four states had statutes on the books allowing derivatives (substances obtained from) of marijuana to be used in research and/or treatment. In 1996, Arizona passed Proposition 200 and California passed Proposition 215, effectively legalizing the use of medical marijuana. Although the use of medical marijuana has proven to have few side effects and tremendous benefits for ailing individuals, it is still a hugely controversial topic because of the illegality of "street" marijuana. However, the National Institute of Health (NIH) now supports the use of medical marijuana, and there is a group called National Organization for the Reform of Marijuana Laws (NORML) that organizes and lobbies in favor of changing the laws forbidding the use of medical marijuana, but they haven't been able to garner enough support to counter the antimedical marijuana groups.

Marijuana

Cannabis sativa is the plant that is used to produce both marijuana and hashish. Marijuana is the unprocessed, dried leaves, flowers, seeds, and stems of the plant. Hashish is stronger, and made from the resin (liquidy substance) in the plant. THC is the strongest psychoactive compound found in cannabis. There are many street names for marijuana: pot, grass, weed, bud, kind bud, herb, and reefer. The cigarettes used to roll and smoke the drug are sometimes called doobies, joints, spliffs, fatties, roaches or blunts. Marijuana can also be smoked in a pipe, or a water pipe, called a bong. Pot is the most widely used illicit drug.

The effects of pot often depend on the potency (strength) of the drug. The strength of marijuana has increased tremendously since the 1960s. The common effects of pot smoking are feelings of exhilaration, increased appetite (the "munchies"), relaxation and giddiness (including uncontrollable laughter), increase in heart rate, drowsiness, dry mouth and tongue (referred to as "cotton mouth"), impaired short-term memory, altered perception of time and space, dilated pupils, and paranoia (irrational fear for one's safety). The long-term adverse effects of marijuana are still unknown. Psychological dependence on the drug is common. Regular users begin to depend on smoking pot to relax, and even to sleep. Habitual users often smoke pot immediately upon awakening.

Withdrawal from pot can cause irritability, decreased appetite, sleep disturbances, sweating, nausea and diarrhea. Hangovers are common the day after smoking pot. They are different from hangovers after drinking alcohol, however. Pot hangovers cause dizziness and inability to concentrate. Chronic (frequent) use can cause physical dependence. Marijuana is known to damage the respiratory system and to suppress the body's immune system. Pot can also make men infertile (unable to father children), and interfere with women's menstrual cycles. Children and teenagers (ages eleven to fifteen) who begin smoking before they have reached their full height can suffer stunted growth.

STIMULANTS

Stimulants are the family of substances that temporarily speed up or excite the function of the body or one of its parts. They tend to make the user unusually excited or overactive. The following drugs fall in to the category of stimulants.

Amphetamines

Amphetamines are central nervous system stimulants that give the user a temporary feeling of energy. A popular nickname for amphetamines is "uppers" because they make the user feel up and wide awake. Amphetamines have been prescribed by doctors for a wide variety of ailments for years. Dieters have used amphetamines for many years, in prescription and over-the-counter form. They have been prescribed by doctors for obesity, depression, and narcolepsy (uncontrolled fits of sleep). Ritalin is a drug in the amphetamine family that is still prescribed for hyperactive children. In the 1970s there was a crisis of abuse of amphetamines. People began injecting them intravenously (directly into veins). These individuals were called "speed-freaks" (speed is one of the street names for amphetamines). Doctors responded to this crisis by limiting the amount of prescriptions for amphetamines. Nonprescription, over-the-counter versions of amphetamines are used every day by, for example, college students cramming for exams and truck drivers attempting to stay awake for long drives.

Therapeutic doses of amphetamines stimulate the central nervous system, increase blood pressure, widen the pupils, quicken the breath, lower appetite, and decrease fatigue. Higher doses can cause agitation, blurred vision, tremors, and heart palpitations. Severe reactions can result in dilated pupils, sweating, cramps, nausea, heart problems, hypertension, panic, aggressive and violent behavior, hallucinations, delirium, high fevers, convulsions and seizures. People have died from amphetamine abuse because of burst blood vessels, heart attacks and high fevers. Physical dependence to moderate doses of amphetamines is highly unusual, but psychological dependence from even low doses is common. Chronic users of amphetamines have long-term health consequences.

Methamphetamines

Methamphetamine is a newer class of illegal amphetamine. Some street names for it are meth, ice, zip, go-fast, cristy, and chalk. When meth is mixed with water and injected with a needle it is called crank. Sometimes crank is mixed with crack cocaine. The mixture is called "croak."

Often meth and certain so-called designer drugs (see section below) are cut (mixed or diluted) with cocaine or heroin. Sometimes they are cut with cornstarch, baby laxatives, baking soda, or even rat poison. Meth is even more dangerous than the typical, older forms of amphetamines because it gets into the system faster, lasts longer, and can have even more deadly effects.

CLUBS AND DRUGS

The newest form of methamphetamine is a very pure version that is smoked in a pipe. In this form, the drug looks like little chips of ice. For that reason, it has picked up the nicknames ice, glass, or crystal. Meth is often used by ravers, kids that go to all-night parties that take place in empty warehouses and clubs. Raves are parties where electronic music is played and drugs such as meth, acid (LSD, or lysergic acid diethylamide) and ecstasy (MDMA, or methylenedioxymethamphetamine) are common and easily available. Kids who want to stay awake and dance until the sunrise (and often beyond) often use meth. Lokers (another name for people who smoke meth) can be identified by their hyper-energized, artificial dance moves.

Cocaine

Cocaine is another central nervous system stimulant. It comes from the coca plant, found in South America. (The soft drink Coca-Cola originally contained extracts of the coca leaf.) Some street names for cocaine are blow, C, coke, and snow. It is usually snorted. At one time, cocaine was very expensive, and only the very wealthy could buy it. In the 1980s, it became much more affordable and was considered the "drug of choice" among young, successful professionals. Crack is a smokable form of cocaine that is much more potent (strong), cheaper and sold in rocks. Crack is highly addictive; some experts say even one use has the potential to make someone addicted.

Cocaine causes an initial euphoric high that can last from fifteen to thirty minutes. People on cocaine tend to talk a mile a minute and feel like they are invincible. Socially awkward people on cocaine jump out of their shells and act tremendously self-confident, often arrogant. A cocaine user may feel sexually stimulated at first, but as the drug wears off this usually doesn't last.

The high from cocaine is short-lived, and "crashing" quickly sets in. A person crashing from a cocaine high is usually depressed, paranoid, irritable, and extremely tired. Because the high is so brief, cocaine users tend to buy a large amount of the drug and go through it quickly. Cocaine has the reputation of being a social drug, and people tend to do it with groups in bars and clubs. For serious users, cocaine binges can last for days. On a binge, a user will snort cocaine every half-hour for days on end. They will live without sleep or food until they crash from exhaustion.

Cocaine is highly addicting, although it is not physically addictive in the way that narcotics, such as heroin, can be. That is, physical tolerance to cocaine does not develop. Rather, users need to take it again and again to avoid crashing. One-time use of cocaine can result in death.

PCP

PCP (phencyclidine) is considered a stimulant although it is not commonly thought of as such. Also known as angel dust, it usually looks like white or colored chunks, powder or crystals. It's often smoked. Low doses produce muscle stiffness and poor coordination, slurred speech, drowsiness, confusion, numbness of the arms and legs, profuse sweating, nausea, vomiting, flushing and increased heart rate. Strange and violent behavior can result from higher doses. In some cases effects from PCP have lasted up to ten weeks. Heavy users can experience deep anxiety, depression and psychotic symptoms.

HALLUCINOGENS

Hallucinogens or psychedelics were the most popular class of drugs in the 1960s. Timothy Leary (1920–1996), a doctor from Harvard University, coined the phrase, "Tune in, turn on, drop out," encouraging young people everywhere to experiment with psychedelics. Hallucinogens affect people by distorting reality, and, at higher doses, often cause hallucinations (the illusion of seeing or hearing something that doesn't really exist). (Other drugs, even alcohol and marijuana, can cause hallucinations, too.)

Synthetic hallucinogens are LSD (lysergic acid diethylamide), mescaline (peyote), and DOM and STP (2,5-dimethoxy-4methylamphetamine), an amphetamine derivative. LSD is also called acid. The synthetic hallucinogens are manufactured in underground laboratories that exist only to serve the illegal drug market. Natural hallucinogens include mescaline, or peyote (this can also be synthetically produced), morning glory seeds, and psilocybin mushrooms (these are often called "shrooms" or "magic mushrooms"; they are not the kind of mushrooms found in supermarkets).

The slang term for taking hallucinogens is "tripping." The experience an individual can have on psychedelics varies widely. The emotional and mental state of the user at the time of "dropping" or taking the drug sets the tone for the trip. If the individual has any feelings of doubt or fear, the drug often exaggerates these emotions. This can cause a nightmarish experience, called a "bad trip." Trips can last anywhere from four to twenty-four hours depending on dosage and circumstances.

LSD. LSD can be taken in different forms. Because it is highly potent, only small amounts are necessary. It is sometimes produced in pill form. More commonly, sheets of LSD called blotter paper are produced. The user puts a tiny piece of the sheet in his or her mouth. These pieces are called dots, tabs or doses. Sometimes acid is taken in liquid form.

The effects of LSD are usually felt within an hour. Physical effects include increased blood pressure, dilated pupils, rapid heartbeat, muscular weakness, trembling, nausea, chills, and hyperventilation. (Sometimes LSD is mixed with amphetamines, and the effects match the speedy physical effects of that class of drugs.) Another possible effect of taking LSD is the flashback. Up to a year after the acid trip, users can have hallucinations caused by LSD left in their systems.

MESCALINE. Mescaline is made from the peyote cactus. The heads or "buttons" of the cactus are dried and put into capsules. It is usually taken orally but can be smoked or injected. It is less potent than LSD. Physical effects include dilated pupils, high body temperature, nausea and vomiting, and muscular relaxation. Mental effects include euphoria, heightened sensory perception, hallucinations, and difficulty in thinking. Higher doses can cause headaches, dry skin, hypotension (lowering of the blood pressure), cardiac depression, and slowing of respiration.

Designer Drugs

Designer drugs, called such because they are "designed" in a laboratory, were created in the 1970s by underground chemists attempting to subvert the drug laws of the day. The designer drugs were only a molecule or two different than some of the synthetic drugs then listed as illegal according to the Controlled Substance Act.

MDMA, better known as Ecstasy, is a very popular designer drug. Some street names for Ecstasy are X, E, XTC, Rave or Adam. It's related to amphetamines and mescaline. It's also called the "love drug" or the "hug drug" because it enhances empathy and relatedness. It also causes a positive mood change, a drop in defense mechanisms, and elevated mood. Some of the negative effects of Ecstasy are the potential for overdosing, extreme fatigue, dilated pupils, dry mouth and throat, tension in the lower jaw, grinding of the teeth and over-stimulation. It can also cause extreme paranoia and panic that call for emergency care.

Special K is one of the newer, deadlier designer drugs. It is actually ketamine hydrochloride, a drug widely used as an animal tranquilizer by veterinarians during pet surgery. It is a very powerful hallucinogen. Special K is usually snorted, but it is sometimes sprinkled on tobacco or marijuana cigarettes and smoked. Special K is frequently used in combination with other drugs, such as Ecstasy, heroin and cocaine.

GHB

GHB (gamma-hydroxybutyrate), an unpredictable, often deadly, designer drug has recently become popular with young adults. It has been used for euphoric, sedative, and anabolic (body building) effects, and is available in liquid or powder forms. Users report it induces a state of relaxation. Known as "liquid ecstacy," "Georgia Home Boy," "scoop," or "grievous bodily harm," GHB, taken alone or with other drugs (such as alcohol), can depress the central nervous system. Serious side effects include: coma, seizures, vomiting, tremors, dizziness, and difficulty breathing or respiratory arrest.

GHB is odorless and colorless with a slightly salty taste. This makes it easy to slip into someone's drink without detection (for this reason, GHB has reportedly been used in cases of date rape). Due to the unpredictable nature of the drug, there is little difference between a dose that will get a person high and one that will kill. Experts agree that there is no safe level of use of GHB.

Those high on Special K can enter a "K-hole" and never come out of it. Users describe the "Khole" as a space where profound hallucinations may occur that include visual distortions and a lost sense of time, sense and identity. Some report experiencing total temporary paralysis (loss of the ability to move or feel sensation). Because users generally become unable to speak or even see what is happening around them, it is not a social drug. One of the other dangers of Special K is that it's hard to determine that the dosage one has bought from a dealer is authentic. Like some of the other designer drugs, Special K is often cut with other drugs and poisonous agents.

INHALANTS

Inhalants are products that people sniff to get high. The sniffing of glue, solvents, aerosols, cleaning agents, gas from dessert topping sprays, and other gases is common. Because common, everyday products found in most homes and grocery stores can be used as inhalants, sniffing, also called huffing, is popular with teens and others who don't have money or access to buy illegal drugs. People who use inhalants are sometimes referred to as "huffers."

Sniffing is a deadly habit that gained much notoriety in the 1990s, although the practice existed before then. Because the inhalants are legal, everyday products, many teens do not view sniffing as being as harmful as doing "hard" drugs. This is a dangerous and untrue belief. Symptoms of inhalant use are slurred speech, mental disorientation, headaches, dizziness and weakness, muscle spasms, euphoria, and nystagmus (eye movement from side to side). Some of the more serious adverse effects are nausea and vomiting, confusion, panic, tension, aggressive behavior, and permanent brain damage. At higher doses use of inhalants can cause respiratory depression and eventual unconsciousness, resulting in coma and death. Sniffing can also cause heart failure.

ALCOHOL AND ALCOHOLISM

Alcohol is classified as a central nervous system depressant like barbiturates and tranquilizers. Although it is legal for those of a certain age in the United States to use, it is still very much a drug. It is, however, a socially acceptable drug, unlike some of the drugs already discussed. After tobacco use, alcohol is the most widely used psychoactive drug in the world.

Drinking alcohol, whether beer, wine, or liquor, causes a vast array of effects. Even small amounts of alcohol impair drinkers so much that they cannot perform simple motor tasks. Every tissue in the human body is affected by alcohol consumption. Individual effects of drinking vary. Body weight and size, gender, metabolism, the amount of alcohol consumed at the time, and the type and amount of food in the stomach determine the blood alcohol level. Mild intoxication

can cause feelings of warmth, flushed skin, impaired judgment, and decreased inhibitions. Deeper intoxication can cause a slowing of reflexes and more obvious lessening of judgment and inhibitions. Slurred speech, double vision, and memory and comprehension loss can follow.

Eventually drinkers can experience vomiting, incontinence (losing bladder or bowel control), and the inability to stand on their own. Many people pass out when they've had too much to drink. Blackouts are not uncommon. In a blackout, drinkers will not remember large segments of their experiences, even when the story is relayed to them. Coma and death are possible results of excessive drinking. Drinking even a small amount of alcohol can result in a hangover. Hangovers can cause headaches, fatigue, nausea, shakiness, and extreme thirst. (For those who insist on drinking, consuming plenty of water before, during and after will prevent the dehydration that is a consequence of alcohol consumption.)

The dangers of short- and long-term abuse of alcohol are numerous.

Short-term abuse can cause the physical reactions described above, plus the possibility of serious hazards incurred by loss of faculties. Drunk driving is the most serious and immediate consequence. Drunk people make impaired decisions that very often cost them their lives and the lives of those they love. The decision to get behind the wheel after drinking can result in drivers having to spend the rest of their lives in prison. Death is the most serious result of driving drunk. People who have been drinking, even those who do not think they are drunk, should never drive no matter the circumstances.

Long-term effects of alcohol abuse are liver diseases, such as cirrhosis and cancer. These are usually fatal. Alcoholics have higher rates of peptic ulcers, pneumonia, cancer of the upper digestive and respiratory tracts, heart and artery disease, tuberculosis and suicide than the rest of the population. Fetal Alcohol Syndrome (FAS) is a condition that drinking mothers pass on to their infants. Pregnant women should not drink alcohol at all. FAS is the leading cause of birth defects.

Withdrawal from Alcohol

Six to twelve hours after the last drink, an alcoholic can begin to feel the affects of withdrawal from alcohol. The stage one symptoms are psychomotor agitation, anxiety, insomnia, appetite suppression, stomach problems, elevated heart rate and blood pressure, sweating and tremors. Within twenty-four hours, stage two withdrawal symptoms begin. They include the symptoms of stage one, plus hallucinations and seizures.

NICOTINE

Nicotine is a drug that is legal in the United States for those over the age of eighteen. It is found in tobacco products, most notably cigarettes. Although the law prohibits selling cigarettes to minors, smoking is on the rise among teens. Many people do not think of cigarettes as drugs because they are so popular and socially acceptable. In fact, smoking is the most lethal of all the addictive behaviors. Smoking kills more people each year than AIDS, fires, illegal drugs, and suicides combined. It is best to avoid smoking all together because it is among the most difficult addictions to shake.

Smoking causes coughing, shortness of breath, fatigue, yellow teeth, bad breath, lung cancer, throat and mouth cancer, dry skin, dry hair, emphysema (a chronic lung disease), asthma, and a variety of other problems. At one time, the dangers of nicotine and smoking were not as well known as they are today and smoking was a symbol of "being cool." That era is long gone. And the proven negative effects of smoking are well documented. Many teens start smoking at first because they think it looks cool. But more and more teens are learning how truly not cool smoking is. Pregnant and breast-feeding women face special dangers when it comes to smoking. For example, a fetus exposed to the effects of smoking runs the risk of having a low birth weight.

CAFFEINE

Caffeine is a stimulant found in coffee, some teas, chocolate, some over-the-counter drugs, and cola drinks. Due to the popularity of these products, especially of coffee and cola drinks, caffeine is the most popular drug in the world. It is sometimes used medically, but mostly caffeine is used non-medically for its stimulating effect on mood and behavior. When someone wakes up in the morning and can't get started without a cup of coffee, this is a classic sign of caffeine addiction. People who regularly consume five or more cups of coffee per day develop a tolerance to the drug. An addicted person will suffer headache, irritability, and drowsiness when they do not consume the amount of caffeine to which their body has grown accustomed, due to their physical and psychological dependence on the drug.

SUGAR ADDICTION

Sugar addiction is common among children and adults and is no different, in terms of physical response, than addiction to other substances. Refined white sugar is an ingredient in almost all processed foods found at the supermarket: breakfast cereals, sodas, breads, canned soups, cakes, cookies, ice cream and more. It is in just about everything but raw fruits and vegetables (which contain natural, not refined, sugar). Most people don't think twice about it. But each time the human body consumes sugar it reacts. Insulin (a hormone that regulates the amount of sugar in the blood) in the body rises and energy temporarily shoots up. That is why people sometimes eat candy bars when they need a quick lift. But the problem with the rise in energy is the consequent crash. Once the sugar leaves the system, the sugar-eater gets fatigued and craves more. This causes a cycle of dependence that is hard to break. Because refined white sugar is a food (and because it's hard to avoid unless one really makes an effort) most people do not connect health and emotional problems to sugar addiction (for instance, some hyperactive children can return to normal behavior when taken off sugar). In the long run, too much processed sugar can cause cavities, diabetes, and a host of other illnesses.

TREATMENT FOR ADDICTION

Whether a person is suffering from alcoholism or drug addiction, it is clear that treatment is necessary for successful recovery. Going "cold turkey," the idea of abruptly quitting using a substance without any treatment, only works for a very small minority. Many people believe in the saying "once an addict, always an addict." That is, recovery from addiction is thought to be a lifelong process and not one that stops once an addict initially stops using. Many former addicts who have been substance-free for years still consider themselves in recovery. There are many options and theories about recovery available to addicts who seek help.

Alcoholics Anonymous (AA)

Alcoholics Anonymous is the most famous treatment organization in the world. AA meetings take place just about everywhere in the United States each day and in other countries as well. AA is based on a twelve-step recovery plan. The steps successful members of AA have completed are as follows:

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God, as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed, and became willing to make amends to them all.

9. Made direct amends to such a people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory, and when we were wrong, promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

These steps have been modified and used by many other recovery programs for all different types of addictions. AA is a plan for self-reflection and taking responsibility. Some people are uncomfortable with the word God, and the reference to God as a Him. Those individuals can substitute other words for any spiritual language, and the steps can still work for them.

Abstinence from all alcohol is a requirement for those in AA. New members are given a sponsor, a recovering alcoholic (called such because many former alcoholics feel they are always in recovery) who can lead them through the process. The sponsor stands by to assist the new members. If they feel they might relapse (that is, return to drinking), they are told to call their sponsor right away for guidance.

TAKE THE QUIZ

On its web site (http://www.alcoholics-anonymous.org) Alcoholics Anonymous has a questionnaire for teens. If teens take the quiz and answer even one question with a "yes," they are directed to explore whether they might have a serious problem with alcohol.

A Simple 12-Question Quiz Designed To Help You Decide

Do you drink because you have problems? To relax?
Do you drink when you get mad at other people, your friends or parents?
Do you prefer to drink alone, rather than with others?
Are your grades starting to slip? Are you goofing off on your job?
Did you ever try to stop drinking or drink less—and fail?
Have you begun to drink in the morning, before school or work?
Do you gulp your drinks?
Do you ever have loss of memory due to your drinking?
Do you lie about your drinking?
Do you ever get into trouble when you're drinking?
Do you get drunk when you drink, even when you don't mean to?
Do you think it's cool to be able to hold your liquor?

Methadone Maintenance

Methadone maintenance is a popular treatment for heroin addicts. Methadone is a substitute drug for heroin. It is prescribed and distributed in a controlled environment. It helps to alleviate the severe symptoms of withdrawal from heroin, without enforcing abstinence. The goal of methadone maintenance is to wean a heroin addict from heroin and then, ultimately, from methadone, which does not have as severe withdrawal symptoms as does heroin. Widespread HIV infection among heroin addicts (from sharing dirty needles) increased the acceptance of methadone maintenance as a treatment for addiction in the United States. (European countries have used this treatment for years without problem.)

Intervention

Intervention is a popular mode of treatment for addiction and other negative behavioral problems. Intervention is an organized visit upon the afflicted individual by friends and loved ones. Often a counselor is present and counselors almost always help in planning the meeting. The intervention is designed to confront the addicted individual in a nonjudgmental fashion. The group offers caring, guidance, and love to the person being confronted. The group tells the individual that they are aware of the addiction and that they care for the person and want him or her to seek help and get better. Often an intervention helps addicts realize that their addiction is not a secret and that they are affecting their loved ones' lives. An intervention also sometimes backfires and causes the subject of the intervention to become immediately defensive and storm out of the meeting. That is why taking this approach needs to be considered very carefully and should involve a trained substance abuse counselor (see Chapter 7: Health Care Careers for information on substance abuse counselors).

Other Treatment Considerations

Anyone suffering from addiction and attempting to recover will experience a certain degree of pain and discomfort. The person must believe that kicking the habit is worth it, though, and be willing to ride out the discomfort to reach sobriety. While this is much easier said than done, there are some tools that recovering addicts can use to make the road to recovery a little smoother.

It makes sense for all people to eat right and get a healthy amount of sleep, but for those that have been abusing their bodies with a substance, healthy eating is even more important. Vitamin C can be of great help in flushing the toxic substance out of the system. It cleanses the tissues. Essential fatty acids, such as those found in flax oil (this can be found at the health food store), are really important and will also help to detoxify the system. Flax oil is best mixed with yogurt. Exercise is also vital for the recovering addict. Sweating will help cleanse the toxins out of the body, and getting the heart rate up and the muscles moving will uplift and heal the ailing body.

ACUPUNCTURE. Acupuncture is being used more and more often with addicts to ward off cravings. Acupuncture is an ancient Chinese method of placing tiny, painless needles in strategic points all over the body. The points correspond to energy meridians, and they restore balance to the body. Ear point acupuncture is often offered in methadone clinics for heroin addicts. In clinics in Oregon, heroin addicts are required to try acupuncture before getting methadone.

MEDITATION. Meditation is focusing intently on one sound, idea, image or goal. For a person recovering from addiction, meditation can be extremely difficult. It can also be extremely valuable. When someone stops to look at waves crashing on the beach or a candle flame or even a tree in the park, often that person will enter into a trance-like state. This is a form of meditation. Artists of all types often become so involved it the act of making art that it becomes a meditation.

Concentration is one of the most difficult tasks for recovering addicts. Thoughts and obsessions run like wildfire through the mind. Meditating is like going on vacation in the mind even while the body is stuck in one spot. Meditation also helps with insomnia (sleeplessness), a problem for many recovering addicts. Meditation before bed (but not in bed) helps to create deep and peaceful sleep.

MANTRAS. A mantra is simply a sound, word, or phrase that is repeated over and over as during meditation. A lot of people think the best mantras are the ones that have no distinct meaning, the ones that are simply sounds. (For instance, the sound "ohm" is a popular choice.) This is so that the meditator will not begin thinking about meditation. The goal of meditation is to go to a place of focus where passing, neurotic thoughts do not interfere with relaxation.

HOW TO MEDITATE

The first thing one needs to do is find a safe, quiet space where one will not be disturbed. (Meditation in bed is not recommended.) Sometimes people use a meditation cushion to sit on (this can simply be a pillow or couch cushion). Comfort is essential for meditation. Sitting in a chair, or against the wall if this is more comfortable, is fine, too. Having the feet fall asleep can get in the way of the practice.

Meditation begins by breathing. Breathing should be natural and one should try to be aware of each breath taken. Then the mantra should be repeated, over and over, slowly, in the mind. Obsessive thoughts may creep into the mind during meditation. Meditation teachers suggest that those starting a practice should try to let their thoughts go and use the metaphor of the movie screen. Some people like to pretend that their mind is a movie screen and that the thoughts passing are not their own. This is a good way to detach from painful thoughts. When people try to control their thoughts, or punish themselves for their thoughts, they have a lot of trouble with meditation. Gentle return to the mantra is suggested when thoughts stray. It is important not to get frustrated because thoughts will naturally stray. Twenty minutes per session is usually recommended, but five minutes is good for a starting practice. Healing may not be immediate with meditation, but recovering addicts who have learned to meditate report tremendous benefits from their practice.

The most important factors in healing from addiction are honesty and love of self. Without those fundamental foundations, no treatment plan can work. Once the addict admits to being sick and needing help, he or she is ready to begin the long road to feeling whole again. The addiction has likely become a great comfort to the addict, something he believes he can't do without. Giving up that idea and letting go of the substance itself is not easy. But it can be done, and it is done every day. The happiness that will come as a result of being free from addiction makes the pain of letting go far more than worth it. Just as getting hooked changed one's life, it will change again, for the better, by kicking the addiction.

COMPULSIVE BEHAVIORS

Compulsions are habitual behaviors or mental acts an individual is driven to perform in order to reduce stress and anxiety. Individuals can fall victim to compulsive behaviors that make them feel a craving similar to that of drug addicts and alcoholics. Just like addiction to drugs and alcohol, this kind of compulsion can affect anyone. Psychological vulnerability, cultural and social factors, and contact with others engaging in compulsive behaviors all play a role in whether an individual will become addicted to a certain activity.

It is important to note that any of the following activities or behaviors in moderation is fine. It is when normal activity begins to affect a person's quality of life that it may be turning compulsive.

Gambling

Gambling can be a dangerous compulsion. Compulsive gamblers often spend all their money, their savings, and even resort to stealing money from loved ones to support their habit. People can get addicted to betting on sports events, playing poker, or playing slot machines in bars and casinos. Something about the possibility of winning, perhaps the risk and the consequent adrenaline rush, spur on the compulsive gambler. Now there is even online gambling. Virtual casinos are immediately available to those who cannot travel to popular gambling destinations like Las Vegas, Nevada, or Atlantic City, New Jersey. The Center for Online Addiction (www.netaddiction.com) exists to serve people with all forms of Internet addiction, including addiction to online gambling. Addiction to online auction houses, such as E-bay, is another form of compulsive gambling. Online traders, people who trade stocks on the Internet, can also fall victim to compulsive trading.

Internet Addiction

Internet addiction is a broad term that describes many kinds of compulsive behaviors. Many of the things that individuals can become addicted to in real life are replicated on the Internet. The reason internet addictions are a bit more dangerous is that people often feel secluded sitting in front of their computer screens. There is a sense that they won't get caught in the act.

According the Center for Online Addiction, there are five types of Internet addiction:

Cyber-sexual addiction is an addiction to adult chat rooms or cyber-porn.
Cyber-relationship addiction is addiction to meeting people on the Internet, usually in chat rooms or through newsgroups. People who grow addicted to meeting people in the virtual world often stop seeing and speaking to their friends from real life.
Net compulsions are the gambling-related activities mentioned above.
Information overload is compulsive web surfing and researching. Sometimes information overload can keep people up all night surfing, which impacts normal daily activities.
General computer addiction describes those who compulsively play video games or program their computers.

People who hide out in a cyber universe are often troubled and have difficulty socializing with real people. Counseling is suggested to help Internet addicts come out from behind their computers and rejoin the real world.

Exercise Addiction

Exercise addiction is compulsively exercising to the point of damaging a person's health. Is it possible to be addicted to a seemingly healthy behavior? Anything done in excess is dangerous, even if it is taking vitamins or exercising. Individuals addicted to exercise want to do it all the time. They think about exercise constantly, and plan their every moment around the next time they can run, bike, take a class at the gym, or lift weights. They talk constantly about fitness. They begin to associate only with those people who will indulge their addiction: those who also exercise all the time. If someone gets really angry or depressed by missing a workout, or if he or she constantly exercises and stops taking part in other social activities, that individual might be an exercise addict.

Exercise addiction can lead to exhaustion and death. Women can stop getting their periods, and men who are obsessed with muscles sometimes succumb to taking dangerous steroids to bulk up. For most people, a new exercise regimen, often under the supervision of a doctor or a trainer, is truly beneficial to their health. But in some cases, people become so addicted to their regimen that they cannot stop. The healthful benefits of exercise get lost within the desperate need to be exercising all the time.

Often exercise addiction is related to body image disorders, like anorexia nervosa, bulimia nervosa, and body dysmorphic disorder. In all three of these illnesses, the individual sees herself not as she is, but as a distorted, fat person who does not measure up to society's standards of thinness. (In the case of body dysmorphic disorder, fat is not always the culprit but rather a constant unhappiness with parts of or the shape of one's body.) Women and girls tend to suffer from this kind of disease most often, but boys and men are not exempt.

Exercise addiction can develop for other reasons as well. For instance, athletes can become addicted to training in their quest to improve their performance. Abuse of steroids can result from exercise addiction. Steroids are a class of drugs that increase the male hormone testosterone in the body. This increases muscle mass when accompanied by weight training. In the weight lifting world, there is a focus on looking "buff" or very muscular. Many men (women, too) who weight train sometimes become so focused on the goal of attaining huge muscles that they turn to steroids and other artificial means of bulking up.

[See Chapter 12: Mental Illness for more information on body dysmorphic disorder. See Chapter 13: Eating Disorders for more information on exercise addiction and eating disorders.]

Self-Mutilation

Self-mutilation, also known as cutting, is a form of obsessive-compulsive disorder. Self-mutilators tend to be teenage girls, but anyone can have this compulsion. People who self-mutilate often get a high off of seeing their own blood. They sometimes carve on their body with razor blades, stick themselves with pins, and squeeze and pinch their faces. Depression is a common cause for self-mutilation. Many self-mutilators physically hurt themselves to disguise some emotional pain they might be trying to repress. Self-mutilators are not necessarily suicidal, but the fact that they draw blood from their bodies makes outsiders think so. It is important that self-mutilators receive therapy to uncover the reasons why they are hurting themselves.

Manias

A mania is an excessive or unreasonable enthusiasm for something, especially something destructive such as stealing or starting fires.

Kleptomania is the compulsion to steal. Kleptomaniacs lead dangerous lives, stealing things every chance they get. It's not enough for them to simply shoplift from stores. Kleptomaniacs steal from their friends, teachers, and loved ones. Similar to gambling, something about the risk of getting caught gives these individuals a kind of high.

Pyromaniacs are compelled to start fires. This compulsion can kill not just the individual who sets the fire, but anyone caught in the way. Often this compulsion begins in young people who for some reason feel as if they didn't get enough attention as a child. Pyromaniacs are often angry people, but the anger is often suppressed. Setting fires is a way for them to express their anger. Usually pyromaniacs don't get help until it is too late. A serious fire is often what finally gets them into therapy.

Compulsive Shopping

Compulsive shopping is a behavior that was first given media attention in the 1990s. People with this addiction run up their credit card bills and get so buried in debt that they sometimes have to declare bankruptcy (legally declared unable to pay one's bills due to lack of money). Many people, at one time or another, purchase an item that they do not really need or want. Compulsive shoppers, however, will go on frequent shopping sprees and buy many things that they just don't need at all. Somehow, standing in front of the item before they buy it, they believe that their lives will be better if they own the item. As a result, they end up with closets full of unnecessary items.

Compulsive shoppers are searching for love in the form of material objects. They think that things will provide them with the emotional lack in their lives. Often they will continue going on shopping binges until a loved one stops them or they lose everything to debt. A self-motivated method for stopping compulsive shopping is putting credit cards into a block of ice in the freezer. Then the individual desiring to shop will have to wait until the ice melts to retrieve the card, and hopefully the compulsion will have passed by that time. Professional help is suggested for those individuals who cannot control shopping binges.

Sex Addiction

Sex addiction is the compulsion to repeatedly seek out people and have sexual intercourse with them. Sex addicts put themselves in dangerous situations regularly just to fulfil their need to have sex with someone. People who are sex addicts sometimes meet strangers in bars, or almost anywhere, and go someplace with that stranger to engage in casual sexual activity. Of course, when a stranger is involved there is a great deal of danger from potential personal harm. People who engage in such behaviors are not just being promiscuous; rather, they are psychologically driven to their sex addiction.

Sex addiction is treatable. Once addicts confront and accept their behavior, they can begin to look at the reasons why they are compelled to have sex all the time. Often sex addicts experienced sexual abuse as children. Their sex addiction is a way of having control over their bodies and the act of seduction they compulsively perform is a way of having control over a partner. Sex addiction is never connected to healthy love and desire.

A strong self-image is the first defense against any type of addiction. Many of the habits and behaviors discussed in this chapter are not alarming if imagined in small doses. A cup of coffee, a candy bar, running for good health, or sexual activity isn't dangerous if it is treated as a simple desire that can be fulfilled and then forgotten about. (However, the mind-altering drugs and alcohol discussed in this chapter can be dangerous, even if they are just experimented with even one time.) It is most important to remember that if one has a strong sense of self and a strong support system, addiction is far less likely to result from experimentation.