Overview of Addiction Psychology

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An individual with an addiction abuses uses substances or engages in maladaptive behavior in which the “rewarding” effects induce feelings of repetition, although there may be dire consequences, as stated in an article on addiction by the authors from Psychology today. According to the American Psychological Association (APA), the field of “Addiction Psychology” falls into division 50, also known as, the “Society of Addiction Psychology” (SoAP). In the article “Understanding the Dependence vs. Addiction Debate”, Dr.Jeffrey Juergens states that, “The DSM-IV used to define abuse and dependence as two separate diagnoses''; although they are synonymous. Juergen continues with, “The present DSM no longer makes this distinction”. Additionally, it is stated that, “Some communities use the words interchangeably, while some communities prefer the terms Substance abuse disorder or Drug dependence” (Juergen). Therefore, the field of addiction psychology is referred to in many ways by different communities, although the most common synonym would be Substance Abuse disorder.

The first diagnosis of Substance Abuse/Addiction that was printed in medical literature occurred during the early 19th century. On a podcast aired on the  NPR website about addiction, hosted by Ira Flatow, she discusses how medical historian Howard Merkel explains the story of how “Freud and Halstead fell under the addictive spell of cocaine”(Flatow).

Sigmund Freud and William Halsted were the first scientists that began experimenting with users and the use of cocaine. Freud, along with Halsted, initially were unaware of the effects of cocaine on the human brain and how highly addictive the drug was. Over time they became addicts themselves, becoming their own test subjects for studies on addiction and substance abuse. Based on the above, it is safe to assume that the specialty area of addiction psychology has been around “since the 1880’s”(Flatow); which is estimated to be the time Freud and Halsted became addicts. Overall, the early discoveries, although nonsensical, have contributed largely to the foundations of Addiction psychology. (McCartney, 2012).

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Addiction Psychology is a broad field that can cover multiple addictions such as, gambling, eating disorders, sexual addiction, substance abuse and others. According to the Addiction Psychological Organization, the earliest studies in the field began in the early 19th century. It was first named “Society of Psychologists in Substance Abuse.'' This name changed to addiction psychology as the field got broader and more subdivisions were added (American Psychological Association, 2020).

Addiction is not only a domestic issue, it is also an international problem.  According to the Alberta Gambling Research Institute, an estimated 4.9% of the adult people around the world (240 million people) deal with alcohol use disorder and 22.5% of adult people around the world (1 billion people) smoke tobacco products. Smoking tobacco and alcohol use are the most frequent addictive behaviours and cause a lot of individual issues (Gowing, 2015).

As she mentioned,” 11% of deaths in males and 6% of deaths in females each year are due to tobacco.” According to Gans (2016), the United States has the highest rate of illegal drug use compared to other western countries. The survey by the National Survey on Drug Use and Health found our illegal drug use rate is almost four times the rate of the second-place country, New Zealand. Wrong drug policies such as forcing, presonin and punishing people with addiction are some of the reasons that we have a high illegal drug use (Gans, 2016). Instead of solving the issue with effective ways like therapy, we are trying to ignore it.

Addiction has been steadily increasing around the world; multiple organizations, like the WHO illustrate some of these statistics to the public. The WHO states that, “ 15% of the 152 responding countries have 1/3 of primary health care facilities implement screening and brief interventions for hazardous and harmful alcohol use” (WHO,2020). This indicates that, globally speaking, we are not that well prepared to professionally take care of individuals with any addiction disorders. According to the article, “Job description for an Addiction Psychologist” by Aanya Rose, “These psychologists are also commonly known as substance-abuse or behavioral-disorder psychologists.”

Aanya also states that, it is the duty of these psychologists to perform many functions such as evaluating their client’s physical wellness and mental health, analyzing any behavioral problems and developing treatment plans tailored to the individual. Aanya continues with, “Clients may work with these psychologists to develop the skills necessary to overcome their addictive behaviors' '(Aanya).

Most aim to help their clients by acknowledging their problem, establishing trust and a rapport, by working together as a whole to come to the treatment method that works best for the addicted individual, and by educating the afflicted loved ones. According to Bobek and Hugue in their article  “What is Family Therapy for Addiction, & How Can It Help My Family?”, they mention that addiction psychology mostly focuses on group, family and individual therapy. “Individual therapy” can help the client clear his thoughts and emotion that can probably be the cause of the addiction.

On the other side, “Family therapy” can be a good tool to use to resolve family conflicts that can affect or aggravate the addiction of the individual.  Moreover, Group therapy can also be very helpful, in group therapy the individual can learn from other people's addictions and how they overcame their addiction.

Dealing with addiction is hard, it is even harder when dealing with it by yourself. Generally, the psychologist works with the client at every step of their recovery treatment to ensure a higher chance of success, whether that be alone or within a group. Aanya states that, “Most addiction psychologists will work with their patients' families, while also incorporating group counseling alongside one-on-one therapies”(Aanya).  These psychologists also tend to work with their clients family members to educate them about how addictive behaviors affect the whole family. They would provide them with helpful strategies to help cope with the side effects of addictive behaviors.

In rare cases, Aanya also concludes that, “The duties of a psychologist may also include referring clients to job placement resources or support groups”(Aanya). The support group sessions focus on 12-step programs, which help clients develop coping strategies for the challenges they face on a daily basis. In accordance with the U.S. Bureau of Labor and Statistics, most addiction psychologists work in “outpatient mental health and substance abuse clinics”. While others will work in local, state and private hospitals.

Addiction psychology is needed as a “specialty” field due to the numerous excessive behaviors that are considered as possible addictions as well as the complexities of risk factors that lead to addiction. According to the APA, genetics plays an important role in addiction. Scientists have proposed that genetic problems can affect the prefrontal and subcortical cortex of the brain which is in-charge of our cognitive process. When this area of our brain is damaged we have less control of our cognitive behavior and it is easier for us to develop any behavior problem. Therefore, those with a genetic predisposition for addiction may heavily benefit from this specialty field, whether that be with knowledge or future treatments.

This field benefits anyone who may be under the category of an Addict under the APA. Ranna Parekh, a physician for the APA, states in her article “What is Addiction'' that, “Individuals with impaired control, social problems, risky use, and physical issues” (Parekh),  fall under the category of severe substance use disorder, aka addiction. So, those that are concerned that the recurrent use of a substance, or engagement with a certain behavioral activity, is leading to impairment and distress in their daily life or the lives of loved ones they may choose to seek out help from an addiction psychologist. For procedure and treatment, Addiction psychologists rely and borrow heavily on parallel aspects throughout clinical psychology such as the integration of science, theory, and practice to understand, predict, and alleviate maladjustments in an individual's behavior.

Addiction psychology shares a lot of the foundations of clinical psychology such as the integration of science, theory, and practice to understand, predict, and alter an individual's behavior for the better. It's not just a physical need for them to smoke or drink, but it's more like an emotional and mental necessity. Addiction psychologists, compared to clinical and counseling psychologists, have to deal with clients and patients with behaviors that are naturally resistant and are prone to relapse. They all use group, family and individual therapy to help their clients overcome their mental stress and then work towards recovery.

Addiction psychology mostly comprises the clinical psychology and abnormal psychology disciplines and fosters the application of information obtained from research in an effort to appropriately diagnose, evaluate, treat, and support clients dealing with addiction. However, this field has branched off due to the complexities and the many causal factors that lead to substance abuse/addiction in individuals. It has become its own field due to the difficulties that come with treating an addict and the special skill set needed for the proper and effective treatments of such individuals.

Addiction psychologists deal with a wide variety of addictions such as, substance abuse disorders, gambling or eating disorders, and many other excessive behaviors. Their job is challenging enough that they are not able to work in other areas of psychology.

The disease model, temperance model, and moral model are some of the early foundations of addiction psychology models. Sigmund Freud and William Halsted were the first scientists that started working with addiction. But the field doesn't have a specific founder. There exists different beliefs about addiction; some people believe it is a disorder while other people believe it is choice. Scientists and politicians have realized that banning and forcing people to obey is not an effective way to control and reduce substance use. When the drug is not available, they tend to get it from offhand sources or worse places, like the black market. Not enough information about the drug is known, increasing overall risk.

Something positive is that people have decided to see addiction as an abnormality and are fighting for more therapy related solutions rather than punishment and prison. Because the research has shown that punishment may work sometimes but it's not the most effective solution.  For example, in the article, “Treat V. Punish...” by Operation Clean Recovery argues that, “Since the passage of the Harrison Narcotics Act in 1914, United States drug policy has almost always come down on the side of punishment as the solution to social problems caused by substance use/addiction” (Operation Clean Recovery, 2019).

In other words, individuals who are suffering from addiction receive inappropriate treatments which leads to worsening the issue. It should be common sense that an individual without any external support system will most likely not be able to recover fully. Also, according to Dr. Erlen on “Treat V. Punish…”, he states that, “Before the Harrison Act in 1914, opiates and cocaine were legal to buy, sell, and use. In fact, they were often recommended by doctors.

The Harrison Act didn’t outlaw these drugs altogether, but made it illegal to have cocaine or opiates that were not prescribed by a physician. People who had been obtaining and using these drugs freely were suddenly criminals” (Erlen, 2019). In addition, according to the historian William White, “When the Harrison Tax Act was passed, the maximum possible penalty that could be received for a violation of the Act was only five years in prison”(White, 2019).

In just less than fifty years, penalties had risen to include the option of life imprisonment and the death penalty.” Law enforcement should not be making decisions about how to deal with addicted people, said Lawrence Kolb; it is the physicians job to make such decisions.

On the authority of the article “Genes and Addictions” by doctors, Bevilacqua and Goldman, most recent research is focused on individuals genetic susceptibility to addiction, the origins of addiction, the rates of substance abuse in a community, and the search for effective solutions (Goldman). Research in this field uses a lot of statistical data to compare different treatment methods, compare medications to see rate of affection, and to compare the rate of occurrences in a certain population/community.

Also there have been different researches that show children who have been born in families that have been associated with some sort of drug use or simply just exposed to drugs at an early age leads to an increased risk rate of drug addiction and substance abuse in their future. In recent years there are more scholarly journals that are working to answer these issues and are getting involved with modern addictive behaviors. For example in Washington D.C. the media is working so hard to inform people about the potential dangers of substance abuse.

Washington D.C. has the highest rate of drug abuse in the country and many people die because of lack of knowledge and no willingness to seek help. Eventually, these same people may need to  spend a lot of money they might not have, on treatments that can help these people eradicate maladaptive behaviors.

The first goal of addiction psychologists is to prevent. By making announcements and sharing knowledge to the public about addictions, like in Virginia, these psychologists are taking the first step in order to aid in the prevention of substance abuse by denouncing misinformation and supplying accurate knowledge to the people about the issue at hand; for example like the opioid crisis. Breaking free from addiction is the second step, where they use effective coping methods and also psychological methods.

Although addiction psychology incorporates a lot of the same practice as clinical psych, one who is simply licensed just as a clinical psychologist does not match the criteria necessary to be considered qualified for this type of work. Although most requirements are met, one must also complete specific coursework tailored to Addiction Counseling to gain the knowledge and experience necessary with substance abuse and addiction in a clinical setting and in a real world setting.

According to the article “Become a Substance Abuse Counselor...”  by Rick Reyes, In the United States many states require a “minimum of a master's degree and license to work as a substance abuse counselor”. But, most states require just a bachelor's degree and supervised experience, under a licensed counselor, working in clinical condition.

With a bachelor’s degree, you can start gaining experience as a recovery assistant, there are private and public facilities that you can work in and it  just requires a bachelor’s degree and some experience to start.  Addiction is an important issue but the treatment is even more important. Psychologists need to be licensed and have enough experience to be able to effectively help their clients. If they are not careful enough with what they are doing, it might have terrible outcomes, possibly even the death of the client. 

Undergraduate students are able to take abnormal, clinical and drug psychology which would help them to understand material regarding addiction and addiction psychology if one is interested in this field. But for graduate students, class would be tailored to more specific aspects of the field; Like how drugs would affect the brain and their actions or how to assist people to make better choices and maintain healthy coping mechanisms other than drugs.

Some addiction counselors are licensed psychiatrists and others have a master’s degree in counseling with a concentration in substance abuse or addiction/addiction studies. According to the article, “How to Become a Therapist: Education and Career Roadmap”, in order to obtain a California Substance Abuse Counseling Certification one must earn an Associates/Bachelors/Masters/degree in a behavioral science field with counseling/Addiction counseling preferred. Then one must complete a 255 hours practicum approved by the CAADAC, earn sufficient supervised work experience, pass an official written examination through the state, then finally apply for the certification under the California Commission for Behavioral Health, and hope that one’s combination of education and accrued documented work experience make one eligible.

The article, “How to Become a Therapist: Education and Career Roadmap'' from study.com (2018), continues that the University of Detroit Mercy, New York Institute of Technology and University of the Pacific have the best program in this field and they are ranked as top addiction psychologist schools in the country. After graduation, they will be qualified to work under the control of an addiction psychologist inorder to gain clinical and hands on experience.

Different states have different prerequisites but students in bachelor's degree program will learn about physical and mental aspects of addiction.  The classes are mainly about dependency of chemicals, research and understanding of statistics, evaluation and treatment. Learning about different types of counseling like individual, family and group counseling. Continuing students would learn about psychopharmacology, prevention and the ways to deal with individual and family emotional issues caused by addiction..

According to Warner, new addiction psychologists with less than 4 years of experience have an average income of $41,633. As they gain more experience, they make more profit. An average income of addiction psychologist with 5-9 years experience is $47,665, 10-19 years of experience is $48,477 and more than 20 years of experience is 59,850. So we can conclude that the average range of addiction psychologists income is between 40,000$ to 65,000$, but psychologists who are MD’s are able to make more than 200,000$ a year. The United States is one of the best places for this field because we have a high rate of addiction compared and a survey showed the United States has the highest rate of illegal drug use compared to other countries(Warner, 2008).

According to the article, “Statistics on Addiction in America”, by the Addiction Center, more than 20,000,000 individuals in the United States have an addiction disorder and not even ten percent of seek treatment, moreover, drug overdose deaths have passed the 700 thousand U.S. citizens from 1999 to 2017 and that numbers keep rising everyday. (Addiction Center, 2020).  The increase of the opioid crisis and other types of behavioral addictions leads to more potential “clients” for this field.

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Many individuals are suffering from addictions, whether that be to opioids or something like video games, and are seeking the help necessary to avoid permanent damage to their lives or even damage physically.  We can conclude that addiction psychology is a growing and stable job field, not only that but addiction psychology is growing enormous in the public and private sectors of this field.

Nowadays, more individuals are willing to pay for a good treatment and spend a good amount of money seeking a perfect treatment that fits them or their loved ones. You can clearly notice the growth in this industry, where you can see cheap treatment and really expensive crazy ones with luxury facilities, as consequence of this, the payment for addiction therapies or clinical psychologists can vary depending on the state or the facility that you’re trying to apply to. Yes, this field is growing at a fast paced but, and the employment opportunities are rising too, except that, this field is also getting  very demanding since the recruiters are looking for  highly knowledgeable qualified professionals that can fit and conduct their facilities with professionality.

One of the oldest and most controversial arguments around this field is whether or not the addiction is a disease or if it is the individuals choice. In the opinion of the article “Addiction Treatment or Punishment: Which Works Best Long-Term” by Pyramid Healthcare, addiction is a chronic and progressive brain disease.

Individuals who repeatedly take drugs or excessively consume alcohol undergo changes in the structure and function of their brain. These changes ultimately result in compulsive substance use and a lack of executive functioning which in combination leads to higher risk of maladaptive behavior. The lack of executive functioning in the affected individuals prefrontal cortex causes loss of control over the related behaviors that characterize addiction.

Socially, it is assumed it is the sole responsibility of the person with a substance use disorder to seek treatment. However, it is also society’s responsibility to make treatment readily available and easily accessible.

The second controversy around addiction and individuals who suffer from substance abuse is that the individual has to hit an extreme low before seeking help. Since addiction is progressive, if the individual goes untreated, one’s condition will most likely worsen to extremes, affecting many aspects of the individuals life. Seeking treatment, whether that be alone or with the help of others, helps individuals suffering from addiction find ways of using their cognitive process more effectively to help break the addiction and replace maladaptive behaviors with good behaviors.

Another big controversy regarding addiction is that much of society still believes that addicts should be punished as they see that these individuals are breaking the law and should be put in prison/fined. A significant amount of these individuals that have any drug addiction problem usually break the law not because they want to, but because they want to feed their substance abused need, and when they break the law it’s most of the time too late to find recovery. Usually when a person with some type of drug addiction goes to jail, the individual never receives a professional help or some type of mental health treatment that will help him overcome his addiction. However, in 2015 Massachusetts adopted a new policy where if an addict turns themselves in along with the rest of their drugs and paraphernalia, they will not be arrested and charged. Instead,  as Chief Campanello from the Gloucester police department said,  “ Any addict who walks into the police station with the remainder of their drug equipment (needles, pipes, etc) or drugs and asks for help will NOT be charged”(Campanello, 2015).

For these individuals who turned themselves in it was like having a second chance, which hopefully leads to a successful recovery. The “Gloucester Angel Initiative '' also provided them with a sponsor opportunity that would take them into the right path of recovery. The division of Psychological Addiction is full of controversy, a lot of it is because in reality there are not the necessary resources to help people who suffer from some type of addiction and it is also difficult to help individuals who do not want help or think they do not need it.


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