Causes of Addiction

There is much debate about the causes of addiction. Because there are two components to addiction --the physical addiction and the psychological addiction-- it is likely that many factors create a risk for addiction. In the case of certain drugs such as methamphetamine or heroin, almost any individual who comes into contact will become addicted. On the other hand, addictive behaviors such as shopping or eating are used moderately by the majority of the population and only become addictions for some.
The following risk factors are involved in developing addictions:
Genetics: It is believed that addictions such as alcoholism may be inherited. Individuals from families with a history of alcoholism are more likely to develop the disease themselves. Also, individuals from families with a history of any kind of addiction are more likely to develop some other form of addiction. For example, someone from an alcoholic family may develop a problem with compulsive overeating or workaholism. While environmental factors can also have influence, individuals who have been removed from their alcoholic parents and raised by non addicted individuals still show a higher risk for developing an addiction themselves.
Environment: Children raised by alcoholic or drug addicted parents are more likely to view substance abuse or certain behaviors as acceptable, making them more likely to engage in the addiction themselves. Individuals from countries where use of a certain substance or engagement in an addictive behavior are frowned upon or hard to obtain show a much lower incidence of addiction, pointing to possible environmental factors.
Abuse: Individuals who experienced sexual, psychological, emotional or physical abuse are more likely to become addicts. The addiction becomes a coping mechanism, helping the addict to deal with strong negative emotions surrounding the abuse, feelings of severe low self-esteem, and possible flashbacks.
Emotional Disorders: Emotional disorders such as anxiety, depression, bipolar disorder or post-traumatic stress disorder often increase the risk of substance abuse and addictive behaviors, especially amongst those who are misdiagnosed or undiagnosed. Individuals often use drugs, alcohol, food, exercise, or work as a way to self-medicate and escape the symptoms of their primary disorder.
The Substance: Certain substances are more addictive than others, and risk of full-blown addiction is higher for drugs such as cocaine, heroin, or methamphetamine because of their ability to create dependence after just a few uses.
Low Frustration Tolerance: One common factor found amongst addicts of all types is a low frustration tolerance. Addicts are highly susceptible to the negative effects of stress, often experiencing distress at a relatively low level of frustration. They become easily upset over everyday stress factors, creating a need for escape. They find this escape in their addiction.
These are all contributing factors as to why addiction occurs. Overall, there is no absolute solution when dissecting the causes behind addiction. Today, there are many options available to the alcoholic or drug addict who wishes to stop and stay stopped.
Many possible factors have been considered in trying to explain and understand the causes of addiction. One thing is clear: no single factor can be said to cause addiction. People become addicted because of a combination of factors.
Genetic Factors
It appears that some people may inherit a vulnerability to the addictive properties of drugs. Studies have shown, for example, that the risk of substance use disorders is higher for people who have close relatives with substance use disorders (Glantz & Pickens, 1992). However, many people who have a genetic vulnerability to addiction do not become addicted, and others who do not have a family history of addiction do become addicted.
How drugs interact with the brain
People use alcohol and other drugs because they stimulate the brain in ways that “feel good.” This immediate rewarding experience makes people want to repeat it. All substances with addictive potential stimulate the release of dopamine, a chemical in the brain that is associated with reward and pleasure. Eating, drinking and having sex are all activities that release dopamine. Substance use, however, brings a flood of dopamine, which alters the chemistry of the brain. The brain, in turn, tries to keep things in balance by developing tolerance, which means that more and more of the drug is needed to bring feelings of pleasure. The brain also adapts by decreasing the amount of dopamine available. That’s one reason why people who are addicted report feeling “flat” and depressed without drugs (NIDA, n.d.; Glantz & Pickens, 1992).
Environment
The home, neighbourhood or community where people live, go to school or work can influence whether or not they develop substance use problems, as can the attitudes of their peers, family and culture toward substance use. People who experience prejudice, discrimination or marginalization due to culture, race, gender identity, sexual orientation, ability, age or other factors may use substances to cope with feelings of trauma or social isolation.
Mental health issues
Research shows that more than half of people with substance use disorders have also had mental health problems, especially anxiety or depression, sometime in their lifetime (Reiger et al., 1990).
The relationship between substance use and mental health problems is complex. Some people with mental health problems use substances to help themselves feel better, but end up making the situation worse. When people have mental health problems, even limited substance use (e.g., a drink or two) can worsen the problems.
For more information on the relationship between substance use and mental health problems, see the CAMH publication Concurrent Substance Use and Mental Health Disorders (available online at Concurrent Disorders: An Information Guide. For order information e-mail: publications@camh.net).
Coping with thoughts and feelings
People may turn to substances as a way of coping with difficult emotions or situations. They may find it hard, for example, to calm themselves down when they feel angry or upset, and come to rely on substances to help them regulate their emotions. People may also use substances to help relieve stress, boredom or sadness, or to reduce their inhibitions and make it easier to talk to others and speak up about feelings.
Spiritual or religious affiliation
Spirituality can mean different things to different people. One aspect that many people experience is a need to feel connected to others and the world around them. People who lack this sense of spiritual connection may feel empty or hopeless. They may use substances to mask these feelings and develop a substance use problem as a result.
Risk and protective factors
Researchers have tried various ways to sort out the complex causes of substance use problems. One way is to ask which factors put people at risk and which protect them from substance use problems. Since substance use often begins in youth, research has focused on this age group.
The risk factors for substance use problems in youth include:
alcohol or other drug problems among family members
poor school performance
poverty, family conflicts, chaos or stress
having friends who drink or use other drugs
not fitting in socially, or being excluded because of race, ethnicity, gender, age, sexual orientation, abilities or other factors
emotional, physical or sexual abuse
experiencing discrimination or oppression.
The protective factors for substance use problems in youth include:
having a positive adult role model (e.g., a parent, relative or teacher)
good parental or other caregiver supervision
having a strong attachment to family, school and community
having goals and dreams
being involved in meaningful and well-supervised activities (e.g., sports, music, volunteer work).
Risk and protective factors do not guarantee that a person will or will not develop problems, but they do affect the level of risk. Once a person has a problem with substance use, risk and protective factors also influence how readily that person is able to change his or her use.
Whether a person is genetically or bio-chemically predisposed to addiction or alcoholism is a controversy that has been debated for years within the scientific community. One school of thought advocates the Disease Concept, which embraces the notion that addiction is an inherited disease, and that the individual is permanently ill at a genetic level, even with those experiencing long periods of sobriety.
Another philosophy argues that addiction is a dual problem consisting of a physical and mental dependency on chemicals, compounded by a pre-existing mental disorder (i.e. clinical depression, bipolar disorder, or some other mental illness), and that the mental disorder needs to be treated first as the primary cause of the addiction. This treatment philosophy is commonly referred to as Dual Diagnosis. A third philosophy subscribes to the idea that chemical dependency leads to "chemical imbalances" in the neurological system, which would be a substance induced imbalance.
The fact remains that there is scientific research to support all of these concepts, but that none of these theories are absolute.
The concept of drug addiction/dependence is being refined in light of new research on blood concentrations, receptor sites, brain chemistry and withdrawal syndromes. All mind-altering drugs, including alcohol, marijuana, heroin, other opiates, methamphetamine and cocaine, can produce addiction or dependence, develop intolerance, and induce a withdrawal syndrome after cessation of chronic use.
Putting all this together, persons dependent on drugs or alcohol may have any or all of the following problems at the time they enter treatment:
Induced chemical imbalance
Genetic chemical imbalance
Social and psychological problems
Inhibited life and/or coping skills
On the assumption that one or more of these factors may be present, it is easy to see why different treatments work for some persons but not others. In summary, it is now believed that severe chemical imbalances exist in persons who continuously relapse despite treatment and that the origins of those chemical imbalances may be chemically induced, genetic, or social and psychological.
What Are The Risk Factors?
Genetic/Inherited
We are all a product of our parents. If your parents have addiction struggles, chances are you are more susceptible to addiction. That’s why drug addiction is more common in some families than in others. If your parents smoke, chances are good you will smoke. If your parents used alcohol, you’ll probably follow and use that drug in much the same way. If your father was an alcoholic, you have a predisposition to abusing that drug.
Drug addiction causes one generation to pass it on to the next.
Personality
Aside from the inherited factors, some people have a personality that is more likely to become drug dependent. - People are curious, so that alone can lead a person to try a drug. We experiment and see what happens.
- We are looking to relax and have pleasure.
- We all want to feel good, and we’re by nature impatient. Drugs give us an instant gratification that other things do not, so for that moment or hour of for whatever time-frame, we feel good.
- We want what we want.
- Someone diagnosed with depression, attention deficit disorder, or hyperactivity.
- Maybe there has been some stress, or anxiety in their life. Whatever the case, these are contributing factors.
Even some common personality characteristics, such as aggression, may be a factor. Children who do not have confidence, healthy self-esteem may be prone to turning to drugs to fill the void.
Drug addiction causes negative changes in personality that can lead to an even more destructive behavior.
Peer Pressure/Social
We are all wired to have relationships, and sometimes those relationships cause us to give in to something we otherwise would avoid in order to maintain the relationship. Peer pressure is huge and nowhere is this greater than during our teenaged years. Kids want to be cool. It begins as a social action, to take the drugs to be a part of the group, to be accepted. It’s not just teenagers, as peer pressure takes so many different forms. There is social etiquette, for example, to take a drink during a party. “I’m a social drinker.” How many times have you heard that? Some people actually believe that drug addiction causes you to be accepted and part of the 'popular' group.
Easy Access
If you want to get drugs, you won’t have to look far because they are everywhere. High school students can tell you this. Drug addiction causes people to sell drugs to the most vulnerable population, children. It’s not just the stereotypical poor sections of the inner city that serve as the hotbed for drugs. Drugs are found in suburban shopping malls, rural schools, well-to-do private school, on the job in factories, offices and remote job sites.

Race, Ethnicity
We include this heading because we want to stress that there is no data to support any claim that one race of people or any particular cultural group is more prone to drug addiction than another. Drug addiction is a human problem and crosses all boundaries. Drug addiction causes do not include race.
Loneliness, Depression
We want to feel good physically and emotionally. Sometimes drugs are the substitution for a healthy life experience. The person in pain and they want to numb the pain. The drug numbs the pain and for a moment they don’t feel as poorly. The person needs to escape the pain of the life experience, and for a short while, the drug takes them away and they feel “better.”
Anxiety
Sometimes people need some help coping with life. Everyday life becomes a struggle and simple things become too much to handle. Drugs are used to deal with it. In the case of addiction, we are not talking about the use of medication, under the care and observation of a doctor. People who have been clinically diagnosed with anxiety can lead a very good life. We’re talking here about people who just need to escape. Their drug of choice facilitates that escape.
Additional Risk Factors
There are many contributing factors to drug addiction, which may give us some insight into why one person becomes addicted and another person does not. Ask yourself a few questions. - Are they unhappy or angry, for example, and if they are, is there an external source of irritation or are they just like that naturally?
- Along the same lines, are they “depressed” or to put it another way, do they appear sad?
- Are there factors in their life that may cause them to seek relief, such as financial pressures, problems at work, loss of a loved one or other negative experiences?
- What is their psychological makeup? A person may turn to drugs if they lack self esteem. The drug makes them feel better, because it fills a gap that they are incapable of filling themselves.
As the disease progresses, taking the drug to feel better is not enough, they have to take the drug just to feel “normal.” Some people have a personality that is more likely to become drug dependent. For example, they may be curious and want to try new things.
That leads them to try drugs, and might be the beginning of becoming addicted to a certain drug because it meets a desire. People naturally want to relax and have a good time, but people are often impatient and drugs will provide instant gratification. Over time, the drugs become the only way a person can relax, or feel good.
There is a genetic risk factor to drug abuse and drug addiction. Just as you have inherited your parent’s physical characteristics, you have also inherited their chemical characteristics. If mom and dad used drugs, chances are high you will too, and addiction, like any other disease, runs in families. Most people have an alcohol link in their family tree, so even if the parents did not use, there was an aunt or uncle, etc. The alcohol use is often the first step towards the use of drugs, so one generation might have abused alcohol and their children might abuse illegal drugs.
We are all wired to have relationships, and sometimes those relationships cause us to give in to something we otherwise would avoid in order to maintain the relationship.
Peer pressure is huge and nowhere is this greater than during our teenaged years. Kids want to be cool. It begins as a social action, to take the drugs to be a part of the group, to be accepted. It’s not just teenagers, as peer pressure takes so many different forms. There is social etiquette, for example, to take a drink during a party. “I’m a social drinker.” How many times have you heard that? Some people actually believe that drug addiction causes you to be accepted and part of the 'popular' group.
Today, drugs are in our schools, in small towns and large urban areas. If you want to get drugs, you won’t have to look far because they are everywhere. High school students can tell you this. Drug addiction causes people to sell drugs to the most vulnerable population, children. It’s not just the stereotypical poor sections of the inner city that serve as the hotbed for drugs. Drugs are found in suburban shopping malls, rural schools, well-to-do private school, on the job in factories, offices and remote job sites

Menopause- the change of life

Menopause implies permanent ending of menstruation in women. Menopause marks the end of a woman’s natural ability to bear children. Perimenopause encompasses this period of changing ovarian activity and also the first few years without menstrual cycling, typically characterized by hormonal and physical changes and sometimes emotional and psychological changes as well.
Menopause symptoms are part of a natural biological process experienced by all women as their child-bearing years come to an end. The transition can begin as early as the 30s and last even into the 60s.
The symptoms of menopause are not an illness, just a natural consequence of aging. All women experience "the change" in different ways. Some will have no symptoms or only mild issues while others will battle a range of annoying alterations in their body like hot flashes or mood swings than can negatively affect their daily lives.
Signs that Menopause is Starting
Menopause manifests at different times and in different ways for individual women. Some are lucky enough to get through the experience with no significant problems but for others, menopause disrupts both their lives and their interpersonal relationships. The experience of menopause differs among women, depending on differences in diet and nutrition, general health and health care, and even how women are taught to think about menopause. Not all women experience symptoms.
Both the lining of the vagina and of the urethra become drier, thinner, and have less elasticity with the onset of menopause. Consequently women tend to experience burning and itching and have an increased chance of urinary or vaginal infections. A frequent urge to urinate is common with minor incontinence especially when laughing, sneezing, or coughing. In addition, sexual intercourse may become increasingly uncomfortable, even painful.One of the most common menopause symptoms, the hot flash, is a consequence of dropping estrogen levels that cause blood vessels to expand rapidly with an attendant increase in skin temperature. Generally women experience sweating and a flushed appearance. This can last from 30 seconds to several minutes and can occur as often as once an hour.Although hot flashes can occur at any time of the day or night, night sweats are a related problem that severely disrupts the sleep cycle. Women report waking up from a deep sleep to find their night clothes and bedding soaked with sweat.Most women gain some degree of weight during the onset of menopause, usually an average of five pounds. The increased weight concentrates around the waist and abdomen. Other changes in appearance can include fullness of the breasts, thinning hair, wrinkles, adult acne, and coarse hair (usually on the chin, upper lip, and sometimes on the chest and abdomen).
Management of Menopause
In order to relieve symptoms of menopause, as well as to reduce specific health risks in menopausal and postmenopausal women, physicians often prescribe the synthetic hormones estrogen, progestin (a synthetic form of progesterone), and sometimes androgens. This therapeutic approach is called hormone replacement therapy (HRT). For instance, osteoporosis, in which bones become brittle and vulnerable to fractures, is caused by calcium loss. Calcium loss accelerates in women for three to seven years after menopause. The use of HRT combats bone calcium loss and significantly lessens the risk of osteoporosis.
Other ways of reducing negative effects of menopause include eating a healthy diet, eliminating caffeine and alcohol, reducing sugar and salt intake, stopping smoking, and taking vitamin supplements. Exercise helps increase conversion of androgens to estrogens and can help alleviate menopausal symptoms.
Homeopathic Remedies
Glonoinum 30C 5 pills twice a day for intense hot flashes and flushing during menopause, along with feelings of pulsation or pounding in the head
Amyl nitrate 6C 5 pills twice a day for climacteric headache, palpitations and anxiety.

VITILIGO CONCERNS TO BE ADDRESSED

1) Will it spread in spite of treatment?
•Yes, in progressive cases of vitiligo, it can spread. Therefore its very important to clarify to the patient in the case history itself that yours is a case of progressive vitiligo and can spread in spite of treatment. It is a very unpredictable illness. However if the patient is regular with the medicines, the rate of progress can be slowed down. In case of patients using steroids, tapering of the steroids can lead to the spots coming back and hence should not be mistaken as disease or medicinal aggravation

2) Will it get completely cured?
The cure depends on the following factors
a)Chronicity- more chronic, bad prognosis
b)Extent of spread- generalised bad prognosis, focal and segmental-good prognosis
c)Location- muscular araes better prognosis then lip-tip, joint areas better prognosis as compared to allopathic view
d)Associated autoimmune disease- uncontrolled thyroid or diabetes bad prognosis, hence regular investigations and treatment
e)Suppression by steroids

3) Will it recur back after going away completely?
Generally no recurrence but if some triggering factor, then can come back, but with homeopathy recovery can be faster.

VITILIGO PROGNOSIS

Bad Prognosis
•Strong Family History
•High Stress levels
•Association with other autoimmune disorders like Thyroid, DM, Pernicious Anemia
•Type- Generalised Vitiligo,Spreading or Progressive Vitiligo
•Location- Lip tip, Joint prominences, Perorificial, non hairy areas
•Chronicity

Good Prognosis
•Young people
•Compliant with medications
•No Family History
•No H/O Major Stressors in Life
•Hairy areas affected
•Type- Stable Vitiligo, Focal or Segmental Vitiligo
•Location- Hairy areas, Muscular areas, Vitiligo on Exposed areas
•Stable Emotional Status

CAUSES OF SQ VITILIGO

1)Lip-tip, bony prominences, joints
2)Progressive cases, spreading vitiligo
3)Long term vitiligo
4)Uncontrolled stress about diseases and personal issues
5)Associated autoimmune diseases and deficiencies
6)Poor lifestyle- alcoholism, smoking, improper diet
7) Changes in life- puberty, menopause
8) Diseases like Typhoid, malaria
9) Anxiety about the disease and outcome
10)Suppression by allopathy, ayurveda or homeopathy
11) Strong Family History
12) Perceptional SQ