Process addiction and co-occurring Disorders

Process addiction: Contrary to the commonly held belief that addiction is a dependence on alcohol, illicit drugs, prescription drugs or nicotine, behavioral science experts believe any source capable of stimulating an individual has the potential to become addictive.

Although process or behavioral addictions can cause devastating psychological effects, they are not associated with a high incidence of mortality like substance use addictions. Some of the more common activities identified as potential factors in the development of process addictions include gambling, sex, work, spending/compulsive shopping and use of the Internet.

Research has identified the presence of psychopathologies such as depression, substance dependence or withdrawal, social anxiety and a lack of social support as precursors to behavioral addictions. Furthermore, the high comorbidity of behavioral addictions and substance-related addictions suggests comparable underlying etiological mechanisms.

Evidence shows people who excessively participate in non-substance-related pleasurable activities undergo lasting chemical changes in the neural pathway of the reward system in the brain. There is increasing evidence individuals with a genetic predisposition to addictive behaviors have an inadequate number of dopamine receptors or have an insufficient amount of serotonin/dopamine. Therefore they cannot experience normal levels of pleasure from pursuits most people would find rewarding and seek out pleasure through activities that can be highly addictive.

 Co-occurring disorder describes the simultaneous presence of a mental illness and a substance use disorder. The term co-occurring disorder replaces the terms dual disorder and dual diagnosis when referring to an individual who has a co-existing mental illness and a substance-use disorder. While commonly used to refer to the combination of substance-use and mental disorders, the term also refers to other combinations of disorders (such as mental disorders and intellectual disability).

People with co-occurring disorders often experience more severe and chronic medical, social, and emotional problems than people experiencing a mental health condition or substance-use disorder alone. Because they have two disorders, they are vulnerable to both relapse and a worsening of the psychiatric disorder. Further, addiction relapse often leads to psychiatric distress, and worsening of psychiatric problems often leads to addiction relapse. Thus, relapse prevention must be specifically designed for the unique needs of people with co-occurring disorders. Compared to patients who have a single disorder, patients with co-existing conditions often require longer treatment, have more crises, and progress more gradually in treatment.

Approximately 7.9 million adults had co-occurring disorders in 2014. During the past year, for those adults surveyed who experienced substance use disorders and any mental illness, rates were highest among adults ages 26 to 49 (42.7%). For adults with past-year serious mental illness and co-occurring substance use disorders, rates were highest among those ages 18 to 25 (35.3%) in 2014.

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