Understanding Addiction 

Addiction is a complex, chronic condition characterised by compulsive engagement in rewarding stimuli despite adverse consequences.

In Australia, it affects individuals from all walks of life, impacting not only the person with the addiction but also their families, mates, and the broader community. The unique cultural and social landscape of Australia, including its drinking culture and the prevalence of gambling, presents specific challenges in addressing addiction.

Common Addictions in Australia

• Alcohol: A significant issue, with 16.8% of Australians drinking at levels that put them at risk of alcohol-related disease or injury
• Tobacco: Despite declining rates, smoking remains a leading cause of preventable death and disease
• Cannabis: The most commonly used illicit drug in Australia
• Methamphetamines (including ‘ice’): A growing concern, particularly in rural and regional areas
• Prescription opioids: Australia has seen a significant increase in opioid-related deaths in recent years
• Gambling: With Australians being among the biggest gamblers in the world
• Internet and gaming: An emerging issue, especially among younger Australians

Signs & Symptoms of Addiction

Recognising the signs of addiction is crucial for early intervention. Common symptoms include:

• Intense cravings and compulsivity
• Loss of control over substance use or behaviour
• Continued use despite negative impacts on work, study, or relationships
• Tolerance (needing more to achieve the same effect)
• Experiencing withdrawal symptoms when not engaging in the addiction
• Neglecting responsibilities and hobbies
• Failed attempts to quit or cut back
• Spending excessive time and money on the addictive substance or behaviour
• Engaging in risky behaviours (e.g., driving under the influence)
• Experiencing mood swings or personality changes

Diagnostic Criteria

Mental health professionals use the ICD-11 or DSM-5 criteria for diagnosing substance use disorders. A diagnosis requires at least two of the following within a 12-month period:

The Impact of Addiction in Australia

Addiction has significant personal, social, and economic costs in Australia:

• According to the Australian Institute of Health and Welfare, alcohol and illicit drugs contributed to 4.5% of the total burden of disease in Australia in 2015.
• The social cost of alcohol misuse alone is estimated to be $14.35 billion annually.
• Problem gambling affects up to 500,000 Australians, with social costs estimated at $4.7 billion a year.
• Workplace productivity losses due to alcohol and other drug use are estimated at $6 billion annually.
• The cost of tobacco use to the Australian economy is estimated at $136.9 billion annually.

Causes of Addiction

Addiction is complex and multifaceted, involving a combination of factors:

• Genetic predisposition: Family history can increase the risk of addiction
• Environmental influences: Including family dynamics, peer pressure, and socioeconomic factors
• Mental health disorders: Such as depression, anxiety, or PTSD
• Trauma or stress: Including childhood trauma or ongoing life stressors
• Brain chemistry alterations: Substance use can change brain structure and function
• Cultural factors: Such as Australia’s drinking culture or acceptance of gambling
• Accessibility: Easy access to substances or gambling opportunities

The Brain and Addiction

Addiction significantly impacts the brain’s reward system, particularly affecting areas such as:

• Ventral tegmental area (VTA)
• Nucleus accumbens
• Prefrontal cortex
• Amygdala

These areas are involved in motivation, pleasure, decision-making, and emotional regulation. Understanding these neurological changes is crucial in developing effective treatments.

Managing Addictions: 8 Essential Tips 

1. Recognise Triggers: Identify people, places, or situations that trigger cravings. This might include certain pubs, mates who use substances, or stressful work situations.
2. Plan Ahead: Develop strategies to avoid or cope with triggering situations. For example, plan alternative activities during events where alcohol is served.
3. Accept Urges: Acknowledge cravings without acting on them, understanding they will pass. Practice mindfulness techniques to observe urges without judgment.
4. Practice Rational Thinking: Challenge negative thoughts and replace them with positive, constructive ones. For example, instead of thinking “I can’t cope without a drink,” try “I have the strength to handle this situation sober.”
5. Use Distractions: Engage in healthy activities to divert attention from cravings. This could include going for a surf, playing footy with mates, or trying a new hobby.
6. Build a Support Network: Surround yourself with supportive friends and family. Consider joining support groups like SMART Recovery Australia.
7. Practice Self-Care: Prioritise sleep, exercise, and healthy eating. These can help manage stress and reduce cravings.
8. Seek Professional Help: Don’t hesitate to reach out to local support services, your GP, or a mental health professional for guidance and treatment.

Treatment Options 

Australia offers a range of evidence-based treatment options for addiction:

• Psychotherapy (e.g., CBT, Motivational Interviewing)
• Medication-assisted treatment (e.g., methadone for opioid addiction)
• Support groups (e.g., SMART Recovery Australia, Alcoholics Anonymous)
• Inpatient rehabilitation programs
• Outpatient counselling and day programs
• Telehealth services for remote areas
• Holistic approaches (e.g., mindfulness, yoga, art therapy)
• Harm reduction strategies (e.g., needle exchange programs)

Addiction Therapy Modalities

• Cognitive Behavioural Therapy (CBT): Focuses on changing maladaptive thoughts and behaviours.
• Acceptance and Commitment Therapy (ACT): Helps individuals accept difficult experiences and commit to positive changes.
• Dialectical Behaviour Therapy (DBT): Teaches skills for emotional regulation and distress tolerance.
• Motivational Interviewing: Enhances motivation for change.
• Family Therapy: Addresses family dynamics that may contribute to addiction.
• Group Therapy: Provides peer support and shared experiences.

Recovery and Relapse Prevention

Recovery is an ongoing process that requires commitment and support. Key elements include:

• Building a strong support network
• Developing healthy coping mechanisms
• Maintaining physical and mental health
• Continuing therapy or support group attendance
• Practicing relapse prevention techniques
• Setting realistic goals and celebrating milestones
• Developing a meaningful, substance-free lifestyle

Australian Resources for Addiction Support

• Australian Department of Health – Drugs
• Australian Institute of Health and Welfare – Alcohol, tobacco & other drugs
• Beyond Blue – Mental health support
• Gambling Help Online
• Lifeline Australia – Crisis support and suicide prevention
• SMART Recovery Australia
• Turning Point – Addiction treatment, research and education
• Counselling Online – Free 24/7 drug and alcohol counselling

Remember, seeking help is a sign of strength, not weakness. If you or someone you know is struggling with addiction, don’t hesitate to reach out to these services, speak with your local GP, or contact Mind Health for professional support.

References

1. Australian Institute of Health and Welfare. (2020). Alcohol, tobacco & other drugs in Australia. Canberra: AIHW.
2. Manning, M., Smith, C., & Mazerolle, P. (2013). The societal costs of alcohol misuse in Australia. Trends and issues in crime and criminal justice, (454), 1-6.
3. Productivity Commission. (2010). Gambling, Report no. 50. Canberra.
4. National Health and Medical Research Council. (2020). Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC.
5. Lubman, D., Manning, V., & Cheetham, A. (2017). Addiction in Australia. Oxford Research Encyclopedia of Psychology.
6. Collins, D. J., & Lapsley, H. M. (2008). The costs of tobacco, alcohol and illicit drug abuse to Australian society in 2004/05. Canberra: Department of Health and Ageing.
7. Ritter, A., McLeod, R., & Shanahan, M. (2013). Government drug policy expenditure in Australia – 2009/10. Drug Policy Modelling Program, Monograph 24. Sydney: National Drug and Alcohol Research Centre.
8. Pennay, A., Livingston, M., & MacLean, S. (2015). Young people are drinking less: It is time to find out why. Drug and Alcohol Review, 34(2), 115-118.