This week's literature and lecture was about addiction. Topics discussed are addiction to drugs and alcohol and how addiction develops and how it is maintained. Before attending this workgroup the students were asked to watch the documentary The city addicted to crystal meth, which is available on NPO. This documentary was discussed during the workgroup: what were scenes/things which stood out to you? What surprised you? What do you think about the therapy session showed in the documentary?

In the therapy sessions, demonstrated in the documentary, addicts were confronted with their loved ones while other addicts and their relatives sat around them and watched them and listened to their conversations. The addicts' loved ones had to tell them how the addiction had impacted their lives. 

DSM V criteria for addiction

• Hazardous use (driving under influenced, blacking out)
• Social or interpersonal problems related to use (relationship problems, conflicts with others)
• Neglected major roles to use (failing to meet responsibilities at work/school/home)
• Withdrawal symptoms
• Tolerance
• Used larger amounts/longer
• Repeated attempts to control use or quit
• Much time spent using
• Physical or psychological problems related to use (cancer, liver damage, depression, anxiety)
• Activities given up to use
• Craving

Incentive-sensitisation theory of addiction

This theory suggest that addiction occurs due to incentive sensitization. The reason why incentive salience occurs with addiction is because the brain of the individual has become sensitized to the substance. Individuals can develop hypersensitization if they are repeatedly exposed to addictive substances. In the future the drug will stimulate neurobehavioural systems at a great intensity. The individual will get an increased level of pleasure from their drug use. This leads to incentive salience and the symptoms associated with addiction. The individual will have a strong desire for the drug that goes way beyond liking it. This will result in the repetition of the behaviour. At the same time, the unconscious forces that drive addiction will become conscious desires for using the drug. Initially it is about ‘liking’ the drug, but addiction process will gradually be dominated by stress, negative reinforcement and compulsive ‘wanting’.

Anticipation effect: physical effects will appear when people think/know they are going to use drugs

Social-cognitive learning: most people learn about alcohol/drugs through observation of others, and learn to attribute certain meaning to its use (pleasurable, exciting, reducing social anxiety)

Learned helplessness: In adults, learned helplessness presents as a person not using or learning adaptive responses to difficult situations. People in this state typically accept that bad things will happen and that they have little control over them. They are unsuccessful in resolving issues even when there is a potential solution