Addictions

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What are addictions?

Addictions refer to a broad group of conditions in which an individual is regularly involved with a substance or activity in a way that is compulsive, hard to control, and often has harmful consequences.

Addictions are most often defined by using a substance like drugs or alcohol (commonly called substance use disorders), but some definitions of addiction also include compulsive engagement in behaviors such as sex, gambling, or shopping.

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Many people engage in substance use or potentially addictive behaviors without these habits becoming addictions. For example, looking forward to getting a drink at happy hour doesn’t mean you’re addicted to alcohol, and one evening at a casino doesn’t equal a gambling addiction. However, when you frequently seek out a substance or behavior in a way that feels difficult to cut back, control, or disengage from even when it interferes with your day-to-day life, it may be worth considering whether you’re struggling with an addiction.

Different types of addiction

Addictions can come in many forms. A few of the most common addictions include:

  • Alcohol Use Disorder: A person regularly consumes alcohol in a way that is compulsive, and has harmful consequences at least some of the time.

  • Drug Use Disorders: This category includes addictions to, among other substances: amphetamines, cocaine, heroine, prescription drugs, and opioids. Tobacco addiction falls under this category of addiction.

  • Behavioral Addictions: These are addictions to activities, rather than substances. Some common activities that can be addictive include sex, gambling, shopping, working, exercising, and using the Internet.

How common are addictions?

Addictions are considered to be very common.

According to the 2014 National Survey on Drug Use and Health [1]:

  • About 21.5 million people in the United States ages 12 and older had a substance use disorder

    • Of these, nearly 80% had an alcohol use disorder specifically

    • More than 7 million individuals had a drug use disorder

American Addiction Centers indicate that substance use disorders are more common in men than in women [2].

  • In particular, men are about twice as likely as women to have alcohol use disorder

The National Survey on Drug Use and Health also indicates that many people struggle with drug and alcohol use disorders simultaneously.

Additionally, nearly eight million adults in the United States in 2014 had both a substance use disorder and a diagnosed mental health condition [3]. This is what’s known as co-occurring disorders.

What are some symptoms of an addiction?

Symptoms of addiction can vary, but the most common indicators are as follows:

  • Compulsive use of a substance or engagement in a behavior: Individuals struggling with addictions may wish to stop or decrease use of a substance or behavior, but they find it difficult to do so. Cravings for the substance or behavior may be intense enough to interfere with other activities or even thoughts.

  • Risky use and/or harmful consequences: If you have an addiction, you might continue to use a substance or engage in a behavior even when it is dangerous—driving a car after drinking, for instance—or has a negative impact on you or those around you. Examples of such consequences might include problems at work, conflicts with friends or family, or excessive spending.

  • Lack of enjoyment: Substances or activities that once provided happiness or entertainment are now sources of stress, pain, or conflict.

  • Tolerance: You might need to use more of the substance or engage in the activity more frequently to experience the same effects you once did from a lesser amount.

  • Withdrawal: If you stop using the substance or engaging in the activity, you experience painful physical and/or psychological symptoms.

What to do if you’re experiencing addiction-related challenges

Addictions are generally considered highly treatable. If you may have an addiction, you can explore the following options:

  • Therapy: Find a therapist who can help you understand your addiction and take steps toward recovery. (See more tips below on selecting a therapist.)

  • Recovery groups: Recovery groups, where you can meet others facing the same challenges that you are, are a common form of treatment for many different addictions. You can look for local chapters of Alcoholics Anonymous, Sex Addicts Anonymous, and Narcotics Anonymous, to name a few.

  • Rehabilitation programs: Rehabilitation programs for addictions come in many forms, from long-term residential programs to outpatient programs. These programs often include a variety of services, such as counseling, group therapy, and medical treatment. Look for options in your area, or consult the national directory provided by The Substance Abuse and Mental Health Services Administration.

  • Medical treatment: Treatment for many addictions often begins with a medically managed withdrawal process, sometimes followed by treatment with pharmaceutical tools or other medical supports. Contact your primary care doctor or an addiction treatment center to discuss these options.

  • Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at at 1-800-273-8255. The Substance Abuse and Mental Health Services Administration hotline at 1-800-622-4357 can also help you locate resource and treatment options.

What should I look for in a therapist for addiction?

Look for a therapist who has a specialty in treating addiction

Several different treatment methods have been shown to be helpful for various addictions. A few of the most common include:

You may also want to work with a therapist who has specific credentials, such as a Credentialed Alcoholism and Substance Abuse Counselor (CASAC).

Know what questions you need to ask potential therapists

These questions may prove helpful when interviewing potential therapists:

  • What therapy type (possibly one of the examples above) do you use when treating addictions?

  • Do you have a harm reduction or abstinence-based philosophy?

  • Are you able to help me transition to a higher level of care, if necessary? What might that look like?

Prioritize personal fit

While personality fit is a nuanced factor, it is critical to your success in therapy. Multiple studies have revealed the importance of this factor, often referred to as “therapeutic alliance.”

On your initial phone call with the therapist, ask yourself:

  • Could I see myself forming a connection with this therapist?

  • Does their approach suit my personality?

  • Do I feel like I will be heard and respected by this therapist?

Additionally, consider these factors:

  • Some therapists are more reflective and spend most of the session listening and drawing insights about your patterns and coping styles.

  • Some therapists are more directive, establishing weekly agendas and assigning tasks to complete between sessions.

  • Some utilize specific techniques or tools (exposure exercises, eye movements, tapping, breath work, guided imagery, art and music, etc.).

  • Some use a combination of multiple approaches.

Consider cost, location, and scheduling

Therapy will only work if it works for you. Before making an appointment, ask yourself honestly:

  • Can I afford these session fees? The cost of therapy for addiction depends on location, practitioner, and whether you’re using insurance.

  • Can I commit to attending sessions regularly? Remember to account for travel time, and other demands in your schedule.

  • Do the therapists’ available times work for me? Some therapists offer evening and weekend appointments if you have an otherwise limited schedule.

Find therapists specializing in addiction treatment near you

Find therapists who treat addiction on Zencare, below. Search by insurance, fees, and location; watch therapist introductory videos; and book free initial calls to find the right therapist for you!

New to therapy? Learn about how to find a therapist here.