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Overview of Addiction Psychology

An individual with an addiction abuses substances or engages in maladaptive
behaviour in which the “rewarding” effects induce feelings of repetition. However,
there may be dire consequences, as stated in an article on addiction by the authors
from Psychology today. According to the American Psychological Association (APA),
the field of “Addiction Psychology” falls into division 50, also known as the “Society
of Addiction Psychology” (SoAP). In the article “Understanding the Dependence vs
Addiction Debate”, Dr Jeffrey Juergens states, “The DSM-IV used to define abuse and
dependence as two separate diagnoses''; although they are synonymous. Juergen
continues with, “The present DSM no longer makes this distinction”. Additionally, it is
stated that “Some communities use the words interchangeably, while some
communities prefer the terms Substance abuse disorder or Drug dependence”
(Juergen). Therefore, addiction psychology is referred to in many ways by different
communities, although the most common synonym would be Substance Abuse
disorder.

The first diagnosis of Substance Abuse/Addiction printed in medical literature

occurred during the early 19th century. On a podcast aired on the NPR website about
addiction, hosted by Ira Flatow, she discusses how medical historian Howard Merkel
explains how “Freud and Halstead fell under the addictive spell of cocaine” (Flatow).

Sigmund Freud and William Halsted were the first scientists that began
experimenting with users and the use of cocaine. Freud, along with Halsted, was
initially unaware of the effects of cocaine on the human brain and how highly
addictive the drug was. Over time they became addicts themselves, becoming their
test subjects for studies on addiction and substance abuse. Based on the above, it is
safe to assume that the speciality area of addiction psychology has been around
“since the 1880s” (Flatow), estimated to be the time Freud and Halsted became
addicts. The early discoveries, although nonsensical, have mainly contributed to the
foundations of Addiction psychology. (McCartney, 2012)

Addiction Psychology is a broad field covering multiple addictions such as gambling,

eating disorders, sexual addiction, substance abuse and others. According to the
Addiction Psychological Organization, the earliest studies in the field began in the
early 19th century. It was first named “Society of Psychologists in Substance Abuse.''

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This name changed to addiction psychology as the area got broader and more
subdivisions were added (American Psychological Association, 2020).

Addiction is not only a domestic issue but also a global problem. According to the
Alberta Gambling Research Institute, an estimated 4.9% of adult people around the
world (240 million people) deal with alcohol use disorder and 22.5% of adult people
around the world (1 billion people) smoke tobacco products. Smoking, tobacco and
alcohol use are the most frequent addictive behaviours and cause many individual
issues (Gowing, 2015).

She mentioned that” 11% of deaths in males and 6% in females yearly are due to
tobacco.” According to Gans (2016), the United States has the highest rate of illegal
drug use compared to other western countries. The National Survey on Drug Use and
Health survey found that our illegal drug use rate is almost four times the rate of the
second-place country, New Zealand. Wrong drug policies, such as forcing and
punishing people with addiction, are some reasons we have high illegal drug use
(Gans, 2016). Instead of solving the issue effectively like therapy, we are trying to
ignore it.

Addiction has been steadily increasing worldwide; multiple organisations, like the
WHO, illustrate some of these statistics to the public. The WHO states that “15% of
the 152 responding countries have 1/3 of primary health care facilities that
implement screening and brief interventions for hazardous and harmful alcohol use”
(WHO,2020). This indicates that, globally, we are not prepared to care for individuals
with addiction disorders professionally. According to the article “Job description for
an Addiction Psychologist” by Aanya Rose, “These psychologists are also commonly
known as substance-abuse or behavioural-disorder psychologists.”

Aanya also states that these psychologists must perform many functions, such as
evaluating their client’s physical and mental health, analysing any behavioural
problems, and developing treatment plans tailored to the individual. Aanya
continues, “Clients may work with these psychologists to develop the skills necessary
to overcome their addictive behaviours' '(Aanya).

Most aim to help their clients by acknowledging their problems, establishing trust
and rapport, working together to come to the treatment method that works best for
the addicted individual, and educating the afflicted loved ones. Bobek and Hugue, in
their article “What is Family Therapy for Addiction, & How Can It Help My Family?

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Mentioned that addiction psychology focuses on the group, family, and individual
therapy. “Individual therapy” can help the client clear his thoughts and emotions that
can probably be the cause of the addiction.

On the other hand, ‘Family therapy can be an excellent tool to resolve family
conflicts that can affect or aggravate the individual's addiction. Moreover, ‘Group
therapy can also be beneficial; in group therapy, the individual can learn from other
people's habits and how they overcame their addictions.

Dealing with addiction is hard; it is even more challenging when dealing with it
yourself. Generally, the psychologist works with the client at every step of their
recovery treatment to ensure a higher chance of success, whether alone or within a
group. Aanya states, "Most addiction psychologists will work with their patient's
families while also incorporating group counselling alongside one-on-one therapy”.
These psychologists also tend to work with their client's family members to educate
them about how addictive behaviours affect the whole family. They would provide
them with helpful strategies to help them cope with the side effects of addictive
behaviours.

In rare cases, Aanya also concludes, "The duties of a psychologist may also include
referring clients to job placement resources or support groups”. The support group
sessions focus on 12-step programs, which help clients develop coping strategies for
daily challenges. By the U.S. Bureau of Labour and Statistics, most addiction
psychologists work in “outpatient mental health and substance abuse clinics”. At the
same time, others will work in local, state, and private hospitals.

Addiction psychology is needed as a “speciality” field due to the numerous excessive

behaviours considered possible addictions and the complexities of risk factors that
lead to addiction. According to the APA, genetics plays a vital role in addiction.
Scientists have proposed that genetic problems can affect the prefrontal and
subcortical cortex of the brain, which oversees our cognitive process. When this area
of our brain is damaged, we have less control of our cognitive behaviour, and it is
easier for us to develop any behaviour problem. Therefore, those with a genetic
predisposition for addiction may heavily benefit from this speciality field, whether
with the knowledge or future treatments.

This field benefits anyone under the category of an Addict under the APA. Ranna
Parekh, a physician for the APA, states in her article “What is Addiction'' that

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“Individuals with impaired control, social problems, risky use, and physical issues”
(Parekh) fall under the category of a severe substance use disorder, aka addiction.
So, those concerned that the recurrent use of a substance, or engagement with a
specific behavioural activity, is leading to impairment and distress in their daily life or
the lives of loved ones may choose to seek help from an addiction psychologist. For
procedure and treatment, Addiction psychologists rely heavily on parallel aspects
throughout clinical psychology, such as integrating science, theory, and practice to
understand, predict, and alleviate maladjustments in an individual's behaviour.

Addiction psychology shares a lot of the foundations of clinical psychology, such as

the integration of science, theory, and practice to understand, predict, and alter an
individual's behaviour for the better. It is not just a physical need for them to smoke
or drink but more like an emotional and mental necessity. Compared to clinical and
counselling psychologists, addiction psychologists must deal with clients and patients
with naturally resistant behaviours and prone to relapse. They all use group, family,
and individual therapy to help their clients overcome their mental stress and work
towards recovery.

Addiction psychology mainly comprises the clinical psychology and abnormal

psychology disciplines. It fosters the application of information obtained from
research to diagnose, evaluate, treat appropriately, and support clients dealing with
addiction. However, this field has branched off due to the complexities and the many
causal factors that lead to substance abuse/addiction in individuals. It has become its
field due to the difficulties of treating an addict and the unique skill set needed for
effectively and adequately treating such individuals.

Addiction psychologists deal with various addictions such as substance abuse,

gambling or eating disorders, and other excessive behaviours. Their job is challenging
enough that they cannot work in other areas of psychology.

The disease model, temperance model, and moral model are some of the early
foundations of addiction psychology models. Sigmund Freud and William Halsted
were the first scientists working with addiction. However, the field does not have a
specific founder. Different beliefs exist about addiction; some people believe it is a
disorder, while others think it is a choice. Scientists and politicians have realised that
banning and forcing people to obey is not an effective way to control and reduce
substance use. When the drug is unavailable, they tend to get it from offhand

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sources or worse places, like the black market. Not enough information about the
drug is known, increasing overall risk.

Something positive is that people have decided to see addiction as an abnormality

and are fighting for more therapy-related solutions rather than punishment and
prison. Because research has shown that punishment may work sometimes, but it is
not the most effective solution. For example, the article “Treat V. Punish...” by
Operation Clean Recovery argues that “Since the passage of the Harrison Narcotics
Act in 1914, United States drug policy has almost always come down on the side of
punishment as the solution to social problems caused by substance use/addiction”
(Operation Clean Recovery, 2019).

In other words, individuals suffering from addiction receive inappropriate

treatments, which worsens the issue. It should be common sense that an individual
without any external support system will most likely not be able to recover fully.
Also, according to Dr Erlen in “Treat V. Punish…”, he states that, “Before the Harrison
Act in 1914, opiates and cocaine were legal to buy, sell, and use. Doctors often
recommend them.

The Harrison Act did not outlaw these drugs altogether but made it illegal to have
cocaine or opiates that a physician did not prescribe. People who had been obtaining
and using these drugs freely were suddenly criminals” (Ellen, 2019). In addition,
according to the historian William White, “When the Harrison Tax Act was passed,
the maximum possible penalty that could be received for a violation of the Act was
only five years in prison”. (White, 2019)

In just less than fifty years, penalties had risen to include the option of life
imprisonment and the death penalty.” Law enforcement should not be making
decisions about how to deal with addicted people, said Lawrence Kolb; it is the
physician's job to make such decisions.

On the authority of the article “Genes and Addictions” by doctors Bevilacqua and
Goldman, the most recent research focus on individuals' genetic susceptibility to
addiction, the origins of addiction, the rates of substance abuse in a community, and
the search for practical solutions (Goldman). Research in this field uses many
statistical data to compare different treatment methods, compare medications to
see the rate of affection and reach the speed of occurrences in a specific
population/community.

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Also, other research shows that children born in families associated with some drug
use or just exposure to drugs at an early age lead to an increased risk of drug
addiction and substance abuse in the future. In recent years, more scholarly journals
have been working to answer these issues and are getting involved with modern
addictive behaviours. For example, in Washington, D.C., the media is working hard to
inform people about the potential dangers of substance abuse.

Washington, D.C., has the highest rate of drug abuse in the country, and many
people die because of a lack of knowledge and willingness to seek help. Eventually,
these same people may need to spend much money they might not have on
treatments that can help them eradicate maladaptive behaviours.

The first goal of addiction psychologists is to prevent it. By making announcements

and sharing knowledge with the public about addictions, like in Virginia, these
psychologists are taking the first step to aid in preventing substance abuse by
denouncing misinformation and supplying accurate knowledge to the people about
the issue at hand, for example, the opioid crisis. Breaking free from addiction is the
second step, where they use effective coping and psychological methods.

Although addiction psychology incorporates much of the same practice as clinical

psych, one who is l just a clinical psychologist does not match the criteria necessary
to be considered qualified for this type of work; However, most requirements are
met; one must also complete specific coursework tailored to Addiction Counseling to
gain the knowledge and experience necessary with substance abuse and addiction in
a clinical setting and a real-world environment.

According to the article “Become a Substance Abuse Counsellor...” by Rick Reyes, In

the United States, many states require a “minimum of a master's degree and licence
to work as a substance abuse counsellor. However, most states require just a
bachelor's degree and supervised experience under a licensed counsellor working in
clinical conditions. With a bachelor’s degree, you can start gaining experience as a
recovery assistant. There are private and public facilities that you can work in; it just
requires a bachelor’s degree and some experience. Addiction is an important issue,
but treatment is even more critical. Psychologists must be licensed and have enough
experience to help their clients effectively. If they are not careful enough with what
they are doing, it might have terrible outcomes, possibly even the client's death.

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Undergraduate students can take abnormal, clinical and drug psychology, which
would help them understand addiction and addiction psychology material if they are
interested in this, however. However, for graduate students, the class would be
tailored to more specific aspects of the area, like how drugs would affect the brain
and their actions or how to assist people in making better choices and maintaining
healthy coping mechanisms other than drugs.

Some addiction counsellors are licensed psychiatrists, and others have a master’s
degree in counselling with a concentration in substance abuse or addiction/addiction
studies. According to the article “How to Become a Therapist: Education and Career
Roadmap, " one must earn a California Substance Abuse Counseling Certification,
and an Associate/Bachelor/Master/degree in a behavioural science field with
counselling/Addiction counselling preferred. Then one must complete a 255-hour
practicum approved by the CAADAC, earn sufficient supervised work experience,
pass an official written examination through the state, then finally apply for the
certification under the California Commission for Behavioral Health and hope that
one’s combination of education and accrued documented work experience make one
eligible.

The article “How to Become a Therapist: Education and Career Roadmap'' from
study.com (2018) continues that the University of Detroit Mercy, New York Institute
of Technology, and the University of the Pacific have the best program in this field,
and they are ranked as top addiction psychologist schools in the country. After
graduation, they will be qualified to work under the control of an addiction
psychologist to gain clinical and hands-on experience.

Different states have different prerequisites, but bachelor's degree students will
learn about addiction's physical and mental aspects. The classes are mainly about
dependency on chemicals, research and understanding of statistics, evaluation, and
treatment. They are learning about different types of counselling like an individual,
family, and group counselling. Continuing students would learn about
psychopharmacology, prevention and how to deal with individual and family
emotional issues caused by addiction.

According to Warner, new addiction psychologists with less than four years of
experience have an average income of $41,633. As they gain more experience, they
make more profit. An average income of an addiction psychologist with 5-9 years of
experience is $47,665, 10-19 years of experience is $48,477 and more than 20 years

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of experience is 59,850. So, we can conclude that the average range of addiction
psychologists' income is between 40,000$ to 65,000$, but psychologists who are
MDs can make more than 200,000$ a year. The United States is one of the best
places for this field because we have a high rate of addiction compared, and a survey
showed that the United States has the highest rate of illegal drug use compared to
other countries. (Warner, 2008)

According to the article “Statistics on Addiction in America” by the Addiction Center,

more than 20,000,000 individuals in the United States have an addiction disorder,
and not even ten per cent seek treatment; moreover, drug overdose deaths have
passed the 700 thousand U.S. citizens from 1999 to 2017, and that numbers keep
rising every day. (Addiction Center, 2020). The increase of the opioid crisis and other
types of behavioural addictions leads to more potential “clients” for this field. Many
individuals are suffering from addictions, whether that be to opioids or something
like video games and are seeking the help necessary to avoid permanent damage to
their lives or even damage physically. We can conclude that addiction psychology is
a growing and stable job field; not only that, but addiction psychology is growing
enormously in this field's public and private sectors.

Nowadays, more individuals are willing to pay for good treatment and spend a good
amount of money seeking the perfect medicine that fits them or their loved ones.
You can notice the growth in this industry, where you can see cheap treatment and
costly crazy ones with luxury facilities. Consequently, the payment for addiction
therapies or clinical psychologists can vary depending on the state or the facility to
which you are trying to apply. Yes, this field is growing at a fast pace, and the
employment opportunities are rising too, except that this field is also getting very
demanding since the recruiters are looking for highly knowledgeable qualified
professionals that can fit and conduct their facilities with professionality.

One of the oldest and most controversial arguments in this field is whether addiction
is a disease or if it is the individual's choice. In the opinion of the article “Addiction
Treatment or Punishment: Which Works Best Long-Term” by Pyramid Healthcare,
addiction is a chronic and progressive brain disease.

Individuals who repeatedly take drugs or excessively consume alcohol change the
structure and function of their brains. These changes ultimately result in compulsive
substance use and a lack of executive functioning, which leads to a higher risk of
maladaptive behaviour. The lack of executive functioning in the affected individual’s

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prefrontal cortex causes a loss of control over the related behaviours that
characterise addiction. Socially, it is assumed it is the sole responsibility of the person
with a substance use disorder to seek treatment. However, it is also society’s
responsibility to make treatment readily available and accessible.

The second controversy around addiction and individuals who suffer from substance
abuse is that the individual must hit an extreme low before seeking help. Since
addiction is progressive, if the individual goes untreated, one’s condition will most
likely worsen to extremes, affecting many aspects of the individual's life. Seeking
treatment, whether alone or with the help of others, helps individuals suffering from
addiction find ways of using their cognitive process more effectively to help break
the habit and replace maladaptive behaviours with good behaviours.

Another considerable controversy regarding addiction is that much of society still

believes that addicts should be punished as they see that these individuals are
breaking the law and should be put in prison/fined. A significant number of these
individuals with any drug addiction problem usually break the law not because they
want to but because they want to feed their substance abuse needs. It is generally
too late to find recovery when they violate the law. Usually, when a person with
some drug addiction goes to jail, the individual never receives professional help or
health treatment to help him overcome his obsession. However, in 2015
Massachusetts adopted a new policy where if an addict turns themselves in along
with the rest of their drugs and paraphernalia, they will not be arrested and charged.
Instead, as Chief Campanello from the Gloucester police department said, “Any
addict who walks into the police station with the remainder of their drug equipment
(needles, pipes, etc.) or drugs and asks for help will NOT be charged” (Campanello,
2015).

For these individuals who turned themselves in, it was like having a second chance,
hopefully leading to a successful recovery. The “Gloucester Angel Initiative '' also
provided them with a sponsored opportunity to take them to the right path of
recovery. The division of Psychological Addiction is full of controversy because there
are not the necessary resources to help people who suffer from some addiction. It is
also challenging to help individuals who do not want help or think they do not need
it.