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Addiction can include a maladaptive pattern of taking certain drugs (prescription or non-prescription), alcohol, or purposeful exposure to toxins (for example, gasoline). Addiction can also include a maladaptive pattern of engaging in certain behaviours such as sex, gambling, shopping, being online, as well as many others. Our focus is on substance abuse, but much of this material applies to understanding other addictive behaviours. 

Substance abuse is the maladaptive pattern of substance use leading to significant impairment or disruption in one or more of the following areas of one’s life:

  1. Difficulty fulfilling major obligations related to work, school or home
  2. Recurrent substance use in situations that are hazardous to one’s safety
  3. Recurrent substance-related legal problems
  4. Continued substance use despite interpersonal or social problems due to using the substance

Substance dependence can be characterized by experiencing tolerance or withdrawal related to the substance.

Tolerance is the need for increased amounts of the substance in order to achieve the desired effects.

Withdrawal is the development of physiological, behavioural and cognitive symptoms related to the cessation or reduction in use of the substance. These symptoms are often very uncomfortable and tend to be associated with cravings for the substance. 

Our understanding of addiction is that it is a complicated and multi-influenced issues. There are genetic, environmental and personal factors that can influence addiction.

  • Genetic: Research shows there is genetic risk for developing addiction. Those individuals who have a family member who has struggled with addiction are often at an increased risk for struggling with addiction. It is important to note that while one may have a relative who has been addicted this does not guarantee that they will develop a problem.
  • Environment: Certain environmental factors are also related to increases in addiction. For example, if heavy substance use is normalized or witnessed frequently, one may be more likely to develop a substance use problem. 
  • Personal factors:  Certain individual personal factors can be related to substance use and addiction. For example, some use substances in order to  cope with difficult and painful feelings or circumstances. Addictive behaviours, whether it is substance use or other addictive behaviours (sex, gambling, shopping, etc) are often used as a way for an individual to self-soothe when the person does not feel they have any other skills to do so.  For such an individual it may be important to develop alternative self-soothing skiils.
    • Self-soothing skills are a way to calm, reassure, or take care of the self when distressed.  Examples of healthy and non-self-destructive self-soothing include writing, doing art, taking a bath, going for a walk, doing exercise, cooking and many other behaviours that lead to one feeling calmed when distressed.  


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  • Women's College Hospital