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Addiction is a chronic condition characterised by compulsive engagement in a behaviour or substance use despite negative consequences. It involves both physical and psychological dependence and can have devastating effects on individuals, families, and society.
Addiction can involve substance use (e.g. drugs, alcohol, nicotine) or behavioural activities (e.g. gambling, gaming). It is characterised by a loss of control — the person continues the behaviour even though they know it is causing harm.
Tolerance occurs when a person needs increasingly larger amounts of a substance (or more intense engagement in a behaviour) to achieve the same effect that a smaller amount previously produced.
Withdrawal refers to the physical and psychological symptoms that occur when a person stops using a substance or engaging in an addictive behaviour.
| Type | Symptoms |
|---|---|
| Physical withdrawal | Tremors, sweating, nausea, headaches, muscle aches, seizures (in severe cases) |
| Psychological withdrawal | Anxiety, depression, irritability, cravings, difficulty concentrating, insomnia |
Withdrawal symptoms are often the opposite of the substance's effects (e.g. a stimulant produces withdrawal symptoms of fatigue and low mood).
The person feels a powerful urge (craving) to use the substance or engage in the behaviour. This compulsion overrides rational decision-making and can dominate the person's thoughts.
The person is unable to limit or control their use, despite wanting to. They may use more of the substance than intended or for longer periods than planned.
The addiction becomes the most important thing in the person's life. It dominates their thoughts, feelings, and behaviour, taking priority over relationships, work, health, and other activities.
The person continues to use the substance or engage in the behaviour despite knowing it is causing physical, psychological, social, or financial harm.
Relapse is the return to addictive behaviour after a period of abstinence. Relapse is common in addiction and is often triggered by stress, environmental cues associated with the addiction, or exposure to the substance.
flowchart TD
A[Addiction] --> B[Tolerance: need more for same effect]
A --> C[Withdrawal: symptoms when stopping]
A --> D[Compulsion: powerful urge to use]
A --> E[Loss of control: cannot limit use]
A --> F[Salience: dominates life]
A --> G[Continued use despite harm]
A --> H[Relapse: return after abstinence]
B --> I[Physical and psychological dependence]
C --> I
| Type | Description | Example |
|---|---|---|
| Physical dependence | The body has adapted to the substance and requires it to function normally; stopping causes withdrawal symptoms | Alcohol withdrawal causing tremors |
| Psychological dependence | The person feels they need the substance or behaviour to cope emotionally; feels unable to function without it | Feeling anxious or depressed without smoking |
Most addictions involve both physical and psychological dependence.
AQA expects you to recognise that addiction can involve substances (alcohol, nicotine, opioids, stimulants) and behaviours (gambling, gaming, problematic internet use). In both cases the core features are the same — tolerance, withdrawal, salience, loss of control and continued engagement despite harm — though the biological mechanisms may differ. ICD-11 now includes both gambling disorder and gaming disorder as recognised conditions, reflecting increasing clinical and research evidence that behavioural addictions are real.
Several features make addiction particularly challenging to treat:
Effective treatment usually combines behavioural or psychological therapy (such as CBT), pharmacological support (nicotine replacement, methadone, naltrexone), social support and relapse-prevention planning.
NHS Digital reports that around 600,000 adults in England have an alcohol dependence serious enough to benefit from specialist treatment, and around 300,000 people use opioids such as heroin. The Gambling Commission estimates around 0.3% of adults have a gambling disorder and a further 1.8% are at moderate risk. Public Health England has highlighted that tobacco remains the single largest preventable cause of death in the UK. Services are available through the NHS, local authority-commissioned drug and alcohol services, and charities such as Frank (talktofrank.com), GamCare and the National Gambling Helpline.
Different addictions have different profiles of physical and psychological harm:
Addiction rarely affects one person alone: families, partners and children are often deeply affected, which is why UK services increasingly involve family members in treatment planning.
Relapse is common in addiction and is best understood as a process rather than a single failure:
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