Pill Pushing©

Addictions you don‘t want anyone to know about - (5/1/2018)

By Dr. Ron Gasbarro

The year was 2018. The world had flipped on its axis. In 2018, a forthright, tough pornographic film actress had a higher approval rating than a narcissistic, bullying, vacuous President of the United States. In the same year, America’s Dad, Bill Cosby became a common felon for cowardly drugging hopeful starlets and sexually assaulting them. A school shooting occurred at Marjory Stoneman Douglas High School in Parkland, Florida, killing 17 people and injuring 17. In over 800 cities around the world, people participated in student-led demonstrations against gun violence and mass shootings, calling for stronger gun control in the "March for Our Lives".

In 2018, certain phrases went viral: Fake news! No collusion. Witch hunt. Lock her up! President Donald Trump was reported to have used the term "shithole countries" when referring to Haiti, El Salvador and parts of Africa.

So, unless your mom has not fallen face-first into her apple pie, she might not be too surprised as to what your secret addictions are. And everyone has one…or two. 

Does everyone have an addiction? 
Most people think of an addiction that involves the craving for drugs or alcohol. However, people have addicts, or fetishes, or compulsions in which they perform other activities. In her book, When Society Becomes an Addict, clinical psychologist Anne Wilson Schaef, Ph.D., asserts that life in America is so fraught with stress that it is a challenge not to become addicted to something. Dr. Schaef points out that some addictions, such as workaholism, are actually applauded in our culture - while others, such as nicotine, TV, internet porn, gambling, and sex addiction, are simply tolerated. Nevertheless, no one grows up in our country without becoming addicted to something. 

Before we get into the weirder stuff, here are some statistics about the more common addictions:
The National Institute of Drug Abuse reports that marijuana is the most commonly used illicit drug in the US. Over 14 million Americans aged 12 or older used marijuana at least once in the past month; 6,000 people a day try marijuana for the first time; 62% of them are under age 18.
Conservative estimates indicate that there are about 2 million cocaine addicts, 1.4 million regular methamphetamine users, and 800,000 hardcore heroin addicts. [pbs.org/frontline],
15 million Americans display signs of gambling addiction. Researchers call gambling the fastest-growing teenage addiction: 42% of 14-year-olds, 49% of 15-year-olds, 63% of 16-year-olds, and 76% of 18-year-olds. [overcominggambling.com/facts.html]
40 million adults in the United States regularly visit pornography sites; 10% of them admit to having a sexual addiction to pornography. [reliableanswers.com]
According to the National Institute on Drug Abuse, in 2013, an estimated 56 million Americans aged 12 or older, or 21% of the population, were current cigarette smokers. This reflects a continual but slow downward trend from 2002 when the rate was 26%. Teen smoking is declining even more rapidly. The rate of past-month cigarette use among 12- to 17-year-olds went from 13% in 2002 to 5% in 2013.

While alcohol, tobacco, and marijuana are relatively humdrum, albeit significant, addictions, here are some that are a bit more bizarre. 

Ice chewing 
Krista is a 35-year-old stay-at-home mom of two kids who developed a serious addiction to eating ice. “After I gave birth to my daughter at the age of 24, I developed iron deficiency anemia. Even with iron pills and changes to my diet, the anemia never really resolved. When my daughter was in first grade, I discovered that I craved ice and it was then that I began chewing ice throughout the day.”

“At the height of my addiction, I was buying large bags of ice at the store. Eventually, I bought an ice-making machine, which I kept running all day. I was always freezing. Anybody around me knew I had an ice-chewing problem. I always had a large cup of ice nearby. This went on for 2 years.”

“For me,” continues Krista, “chewing ice was a serious addiction. I knew the ice-chewing was a problem and discussed it with both my doctor and dentist. I'm a former smoker and I compare the ice chewing to smoking. I'd try not to chew ice but the urge would become overwhelming. I didn't know how to quit chewing ice. My anemia was getting worse and I finally ended up in a hematologist's office. The specialist diagnosed me as being severely anemic and wanted to start me on IV iron infusions the next day. On the way to my infusion, I had a huge cup of ice. That was the last ice I ever chewed. After my infusion, I no longer craved ice in any way.”

Pagophagia is the practice of compulsively chewing and consuming excessive amounts of ice. It is a form of pica, a condition where people crave and eat non-food items that have no nutritional value. About 2% of US men aged 18 and older and 16% of women aged 16 to 19 have it, says the Centers for Disease Control and Prevention (CDC). Pregnancy can result in iron-deficiency anemia and some pregnant women may be surprised that they have a craving for ice. Also, chewing ice can lead to chipped teeth.  

Pagophagia has long been associated with iron deficiency anemia, but prior attempts to account for this craving have been inadequate. One study showed that chewing ice triggers vascular changes that lead to an increase in blood flow to the brain [Hunt, 2014]. Individuals who are not iron-anemic do not crave ice because they are already at maximal mental alertness. Perhaps the chill of chewing on ice cubes may lead to an increase of oxygenated blood to the brain, providing the cognitive boost that iron-anemic patients need. In another study, researchers asked 81 people with iron deficiency anemia to share their eating habits. Of the participants, 13 (16%) showed signs of pagophagia. Some of these people took oral iron supplements, which ended up stopping their cravings for ice.  

However, do not start taking iron supplements if you crave ice. Instead, talk to your doctor or pharmacist about how to proceed. High doses of iron can contribute to constipation and also to certain forms of cancer [Zachaski, 2008]. The body has no way to dispose of an excess of iron in the blood. 

Funeral addiction
Rita, 60, scans the newspaper each morning to read the obituaries. She then compiles a schedule so that she can go to as many funerals as possible. “Last week,” said Rita, “I went to 30 funerals. The one I liked best was my cousin’s neighbor’s real estate agent’s dentist. It was beautiful!” Rita even gave up her job last year so she could attend more funerals. She may not remember her grandson’s birthday, but she knows when Elizabeth Taylor died. “Poor thing,” Rita said of the actress.

Funeral Addicts Anonymous (FAA) describes funeral addiction as a compulsion to attend funerals, and to wear the appropriate attire – frequently called funeral chic. Funeral addicts search the daily obituaries in the local newspaper or on the Internet and then attend as many funerals as they can fit into their schedule. As their addiction grows, some attend 50 or more services a week. The funeral addict will travel to funerals in other cities, states, and even countries. Some addicts will wear funeral chic at all times, in the hope of stumbling upon a surprise funeral.  

As with many other addictions, the addict is usually blind to his or her obsession. As funeral addiction is becoming more recognized as a major distraction in one’s quality of life, FAA is providing support for these people, like Rita, and helping the addict overcome an obsession with death. As with many other dependencies, the funeral addict can spiral out of control.  

Love addiction
Is it love? Or is it the love of being in love? From the skyscraping highs to Dante’s second ring of Hell. The thrill of standing on a mountaintop to the shattering pain of being pushed off that pinnacle. There are those who relish the fickleness of Cupid’s arrows. Judy is like that. She falls head over heels in love within minutes of meeting someone. She cannot think of anything else – her job, her friends, her worldview – anything but “the one.” Then, when it falls apart in a watery grave, Judy cannot eat, laugh, or even function. This is an addiction to love. 

By nature, love is every human’s addiction. In other words, we want it, seek it, and have a difficult time not thinking about it. We need attachment to survive and we instinctively seek that romantic connection. Hence, there is nothing dysfunctional about wanting love. It is when it becomes crippling that it becomes a problem. For example, if you went out with a guy for 2 weeks, and you are still grieving after 2 months, something is wrong with the way you are processing the experience.  

Love addicts persistently chase the feeling of being in love. This pursuit is similar to an addict going after their target of choice, such as alcohol, drugs, gambling, or sex. Love addicts might be driven by the hope that their target will complete them, once and for all. A love addiction is typically contingent upon a persistent attempt to fulfill some emotional need, although it may not be a conscious one. Love addicts obtain a feeling of intoxication or euphoria when they feel they are in love, just like the rest of us; however, they may seek out this feeling to a greater and potentially unhealthy degree.

At some point, love addicts usually fail to achieve this sense of satisfaction, which increases their need for being in love. This self-defeating spiral may continue until they drive away the person they love. They may also be unable to establish true emotional bonds with other people, preventing them from establishing stable long-term relationships.

The International Institute for Trauma and Addiction Professionals estimates that 3% to 6% of all people suffer from some type of emotional dependency. The treatment for love addiction is generally similar to that used for other forms of addictive behavior such as alcoholism, among which are meetings, support groups, and other forms of professional treatment (e.g., psychotherapy).

According to recovery.org, residential treatment requires a love addict to live at the treatment facility. This arrangement provides patients with a controlled environment that allows them to dedicate themselves to their recovery. The specific types of therapy available in a residential treatment center vary greatly and typically include psychological counseling, life training, educational training, and recreation. Inpatient programs typically last for 1 to 3 months.

A 12-step program for love addicts is similar to the other 12-step programs used to treat addictive behavior. The first 12-step program was developed to treat alcoholism, and other programs were created by modifying this original program as needed for each particular addiction. A 12-step program is open to any love addict who wants treatment. These programs rely heavily on meetings in which addicts talk to each other. These meetings are traditionally done in person, but the programs also support communication between patients over the phone and online.

Psychological counseling for love addicts may include a range of specific methodologies. Behavioral therapy is generally the most common form of psychological counseling, which requires the therapist to have formal training in psychology or psychiatry. Counseling is often done on an individual basis and addresses underlying psychological issues. Counseling is often part of a residential treatment program.

Outpatient centers for love addiction allow patients to live at home, requiring them to return to the center as needed to attend therapy sessions. The sessions in these centers typically include 12-step programs and individual counseling. An outpatient center may also provide support groups for family members of love addicts. Major hospitals frequently offer outpatient treatment for many types of addicts.

Tattoo addiction
Dominic, 26, was undressing in the locker room at the gym. Standing next to him was an acquaintance, Luke, who was getting dressed after taking a shower. As Dominic undressed, Luke was surprised to see Dominic’s many tattoos. In fact, when Dominic had removed all his clothing, Luke noted that not a single area below Dominic’s neck was untattooed. Luke remarked, “Wow, that is some art project!” Dominic replied, “I’m not done yet!” 
According to a 2012 Harris Poll, 1 in every 5 (20%) adults in the US has at least one tattoo. Twenty-six percent of adults in the Western US have at least 1 tattoo, while only 21% percent of people living in the Eastern US and 21% of Americans residing in the Midwest have a tattoo. Only 18% of those who reside in the American South have tattoos, according to the Harris Poll. The poll also indicated that women are more likely to have tattoos than men. Among those who were polled, 86% said they did not regret getting their tattoo.

Tattooing and other body modification such as piercing, branding, and scarification, are ways for individuals to express themselves and display body art. Many people report that the endorphins released during a tattoo session make up for any discomfort during the process. However, when body modification turns to self-mutilation or self-injury, mental health professionals grow concerned. Cutting, for example, is a technique people with emotional problems use to control their emotional pain. Cutting and other self-injurious behaviors can be symptoms of mental illnesses including bipolar disorder and schizophrenia.

But for the most part, getting multiple tattoos is a form of self-expression. Why does one so often lead to another? In a 2013 article posted by Gregory Malnar on tattoo.com called “Tattoo addiction: The psychology of tattooing” the question “Can people really become addicted to tattoos?” is answered. In a strict medical sense, what we commonly call a “tattoo addiction” may actually be more of a passion. If, however, we broaden our view of what constitutes an addiction, then several factors could contribute to a tattooing addiction.

These natural pain relievers originate in the brain and are released to combat the pain you feel from the tattoo gun’s needles. Endorphins are very powerful. Think of the natural ‘highs’ that can come with exercise and orgasms. Some folks get more tattoos to feel this rush again.

As part of the ‘fight-or-flight’ response, the nervous system releases adrenaline in response to pain. Some ‘adrenaline junkies’ might get tattoos for the rush of adrenaline that they feel, similarly to the way others bungee jump or skydive.

Most tattoo enthusiasts view tattooing as a way to express themselves. Some individuals, however, have difficulty with writing and speaking, and so expressing their identity through a visual medium becomes an important part of their vocabulary. For them, tattoos may be the only way that they feel comfortable showing the world who they really are.

Artistic freedom
This form of body modification is often recognized as an art form with the tattoo recipient as the artist, even if a professional drew the actual tat. Sculptors, painters, writers, musicians, and other artists have been known to show signs of addiction to their art forms. Think of Vincent Van Gogh and William Faulkner. Thus, it is not surprising that tattoo aficionados may also do so.

Tattoo culture
Some tattoo enthusiasts may feel connected to the thriving tattoo sub-culture, especially if they feel ostracized from a larger community, and they may crave the sense of belonging and the bonds created through shared experiences.

All of these factors can certainly mimic an addiction, but we must consider the ramifications of a true addiction. The individual feels compelled to engage in the behavior, neglects regular, necessary aspects of daily life like work, family or even health. In these regards, passion for tattooing diverges toward the pathologic.

But back to Dominic who has so many tattoos that he’s lost count. The one tattoo he says means the most to him, however, is the tattoo he has on the back of his left shoulder. The tattoo is an elaborate, colorful drawing of a Phoenix with fiery wings. Dominic got this tattoo shortly after his 30-day mark in recovery. A former heroin addict, Dominic said, “After I made it a month without dope I was like, ‘Wow, I can actually do this.’ I felt like a new man, and that’s why I got a tattoo of the Phoenix rising from the ashes – because I was rising from the ashes, too.” Dominic, like many others, got his tattoo to remind him of the struggles he went through in his addiction and, most importantly, how he overcame them. For Dominic, it is a symbol of his strength and determination. “It’s a symbol of how hard my life used to be, but how I made it to the other side into recovery.” It is a reminder of his ability to change the worst things about himself.

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com 

Hunt MG, Belfer S, Atuahene B. Pagophagia improves neuropsychological processing speed in iron-deficiency anemia. Med Hypotheses. 2014;83:473-6. 

Uchida T, Kawati Y. Pagophagia in iron deficiency anemia. Rinsho Ketsueki. 2014;55:436-9.

Zacharski L, Chow B, Howes P, et al. Decreased cancer risk after iron reduction in patients with peripheral arterial disease: results from a randomized trial. J Natl Cancer Inst. 2008;100:1-7.


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